扶正法治疗精神疾病的心悟

慎察精神疾病患者之症象,准确辨证,若系正气虚匮或不足,予相应之扶正方药、针灸等主治或辅治之,收效颇佳。反之,审证不清,“实而误补,固必增邪”(《顾氏医镜》)。同时,宜鼓励患者多做活动锻炼,增强体质,提高正气,亦可谓一种较好的扶正辅助疗法。     

影像后处理技术在神经外科教学查房中的应用

目的  评价以问题为基础的教学法(problem-based learning,PBL)联合影像后处理技术在神经外科教学查房中的应用效果。方法  选择神经外科典型病例，以病例为基础，以问题为导向布置课前预习内容，联合影像后处理技术在教学查房中以导向问题为主线实施教学培训，与传统教学方法相比评价教学效果。结果  PBL联合影像后处理技术教学查房模式和传统讲授教学查房模式的学员理论考试成绩分别为92.53±2.17分、81.40±6.17分，临床诊疗考核成绩分别为91.10±1.97分、79.60±3.27分，P值分别为<0.001、<0.001，差异有统计学意义。接受PBL联合影像后处理技术教学模式的学员对教学方式的认可度、增加学习兴趣、利于神经科思维，P值分别为0.013、0.024、0.035。结论  PBL联合影像后处理技术可有效提高教学查房效果，帮助学员提高对基础知识的理解能力，抓住神经外科疾病的关键点加速神经外科诊疗思维能力的形成。     

Primary-school-based art therapy: exploratory study of changes in children’s social,emotional and mental health

ABSTRACT

AIM: This exploratory mixed methods study aimed to inform future research by investigating if teachers and children from one primary school perceived any changes in children’s social, emotional and mental health difficulties following art therapy and if so, what the children perceived as helpful about the sessions. METHODS: The study included 45 children and 10 class teachers within one UK primary school. The researchers analysed routine questionnaires from teachers and a children's evaluation interviews, triangulating these with data from a teacher focus group. RESULTS: The findings show significant and medium effect sizes for positive teacher-rated changes in children’s overall stress, conduct, hyperactivity, and procsocial behaviour and a large effect on perceived impact of children’s difficulties on their lives. Teacher-rated emotional distress and peer problems showed small changes that did not reach statistical significance. The positive changes were corroborated by the teachers' and children's qualitative reports. Aspects of art therapy which children found particularly helpful were; making and thinking about art; expressing, thinking and learning about thoughts and feelings; and sessions being fun. CONCLUSION: The study highlighted perceived positive changes and no negative changes in children’s SEMH difficulties. However, future research is necessary to examine clinical effectiveness.

Plain-language summary

In this article we describe a research study which aimed to explore if teachers and children perceived any changes to children’s social, emotional or mental health difficulties after the children attended art therapy within their primary school. We were also interested in learning from the children if they thought anything in particular had been helpful about their art therapy sessions in order to inform future research and the development of this particular approach to art therapy.

The art therapists asked the class teachers to fill out a Strengths and Difficulties Questionnaires at the beginning and end of art therapy. The class teachers also attended a focus group so we could learn more about their general observations of the children before and after attending art therapy. The art therapists also interviewed the children to learn if they perceived any changes since coming to art therapy and if so, what in particular they thought had helped bring about these changes.

We found that statistical analysis of the questionnaire scores mostly agreed with what the teachers and children said and that there was generally some positive change to the social, emotional and mental health difficulties the children had been experiencing. The teachers also let us know that some of the children still had residual problems. The children emphasised that making and thinking about art along with expressing, thinking and learning about thoughts and feelings had been particularly helpful. It was also important to the children that the sessions were fun.

In conclusion, the teachers and children in this primary school perceived art therapy as helpful to the children and that it merits further research in order to develop the approach used by the art therapists and to see if it is effective in larger research studies including more children, schools and art therapists.     

注射用血栓通中三七元素迁移的规律

目的:分析注射用血栓通中三七从原料到成品全过程的元素迁移规律,以便更好地控制成品中元素杂质。方法:采用ICP-MS法全面分析三七药材、三七总皂苷(中间体)和注射用血栓通中21种元素的含量。结果:21种元素的标准曲线相关系数r均在0. 999以上,回收率在92. 71%～107. 07%之间,RSD均在5%以内。三七药材中铝、铁含量较高,铅、砷、汞、镉、铜符合中华人民共和国药典的相关规定,三七总皂苷(中间体)和注射用血栓通中多数元素均未检出或含量极低。结论:注射用血栓通的提取工艺可有效去除三七中大部分元素,重金属及有害元素也降到较低水平。     

基于微信平台的医学检验教学的应用

目的通过研究基于微信平台的教学模式来提升医学检验专业学生们的学习能力。方法对某高校医学检验专业学生2014-2016三级学生共170人进行对照实验分析,对照组83人,实验组87人。对照组使用传统教学方式教授医学检验专业,实验组使用基于微信平台的课堂教学方式,教授医学检验专业。教学后,比较两组学生的学习状况和学习成绩。结果实验组在应试结果、课堂参与积极性、课堂学习兴趣、课前是否预习、课后是否复习等指标上分数明显高于对照组,差异具有统计学意义(P<0.05)。且实验组成绩明显高于对照组(P<0.05)。结论设置医学检验专业的高校应积极寻找医学检验课程教学改革的方向和切入点,以微信平台为落脚点的互联网教学模式可以被广泛应用到现在医学检验专业课程教学过程中。     

儿童外科教学方法实践及探讨

目的探讨儿童外科的教学特点及教学方法,提高儿外科医生的总体执业水平,促进儿童外科学的发展。方法通过分析四川大学华西医院多年儿童外科疾病的临床教学实践经验,总结出适合医学生、初级儿童外科专科医生的实用的教学方法及经验。结果结合儿童外科特有的疾病特点所总结出的故事式讲述教学、典型病例教学、漫画形式学习、比较学习法及多媒体素材教学五种方式是非常适合儿童外科教学的方法。能够加深记忆,提高兴趣,轻松快捷,事半功倍的掌握相关医学专业知识。结论独特有趣的儿童外科教学方法可提高医学生及儿童外科初级从业者的学习兴趣、专业知识和执业水平。     

反流性食管炎中医学研究进展

反流性食管炎(RE)是由于胃或十二指肠的内容物反流入食管,而引起食管组织黏膜炎症、糜烂和纤维化等病变。属于胃食管反流病(GERD)的范畴,临床上以反酸、烧心、灼热、疼痛、嗳气等为主要表现,常见的并发症为食管狭窄、出血、Barrett食管及食管腺癌等。中医学中没有反流性食管炎的病名,但根据其临床表现,可以归属于“吞酸”、“吐酸”、“嘈杂”、“胃脘痛”等范围。中医对反流性食管炎的认识逐渐完善,治疗上以“和法”为主,并取得了良好的疗效。但因在中医病名、辨证和治疗上缺乏统一标准,有待临床进一步研究。本文通过查阅相关文献,概括出反流性食管炎的中医病因病机、辨证分型、治则治法及常用方药,探讨反流性食管炎的中医学研究进展。     

儿科临床教学中EBM+PBL教学法的应用分析

目的分析儿科临床教学中EBM+PBL教学法的应用效果。方法选取2018年2月—2018年12月在医院儿科实习的医学专业学生50名,随机将其分为参照组(常规教学法)和观察组(EBM+PML教学法)。比较两组的教学效果。结果相对比参照组,观察组学生的理论掌握得分(94.28±3.15)分更高、临床实践得分(90.69±3.55)分明显提高,学生对自主学习、语言表达、问题解决、文献检索及团队合作能力的认可度更高,而学生对教学满意度达到96%,两组数据差异经过比较P<0.05。结论在儿科临床教学期间采用EBM+PBL教学法,学生的综合能力增强,确保教学质量。