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91.
自主学习结合情景模拟在医学生技能培训中的应用 《医学教育管理》2019,5(1):29-33
目的 探讨自主学习结合情景模拟教学法在医学生技能培训中的应用效果和意义。方法 选取2012级的60 名医学生进行研究,随机分为试验组和对照组,每组各30 人,培训前对两组学员进行考核,成绩无统计学差异。对照组采用LBL+ 床旁带教的教学方法,试验组采用自主学习结合情景模拟教学方法进行技能培训。两组学生均培训2 个月后进行考核,对考试成绩进行分析比较。考核结束后进行问卷调查,对培训满意度进行调研。结果 试验组的技能考核成绩明显高于对照组,具有统计学意义(P < 0.05);试验组的理论成绩高于对照组,但不具有统计学意义(P > 0.05);试验组对培训的满意度(90%)明显高于对照组(77.8%),具有统计学意义(P < 0.05)。结论 采用自主学习结合情景模拟教学方法对医学生进行培训能明显提高临床技能培训效果,提高医学生培训满意度,是一种较好的实践技能教学方法。 相似文献
92.
F. Giovanardi F. Nudo Q. Lai M. Garofalo A. Consolo E. Choppin De Janvry G.A. Arroyo Murillo P. Ursi D. Stabile F. Melandro P.B. Berloco R. Pretagostini L. Poli 《Transplantation proceedings》2019,51(1):128-131
Background
Arterial vascular anomalies in patients undergoing kidney transplantation (KT) are correlated with a higher incidence of early surgical complications, potentially causing graft loss. Arterial reconstruction allows patients to overcome these surgical challenges, thus minimizing the risk of poor outcomes. The aim of the present study is to retrospectively investigate the safety and effectiveness of the multiple arterial reconstruction technique with a Teflon patch in case of an unavailable aortic patch: to do so, surgical complications, graft function, and patient survival were evaluated.Methods
During the period January 2009 to August 2016, 202 adult deceased-donor KTs were performed at our center. Group A (n = 27; reconstruction of multiple arteries) and Group B (n = 175; control group) were compared.Results
No differences were observed between the 2 groups in terms of early postoperative course, with no vascular complication observed in Group A. No vascular patch infections were reported, nor longer cold ischemia time rates. Similarly, long-term survival rates were similar between the 2 groups.Conclusions
The Teflon-patch arterial reconstruction technique appears to be safe and effective, with an acceptable balance of benefits and potential risks of using a prosthetic material. Studies based on larger series are needed to further validate this approach. 相似文献93.
94.
X. Cui B. Wang Y. Wu L. Xie P. Xun Q. Tang W. Cai X. Shen 《Nutrition, metabolism, and cardiovascular diseases : NMCD》2019,29(5):467-473
Background and aims
Potential associations of vegetarian diet patterns with fasting insulin (FI) and insulin sensitivity remain unclear. We aimed to investigate whether vegetarian diets were associated with FI and insulin sensitivity in a cross-sectional study in Chinese vegetarians and matched omnivores and then to test whether it is independent of body mass index (BMI).Methods and results
This study included 279 vegetarians (73 vegans, 206 lacto-ovo-vegetarians) and 279 age- and sex-matched omnivores. Fasting blood glucose (FG) and FI concentrations were measured, and β-cell function (HOMA-β) and insulin resistance index (HOMA-IR) were used to evaluate insulin sensitivity. All blood glucose and insulin sensitivity indices were naturally log-transformed, and multiple-linear regression was used to determine the association between vegetarian diet patterns and insulin sensitivity after adjusting for confounders including BMI, visceral fat area, physical activity, sedentary time, income, alcohol consumption, and daily dietary intakes of macronutrients. Compared to omnivores, both vegan diet [β = ?0.25, 95% CI: (?0.38, ?0.14)] and lacto-ovo-vegetarian diet [β = ?0.10, 95% CI: (?0.18, ?0.01)] were negatively associated with HOMA-IR after adjusting for BMI. Vegan diet remained negatively associated with FI [β = ?0.16, 95% CI: (?0.30, ?0.01)] and HOMA-IR [β = ?0.17, 95% CI: (?0.32, ?0.03)] after adjusting for all confounders.Conclusion
Vegetarian diet, especially vegan diet, is negatively associated with FI and IR, independent of BMI. 相似文献95.
96.
Haitao Wang Qiang Zhang Frederick S. Kaplan Robert J. Pignolo 《Journal of bone and mineral research》2022,37(1):95-107
Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disease caused by mutations in activin A receptor type I/activin-like kinase 2 (ACVR1/ALK2), a bone morphogenetic protein (BMP) type I receptor, resulting in the formation of extraskeletal or heterotopic ossification (HO) and other features consistent with premature aging. During the first decade of life, episodic bouts of inflammatory swellings (flare-ups) occur, which are typically triggered by soft tissue trauma. Through an endochondral process, these exacerbations ultimately result in skeletal muscles, tendons, ligaments, fascia, and aponeuroses transforming into ectopic bone, rendering movement impossible. We have previously shown that soft tissue injury causes early FOP lesions characterized by cellular hypoxia, cellular damage, and local inflammation. Here we show that muscle injury in FOP also results in senescent cell accumulation, and that senescence promotes tissue reprogramming toward a chondrogenic fate in FOP muscle but not wild-type (WT) muscle. Using a combination of senolytic drugs we show that senescent cell clearance and reduction in the senescence associated secretory phenotype (SASP) ameliorate HO in mouse models of FOP. We conclude that injury-induced senescent cell burden and the SASP contribute to FOP lesion formation and that tissue reprogramming in FOP is mediated by cellular senescence, altering myogenic cell fate toward a chondrogenic cell fate. Furthermore, pharmacological removal of senescent cells abrogates tissue reprogramming and HO formation. Here we provide proof-of-principle evidence for senolytic drugs as a future therapeutic strategy in FOP. © 2021 American Society for Bone and Mineral Research (ASBMR). 相似文献
97.
目的 对比采用右胸前外侧微创切口和胸骨正中切口行右心房黏液瘤切除手术的手术效果。方法 选取2005年5月至2019年12月在复旦大学附属中山医院行手术治疗的右心房黏液瘤患者共61例,其中男性25例,女性36例,年龄19~82岁,平均(53.6±13.4)岁,根据手术切口分组,45例采用胸骨正中切口(胸骨组),16例采用右胸前外侧微创切口(微创组)。采用独立样本t检验、秩和检验、Fisher精确检验比较两组手术结果。结果 两组术前资料匹配,无院内死亡患者。两组平均心肺转流时间相似,但与胸骨组相比,微创组平均手术时间、主动脉阻断时间均较短,平均机械通气时间和术后住院时间较短,引流量较少,输血率较低,差异有统计学意义。术后随访3~153个月,随访率95.6%,1例患者随访期间非心源性死亡,余患者恢复良好,随访超声心动图未见肿瘤复发。结论 两种手术入路行右心房黏液瘤切除均安全有效,术后中远期复发率低,采用右胸前外侧微创切口进行手术可缩短手术时间,减少手术创伤。 相似文献
98.
头痛是临床上的一种常见病,多发病,内伤外感均能引起,病因复杂多变,病程长短不一,症状轻重有别,容易反复发作,甚者严重影响患者的生活和工作,引发一系列身心问题,给患者带来了极大的痛苦。中医对头痛病的认识可追溯到2000年前的《黄帝内经》,治疗上更是积累了丰富的经验。传统的辨证论治有时候在临床中证型难以明确区分,往往难以和教科书上的辨证分型对号入座。笔者近年来采用张仲景的六经辨证,先辨六经,次辨方证,灵活运用经方加减治疗各种头痛,方证对应,效果明显。 相似文献