面向医患连接的慢性病诊后服务平台设计与应用

目的:构建面向医患连接的慢性病诊后服务平台,实现院内院外慢性病患者诊疗的无缝连接。方法:针对慢性病患者需长期干预指导的需求,重点解决医患连接、健康宣教、体征监测和个性化指导等难题,设计和实现慢性病诊后服务平台。结果:平台投入实际使用,共服务患者1.5万人次以上而且易使用、易维护。结论:面向医患连接的诊后服务方式,实现了慢性病患者的持续干预指导,促进医患关系和谐,提升了慢病治疗的效果以及患者体验。     

构建数字化、可视化教学平台实现妇产科学教学手段多元化

介绍了构建数字化、可视化教学平台,实现妇产科教学手段多元化的做法。内容包括多媒体课件开发制作,利用医学视听教材,建设妇产科图片数据库,建设妇产科标本库(馆),利用模型、模块进行模拟操作,加强实践技能培养和通过临床见习、实习将理论应用于实践等问题。     

Midterm results of mobile-bearing knee replacements

We examined the clinical and radiographic results of 93 patients affected by knee arthritis or osteonecrosis subjected to unilateral cementless mobile-bearing total knee arthroplasty with the LCS prothesis (Depuy/Johnson & Johnson). The mean follow-up was 9.5 years (range, 7–12 years). Clinical evaluation was performed using the Knee Society rating system, while radiographic evaluation was done according to the Knee Society roentgenographic system. At the latest follow-up, the mean knee score was 87 points: the functional score improved from 40 to 90. Radiolucent lines were small and not progressive. The implant survival at 12 years was 88%. Six knees (7%) required revision for implant-related problems. We conclude that the mobile-bearing prosthesis is a successful device even at long-term follow-up.     

浙江省台州市路桥区从业人员乙肝病毒标志物检测的调查分析

目的：了解路桥地区2004年至2006年之间,从业人员健康人群HBsAg、HBsAb的阳性率及大、小三阳所占的比例。方法：对32 490人来体检的健康人群进行乙肝三系二对半检测,采用酶联免疫法（ELISA）测定HBsAg、HBsAb、HBeAg、HBeAb、HBcAb,按不同性别、城区与乡镇之间、两年之间进行比较。结果：不同性别之间HBsAg、HBsAb的阳性率无显著性差异。城区与乡镇之间HBsAg、HBsAb阳性率有显著性差异。两年之间HBsAg的阳性率有下降趋势。大小三阳的比例在各组之间也各不相同。结论：健康人群的乙肝病毒携带率比例偏高,易感者多,相关部门应督促乙肝疫苗的注射,减少乙肝发病率。     

Effects of angle and laminectomy on triangulated pedicle screws

We aimed to demonstrate the effect of angle and laminectomy on paired pedicle screws to determine whether a 90 degrees screw angle is optimal as has been previously suggested. According to the angle between right and left screws, 28 calf vertebrae were divided into three groups and instrumented as follows: Group I: 60 degrees screw angle; Group II: 90 degrees angle; Group III: 60 degrees angle with laminectomy. The screws were connected using rods and cross-fixators and tested to peak pullout force. Triangulated pedicle screws provided 76.5% more pullout strength than single screws. Most of the specimens failed through loss of convergence angle (toggling of screws on the rods) and subsequent uni- or bilateral screw pullout. Mean+/-SD peak loads were: Group I: 2071+/-622 N; Group II: 1753+/-497 N; Group III: 2186+/-587 N. The differences were not significant (p>0.05). 90 degrees triangulation was not associated with a superior pullout performance versus conventional 60 degrees triangulation, suggesting that achieving additional triangulation angle is not necessary to obtain increased pullout strength. Laminectomy did not alter the effect of triangulation on fixation strength.     

Effect of dietary selenium and vitamin E on the biomechanical properties of rabbit bones

Summary It is generally agreed that combined deficiency of selenium and vitamin E leads to several abnormalities including Kashin-Beck disease which is an endemic and chronic degenerative osteoarthrosis. The abnormalities can be reversed by the administration of various forms of selenium and vitamin E.The present study was designed to investigate the effects of dietary selenium and vitamin E on bone tissue and on the biomechanical properties of bone. Young rabbits of both sexes were fed with either a selenium- and vitamin E-adequate diet (control group), or a selenium- and vitamin E-deficient diet or a selenium-excess diet. The selenium-deficient diet resulted in a significant decrease in plasma selenium level and the selenium-excess diet resulted in a significant increase in the plasma selenium level with respect to the corresponding control values (p<0.05). The diets did not affect the blood cell counts considerably but erythrocyte glutathione peroxidase activity increased (decreased) relatively when the plasma selenium level increased (decreased) (p<0.05). The light microscopic investigations of the bone tissues of the two experimental groups indicate that the findings of the present work are compatible with osteomalacia. The biomechanical properties of the bones from the three groups were determined experimentally with bending tests. Both the Se-and vitamin E-deficient diet and the Se-excess diet decreased the biomechanical strength of the bones significantly while the bones belonging to the control group always had the largest modulus of elasticity (p<0.05).     

基于“超星学习通+直播”模式的中药学在线教学实践研究

本文以中药学课程为例,从在线教学课程设计、教学实施、教学效果评价、教学反思4个方面论述在线教学模式的构建及实施效果,以期通过总结在线教学的经验,为后续进行混合式教学、提升混合式一流课程建设提供有益借鉴。     

住院医师规范化培训过程管理的实践与探索：基于信息化管理平台

本研究基于信息化管理平台的建设,深入探索了住院医师规范化培训过程管理方法。研究结合管理实践,对过程管理内容进行了梳理和分析,并将过程管理理念与内容融入信息化管理平台的开发建设中。通过信息化平台的建设,实现了科学有效的住培过程化管理,以过程管理为核心的信息化管理平台不仅有助于住培制度的更新与落实,还构建了多角色关联互动的桥梁,保证了信息的准确性,推动了质量保障体系的建设。该研究为保障培训质量提供了有效工具,对培养卓越医学人才具有重大意义。     

以信息技术构建系统解剖学网络课程体系的实践和思考

为推动医学教育的信息化建设,进一步提升教师的信息化的认知,遵义医科大学积极推广数字化教学工具,创新教育教学管理,促进信息技术与教育的深度融合。为此选择临床专业系统解剖学进行网络课程体系的建立,利用Camtasia studio 9、Adobe After Effects CS6及格式工厂等视频软件制作系统解剖学的网络课程,并在超星学习通平台上打造专属的系统解剖学网络课程体系,进行线上教学模式的探索。通过对线上、线下教学的评估得知,此次线上教学改革达到了预期的教学效果,激发了学生学习的自主性,实现了系统解剖学的教学要求;但还有许多问题,如何将线上线下更好地融合,还有待进一步探索。     

Loss of heterozygosity on chromosome 9q22.3 in microdissected basal cell carcinomas around the Semipalatinsk Nuclear Testing Site, Kazakhstan

A high incidence of skin cancers has been noted around the Semipalatinsk Nuclear Testing Site (SNTS) in Kazakhstan. Recently, basal cell carcinoma (BCC) susceptibility genes, human homolog of the Drosophila pathed gene (PTCH), and the xeroderma pigmentosa group A-complementing gene (XPA), have been cloned and localized on chromosome 9q22.3. To clarify the effect of low-dose irradiation on the occurrence of BCC, we used microdissection and polymerase chain reaction to identify loss of heterozygosity (LOH) at 9q22.3 using BCC samples obtained from this region. Ten Japanese samples were analyzed as controls. LOH with at least 1 marker was identified in 5 of 14 cases from around SNTS, whereas only 1 case with 1 marker was identified among the 10 Nagasaki cases. The total number of LOH alleles from SNTS (8 of 45) was significantly higher than the number from Nagasaki (1 of 26) (P = 0.03). The higher incidence of LOH on 9q22.3 in BCC from around SNTS suggests involvement of chronic low-dose irradiation by fallout from the test site as a factor in the cancers.