Seminar教学法在普通外科住院医师规范化培养中的应用

目的 探讨 Seminar 教学法在普通外科住院医师规范化培养中的应用价值。方法 将首都医科大学宣武医院普通外科接受住院医师规范化培训的 35 名学员（自 2016 年 9 月至 2018 年 8 月）采用 Seminar 教学法分为实验组即男生 30 人 , 女生 5 人 , 平均年龄 (25.0±1.7) 岁 , 均为大学本科学历，将 2014 年 9 月至 2016 年8 月的前期住院医师采用传统教学法的 35 名住院医师 ( 男生 29 人 , 女生 6 人 , 平均年龄 (25.0±1.8) 岁 , 均为大学本科学历 ) 作为对照组采用传统教学法。采用客观结构化临床考试 (OSCE) 及学生满意度调查评价教学效果。结果 实验组 OSCE 考试中病史采集和查体、病例分析、基本操作技能及辅助检查结果判读得分均高于对照组 (P ＜ 0.01), 学员对教学方式的满意度评分中对 Seminar 教学模式满意 , 认为通过这种教学方式激发了学习兴趣 , 提高了自学能力 , 口头表达、总结、临床思维、专业知识理解等各方面综合能力。结论 Seminar 教学法有助于提高普通外科住院医师规范化培训质量。     

Skin infection by Mycobacterium marinum – diagnostic and therapeutic challenge

The number of skin infections caused by atypical mycobacteria has increased in recent decades. They usually appear after contact with wounds and interruptions in the integrity of the skin. The present report describes a case of cutaneous infection by Mycobacterium marinum, in a young, immunocompetent patient, with a prolonged evolution, diagnosed through a skin lesion culture (from a spindle biopsy of the skin). The patient was treated with multidrug therapy, including clarithromycin, doxycycline, and rifampicin, due to the lesion extent, with satisfactory results. A brief review of the literature is also provided.     

从认知到行动——浅谈中国医疗健康机构应对气候变化和减少碳排放的措施

介绍了医疗健康机构应对气候变化的必要性,梳理了影响医疗机构碳排放的主要因素,列举了一些国家案例来阐释减少医疗服务碳排放的可能性,最后指出了医疗健康机构在实施温室气体核算和报告过程中须要注意的问题。     

Metabolism and pharmacokinetics studies of allyl methyl disulfide in rats

1. Allyl methyl disulfide (AMDS) is one of the main compounds in garlic, whereas its metabolism has not been studied yet.

2. In this work, we first identified the metabolites of AMDS in rat erythrocytes and rats using GC–MS. The transformation mechanism study among different metabolites was then conducted. The apparent kinetics of AMDS in rat erythrocytes and pharmacokinetics of AMDS by oral administration in rats were also studied.

3. The metabolic pathway study showed that AMDS was mainly metabolized in rats to allyl methyl sulfoxide (AMSO) and allyl methyl sulfone (AMSO₂) through mechanisms of reduction, methylation and oxidation. The transformation mechanism study indicated that AMDS was firstly reduced to allyl mercaptan (AM) in rat erythrocytes, and then methylated to allyl methyl sulfide (AMS) by S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH), and finally oxidized to AMSO and AMSO₂ by liver microsomes. The half-life of AMDS in rat erythrocytes was 6.285?±?0.014?min while the half-lives of its active metabolites AMSO and AMSO₂ in vivo were 18.17 and 17.50?h, respectively. Also, the large AUCs of the two active metabolites were observed, indicating potential applications of AMDS for certain pharmacological effects.     

Melatonin alters neuronal architecture and increases cysteine-rich protein 1 signaling in the male mouse hippocampus

Neuronal plasticity describes changes in structure, function, and connections of neurons. The hippocampus, in particular, has been shown to exhibit considerable plasticity regarding both physiological and morphological functions. Melatonin, a hormone released by the pineal gland, promotes cell survival and dendrite maturation of neurons in the newborn brain and protects against neurological disorders. In this study, we investigated the effect of exogenous melatonin on neuronal architecture and its possible mechanism in the hippocampus of adult male C57BL/6 mice. Melatonin treatment significantly increased the total length and complexity of dendrites in the apical and basal cornu ammonis (CA) 1 and in the dentate gyrus in mouse hippocampi. Spine density in CA1 apical dendrites was increased, but no significant differences in other subregions were observed. In primary cultured hippocampal neurons, the length and arborization of neurites were significantly augmented by melatonin treatment. Additionally, western blot and immunohistochemical analyses in both in vivo and in vitro systems revealed significant increases in the level of cysteine-rich protein 1 (crp-1) protein, which is known to be involved in dendritic branching in mouse hippocampal neurons after melatonin treatment. Our results suggest that exogenous melatonin leads to significant alterations of neuronal micromorphometry in the adult hippocampus, possibly via crp-1 signaling.