呼吸内科PBL教学法在全科医师规培中的应用

目的探索基于呼吸治疗团队教学的以问题为基础的教学法(problem based learning,PBL)在全科住院医师规范化培训中的应用。方法呼吸系统以老年人慢性疾病为主,是全科医学生教育的重要环节。开展PBL教学法的教学探索,以期达到对全科医师的专科疾病培训,使其理解并掌握相关疾病知识,能适应未来医学发展和社会需要,为患者提供更好的社区医疗服务。结果PBL教学法的精髓是发挥问题对学习过程的指导作用,调动学生学习的积极性和主动性,整体提升学生的综合素质和能力。结论在全科医学规范化培训教学中运用PBL教学,带教老师以任务为主线、以学员为主体进行引导,可极大的提高学生的学习兴趣、主动性以及自学能力,从而培养学员的分析问题、解决问题的能力。可以更好的帮助学员形成以患者为中心的临床诊断思路、提高解决临床问题的综合能力及团队合作能力。     

青少年近视综合防控的基本原则与对策分析

目的 探讨青少年近视综合防控的基本原则与对策。方法 随机选取2017年6月～2019年6月我院健康体检青少年60例，随机分为综合防控组（n=30）和常规防控组（n=30）两组，常规防控组青少年接受常规防控，综合防控组青少年接受综合防控，然后统计分析两组青少年的近视情况。结果 综合防控组青少年防控前后的近视率分别为73.3%（22/30）、33.3%（10/30），常规防控组青少年防控前后的近视率分别为76.7%（23/30）、56.7%（17/30）。两组青少年防控后的近视率均显著低于防控前（P＜0.05）；防控前两组青少年的近视率比较，差异无统计学意义（P＞0.05），防控后综合防控组青少年的近视率显著低于常规防控组（P＜0.05）。综合防控组总满意度为93.3%（28/30），显著高于常规防控组的73.3%（22/30）（P＜0.05）。结论 青少年近视综合防控的效果较常规防控好，能有效降低青少年的近视率，值得推广。     

吴茱萸化学成分和药理作用及质量标志物(Q-marker)的预测分析

吴茱萸是我国常用的大宗中药材,资源丰富且分布较广,具有广阔的开发利用前景。吴茱萸中化学成分类型丰富,包括生物碱、苦味素、挥发油、黄酮等类成分,传统认为生物碱和苦味素为其主要药效成分。对其化学成分、药理作用综述的基础上,根据中药质量标志物(Q-marker)理论,从生源途径、化学成分与传统功效、传统药性、新的临床用途、毒性、可测成分、入血成分及不同配伍环境几方面对吴茱萸Q-marker成分进行预测分析,为明确吴茱萸Q-marker和制定科学的质量标准提供基础。     

The invisible nature of learning: Patient education in nursing

BackgroundLearning for patients and their families within nurses’ patient- and family-education practice is an important part of person- and family-centred care. Patients and their families must master health promotional or management strategies to optimise their health outcomes. Support is often provided by nurses, but how nurses facilitate each patient’s and their family’s learning, using cognitive learning principles, seems invisible in the nursing literature.AimThis discussion paper examines the important role of cognitive learning within nurses’ patient- and family-education practice. How learning is enabled, the differences between teaching and learning and the role of learning principles are discussed. Shortcomings are identified and possible ways to address these within nurses’ practice are considered.MethodsThe discussion draws on the limited current literature surrounding cognitive learning principles in nurses’ practice and nurses’ awareness of learning principles. Readers are encouraged to question their current conceptualisation of learning and their perceptions and use of learning principles in their practice.Findings and discussionThe learning process within nursing is overshadowed by explanations of teaching strategies, determinants of learning and the learning principles of one specific theorist. The principles of cognitive learning and their role in patient- and family-education are poorly described and possibly poorly understood. This creates a fundamental knowledge gap in nursing practice.ConclusionA significant rethink about the role of learning principles within nurses’ patient- and family-education practice is overdue. These principles need to be explored further by involving nurses, patients and their families to identify how nurses are perceiving and using learning principles in their practice.     

中西医结合治疗新型冠状病毒肺炎验案1例＊

在新型冠状病毒肺炎治疗救护工作中，中医药以其延缓轻症患者病情发展、提升疑似患者免疫机能等方面的诸多优势和效果得以参与其中。本文结合武汉一线的临床实践，探讨武汉一线新型冠状病毒肺炎验案1例，提出了治疗过程中的重要治则，以期对临床有所裨益。     

吕仁和治疗慢性肾功能衰竭药对挖掘与浅析

目的:慢性肾功能衰竭(Chronic Renal Failure,CRF)是由各种慢性肾病迁延不愈导致的以肾功能不同程度的损害甚至丧失为主要临床表现的病症。文章通过整理吕老治疗CRF的医案,探讨吕仁和的用药和配伍规律。方法:对门诊49例CRF患者的病案进行回顾性研究。运用关联规则分析的统计学方法,探索吕仁和教授治疗CRF的用药规律。结果:治疗总有效率81.6%。通过统计、归纳和分析发现常用黄芪及当归、香附及乌药、牡丹皮及丹参、枳壳及枳实、陈皮及半夏、栀子及茵陈、丹参、桃仁、红花及水红花子、狗脊、川续断及川牛膝、苏梗、香橼、佛手及丹参配伍使用。结论:吕老治疗CRF经验丰富,用药灵活独特,善用药对,药串及经验方,临床疗效确切,体现了中医药治疗CRF的特色和优势。     

Principles of Statistics in Surgery

ABSTRACT

Surgery, like any other scientific discipline, requires a systematic analysis of all its different variables in order to prove the real significance of research findings. Statistics, the science of numerical evaluation, can thoroughly help to determine the real value of surgical treatment. In this work, we study the statistical tests and principles needed to demonstrate their role in surgical research.

Without a strong statistical background, a researcher may feel overwhelmed when deciding what statistical methods to utilize in research. Determining what type of data to collect and what hypothesis test to run can alter the entire way a surgical study is conducted.

The relationship between power, sample size and effect size is discussed as well as the components necessary for a power analysis. Selecting an appropriate sample size is of utmost importance in any type of research since an undersized sample can invalidate an entire study.

Categorical surgical data, numerical data, and the appropriate statistical procedures needed for analysis are reviewed. Methods discussed include the 2-Sample t-test, Mann Whitney U test, Kruskal-Wallis, ANOVA, Chi-Square test and Fisher's exact test.