生理学教学核心理念变革的探讨

医学教育改革更多的是热衷于授课形式和方法的改革，而忽视了真正能够渗透到教学各方面的教学理念的改革。结合对生理学教学目标的反思和“岗位胜任力”培养的需求，将生理学教学的核心理念总结为四个方面：“三观”要正，帮助学生树立平衡观、辩证观和整体观；“三基”要牢，培养学生掌握基本的知识架构体系、基本的知识获取能力、基本的操作技能；重视学以致用和强化人文素养。上述核心理念在教学实践中得到学生的广泛认可，临床医学专业学生对核心理念的评价明显高于护理专业。下一步教学改革的方向是在教学理念的指导下如何细化授课内容，以适应专业设置越来越细化的现状。     

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。     

卢尚岭对高血压的病机认识与临证经验总结

总结卢尚岭教授对髙血压病机的理论认识及临证经验。髙血压发病之本在气机失调,气机失调先责肝脾二脏。由此引起诸多病机变化,如,情志所伤,肝气郁结,诸郁遂生;饮食失节,损伤脾胃,导致中焦壅滞,气机不利,日久必然损伤血脉,危害脏腑。据此,卢老强调肝脾气机失调、升降之机失常、脏腑功能紊乱存在于髙血压全过程,进而提出调治髙血压以斡旋气机,调整脏腑功能,藉以恢复阴平阳秘之常态为主导。认为临证应首辨气机失调及病变脏腑,治以调气为先,兼顾化痰、活血、疏肝清火、平肝潜阳、滋补肝肾、滋阴和阳、扶阳镇水等,同时强调外治,善用足浴。     

Effect of Electroacupuncture on Spermatogenesis in Rats with Oligozoospermia of Insufficiency of Shen (Kidney) Essence Syndrome

Objective: To assess the effect of electroacupuncture(EA) on expression of cytoskeletal proteins from Sertoli cells(SCs) and spermatogenesis in rats with oligozoospermia of insufficiency of Shen(Kidney)essence syndrome(OIKES).Methods: Twenty healthy male Sprague-Dawley rats were randomly assigned to four groups using a random number table: control,tripterygium glycosides(TG) treatment,sham and EA groups(n=5 in each group).A rat model of OIKES was established by oral gavage with TG.The EA group was treated with TG and received EA at Shenshu(BL 23) and Zusanli(ST 36) acupoints for 20 min,once daily for 30 days,while the sham group received EA at identical acupoints with skin penetration without stimulation.After 30 days,the ?nal body weight and coef?cients for the testis and epididymis were calculated and sperm parameters were measured.Immunohistochemical analyses were performed to detect expression of vimentin and α-tubulin in SCs and proliferating cell nuclear antigen(PCNA) immunoreactivity in germ cells.Apoptosis in germ cells was quanti?ed by the transferase biotin-dUTP nick end labeling assay.Results: Compared with the control group,the final body weight and testis/epididymis coefficients of rats in the TG-treated group were not significantly different,but the sperm count and motility were lower(P0.05).Expressions of vimentin and α-tubulin were also signi?cantly weaker(P0.01).The PCNA immunoreactivity of germ cells was decreased(P=0.059),whereas the apoptotic index of germ cells was increased signi?cantly(P0.01).In contrast,EA at BL 23 and ST 36 acupoints signi?cantly improved the ?nal body weight as well as the sperm count,concentration and motility(P0.01 or P0.05).EA increased expression of vimentin and α-tubulin in SCs markedly,and signi?cantly enhanced PCNA immunoreactivity with decreased apoptosis in germ cells(P0.01 or P0.05).Conclusions: EA at BL 23 and ST 36 acupoints has protective effects on spermatogenesis in rats with OIKES.This effect seems to be achieved by attenuating TG-induced disruption of cytoskeletal protein in SCs.     

"肾脑相济"电针对阿尔茨海默病模型小鼠行为学及IL-1β、TNF-α表达的影响

目的观察"肾脑相济"电针对阿尔茨海默病(AD)模型小鼠行为学和大脑皮质炎性因子白细胞介素-1β(IL-1b)和肿瘤坏死因子-α(TNF-α)表达的影响,探究"肾脑相济"电针疗法治疗阿尔茨海默病的作用机理。方法将7月龄雄性SAMP8小鼠随机分成模型组、西药组和电针组,每组6只;将SAMR1小鼠作为对照组。西药组给予盐酸多?哌齐灌胃,电针组电针百会、肾俞和三阴交。采用Morris水迷宫观察小鼠行为学,应用免疫组化法、Western Blot法测定大脑皮质区IL-1b、TNF-α的阳性细胞数和蛋白表达。结果与对照组比较,模型组小鼠学习记忆能力明显下降,IL-1b、TNF-α的表达升高,差异有统计学意义(P<0.05);与模型组比较,西药组和电针组小鼠学习记忆能力增强,IL-1b、TNF-α的表达降低,差异有统计学意义(P<0.05);与西药组比较,电针组小鼠学习记忆能力及IL-1b、TNF-α的表达变化不明显,差异无统计学意义(P>0.05)。结论"肾脑相济"电针疗法可以改善SAMP8模型小鼠的学习和记忆能力,降低大脑皮质区IL-1b、TNF-α的含量,从而对阿尔茨海默病达到治疗效果。     

Fundamentals about onset and progressive disease character of type 2 diabetes mellitus

ResearchGate is a world wide web for scientists and researchers to share papers, ask and answer questions, and find collaborators. As one of the more than 15 million members, the author uploads research output and reads and responds to some of the questions raised, which are related to type 2 diabetes. In that way, he noticed a serious gap of knowledge of this disease among medical professionals over recent decades. The main aim of the current study is to remedy this situation through providing a comprehensive review on recent developments in biochemistry and molecular biology, which can be helpful for the scientific understanding of the molecular nature of type 2 diabetes. To fill up the shortcomings in the curricula of medical education, and to familiarize the medical community with a new concept of the onset of type 2 diabetes, items are discussed like: Insulin resistance, glucose effectiveness, insulin sensitivity, cell membranes, membrane flexibility, unsaturation index (UI; number of carbon-carbon double bonds per 100 acyl chains of membrane phospholipids), slow-down principle, effects of temperature acclimation on phospholipid membrane composition, free fatty acids, energy transport, onset of type 2 diabetes, metformin, and exercise. Based on the reviewed data, a new model is presented with proposed steps in the development of type 2 diabetes, a disease arising as a result of a hypothetical hereditary anomaly, which causes hyperthermia in and around the mitochondria. Hyperthermia is counterbalanced by the slow-down principle, which lowers the amount of carbon-carbon double bonds of membrane phospholipid acyl chains. The accompanying reduction in the UI lowers membrane flexibility, promotes a redistribution of the lateral pressure in cell membranes, and thereby reduces the glucose transporter protein pore diameter of the transmembrane glucose transport channel of all Class I GLUT proteins. These events will set up a reduction in transmembrane glucose transport. So, a new blood glucose regulation system, effective in type 2 diabetes and its prediabetic phase, is based on variations in the acyl composition of phospholipids and operates independent of changes in insulin and glucose concentration. UI assessment is currently arising as a promising analytical technology for a membrane flexibility analysis. An increase in mitochondrial heat production plays a pivotal role in the existence of this regulation system.     

关于医用B超基本工作原理及故障维修措施的研究

经济社会的快速发展,提升了人们的生活水平人们对医疗事业的发展提出了更高的要求,我国也加大了对医疗事业的建设与发展。尤其是所使用的相关设备与仪器。其中,医用B超就是最主要的医疗设备,能够通过设备的检查,对人体的身体情况以数据的形式展现,直接能够了解到人体的健康情况,提升医疗事业的技术水平,同时,也为医疗工作这提供了方便快捷的工作方式。但是,医用B超设备在使用的过程中,会受到一些因素的影响,使其发生故障,会对各项工作造成不同程度的影响。因此,需要对其加强管理,能够及时地发现故障问题,采取科学的措施解决,确保医疗事业的稳定发展。     

从气机升降探讨胃癌的病机治则

胃癌是因外邪侵袭、情志内伤、饮食失调等,致气机升降失调,气血津液运化失常,气滞、血瘀、痰浊及癌毒内生,日久积聚于胃脘而成。脾胃为气机升降之枢纽,脾不升清,胃不降浊,则精微不能濡养,浊液不能排出,影响体内正常气机升降。肝主疏泄,调节全身气机的条达,肝之疏泄功能失常,气机升降失调,则影响气血运行。气机升降关系在胃癌形成中起关键作用,气机升降失调,气血津液不能正常输布运行,则气凝血滞,痰浊内停,甚则癌毒内生,发为癌瘤。故在临床治疗中注重恢复脾胃的升降功能,辛开苦降,调畅气机,恢复脾胃的正常升降功能,为胃癌的治疗提供临床指导。     

吴澄《不居集》学术思想撷要

《不居集》是清代著名新安医家吴澄的代表著作。本文对吴澄《不居集》的学术思想进行了分析与总结,集中体现其阐述的虚损病统治大法,提出了虚损病的嗽、热、痰、血四大证,指出治虚损之痰三法即培脾、保肺、补肾,总结了血证八法合八卦及治未病思想。该书的遣方用药及论证详明清晰,既总结前贤治虚之旨,又结合自身临证之体验,开阔了虚损病辨证诊疗的思路,体现了新安医学的思想传承,其学术思想对后世医家及中医虚损理论的创新与发展具有较大的指导意义。     

调脂治疗是收益还是风险？

诸多的研究结果证明了他汀类药物调脂治疗对降低心血管事件具有一定的有效性和安全性。然而,也有研究结果显示了强化调脂治疗的风险性。为尽可能发挥调脂治疗的功效又避免或减少用药的风险,可遵循生活方式干预、常规剂量给药、全面调脂治疗、个体化治疗和综合治疗等原则。