讨论式教学法在温病学中的教学设计——以温病的祛湿法为例

文章以温病的治法祛湿法为例,提出讨论式教学法的教学设计,包括建立"三人为师"规则、"发言签"规则,营造讨论气氛,角色分配包括向导、刺头、记录员、法官、汇报人,然后按照"领结模型"展开讨论,最后按照表达意愿、思维技能、学生间互动、内容知识掌握情况等进行评估,旨在培养学生温病学临床思维能力与团队协作能力。     

情景模拟联合案例讨论在急诊护理临床带教中的应用体会

目的探究急诊护理临床带教中采用情景模拟、案例讨论联合教学法效果。方法在本院实习的若干名护生中,选取124名护生分按照教学方法分组,对照组62名实施传统急诊护理带教,观察组62名实施案例讨论、情景模拟联合教学法,对比临床带教效果。结果两组实践与理论成绩相比,观察组成绩更高(P<0.05)。思维、急救及应激能力自我评价相比,观察组的总提高率高于对照组(P<0.05)。实施案例分析结合情景模拟教学模式后,问卷调查中观察组无护生不赞同此模式,非常赞同此教学模式的护生占总人数的90%以上。结论实施案例讨论、情景模拟联合教学模式后,护生急诊护理实践与理论水平均提升,护生我评价较高。     

基于“肾藏精”理论探讨衰老与骨关节炎的关系＊

中医认为人体生长壮老已的自然规律和筋肉骨髓的生长发育均与五脏中的肾密切相关。本文在探论肾藏精的生理功能的同时从中医基础理论和现代系统分子生物学角度对肾虚、衰老和骨关节炎三者之间的联系进行全新的阐释，肾通过调控骨组织局部微环境和骨代谢功能影响骨关节炎（Osteoarthritis，OA）的发生发展，提示肾虚精亏是骨关节炎发病的本源。肾虚是导致衰老的核心要素，而肾虚致衰在免疫和氧化应激方面参与OA病程进展，揭示肾虚致衰是骨关节炎发病 的重要机制。骨关节炎是衰老的一种表征，关节软骨细胞衰老不仅是人体衰老代谢的产物，也是诱发OA的重要因素，近年研究证实清除衰老软骨细胞成为治疗OA热点。补肾强骨中药作为传统中医疗法应用于OA疾病防治，由于病情、体质之不同，效果虽存有差异，但均可得到改善。     

图像识别技术在全国中药资源普查中的应用

随着计算机和图像处理技术的发展应用,图像识别技术已经应用于全国中药资源普查工作的各个阶段。其中,(1)在前期准备工作中,为建立统一的中药资源名录库,基于纸质文献资料采用文字识别技术,辅助进行与中药资源相关各类名录的数字化;为确定每个普查队外业调查的代表区域和样地,基于卫星遥感图像和植被图等基础数据,采用遥感图像分类等技术方法,辅助确定重点调查区域。(2)在外业调查过程中,为相对准确地获取中药材种植面积,基于遥感图像采用决策树模型、光谱特征、面向对象等方法,辅助进行中药材种植区域识别和面积估算。(3)在内业整理过程中,为相对准确的确定区域内中药资源种类,基于植物个体照片、标本照片和名称等采用图像识技术,辅助进行中药资源种类的统计汇总。(4)在成果转化应用中,基于药用资源个体和药材样品照片,开发中药资源种类识别APP和道地药材3D展示系统,辅助进行中药资源种类识别和药材鉴别特征展示。在中药资源普查工作中引入图像识别技术,辅助普查人员开展相关工作,不但能降低人工的工作量、提高工作效率,而且提高了普查成果的信息化水平和共享应用能力。随着中药资源普查工作的不断深入,图像识别技术方法在相关工作中还将发挥其特有的作用。     

胡思荣运用整体观辨治慢性阻塞性肺疾病

在慢性阻塞性肺疾病(慢阻肺)的辨治中,胡思荣教授运用整体观点对慢阻肺病因病机、诊断及治则治法等进行了论述及阐释,病机辨证从脏而论,气化失常为本。胡恩荣教授针对慢阻肺的病机特点,提倡辨证治脏,调气为主;制源补虚,调体培本;畅流化饮,治痰化湿祛瘀;防病养体,顺应四时等观点,并灵活运用于临床,为慢阻肺的中医辨治带来新的生命活力。     

Dental practitioners’ use of health risk assessments for a variety of health conditions: Results from the South Atlantic region of The National Dental Practice-Based Research Network

BackgroundAn important step in integrating dental and medical care is improving understanding of the frequency and characteristics of dental practitioners who conduct health risk assessments (HRAs).MethodsFrom September 2017 through July 2018, active dentist and hygienist members of the South Atlantic region of The National Dental Practice-Based Research Network (N = 870) were invited to participate in a survey evaluating their HRA practices (screening, measuring, discussing, referring patients) for 6 health conditions (obesity, hypertension, sexual activities, diabetes, alcohol use, tobacco use). For each health condition, the authors used ordinal logistic regression to measure the associations among the practitioner’s HRA practices and the practitioner’s characteristics, barriers, and practice characteristics.ResultsMost of the 475 responding practitioners (≥ 72%) reported they at least occasionally complete 1 or more HRA steps for the health conditions except sexual activities. Most practitioners screened (that is, asked about) and gave referral information to affected patients for diabetes (56%) and hypertension (63%). Factors associated with each increased HRA practice for 2 or more outcomes were non-Hispanic white compared with Hispanic practitioner (cumulative odds ratio [COR] obesity, 0.4; 95% confidence interval [CI], 0.2 to 0.8; and COR diabetes, 0.3; 95% CI 0.2 to 0.8), male compared with female practitioner (COR tobacco, 0.3; 95% CI, 0.2 to 0.7; and COR hypertension, 0.4; 95% CI 0.2 to 0.8), and practitioner discomfort (COR, obesity and alcohol use, 0.7; 95% CI, 0.6 to 0.9; and COR, sexual activities 0.6; 95% CI 0.5 to 0.8).Conclusions and Practical ImplicationsDental practitioners are conducting HRA practices for multiple conditions. Interventions should focus on reducing practitioner discomfort and target non-Hispanic white, male practitioners.     

基于子宫腺肌症痛经的发病机制浅析电针、温针序贯治疗理论

探讨在众多治疗痛经有效的针灸方法中,依据子宫腺肌症痛经的发病机制,分别选用电针、温针进行序贯治疗,观察该方案对痛经远期疗效及瘤体大小的影响,为针灸治疗腺肌症痛经探索更高效的方法。     

从“木郁达之”辨证论治乳腺癌

依据《素问·六元正纪大论》对"木郁达之"的论述,探究乳腺癌病理机制及对乳腺癌辨证论治的指导意义,论述了少阳厥阴脏腑气机郁滞与乳腺生理病理的关系,突出了少阳气结与厥阴血瘀是乳腺癌发病基础。认为乳腺癌有木失调达、乳络瘀阻、木郁乘土基本证型,和解少阳、活血化瘀、疏肝健脾为乳腺癌辨证论治之关键。"木郁达之"可为乳腺癌的临床治疗提供理论依据。     

Effectiveness of chemotherapy counselling on self-esteem and psychological affects among cancer patients in Malaysia: Randomized controlled trial

Objectives

The aim of this study was to implement and evaluate the outcomes of chemotherapy counselling based on the “Managing Patients on Chemotherapy” module on self-esteem and psychological affect (anxiety, depression) of cancer patients by pharmacists in ten selected government hospitals in Peninsular Malaysia.