数码互动系统应用于寄生虫学实验教学的效果分析

数码显微互动系统应用于寄生虫学实验教学后,增强了师生及学生之间的互动,丰富完善了实验内容和教学手段,提高了教学效率和质量。     

浅谈高中英语互动课堂教学模式的构建

实践证明,课堂互动教学模式能够最大限度地体现新课标所倡导的生本理念,如何通过互动教学模式使高中英语课堂焕发活力,提升高中英语课堂教学有效性,是高中英语教学所面临的重要课题。1.实现教师与学生的和谐互动传统的高中英语教学,教师是高高在上的讲解者,是知识的灌输者,教师无视学生的接受能力,以高考为指挥棒进行教学,认为这样可以重点突出、增加知识容量,为学生高考奠定基础。但往往事与愿违,学生对枯燥乏味的讲解与无休     

问题式教学法在形态实验教学中的应用

实验教学不是对理论教学的单纯验证,而是培养学生各种能力和综合素质的教学过程。把问题引导式教学注入实验教学中,着重从问题引导与强化理论、问题引导与多媒体互动、问题引导与批判性思维能力培养、问题引导与比较式学习、问题引导与技能培养等方面入手,旨在培养学生的多种思维能力、科研意识和操作技能,切实提高组胚实验课教学质量。     

基于“雨课堂”的智慧课堂在《人体寄生虫学》 教学中的运用

为探索《人体寄生虫学》教学新模式,将基于" 雨课堂" 的智慧课堂教学模式融入《人体寄生虫学》课堂 教学实践中。 结果表明,基于" 雨课堂" 的智慧课堂教学模式改变了教师在课堂教学中的角色,激发了学生的学习热 情,能充分调动学生学习的主动性,促进了师生之间在课堂和课后的交流互动,让教师更好地了解学生对知识的掌 握情况,有助于教师教学能力的提高。 基于" 雨课堂" 的智慧课堂教学是一种高效的智慧课堂教学模式。     

基础-临床协作的双师同堂教学模式在《医学寄生虫学》课堂教学的探索

传统医学教学模式存在一定的局限性，阻碍学生将基础知识和临床技能融会贯通，也使得基础教学和临床教学长期割裂，基础教师与临床教师缺乏沟通和知识的互补。通过双师同堂教学模式在长学制《医学寄生虫学》课程的初步尝试和探索，包含从内容选取、病例筛选到课堂设计全程，在总结教学效果成效的同时也暴露了一些需要改进的问题。双师同堂教学模式构建多元化的课堂主体，增加主体间的互动性，由“师师”对话引发“师生”互动，继而带动“生生”互动，创设良好的教学情境，有利于培养学生多元的思辨能力，促进知识的多向流动，弥补目前医学基础教育的局限性，丰富学生的临床知识和早期临床诊疗思维的渗透。双师同堂教学模式对教师的默契程度提出更高的要求，督促基础教师和临床教师通过充分沟通和相互学习，提高教学能力，重新梳理课堂设计，实现基础知识和临床知识的有机结合，实现教学相长。同时，双师同堂教学模式对学生的临床知识储备以及课前、课中、课后学习均提出了更高的要求，要求学生养成思考的习惯，有利于临床思维的培养。     

临床护理教师教学竞赛的几点体会

目的探讨临床护理教师如何提高护理教学能力及教学质量。方法参加教学竞赛全程实践:教学授课初赛,复赛,决赛;总结教学体会。结果本人最后决赛成绩优异,获得教学授课三等奖,并总结了几点体会。结论教学授课比赛能提升临床护理教师的教学能力和教学质量。同时,能促进临床护理教师和学生的教学相长,意义重大。     

临床护理带教现状调查分析与对策

目的全面评估护理临床教学效果，适应素质教育，提高临床教学质量。方法对2006、2007两个学年的中专和大专及本科护生125人实习期间采取问卷调查，制定”临床护理带教质量评价表”由学生出科后填写。结果护理教学中主要存在的问题；实习指导工作不系统；理论与实际相脱离；传授知识技能的机会少；关心尊重学生不够；护理教学查房质量低、次数少；护士长教学意识差；教师专业理论水平较低；教学能力欠缺等。结论分析临床护理教学中存在的问题，及时提出对策，以便不断改进临床教学质量。使带教老师的自身素质和带教水平显著提高。使护生对患者的服务意识增强，对护理工作意议的认识得到进一步的加深。     

研究性教学在航空航天生理学课程教学中的探索

航空航天生理学是航空航天医学的主干学科,也是培养航空航天医学人才的关键课程。为培养该专业学生的岗位任职能力,在课程教学中引入了研究性教学形式,采用课堂授课与专题讨论课、综合案例分析课、“开放式”论文撰写相结合的教学办法;配套更新了课程考核方式,使其更全面地反映学生的学习效果。探索研究发现,该方法不仅提高了学生的学习兴趣,同时,通过自主学习促进了个人知识体系的构建,提高了灵活运用理论解决实际问题的能力。此外,提升教师的综合素质以及建立专业的信息资源库有助于更好开展研究性教学。     

医学高等院校教师教学能力的培养及发展

针对师资力量薄弱问题,发挥老教员帮带作用,提高医学院校教师授课能力,尽快成为教研室主力军是我教研室亟待解决的问题。熟悉医学院校教师在承担理论授课初期所表现出的主要问题,结合授课能力培训的主要方法以及实践中总结出来的经验,有规划地从助教培养和讲师培养两个阶段提高授课能力。通过培训后授课案例展示,教师授课能力得到极大提高,老教员成功完成理论授课交接。     

人体寄生虫学混合式教学的效果评价

我国的重要寄生虫病已得到有效控制或传播阻断,寄生虫病患者数虽显著减少,但误诊误治率却相对较高;在"一带一路"历史背景下,我国面临着境外输入性寄生虫病增多的挑战;然而,与这一形势不相适应的是,人体寄生虫学教学课时却在不断地减少;在学时数大幅减少的前提下,要提高国家对寄生虫病的防控能力,降低寄生虫病误诊、误治率,唯一有效途径就是不断提高人体寄生虫学的教学效果,培养既"懂分子"又"认虫子"的医学生。结合本校已开展的人体寄生虫学混合式教学实践,在简要介绍混合式教学设计与实施流程的基础上,本文从参与主体和教学流程两个角度,重点探讨了混合式教学的效果评价;围绕网络支撑系统、教学资源、教师和学生4个主体对象,筛选建立了评价指标体系,通过问卷调查、试卷分析和访谈,简要分析了人体寄生虫学混合式教学的实施效果。结果发现,混合式教学的教学效果优于传统课堂;教师的线下活跃度与学生的参与度、考试成绩均呈显著正相关;教师的全程督导能有效地促进学生自主学习,并有助于提高团队协作能力和考试成绩。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.