《实验诊断学》教材的评析与发展

本文回顾了卫生部组织编写的《诊断学》教材第1版至第6版中实验诊断篇的基本内容，介绍了其他5个版本《实验诊断学》教材的特点，提出了实验诊断学教材编写应当考虑的因素：①注重“三基”培养；②体现本学科领域的新进展；③加强双语教学；④编排内容和组织形式不断完善；⑤针对不同专业学生，教材编写应当有所侧重。     

对《中医诊断学》五版教材的几点看法

对《中医诊断学》五版教材的几点看法庄泽澄（中医诊断学教研室２５００１４）关键词中医诊断学；科学性；实用性；统一性；严密性；教材编写教材是学生学习的课本，教师执教的依据，因此，教材的编写为广大教师和学生所重视。鉴于《中医诊断学》五版教材（以下简称教材）...     

浅析《诊断学》(专科三版)教材

诊断学函盖着物理诊断学、心电诊断学、超声诊断学、实验诊断学、放射诊断学等多门学科知识，是一门基础医学与临床医学的桥梁课程。近年来，除了物理诊断学之外，心电、超声、实验等诊断技术均有了长足的发展。大专诊断学教材如何跟上医学科学的发展步伐，适应医学教育改革的要求，培养合格人材，是必须研究的课题。由卫生部高等医学专科教材评审委员会评审的《诊断学》（三版）医专教材（以下称三版教材），有了可喜的变化和多方面的进步，我校已使用了两届。现就《诊断学》（三版）教材，谈一点个人粗浅的看法。1《诊断学》（三版）教材…     

浅谈《中医诊断学》案例版教材的编写

《中医诊断学》案例版教材是普通高等教育“十一五”国家级规划教材,它的编写是在中医诊断学案例教学的基础上所进行的创新和尝试,是以启发式教学为总的指导思想,以临床辨证思维能力培养为宗旨。本教材突破了传统教材的编写体例和书写格式,使传统教材中的中医诊断学理论知识在案例中得到了阐述和深化,通过案例训练了学生的辨证思维能力和临证应变能力。     

中职助产专业《母婴保健》教材编写思路和特点及授课建议

1《母婴保健》教材编写背景 卫生部2001年版中等职业教育助产专业教学大纲中增添了妇婴保健课程。人民卫生出版社2002年出版了第1版《妇婴保健》教材。该版教材是对教学大纲进行认真研究并对部分内容调整后编写的,将妇女、儿童保健内容首次从妇科学、产科学和儿科学中分离出来,并融入妇女、儿童保健学科的新知识和新进展,内容全面,注重基本保健知识和技能的培养,为后续教材编写奠定了坚实的基础。     

关于五年制《诊断学》规划教材编写的几点建议

浅析现有五年制《诊断学》规划教材存在的问题,对教材的编写提出三点建议。第一,应改变对主诉中时间的描述;第二,应设立勘误表;第三,修改“附录一：临床常用诊断技术”的编排方式。通过修订,可使《诊断学》教材中的名词定义更准确,使教材编写形式更加完善,使错误得到及时纠正,有利于教师教学和学生学习,以及提高临床医学专业人才培养质量。     

全国中医诊断师资班结业

受卫生部委托,由我院主办的第二届中医诊断学师资班于一九八五年元月中旬结业。该班学员三十三人来自二十四个省、市、自治区的高等中医院校。在学习期间,除对《中医诊断学》五版教材编写大纲及其内容按重点、难点、疑点进行深入系统的讨论外,还在中医科研方法、医学数理统计以及“微型电子计算机与中医诊断”等方面进行了探讨。在此基础上,该班编辑了《中医诊断学题解》,题型多样,内容翔实,可备教学及自学之参考。     

关于《〈中医诊断学〉九版教材存在的问题》的商榷

《山东中医药大学学报》2016年第6期发表的《〈中医诊断学〉九版教材存在的问题》存在着逻辑比较混乱、中西医概念混淆以及以西医临床标准验证中医、以特殊性取代普遍性等现象,忽略了《中医诊断学》作为教材所讨论的是内外妇儿各科共性的问题,不可能像百科全书一样,更不可能介绍个人的临床经验,尤其是一些不成熟的观点不可能纳入教材,尽管都是诊断学,但中医诊断学和中西医结合诊断学是有区别的。以中医经典理论及临床为依据,对作者质疑九版教材的50多个问题进行梳理,提出商榷。     

第八届全国诊断学教学改革暨临床实验诊断学规范化检查研讨及学术交流会征文通知

全国高等院校诊断学教学咨询委员会委托吉林大学举办第八届全国诊断学教学改革研讨暨学术交流会，中心内容是实验诊断学检查规范化和编写实验诊断学教材改革研讨。时间：2005年8月5日～8月10日，会议语种：中、英文、地点：吉林省长春市。参加人员全国高等院校医学教学及其附属医院领导、内科、外科、检验科、诊断学和实验诊断学教研室教学人员，     

对中等卫校《化学》教材的使用体会与建议

现在中等卫校专业所使用的《化学》教材,是根据孟龙韬主编的第二版《化学》教材重新编写而成的,从 1997年使用至今已有 3年。如何用好中等卫校的最后一部教材,为将来的高等职业教育铺路搭桥,这是化学同行们共同关注的问题。本文对第三版《化学》教材的编排特点及内容谈点体会与建议,以便为高一层次的医学化学教育提供参考。 1现行教材编排的主要特点 第三版《化学》教材内容按 108学时编,除绪言外共分 18章和 17个学生实验,教材主要特点有： 1. 1编排体系合理,利于学生接受 在学生原有的化学知识基础上合理设计,编排内容分 3部分,…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.