基于专业培养目标的“卫生信息管理专业”混合式教学模式

探讨了基于专业培养目标的“卫生信息管理专业”混合式教学模式改革的可行性与实现模式,从模型构建、过程实施和效果评价3个方面分析了蚌埠医学院“卫生信息管理专业”实施基于专业培养目标的混合式教学模式改革所涉及的问题。     

基础医学课程“一体两翼”混合式教学模式的探讨

卫生职业院校教学模式已经从学习资源服务模式转变为“互联网+”实体课堂的混合式教学模式,混合式教学模式因其时代契合性,成为时下卫生职业院校课程改革和研究的热点。基于最近发展区理论、成果导向教育理念和布鲁姆教育目标分类法阐述了卫生职业院校基础医学课程“一体两翼”混合式教学模式的设计理念、实施过程、特征和策略,并做了总结和展望。     

卫生信息管理专业网络数据库课程“教学做”一体化教学模式探索

网络数据库是卫生信息管理专业的必修课,其以程序设计、数据库原理等课程为前导课程,是一门对学生实践能力要求较高的学科,因此该课程是南阳医学高等专科学校卫生信息管理专业开展"教学做"一体化课程改革的试点课程之一。基于2015年以来该课程"教学做"一体化教学改革实践,从教学内容、教学实施、教学手段、考核机制4方面,探索适用于卫生信息管理专业的"教学做"一体化教学模式。     

基于基层卫生服务体系岗位需求的三年制临床医学专业教学模式探索与实践

结合我国当前基层卫生服务体系发展与改革需求,以及三年制临床医学专业的教学模式现状进行分析,提出了该专业教学模式改革的思路,并从专业培养目标、培养规格、课程体系设置以及核心课程改革等方面进行了一些初步探索。     

混合式教学模式下《微生物学检验》教学改革探讨

目的　采用“基于工作过程系统化”对课程进行重构,探讨“以学生为主体、以教师为引导”混合式教学模式下任务驱动教学法在微生物学检验教学改革中的教学效果。方法　以2017级医学检验专业专科学生120人为研究对象,分为实验组和对照组;实验组实施重构后的课程内容采用混合式教学模式下任务驱动教学法,对照组采用传统教学方法;结束后通过问卷调查和期末考核相结合的形式进行评价。采用SPSS 21.0进行统计分析。结果　问卷调查显示学生对改革后的教学评价普遍较高,教学实验组成绩高于传统教学对照组,差异有统计学意义（P<0.005）。结论　混合式教学模式下的任务驱动教学,开展以强化技能培养为目的的理实一体化教学形式,能够促进学生专业知识和专业技能的提高以及促进其职业素养的养成,使微生物检验技术课程更好地满足高职医学检验专业培养目标的要求。     

卫生管理专业实施"以学生为中心"教学模式改革研究

分析了卫生管理专业采用“以教师为中心”教学模式的弊端和不足，通过实验研究实施“以学生为中心”的教学模式，探索培养适应卫生事业发展需求的知识、能力、素质型卫生管理专门人才。结果发现：该教学模式较之于传统的“以教师为中心”的教学模式，在不会偏废对书本知识学习的同时，更利于对学生综合管理素质和管理能力的培养。     

培养21世纪卫生信息管理人才

自七十年代起,全国各地有十几所卫生学校相继开办了会统、病案管理、计算机、社会医疗保险等相近专业,为社会培养了大批的卫生信息管理人才,对地方经济及卫生事业的发展起到了积极作用。九十年代中期,国家为了抑制经济过热,化解金融风险,实施了财政紧缩政策,市场人才需求形势发生了变化。上述专业分工过细,专业面向过窄,已经不适应市场职业变化的需求。为了迎接21世纪信息、网络时代的到来,社会需要“高素质、宽知识、强能力”的实用型职业劳动者我们通过对国内开办相关专业的部分学校的考察,结合国际上卫生信息管理的发展趋势,提出将以上专业调整合并为“卫生信息管理”专业,并提高学历培养层次。同时对该专业的前景、培养目标、课程设置及学时安排进行了设计和探讨,认为这种调整符合我国第三次全教会“深化职教改革、全面推进素质教育”的主题精神;符合21世纪社会卫生人才的需求形势。     

山西医科大学汾阳学院卫生信息管理专业教育的SWOT分析

应用SWOT分析法对汾阳学院卫生信息管理专业教育的优势、劣势、机会及威胁进行分析,提出了发展汾阳学院卫生信息管理专业教育的对策:明确培养目标,突出专业特色;壮大师资队伍,提高教师素质;转变教学理念,强化实践教学;加大宣传力度,提升专业形象.     

卫生事业管理专业教学中"以问题为中心"的教学模式研究

文章结合当前医疗改革对卫生人才的需求,探讨卫生管理教育专业教学阶段实施＂以问题为中心＂的教学模式的基本内容,分析了这一模式的优势,总结了实施这一模式尚面临的问题。     

构建"以学生为中心"教学模式支持系统的思考

结合实施卫生管理专业“以学生为中心”教学模式改革的体会，分析“以学生为中心”教学模式改革顺利实施并取得应有成效的环境，提出要构建“以学生为中心”教学模式改革的宏观支持系统，包括树立现代的教育观、新型的人才观、正确的学习观与微观支持系统，包括成立专门组织、建立发展性教学评价体系、制定相关政策、制度与措施。     

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.