临床教学中参与式教学模式的探讨

在临床医学课程中，建立和应用参与式教学模式可以激发学生学习兴趣，丰富教学内容，活跃教学形式，从而提高教学效果，锻炼学生独立思考能力、概括总结能力、自学能力、表达能力和创造性思维能力等综合能力，同时也培养了学生的团队合作精神。因此，参与式教学模式适应现代医学发展的要求，可以作为一种新的应用型医学教学模式用于教学。     

口腔临床实习应用参与式教学的探讨

本文探讨了参与式教学方法在口腔实习教学中的应用。建立和应用参与式教学模式有利于激发学生学习兴趣,丰富教学内容,从而提高教学效果。并进一步锻炼学生独立思考能力、概括总结能力、表达能力等综合能力。因此,参与式教学模式适应现代医学发展的要求。但是,目前参与式教学方法还需要选择性地进行。     

《美容皮肤病学》多元化教学模式的探讨

为探讨提高美容皮肤病学教学效果的方法,在教学中采用了系统讲授法、案例式教学法、比较教学法、参与式教学法等多元化的教学模式。结果表明,采用多元化教学模式能提高学生的学习兴趣,自主学习的能力,培养学生临床思维的能力。     

关于"参与式"教学模式的研究

目的 探讨“参与式”教学模式的发展。方法 教学模式分3个阶段实施，总结实施几十年来所取得的成绩，找出存在的问题，拟定今后发展的思路。结果 “参与式”教学模式的实施提高了学生们的教学、科研能力、表达能力和创新能力；增长了社会知识；并取得了显著成效。在此基础上探索出创新思路，由被动变主动。结论 “参与式”教学模式经过多年的实施，不断总结、探索，认为是一种切实可行，且有实用价值的教学模式。     

医学微生物学实验课教学方法的改革与实践

为适应高等医药院校教育工作改革不断深化的要求 ,提高医学微生物学实验课教学的质量和效果 ,培养学生的创新与实践能力 ,我们选择医学微生物学实验课的部分内容进行了"参与式"教学方法改革。通过 3年的实践证明 ,"参与式"教学模式可充分调动学生学习的主动性 ,有利于培养学生自学与实验操作的能力、分析与综合的能力以及语言表达的能力 ,开拓了学生创造性思维的空间 ,有助于学生综合素质的提高     

《妇婴保健》参与式教学教学模式的研究与实践

目的探讨《妇婴保健》参与式教学教学模式的实践效果。方法选取我校开设《妇婴保健》的2015级高职护理3班和4班作为研究对象,其中3班作为对照组在《妇婴保健》教学过程中给予传统教学模式,4班作为观察组则在与对照组相同课程安排下实施参与式教学教学模式。比较两组学生的期末考试成绩以及护理实践成绩,同时比较两组学生对教学模式的满意度。结果观察组班级的平均理论成绩、实践成绩以及总评成绩均显著优于对照组,差异均具有统计学意义(P0.05)。结论参与式教学教学模式能够显著提高学生的理论成绩和实践成绩,能显著提高学生的学习效果。     

参与式教学模式在中职教学中的应用

职业学校须坚持校企合作、工学结合人才培养模式,突出学生实践能力的培养,改革传统教学模式,做到理论和实践并重,培养的毕业生才能真正达到企业用人要求.在中职教学中应用参与式教学模式,突出体现以学生为中心的教学理念,有利于将理论与实践教学有机地结合起来,充分发掘学生的创造潜能,培养学生自主探究、分析问题、解决问题、分工协作的能力,提高学生解决实际问题的综合能力,为学生“对口”就业、稳定就业奠定良好基础.     

参加“参与式”教学模式训练的体会

"参与式"科学研究与教学实践教学模式把教学、科研和服务采取多种形式有机整合 ,集多种教学方式之所长 ,以培养学生的综合能力为突破口 ,使同学们的表达能力、自学能力、科研能力、创新思维能力和社会的适应能力都有明显地提高 ,密切了师生关系。     

参与式教学法在外科护理学教学中的应用

参与式教学是让学生均参与到教学中的一种教学模式。教师创设轻松、愉快、有趣、和谐的教学环境,调动学生学习的积极性、主动性和创造性,使全体学生积极主动地参与其中,自我体验、自我发现、自我反思,达到学生自主学习知识、提高能力、促进自身主体性发展的目的。     

以学生为主体的团队参与式互动教学的实践效果与评价

科学的发展,社会的进步,传统教学不再是课堂传递知识的唯一途径。为了体现以学生为主体、教师为主导、充分发挥学生的主观能动性,本研究在原有的课堂教学手段上融入团队参与式互动教学模式,历经4年的实践证明:团队参与式互动教学能激发学生的学习热情和提高教学效果,具体表现在学生团结协助并积极参与互动教学、活跃学习气氛、提高学习兴趣、降低学习难度、增强理解和记忆能力,营造了你追我赶、互帮共学的良好学习风气,促进自主学习、培养竞争意识与协助精神、开发和拓展学习思路,显著提高学习成绩。因此,团队参与式互动教学能提高教学质量,也深受学生的认可,值得进一步的推广应用。     

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.