口腔预防医学实验课教学改革探索

目的:改革口腔预防医学实验课的教学方法,提高口腔专业学生的口腔宣教能力.方法:对重庆医科大学口腔系2000级本科生口腔预防医学实验课进行教学研究和实践,并对该教学效果进行评价.结果:口腔预防医学实验课的改革实践取得满意的成果,提高了学生的口腔宣教能力.结论:该课程的改革符合教学发展的趋势,有利于提高本科生的综合素质.     

关于牙科色彩学教学的初探

牙科比色是口腔临床工作中十分重要且较难掌握的一项技能,对修复效果起着重要的影响。而目前我国口腔医学教育中相关内容严重不足。采用何种方法和教学手段进行色彩学知识和技能的讲授和训练一直是口腔医学教育工作者们研究的课题之一。该研究通过对尚未学习口腔专业课程的口腔医学生,采用理论讲授,配合比色训练设备培训的方法进行教学,结合教育心理学基本理论,初步探索出一套较为有效的教学手段。     

心电图实验课多元化教学方法的探讨

心电图教学是诊断学教学的重点及难点,心电图实验课是教师进一步指导学生掌握心电图原理和读懂心电图的关键课程。如何提高教学效果,这对带教老师提出了挑战。研究对中山大学2016级临床医学专业和预防医学专业五年制本科生的心电图实验课的教学方法进行变革,综合应用“现身做法”、多媒体教学、病例讨论法、口诀法、比喻法、归纳法等教学方法,采用闭卷考试和问卷调查对教学效果进行评估。闭卷考试成绩包括理论考试和心电图判读考试,并与2015级相同专业五年制本科生的成绩进行比较。结果显示两个年级考试试题难度相当,2016级心电图判读正确率高于2015级,而理论考试成绩相当。调查问卷结果显示学生对新的教学模式和方法满意度大于80%。主要体现在学习兴趣及分析心电图的能力得到了提高。多元化的心电图实验课教学方法提高了学生的学习兴趣,判图能力及考试成绩。     

CPPT病理实验课中采用不同教学方法的教学效果比较

回顾性分析本校医学本科生采用不同教学方法后的病理实验课成绩,探讨不同教学方法在教改课程——临床病理生理学及治疗学(clinical pathophysiology and therapeutics, CPPT)的病理实验课中的教学效果差异。结果显示采用纯数字切片教学与传统教学结合数字切片的教学方法对医学生病理学实验课成绩的差异无显著性,彰显数字切片教学方法的可行性和优越性,特别是在新冠疫情流行期间只能采用线上教学的情形之下。     

自主研发的口腔正畸X线头影测量教学软件在本科生口腔正畸教学中的应用

目的:探索基于临床实践的教学方法,开发口腔正畸X线头影测量教学软件.评价其对本科生口腔正畸教学中的效果.方法:研究教学方法,完成软件开发,应用于本科生教学实施并进行教学成效的评估.结果:新教学方法下学生头影测量定点准确性显著提高(P＜0.05).结论:本教学软件及教学方法有助于提高本科生口腔正畸头影测量教学效果,增加学...     

留学生病理生理学实验教学探讨

目的提高留学生病理生理学实验课的教学质量。方法分析留学生特点、课前准备、教学过程、教学效果评价等方面。结果留学生病理生理学实验课教学的质量有明显的提高。结论正确认识留学生特点,改进课前准备、教学方法、教学效果评价等方面,有利于提高留学生病理生理学实验课教学的质量。     

案例讨论式联合标准化病人在口腔外科教学中的应用

目的探讨案例讨论式联合标准化病人在口腔外科教学中的应用。方法选取2013级和2014级五年制本科生进行比较,2014级作为实验组,2013级作为对照组。实验组采用案例讨论式联合标准化病人教学法,对照组采用传统教学方法。通过期末理论考试及实验课考核成绩、学生问卷调查比较两组教学效果。结果实验组期末理论考试成绩、实验课考核成绩、学生问卷调查结果均与对照组有显著性差异(P<0.05)。结论案例讨论式联合标准化病人教学有利于学生形成临床思维,能够激发其学习热情,提高综合运用知识能力、发现及解决问题能力。     

流行病学以问题为基础学习教学效果的分析与评价

目的：对医学院本科生流行病学以问题为基础学习（problem-based learning,PBL）教学方法的授课效果进行分析和评价,探讨 PBL 教学方法在流行病学教学中的优点和不足,为进一步提高流行病学的教学效果提供理论依据。方法设计信度、效度较好的 PBL 教学质量评价问卷,选取某大学医学院参与流行病学 PBL 课程的本科生开展问卷调查分析及授课反馈。结果流行病学PBL 教学方法在临床医学本科生的教学过程中取得良好的教学效果,学生可以很好地掌握本次课程的重要知识点,而且大部分学生对 PBL 教学予以支持。结论 PBL 教学方法能够有效提高学生的学习动力和兴趣,有助于学生掌握基础知识,能够增强学生分析和解决实际问题的能力。     

模块渐进法在预防医学本科实验教学中的应用

目的 以《环境卫生学》实验课教学为例,评估模块渐进法在预防医学本科生实验课教学中的应用效果。方法 郑州大学公共卫生学院在读和毕业预防医学本科生为调查研究对象,通过电子问卷收集研究对象基本信息、实验课教学内容、教学方式、现场实践活动认知、学生学习状态自我评价等,利用SPSS 23.0比较在校和毕业本科生在模块化《环境卫生学》实验课中教学效果。结果 在读和毕业本科生在教学内容和教学方式的认知方面差异无统计学意义(P>0.05),100.0%在读本科生和96.4%毕业本科生认为教学内容设置基本合理,81.2%在读本科生和78.6%毕业本科生能够举出5种以上环境因素对健康的危害。62.2%在读本科生和57.1%毕业本科生在实验课中能够联想到理论中教师所讲的相关知识点;69.8%在读本科生和75.0%毕业本科生在开始实验操作前能充分理解并认可即将进行的实验步骤。但不同年级本科生对实验课现场实践活动认知和学习状态自我评价方面存在差异,其中57.1%毕业本科生认为现场实践教学对以后所从事的工作很有帮助,高于在读本科生(32.1%);在读本科生听课满意率为86.8%,高于毕业本科生57.2%的满...     

床旁教学结合CBL教学模式在《皮肤性病学》教学中的应用

目的:探讨床旁教学结合案例教学法(CBL)教学模式在《皮肤性病学》临床本科生教学中的应用效果.方法:选取皖南医学院临床医学专业2016级学生65名,按照班级随机分为两组,对照组33人,实验课采用传统的教学模式;实验组32人,实验课采用床旁教学结合CBL教学模式,采用理论考试和问卷调查的方法评估两组的教学效果.结果:实验...     

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.