医学生生涯辅导需求的定性研究

目的了解医学生生涯辅导现状以及需求状况,为医学生的生涯辅导提供依据。方法应用定性研究小组讨论的方法,对某高校医学生的生涯辅导情况进行调查。结果医学生普遍能够接受专题小组讨论的调查形式。定性研究结果显示,医学生对生涯辅导有着较强烈的需求,需求程度与学生的年级高低有关;学生需要学校提供多种形式的生涯辅导。结论生涯辅导对医学生成长有着重要意义,学校应该提供多种形式的生涯辅导以满足医学生的需要。     

医学生职业生涯规划教育现状及影响因素的实证研究

通过对820名医学本科生的职业生涯规划意识、规划水平、规划程度和辅导评价的实证研究,发现现行的先期规划——解决问题医学生职业生涯辅导模式尚不能满足学生的需求。本文从医学生主体因素、医学院校等主导因素、环境因素和介体因素四个方面进行深层次分析和讨论,为探索有效的医学生生涯辅导的综合模式打下基础。     

南京地区高校学生性行为及避孕节育知识现状调查研究

目的了解南京高校学生的性行为及避孕节育知识现状,为高校开展更有针对性、更有效的性健康教育提供科学依据。方法采用定量研究和定性研究相结合的研究方法。定量研究为对南京4所不同类型高校按分层随机整群抽样原则抽取650名学生进行问卷调查;定性研究半结构式专题小组讨论。结果①15.69%的同学有过性行为,医学生与非医学生相比有显著统计学差异(P<0.01)。②11.06%的学生对避孕知识不了解。结论南京高校大学生避孕节育知识水平不高,普遍对性教育有需求,亟待重视和加强高校大学生性与生殖健康相关知识的教育。     

医学教育仪式调查研究分析及展望

目的　在新时代背景下,调查医学生群体对医学教育仪式的态度和诉求,发现存在的问题,为仪式的创新完善提供参考。方法　对医学生群体进行网络问卷调查,采用SPSS 25.0对数据进行描述性统计分析和秩和检验;采用深度访谈法、专题小组讨论法等质性研究方法,对定性资料进行综合分析。结果　被称为网络原住民的“00后”医学生也非常期待传统医学教育仪式的回归;相较低年级学生,高年级学生的仪式重要性认知度、仪式参与意愿以及仪式中的职业认同感唤起程度均较低（P<0.05）;部分医学生表明从未参与过医学教育仪式,部分医学生表明自己的专业在仪式中不被重视。结论　新时代下的医学教育应重拾传统仪式,并跟随时代背景、学生群体特征的转变进行调整;现有仪式教育未能满足不同阶段医学生群体的需求,应加强其系统性、连续性;医学教育仪式对医学生群体的覆盖不全面、不均衡,有必要进一步扩大仪式在医学相关专业的覆盖面和适切度,充分考虑医学生群体中各专业的特点。     

应用团体生涯辅导技术对医学生心理素质的干预性调查研究

目的：探讨团体生涯辅导技术对医学生心理素质培养和改善的作用。方法：医学院校不同专业一、二年级学生40人。其中,研究组20人,对照组20人。研究组进行为期两个月的团体生涯辅导,对照组不做干预。应用SCL-90干预前后对被试统一进行测试,然后再进行差异性检验。结果：干预前后SCL-90总分,躯体化、强迫、人际关系敏感、焦虑、恐惧、偏执6个因子分指标上有显著性差异。结论：团体生涯辅导技术对于提高医学院校一、二年级学生的适应能力、缓解紧张焦虑水平、促进学生自信交往有显著的效果。对培养医学生良好的心理素质可行且有一定的积极意义。     

健康大数据背景下大专医学生数据素养现状及提升策略——以江西医学高等专科学校为例

目的 了解大专医学生数据素养现状及教育需求,为提升大专医学生数据素养提供依据。方法 将江西医学高等专科学校医学生作为调查对象,采用大专医学生数据素养评价量表调查大专医学生数据素养水平及对数据素养教育的需求。结果 大专医学生数据素养水平偏低,尤其在数据收集和数据分析表达方面;不同年级、数据实践经历的学生大专医学生数据素养评价量表得分比较差异有统计学意义（P<0.05）;94.58%的大专医学生认为需要接受提高数据素养的相关教育。结论 学校应提高重视程度,加强校园信息化软硬件建设,组建数据素养教学团队,构建大专医学生数据素养评价体系,并以此为目标建立进阶式数据素养培养模式。     

医科大学新生生涯规划团体辅导实践研究

目的探索以团体辅导的形式进行生涯规划辅导的有效性和可行性。方法对广东医学院40名新生在团体辅导前进行调查,依据结果确定辅导内容;运用多种形式的团体辅导方法进行干预,对团体成员在辅导中、辅导结束时以及3个月后进行调查。结果生涯规划团体辅导中成员投入程度较高,辅导结束时,成员的满意度较高,辅导结束3个月后,团体经验对成员产生了较大的积极影响。结论生涯规划团体辅导是帮助医科大学新生提高生涯自主意识和规划能力的一条重要途径。     

Fuzzy综合评价法在医学生职业素质评价中的应用

目的研究高职医学生的职业素质及有效评价方法,为学校和医院评价医学生的职业素质提供科学方法。方法运用DelphiModel进行专家调查确定指标项目,采用多视角调查560人以确定指标重要性,运用Fuzzy综合评价法建立素质评价数学模型,阐述应用方法。结果该方法使评价行为更科学合理,能使定性评价与定量评价很好地结合,并有效控制定性评价中人为因素的干扰。结论 Fuzzy综合评价法为管理者准确、全面、公正评判医学生的职业素质提供科学有效的方法。     

医学本科生廉洁教育的探讨

本文通过对医学生廉洁认知现状的调查,阐明开展医学生廉洁教育具有现实必要性;提出医学生的廉洁教育要纳入大学生思想政治教育体系、学校廉政文化建设、职业道德教育和日常教育管理中,以正面教育为主,借助多种形式的教育将廉洁理念植入学生头脑.     

师德师风建设新途径的探索研究

为了解师德师风现状，探讨师德师风建设的新途径，为高校师德师风建设提供一定依据与参考，采用问卷调查法、定性研究的深入访谈法及专题小组讨论法对某高校基层学院进行调查。调查分析表明：师生共促；加强制度改革，完善考核制度；鼓励教师参与学生工作及学生管理是高校师德师风建设的有效途径。     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.