七年制临床医学专业(药学方向)课程建设的探索与实践

七年制临床医学专业(药学方向)是一个医学与药学交叉融合的新型专业方向,由山东大学创办,在国内具有较强的示范意义.要实现七年制临床医学专业(药学方向)的培养目标,专业课程的设置及其教学内容的规范至关重要.本文就七年制临床医学专业(药学方向)课程设置、教学内容、存在困难以及改革措施等几个方面的问题进行了探讨.

Abstract：

Seven-year clinical pharmacy program was the first program in this field which was established by pharmacy college of Shandong University. The aim is to cultivate the higher pharmacist with the comprehensive knowledge of medicine and pharmacy. It has a remarkable significance for the program development in China. This article discussed the curriculum setting, teaching contents, existing problems and reform strategies.     

加州大学旧金山分校临床药学教育课程设置及其启示

美国是临床药学的发源地和高等临床药学教育的创始者,其临床药学教育已经成为许多国家高等临床药学教育的范本.加州大学旧金山分校的临床药学教育,在全美药学院校中排名第一.本文在解读加州大学旧金山分校的临床药学教育课程设置的基础上,分析了其课程特点及其对我国高等临床药学教育的启示.     

HIV/AIDS research in China: arising up from skyline

One of the major advances and few real breakthroughs in HIV/AIDS research is the discovery of anti-retroviral drugs and highly active anti-retroviral therapy （HAART）. HAART, achieved by the collective efforts of many scientists and industrials, has significantly improved life expectancy and quality of life of people living with HIV/AIDS. It has also been proven that effective treatment for viral infection is possible. HIV-1 infection chronically depletes CD4~ T lymphocytes and compromises normal function of the immune system of infected persons.1 May et al2 have found that impaired immune function could be restored with continuous HAART. The global HIV/AIDS epidemic is characterized by a great diversity of HIV clades prevalent in various parts of the world.3 The host immune responses to the diversified HIV strains as well as the metabolic patterns to the drugs are also various. Therefore, simply taking the data collected from the other countries＇ HAART is not recommended. It is important that indigenous scientists and clinicians in their respective countries start their own HAART program to conduct research on their patients to obtain local treatment data. Such kinds of research efforts by several Chinese research groups have been published in this issue of Chinese Medical Journal     

Epidemiology of age-related dementia in China.

Since the early 1980s, China has confronting adramatic change in population structure as well as arapid aging process. The proportion of the elderlyhas been increasing nation wide, and dementia is be-coming a major public health problem. However,the distribution of dementia among the aged, itsprevalence and incidence were unknown.Anepidemiological program was initiated in 1986 to in.vestigate this disorder in a community--based agedpopulation and to identify the possible risk factorsof Alzheimer's disease through collaboration withnine psychiatric hospitals in China, headed by the In-stitute of Mental Health, Beijing Medical University.     

Application of the dermatology life quality index in clinical trials of biologics for psoriasis

The significance of patient-reported outcomes(PROs) is increasingly being acknowledged and quality of life(QOL) has become an integral element of the assessment of overall burden of disease.Psoriasis has been known for its major impact on patients’ QOL and various generic,dermatology-specific and psoriasis-specific self- administered psychometric instruments have been used over the years to assess the QOL of psoriasis patients.However,the Dermatology Life Quality Index(DLQI) is the most widely used QOL measure among these measures in psoriasis-related clinical trials. A number of topical and systemic treatments have been used in the management of psoriasis and lately biologics have emerged as a new and promising treatment modality for difficuIt-to-treat psoriasis.The evidence on the efficacy of these agents has been growing dramatically with QOL being used as one of the primary outcome measures in many clinical trials.The aim of this paper is to give an overview of the use of the DLQI as an outcome measure for assessing the QOL impact of biologies on psoriasis patients.Furthermore,the efficacy of five commonly used biologics has been compared in terms of their ability to improve the QOL assessed by the DLQI.This review has revealed that there is a variation in the efficacy of various biologies in terms of QOL improvement with the mean reduction in the DLQI scores being highest for ustekinumab 90 mg(mean DLQI score reduction=9.5),followed by infliximab(8.5),etanercept 50 mg,twice a week(7.7),adalimumab(6.3),and alefacept(4.0).     

Challenges to pharmacy and pharmacy practice in Pakistan

The Islamic Republic of Pakistan is the sixth most populous country in the world. While exploring the history of the development of the pharmacy profession, the author discovered that the late Sheikh Nabi Buksh was the first to start a general store with a pharmacy in 1863. After the independence of Pakistan (14 August 1947), the University of Punjab became the first institution to develop a three-year bachelor programme in 1948 which was extended to four years in 1978-1979. In 2003, a step towards further change was seen when the Higher Education Commission (HEC) upgraded its BPharm programme to a five-year Doctor of Pharmacy (PharmD) programme. At the moment the Pakistani PharmD programme is facing a number of problems which are acting as a hurdle to Pakistani pharmacists and the establishment of pharmacy practice as a profession in Pakistan. This perspective will highlight these challenges so that the HEC and the Pakistan Pharmacy Council (PPC) can intervene to modify the Pakistani healthcare system in order to establish a good foundation for practicing pharmacists and to develop strategies to cope with the challenges accordingly.     

肝移植治疗原发性肝癌的价值

随着肝移植手术技术和术后管理水平的不断提高,肝移植治疗原发性肝癌的作用越来越受到关注。肝癌虽然可以作为肝移植的适应证之一,但是各个中心对选择肝癌肝移植的标准并不统一。国外在肝癌肝移植的适应证掌握方面比较严格,目前参照比较多的有米兰标准、加利福尼亚大学旧金山分校(UCSF)标准和匹兹堡标准。米兰标准和UCSF标准都严格限制肿瘤大小和数目,却未兼顾血管侵犯、组织学分化程度等影响预后的重要因素。浙江大学医学院附属第一医院肝移植中心提出了适合中国国情的肝癌肝移植标准(杭州标准),杭州标准超越了米兰标准,并在考虑了影响预后的多个危险因素的基础上安全地拓展了米兰标准,使更多的肝癌患者能接受肝移植治疗,且取得了和符合米兰标准患者相似的长期生存率。另外,本文还总结了肝癌肝移植的围手术期综合治疗,为减少肝移植术后肝癌复发、提高肝移植患者长期存活率,使肝移植真正成为治疗肝癌的重要方法。     

A model for primary care delivery to a widely dispersed medically indigent population

Access to Care is a unique program uniting private and public resources to provide primary care to the uninsured poor. The model was designed to serve a medically indigent population that is dispersed over a large geographic area, where clinics are not a practical option. Care for illness is provided in the offices of private physicians throughout the area and supported by laboratory, radiology, and pharmacy services. The program is designed for the estimated 88,000 persons in suburban Cook County, Illinois, with family incomes of less than twice the federal poverty level, who are uninsured and ineligible for Medicaid and Medicare. Supported by grants from foundations and local governments, the program, which has been in operation for 2 years in two demonstration areas, is administered by a private not-for-profit confederation of four health and social service organizations.     

中药学专业实验教学体系改革探索

通过对中药学专业实验教学中存在的问题分析,结合具体实验课程的教学规律与特点,提出实验教学体系改革目标与措施,重新设计将各门实验课程联系起来的综合设计性实验,以加强中药学学生专业素质与实际应用能力教育,培养新一代创新中药人才。     

顺应时代要求发展临床药学教育

随着我国经济的快速发展和医疗体制改革的不断深入,以服务病人为中心的药学监护工作模式和以合理用药为核心的临床药学工作,已成为新时期医院药学工作的主要内容.但由于我国临床药学教育的滞后,合格的临床药师目前较为缺乏,这也成为制约医院药学工作模式转变的瓶颈.所以,应以培养顺应时代要求的临床应用型药学人才为主要目标,加快发展临床药学教育,促进药学学科发展.     

七年制临床医学专业(药学方向)学生“三段式”毕业实习的探索

为了提高临床医学专业(药学方向)学生的培养质量,使学生更好地掌握临床医学知识、药学知识与科研写作的技能,培养学生临床药学的实际工作能力,山东大学对七年制临床医学专业(药学方向)学生实施了“三段式”毕业实习的教学改革探索.本文对“三段式”毕业实习进行了详细阐述,包括临床轮转实习、临床药学实习、毕业专题(定向)实习的时间安排、方式与内容、性质与任务、基本要求以及导师组成、专题实习选题、毕业论文的质量要求等.通过“三段式”毕业实习,使培养的学生更加符合临床药师工作的实际需要.此外,本文还就当前我国临床药学人才的培养模式、存在的问题和困难、面临的发展机遇和挑战以及临床药师的工作与定位,提出了思考与建议.     

药房托管的试行与发展

近年来我国居民＂看病难、看病贵＂的矛盾不断突出,党和政府以及广大人民群众十分关心,社会各界对此反映十分强烈。医药分开一直是我国医疗卫生体制改革的重点,医院门诊药房托管作为我国医药分开改革中的一种试点模式,在我国已有6年的试行历史,并取得了不俗的成绩。实行药房托管是现行医药体制下的必然选择。本文归纳介绍了药房托管的起源,一般形式及优点,以及完善药房托管的管理措施等,对医院药房的改革有参考作用。医院在进行药房托管试验模式的同时应该抓住机遇,不断提高医院药学专业人员的综合素质,加快医院业务的开展,进一步不断深化医药卫生体制改革。     

“多元化”教学模式在临床药学教学中的应用与探索

临床药学课程改革已成为药学教育的发展趋势,关系到大众的用药安全、健康水平和生活质量。郑州大学药学院从建立“多元化”教学模式出发,以学生为中心,依托弹性、灵活的教学内容设置,通过以问题为基础的教学方式（PBT）,探讨了培养创新能力和人际沟通能力双发展的高素质临床药学人才的新途径。