健脾益气法治疗老年慢性溃疡性结肠炎临床疗效分析

目的观察健脾益气法对老年慢性溃疡性结肠炎的治疗效果,比较老年与中青年患者在消化吸收及免疫功能的差别.方法以口服健脾灵为主,配合苦参槐花合剂保留灌肠,观察治疗前后纤维结肠镜、D-木糖排泄率、胰功肽试验、唾液淀粉酶活性和细胞免疫指标变化.结果老年组与中青年组治愈率分别为60.0%和74.8%(P＜0.05).老年组各项指标均明显低于中青年组,经治疗后,虽有所增高,但幅度明显低于后者.结论对老年患者适当延长治疗时间才能进一步提高疗效.     

Auditorium of the future: e learning platform

Principles of surgical training have not changed, but methods of training are evolving very fast. Online tools are being adopted in both knowledge and skills training for surgical residents. As a result, to evaluate the outcome of these tools, online assessment is also developing. Knowledge resources are very diverse ranging from lectures, webinars, surgical videos to three-dimensional planning and printing. Skills resources include virtual reality simulators, remote skills training and interdisciplinary teamwork. Assessment of E-learning tools can be performed using online questions, task-based simulations, branching scenarios and online interviews/discussions. In thoracic surgery, video assisted thoracic surgery (VATS) lobectomy simulator has been developed and it appears to be an important tool for minimally invasive thoracic surgery education. Training programs incorporate e-Learning in their curriculum and online training and assessment will become an important part of thoracic surgical training as well.     

中药益气活血法对缺血性脑卒中微栓子的调节作用

目的：观察中药益气活血法对于微栓子（MES）阳性脑梗死患者的治疗效果。方法将80例微栓子阳性脑梗死患者随机分为治疗组和对照组,每组40例。在共同内科药物、康复治疗基础上,治疗组给予中药益气活血法治疗,对照组给予安慰剂治疗。2周后观察微栓子数目变化并评价疗效。结果治疗后微栓子数目观察,治疗组（12.725±4.176）个和对照组（15.025±6.049）个明显减少,治疗组效果优于对照组（P〈0.05）。治疗后美国国立卫生院卒中量表（NIHSS）评分观察,治疗组和对照组明显减少（9.201分±4.937分vs 9.450分±4.668分,P〈0.05）,治疗组效果优于对照组（P〈0.05）。结论中医益气活血法能明显减少缺血性脑卒中患者颅内微栓子数目,可能因此改善患者最终疗效。     

Knowledge and innovation relationships in the shrimp industry in Thailand and Mexico

Experts, government officials, and industry leaders concerned about the sustainability of shrimp aquaculture believe they know what farmers need to know and should be doing. They have framed sustainability as a technical problem that, at the farm level, is to be solved by better shrimp and management of ponds and businesses. Codes of conduct, standards, and regulations are expected to bring deviant practices into line. Shrimp farmers are often cornered in a challenging game of knowledge in which their livelihoods are at stake. In the commodity chain there are multiple relations with both suppliers and buyers, not all of which are trustworthy. The social networks shrimp farmers belong to are crucial for sifting out misinformation and multiplying insights from personal experience in learning by doing. Successful farmers become part of a learning culture through seminars, workshops, and clubs in which knowledge and practices are continually re-evaluated. The combination of vertical and horizontal relationships creates a set of alternative arenas that together are critical to bridging knowledge and action gaps for shrimp farmers. Government and industry initiatives for improving links between knowledge and practice for sustainability have largely succeeded when incentives are aligned: shrimp grow better in healthy environments, and using fewer resources means higher profits.     

艾滋病知识讲座对提高大学生艾滋病知识水平的效果评价

目的 研究在大学生中开展艾滋病知识讲座的可行性及有效性。方法 对某工业大学126名大学生开展艾滋病知识讲座,并对讲座前后学生的艾滋病知识得分作一一配对比较。结果 专题讲座对学生提高艾滋病知识水平相当有效。所有学生都欢迎此类讲座,有82％的学生认为最需要了解艾滋病的预防知识。此外,有部分学生承认自己曾看过黄色出版物,并有26％的学生赞同婚前性行为。结论 在大学生中开展艾滋病知识讲座非常必要而且有效。     

Reflecting on Reflection: Capitalizing on the Learning in Intergenerational Service-Learning

Intergenerational service-learning has become an important practice in gerontology and geriatrics education. Although numerous benefits of service-learning have been documented, greater attention to critical reflection, a key component for harvesting the learning in service-learning, is needed to increase our understanding of what students really are learning from intergenerational service-learning and how we may best enhance the positive aspects of that learning. This article examines the elements necessary for effective service-learning reflection, as well as reports on the results of a survey of gerontology and geriatric educators (N?=?142) regarding their experiences with intergenerational service-learning and their use of specific reflection practices. The findings suggest that the types and implementation of service-learning reflection activities used in aging courses vary considerably. The importance of service-learning reflection and its associated benefits and challenges are discussed.     

Effect of Low-flow Anesthesia Education on Knowledge,Attitude and Behavior of the Anesthesia Team

The aim of this study was to evaluate the effect of education on the knowledge, attitude and behavior of anesthesiology staff and residents towards low-flow anesthesia. The staff and residents in the Department of Anesthesia and Reanimation, Zonguldak Karaelmas University were given theoretical and practical training in delivering low-flow anesthesia. To evaluate their attitudes and behaviors toward low-flow anesthesia, we collected data during the 6 months before training, during the first 3 months after training, and at 4–6 months after training. Anesthesia follow-up records, operation time, volatile anesthetic agent used, and the amount (in liters) of fresh gas low mid-anesthesia were recorded in all three stages. A total of 3,158 patients received general anesthesia and inhalation anesthesia was used in 3,115 of these patients. Our study group consisted of 2,752 patients who had no absolute or relative contraindications to low-flow anesthesia. While the mean fresh gas flow was 4.00 ± 0.00 L/min before training, this level dropped to 2.98 L/min in the first 3 months after training, and to 3.26 L/min in the following 3 months. The mean fresh gas flow was significantly lower at the two post-training assessments than before training (p < 0.05). In conclusion, low-flow anesthesia may be used more frequently if educational seminars are provided to anesthetists. The use of low-flow anesthesia may increase further by allocating more time to this technique in anesthesia training programs provided at regular intervals.     

Effect of sleep state on chest wall movements and gas exchange in infants with resolving bronchopulmonary dysplasia

During active sleep, neonates exhibit asynchronous chest wall movements, which have been associated with a small but significant decrease in oxygenation. To determine the effects of maturation and residual chronic lung disease on both these phenomena, we studied 11 preterm infants with resolving bronchopulmonary dysplasia (BPD) and compared these infants to ten healthy preterm infants all at time of discharge. Synchrony of chest wall (upper rib cage and abdominal) movements, sleep state, O2 saturation, and transcutaneous CO2 (TcPCO2) were recorded during both active (AS) and quiet sleep (QS). Sleep state was determined by electroencephalographic and behavioral criteria. Normal preterm infants displayed asynchronous chest wall movements only in AS, whereas, in infants with BPD, asynchrony predominated in both sleep states, although O2 saturation and TcPCO2 did not differ between sleep states in either group. The O2 saturation during AS was lower in the BPD group than in the group of normal infants (92% vs 96%; P less than 0.02), whereas TcPCO2 was higher in the BPD group unrelated to sleep state. We conclude that infants with resolving BPD exhibit asynchronous chest wall movements in both AS and QS, and that change in sleep state from QS to AS is not associated with a detrimental fall in oxygenation in these infants.     

Transformative Learning Intervention: Effect on Functional Health Literacy and Diabetes Knowledge in Older African Americans

This study evaluated the effect of a transformative learning (TL) intervention on functional health literacy and diabetes knowledge in older African Americans. Twenty participants from senior community centers completed a six-session intervention. The short-form Test of Functional Health Literacy in Adults (s-TOFHLA), Literacy Assessment for Diabetes (LAD), and Diabetes Knowledge Test (DKT) were used to perform pre- and postmeasurements. Postintervention s-TOFHLA scores and DKT scores were significantly increased (p < .5). Participants' verbal responses further affirmed the positive influence of the TL principles.     

Learning More from Microarrays: Insights from Modules and Networks

Global gene expression patterns can provide comprehensive molecular portraits of biologic diversity and complex disease states, but understanding the physiologic meaning and genetic basis of the myriad gene expression changes have been a challenge. Several new analytic strategies have now been developed to improve the interpretation of microarray data. Because genes work together in groups to carry out specific functions, defining the unit of analysis by coherent changes in biologically meaningful sets of genes, termed modules, improves our understanding of the biological processes underlying the gene expression changes. The gene module approach has been used in exploratory discovery of defective oxidative phosphorylation in diabetes mellitus and also has allowed definitive hypothesis testing on a genomic scale for the relationship between wound healing and cancer and for the oncogenic mechanism of cyclin D. To understand the genetic basis of global gene expression patterns, computational modeling of regulatory networks can highlight key regulators of the gene expression changes, and many of these predictions can now be experimentally validated using global chromatin-immunoprecipitation analysis.     

益气活血复方对动脉粥样硬化家兔PAI-1及t—PA影响的实验研究

目的 观察益气活血复方对动脉粥样硬化家兔组织型纤溶酶原激活物(t-PA)、组织型纤溶酶原激活物抑制剂-1(PAI-1)及超微结构的影响.方法 40只雄性新西兰大耳白兔随机分为正常组、模型组、中药对照组、西药对照组、中药治疗组,每组8只.适应性喂养1周后,模型组、中药对照组、西药对照组、中药治疗组行颈总动脉球囊损伤术.术后正常组给予普通饲料,其他组给予高脂饲料喂养4周.实验第4周末开始分别予与益气活血复方、血脂康胶囊和辛伐他汀片,持续给药4周.在治疗前、后分别取血检测PAI-1、t-PA.8周末处死动物,取家兔左右颈总动脉,用透射电镜观察颈总动脉的超微结构.结果 4周末与正常组比较,模型组PAI-1水平持续升高,t-PA略有升高.8周末中药治疗组与模型组相比较,PAI-1水平明显下降(P<0.01),t-PA水平明显升高(P<0.01).各给药组组间PAI-1、t-PA水平无统计学意义(P>0.05);电镜水平证实益气活血中药能够改善颈内动脉的超微结构.结论 益气活血复方能促进动脉粥样硬化家兔纤溶酶原激活物的分泌,减少纤溶酶原激活物抑制物的分泌,从而增强纤溶活性,减少动脉粥样硬化的发生.     

缺血性中风运用益气活血药的规律探讨

通过对缺血性中风益气活血药的运用规律进行探讨 ,认为益气药与活血药必须协同使用 ,不可偏废 ,而且应尽可能早期使用 ,争取早日康复 ;在选药组方方面 ,必须根据气虚的脏腑归属、兼夹症及病情缓急来选择益气药 ;根据缺血性中风的不同病程阶段选用活血药 ;益气活血的用量必须根据气虚、血瘀的程度而定     

健脾益气方对慢性乙型肝炎患儿细胞免疫功能的影响

目的:观察健脾益气方对慢性乙型肝炎患儿细胞免疫功能的影响.方法:将42例服用健脾益气方治疗的慢性乙型肝炎患儿用流式细胞仪检测其治疗前后外周血T淋巴细胞亚群水平,并与健康儿童进行比较.结果:慢性乙型肝炎患儿外周血T淋巴细胞CD3 基本正常,CD4 下降,CD8 上升;治疗组患儿CD4 上升、CD8 下降、CD4 /CD8 上升,治疗前后比较差异有显著性意义(P＜0.05).结论:健脾益气方能够提高慢性乙型肝炎患儿的细胞免疫功能.     

Knowledge Retention after an Online Tutorial: A Randomized Educational Experiment among Resident Physicians

BACKGROUND  The time course of physicians’ knowledge retention after learning activities has not been well characterized. Understanding the time course of retention is critical to optimizing the reinforcement of knowledge. DESIGN  Educational follow-up experiment with knowledge retention measured at 1 of 6 randomly assigned time intervals (0–55 days) after an online tutorial covering 2 American Diabetes Association guidelines. PARTICIPANTS  Internal and family medicine residents. MEASUREMENTS  Multiple-choice knowledge tests, subject characteristics including critical appraisal skills, and learner satisfaction. RESULTS  Of 197 residents invited, 91 (46%) completed the tutorial and were randomized; of these, 87 (96%) provided complete follow-up data. Ninety-two percent of the subjects rated the tutorial as “very good” or “excellent.” Mean knowledge scores increased from 50% before the tutorial to 76% among those tested immediately afterward. Score gains were only half as great at 3–8 days and no significant retention was measurable at 55 days. The shape of the retention curve corresponded with a 1/4-power transformation of the delay interval. In multivariate analyses, critical appraisal skills and participant age were associated with greater initial learning, but no participant characteristic significantly modified the rate of decline in retention. CONCLUSIONS  Education that appears successful from immediate posttests and learner evaluations can result in knowledge that is mostly lost to recall over the ensuing days and weeks. To achieve longer-term retention, physicians should review or otherwise reinforce new learning after as little as 1 week. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users. Trial registration: NCT00470860, ClinicalTrials.gov, U.S. National Library of Medicine.