某医学院校辅导员胜任力的现状研究

目的 了解某医学院校辅导员胜任力的现状,为辅导员选拔、培训及考核提供量化的理论依据.方法 采用自编问卷,分层整群抽样方法,调查某医学院校大学生和辅导员.结果 学生性别、户籍、年级在现实辅导员评价中存在差异;年级在理想辅导员评价中存在差异;大学生对其辅导员的现实评价低于辅导员自我评价、低于理想辅导员评价,对理想辅导员的评价高于辅导员自我评价.结论 辅导员在胜任力与学生的要求还存在一定差距,辅导员应在实际工作中多关注女生、农村学生、低年级学生,同时要通过学习、培训弥补胜任力中存在的不足.     

从医学教育的特点论高校招生制度的改革——对高考成绩与医学成绩相关性的分析研究

如何选拔学生进入高等医学院校、培养有造诣前途的医学人才,成为国内外医学界、教育界十分关注的问题。目前各国正在进行招生制度的改革和入学考试的预测效度研究。①澳大利亚和西德的医学院校,他们招生几乎完全根据中学毕业成绩作为录取学生的标准;瑞典医学院校以数学、生物、化学和物理学的平均评分分数作为录取学生的主要依据;②波兰改革招生办法是以高考成绩     

基于学生视角的应用型医学院校软环境现状与分析

为了解医药专业学生对应用型医学院校软环境的评价并探讨应对策略,选择牡丹江医学院校医药相关专业学生,采用高校软环境评价量表进行问卷调查.结果显示,学生对高校软环境评价总分处于较高水平;不同专业、不同年级、对高校软环境评价差异均有统计学意义.学校应该进一步提高学校软实力,优化学校软环境.     

临床医学硕士研究生分类招生制度改革与实践

对内蒙古地区高等医学院校2017～2019年的临床医学研究生分类录取人数情况进行统计回顾,并对实践教学现状情况进行调研,分析问题的根源,结合当前我国医学院校的特点,深入挖掘直接影响医学院校临床医学人才选拔工作质量的重要核心性因素.随着我国医学院校对于研究生人才培养和教育工作的深化和改革,对于临床医学科学学位和专业学位硕士研究生的招生,科学完善的临床医学硕士研究生分类招生改革制度对于针对性地选拔出更多优秀的科研型技术人才及专业型技术人才意义重大.     

昆明医科大学临床医学毕业生职业胜任力现状调查报告

目的了解近5 a来昆明医科大学临床医学毕业生岗位胜任力现状,为医学院校的医学生培养提供重要参考.方法采用模糊综合评价法对云南省级、市级及地州的26家医院的相关管理部门负责人问卷结果进行系统分析.结果近5 a来昆明医科大学临床医学专业毕业生职业胜任力为"良好".其中,毕业生核心胜任力分数最低,岗位胜任力分数最高.结论应从加强医学生医患沟通能力的培养、加强临床实习的质量评价等方面加强学生核心胜任力的培养.     

美国医学院校课程评价现状及趋势

目前我国医学院校正在进行全方位的教学改革,但如何对改革课程进行评价,在我国医学教育界还是一个较为薄弱的环节.为了帮助我国医学院校更好地开展课程评价工作,本文通过美国哈佛等医学院校的课程评价,全面系统地阐述了目前美国医学院校课程评价的现状及趋势,以期对我国医学院校的课程评价和课程改革起到推动作用.     

浅谈临床前期学生道德逻辑思维能力教育的重要性

将道德逻辑思维的水平和质量与医生各种客观临床手段相关联 ,有助于对这一基本伦理问题的思考 ,也是医学院校在考虑选拔学生和实习学生临床实习结束时 ,是否要对其道德逻辑思维能力进行评估操作的重要依据     

外语教师如何在教学过程中对学生进行形成性评价

课程标准的最大特色是采用形成性评价和终结性评价相结合的方式,以形成性评价为主,重点评价学生掌握知识和技能的程度,评价学生的情感态度、价值观和形成过程.提起教学评价,很多人就会想到考试、分数和名次等,有些教师也往往认为教学评价就是考试,考试就是分析分数,分析分数就是分数排队.实际上,这种对教学评价的简单认识是不妥当的.教学评价不等于测试,即使是测试也不限于终结性测试.传统的评价体系过分注重学习成绩的评价,而且评价方法单一.本文浅析了一些在教学过程中对学生进行形成性评价的方法,以期对学生进行全面客观的评价,从而促进教学活动.     

中美医学院校文化能力教育的比较研究

目的 探讨中美医学院校文化能力教育存在的差异,为我国医学院校的文化能力教育提供科学依据.方法 采用美国医学院校协会开发的“文化能力培养评价工具”(Tool for Assessing Cultural Competence Training,TACCT)对国内某医学院附属医院临床实习学生及新人院的住院医师进行问卷调查,并与美国同类调查结果进行对比分析.结果 中美医学院校文化能力教育存在显著差异;我国医学研究生教育在文化能力方面的培养优于本科生教育;中美学生对于设置不足的课程内容认定基本一致.结论 采用TACCT比较中美医学院校的文化能力教育能够在一定程度上反映出两国教育的差异,为优化我国医学院校文化能力课程设置提供一定的参考.     

关于医学院校应届毕业生统一考试若干问题的认识

卫生部连续两年组织了部分高等医学院校医学专业应届毕业生统一考试,在此前后,各省、市、自治区亦举办了中等卫生学校应届毕业生统一考试。国家用统一考试形式对毕业生进行验收,为人才的使用和选拔提供科学依据;用统考形式及时掌握学生的知识结构和能力状况,以便适时调整和改进人才培养工作;用统考形式检验各医学院校的教学效果,衡量和评价各院校的教学质量,并通过比较,促进教学研究,提高教学质量,开创医学教育的新局面,无疑是有重大意义的。但是,统考是一项复杂的工作,有许多因素影响和决定统考的成败。本文拟就目前大、中专医学院校应届毕业生统一考试的若干问题进行分析。     

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.