多媒体技术在村医大学生农村卫生管理与法规课程教学中的应用

农村卫生工作是我国医疗卫生事业的重点,关系到保护农村生产力、振兴农村经济、维护农村社会发展和稳定的大局.本文分析了"村医大学生"的特点,并针对这些特点探讨了在农村卫生管理与法规课程教学中多媒体技术的应用,培养他们熟悉农村卫生管理与法规和依法行医,为建设社会主义新农村服务.     

多媒体技术在村医大学生农村卫生管理与法规课程教学中的应用

农村卫生工作是我国医疗卫生事业的重点,关系到保护农村生产力、振兴农村经济、维护农村社会发展和稳定的大局.本文分析了"村医大学生"的特点,并针对这些特点探讨了在农村卫生管理与法规课程教学中多媒体技术的应用,培养他们熟悉农村卫生管理与法规和依法行医,为建设社会主义新农村服务.     

首都农村医药卫生人才培养的思考

农村卫生工作直接关系到农民群众的身体健康，关系到农村经济的发展和社会的稳定。本文对首都农村医药卫生人才的现状及存在的主要问题进行了分析，指出高素质医药卫生人才的匮乏是制约农村卫生工作发展的主要因素，并在对农村医药卫生人才的现状及培养等方面的研究概况进行综述和分析的基础上，从教育条件建设、学历教育模式及毕业后教育和继续教育模式等几个方面探索了首都农村医药卫生人才培养的新思路。     

中职农村医学专业发展前景探究

农村始终是我国卫生工作的重点,农村医疗卫生工作关系到农民群众的身体健康、农村经济的发展和社会的稳定,而目前农村卫生人才不足已成为制约农村卫生事业发展的瓶颈.为解决农村卫生工作人员不足的问题,农村医学专业应运而生.该专业的设置与社会需求相适应,但其发展前景如何？笔者采用文献资料法做了初步探究.     

首都农村医学人才培养体系建设与农村医学人才培养的研究与实践——第六届高等教育国家级教学成果特等奖

农村卫生工作直接关系到农民群众的身体健康,关系到农村经济的发展和社会的稳定。本文针对首都农村医学人才匮乏的现状,以培养合格的农村医学人才为目标,对农村医学人才培养的研究与实践进行了探索,以全新的理念、全新的视角,研究并实际构建了农村医学人才的培养基地、教师队伍、教育教学模式和培养机制,形成了一个富有创新性、适合国情、可持续发展的农村医学人才培养体系。     

首都农村医学人才培养体系建设与农村医学人才培养的研究与实践——第六届高等教育国家级教学成果特等奖

农村卫生工作直接关系到农民群众的身体健康,关系到农村经济的发展和社会的稳定。本文针对首都农村医学人才匮乏的现状,以培养合格的农村医学人才为目标,对农村医学人才培养的研究与实践进行了探索,以全新的理念、全新的视角,研究并实际构建了农村医学人才的培养基地、教师队伍、教育教学模式和培养机制,形成了一个富有创新性、适合国情、可持续发展的农村医学人才培养体系。     

培养医学专科人才服务农村卫生事业

医学专科人才是农村卫生工作的主力军，加强医学专科人才培养关系到广大农民群众的身心健康、关系到农村生产力的提高、关系到社会主义新农村建设的成败。要抓住机遇，不断完善政策体系和人才培养模式，加大人才培养力度，服务社会主义新农村建设。     

加强高职卫生人才培养 适应新型农村合作医疗

医学高职高专人才是农村医疗卫生工作的主力军,加强高职卫生技术人才培养关系到广大农民群众的切身利益及身心健康,关系到新型农村合作医疗制度建设的成效,是保障农村卫生工作健康、可持续发展的关键。要抓住机遇,不断完善政策体系和人才培养模式,加大力度为农村基层培养合格的应用型卫生技术人才。作为培养卫生人才的高职院校,如何把握机遇,迎接挑战,为农村基层输送合格的卫生技术人才,成为当前高职院校教育、教学改革中亟待解决的重大课题。     

农村卫生人才培养模式的理论构建与实践探索

为了加强基层卫生人才培养和队伍建设,我国正在实施农村订单定向免费医学教育.赣南医学院在探索实践农村卫生人才订单式培养模式的基础上,构建了农村卫生人才“3.5＋1.5”定向培养模式,完善了“3.5＋1.5”定向培养模式的课程体系,为提高农村订单定向免费医学教育质量提供了重要的保障.     

河北省乡镇卫生院存在的问题与发展对策

农村卫生状况和农民健康水平直接关系到经济与社会发展目标的实现．关系到民族的振兴和社会的稳定，而农村乡镇卫生院的建设则是改善农村卫生状况，提高全体农民健康水平的关键。提高农村卫生水平，加强农村卫生工作，增强农村医疗卫生服务能力，让农民摆脱疾病困扰，同心协力奔小康，是全社会共同的责任。从农村乡镇卫生院的地位、作用和历史发展趋势来看，加快乡镇卫生院建设与发展，既是时代发展的要求，也是广大农民的愿望。     

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.