以问题为基础学习教学方法在口腔正畸学教学中的应用与思考

目的 探讨以问题为基础学习(problem-based learning,PBL)教学方法在八年制口腔医学专业口腔正畸学教学中的应用效果.方法 选取北京大学2003级八年制口腔医学专业41名学生作为研究对象,以八年制口腔正畸学课程教学大纲为标准,对常见错(牙合)畸形的矫治章节内容实施PBL教学.课程结束后,采用调查问卷方式收集、分析学生对PBL教学方法及教学效果的反馈评价,并组织授课教师进行交流.结果 大部分学生能够明确PBL教学的目的,认为PBL教学方法有助于考试成绩的提高,在自学能力、语言表达能力的培养上起到了促进作用.结论 PBL教学方法适合口腔正畸学教学,但需要因地制宜地应用,使教师与学生都能够在参与的过程中得到发展和提高.     

PBL教学法在口腔正畸研究生教学中的应用

目的:探讨PBL教学法对口腔正畸学研究生教学的影响。方法:将14名口腔正畸学硕士研究生随机分成2组,每组7名,分别接受传统讲授式教学法(A组)、PBL教学法(B组)。采取主观问卷调查和客观试卷答题两种方式评价两种教学方式的教学效果。结果:PBL教学法组各项指标均优于传统教学法组。结论:PBL教学法能够显著提高教学效果,值得在研究生教学中进一步推广。     

案例教学法在口腔正畸学教学中的应用效果

目的：探讨案例教学法在口腔正畸学教学中的应用效果。方法：将113名口腔本科学生分为实验组（55名）和对照组（58名）。对照组采用传统教学法,实验组采用案例教学法,课程结束后评价教学效果。结果：实验组学生考核成绩优于对照组（P〈0.05）。结论：采用案例教学法进行口腔正畸学教学有利于学生沟通能力、临床实际应对能力的培养,并解决了教学与临床实际脱节的问题。     

口腔正畸实验课教学的改革

口腔正畸实验课是口腔正畸学教学中的一个重要环节。本课程要求通过学生自己动手的训练 ,掌握本专业的基本知识、基本原理和基本技能。为了达到这一目的 ,近三年来 ,我们对口腔正畸实验课教学内容进行了大胆的改革 ,并与以往的教学方法进行了对照研究。结果表明 ,新的实验课教学法能够提高教学质量和学生们的学习积极性。1　方法和步骤以大连医科大学口腔系 91、 92、 93级学生为对象 ,分成两组 ,Ⅰ组采用旧的正畸实验课实习指导。人数分别为 91级 14人 ,92级 16人 ,93级 16人 ;Ⅱ组采用新的实验课实习指导。人数分别为91级 15人 ,92级 17人…     

翻转课堂结合案例教学在口腔正畸学本科教育中的实践探索

目的：探讨翻转课堂结合以案例为基础的教学法(case-based learning, CBL)的教学效果。方法：选取我校58名学生作为研究对象,实验组采用翻转课堂结合案例教学方法,对照组使用传统教学法,采用多元评价体系评估两种教学方法的效果。结果：实验组学生随堂考试成绩高于对照组(P<0.01)。问卷调查显示实验组对翻转课堂结合案例教学方法效果评价较好,有助于学生掌握口腔正畸学的理论知识,培养自主学习能力,团队协作和创新精神。结论：翻转课堂结合案例教学在口腔正畸学本科教育中可以取得较好的教学效果,为进一步促进口腔医学本科教学改革提供了理论依据。     

PBL结合Typdont模拟合架在口腔正畸本科生教学中的应用

目的:探讨PBL结合Typdont模拟合架复合教学法对口腔正畸学本科生教学的影响。方法:将120名学生随机分成3组,每组40名,分别接受传统讲授式教学法(A组)、PBL教学法(B组)和PBL结合Typdont复合教学法(C组)。采取主观问卷调查和客观试卷答题两种方式评价三种教学方式的教学效果。结果:复合教学法组各项指标上均优于其他两组。结论:PBL结合Typdont模拟合架复合教学法能够显著提高教学效果,值得进一步推广。     

“互联网+教育”下虚拟仿真实验技术在口腔正畸学教学中的应用

目的：打破传统正畸课堂教学的时空限制,发挥学生的主观能动性,加深学生对正畸理论知识的理解,将虚拟仿真诊疗实验结合到口腔正畸学的教学中,并探讨其教学效果。方法：引入真实病例开发突面型虚拟仿真诊疗实验,构建口腔正畸学的虚拟仿真实验教学平台,选取温州医科大学2017级口腔医学专业的学生为研究对象,1班学生为实验组,结合虚拟仿真诊疗实验,2班学生为对照组,未结合虚拟仿真诊疗实验。从应用效果反馈和学生知识能力评估教学效果。结果：虚拟仿真诊疗实验在口腔正畸学的教学中应用后,实验组学生期终考试成绩（88.87±4.58）分,高于对照组的（85.46±4.37）分,差异有统计学意义（P =0.002）,教学反馈显示实验组对虚拟仿真诊疗实验的认可度较高,自觉对知识的理解更加透彻,开始建立正确的正畸设计思路。结论：将虚拟仿真诊疗实验结合到口腔正畸学的教学中使教学过程更加直观形象,能加深学生对正畸理论知识的理解,提高学生的临床诊疗思维及操作能力,通过网络反馈平台和网络作业评价使教师及时掌握学生的学习水平及存在的问题,更好地答疑解疑,切实提高口腔正畸学教学水平。     

PBL在口腔正畸本科生教学中的应用

目的：通过在口腔正畸学本科教学中实验性应用PBL教学方式,提高教学效果。方法：首先设计PBL教案,提出相关问题。该教案分3次执行,每次间隔一周,每次约3小时。学生由带教老师带领进行分组讨论,完成教学内容。在学生全部口腔正畸学理论教学完成后,进行问卷调查,比较学生对PBL教学和传统教学方法的评价。结果：通过实施PBL教学,89．8％的学生认为能够更加深刻理解理论内容,91．8％的认为能够掌握理论知识更加牢固并且发现教科书知识不足以解决临床问题,86．7％的认为提高了学习的主动性和趣味性。81．6％的学生希望在教学中加大PBL教学力度．75．5％的更喜欢PBL教学。结论：PBL教学可以改善理论教学的效果,可以在口腔正畸学教学中逐渐加大PBL教学力度。     

口腔正畸学进修教学总结与分析

采用问卷调查的方法,对北京大学口腔医学院正畸科1996～1999年进修的25名医师进行问卷调查,以评价口腔正畸学进修教学的方式和质量.结果表明,进修教学是口腔正畸学研究生教学的重要补充,经过制订严密的教学计划,设置合理的课程,通过系统的临床前期和临床实际操作培训,能够明显提高教学质量.结论北京大学口腔医学院正畸科口腔正畸学进修教学的经验值得借鉴和推广.     

自主研发的口腔正畸X线头影测量教学软件在本科生口腔正畸教学中的应用

目的:探索基于临床实践的教学方法,开发口腔正畸X线头影测量教学软件.评价其对本科生口腔正畸教学中的效果.方法:研究教学方法,完成软件开发,应用于本科生教学实施并进行教学成效的评估.结果:新教学方法下学生头影测量定点准确性显著提高(P＜0.05).结论:本教学软件及教学方法有助于提高本科生口腔正畸头影测量教学效果,增加学...     

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.