以体验为主导的护理学专业本科生培养模式的构建

目的构建以体验为主导的护理学专业本科生培养模式,为护理教育改革提供参考依据。方法综合运用头脑风暴法、专家深度访谈法、问卷调查法、数理统计法及实证研究等,对护理学专业本科生培养模式的四大要素（培养目标、课程设置、教学方法、考核评价）进行探索。结果形成护理学专业培养目标、确定适合以体验式学习方式的课程体系、探索了适用于护理学专业特色的体验式教学方法、尝试了多种考核评价方式,最终构建了以体验为主导的护理学专业本科生培养模式。结论从人才培养模式四要素（培养目标、课程设置、教学方法、考核评价）出发,构建了以体验式学习理念为主导,以培养高素质应用型护理人才为目标,以提高护理学专业学生综合素质为核心的三阶段螺旋式上升型（认知、发展、成熟）护理学专业本科生培养模式。     

儿科护理学教师教育观念的转变

当前,护理教育改革进一步深化,以整体护理为核心的新型护理体系逐步建立.儿科护理学是高护专业一门重要的临床护理课程,儿科护理学的教师要适应教改的发展,提高临床护理教学效果,必须及时学习,更新认识,转变观念.     

浅谈《护理学基础》中护理技能训练模式的改革

《护理学基础》(下面简称《护基》)是护理专业的一门专业课。它主要介绍护理学基础的基本理论、基本知识和基本技能。本课程任务是以培养护生良好的职业素质为核心 ,在整体护理观指导下 ,使护生具有较高的护理学基本理论以及较强的护理实践技能 ,应用护理学基础知识与技术满足服务对象的基本需要。护理技术操作是《护基》课程中的重要组成部分 ,其课时量约占总课时数的一半。我院从 1998年起开始招收护理专科生 ,2 0 0 0年开始招收护理本科生 ,为不断深化高护教学改革 ,贯彻整体护理观念 ,应用护理程序 ,对《护基》中护理技能训练模式教学改…     

《儿科护理学》教学的探讨

<正>面向新世纪,培养融知识、能力、素质为一体的高质量医学人才是高等医学教育的核心和目标[1]。儿科护理学是一门研究小儿的生长发育规律、儿童保健、疾病防治和护理,以促进儿童身心健康的护理学科。由于儿科护理学的服务对象为身心处于不断发展中的小儿,他们具有不同于成人的特征[2],     

基于护理核心胜任力的《康复护理学》实践教学改革探讨

注重培养学生综合能力,强调以学生为教学活动主体的教育理念已成为目前护理院校实践教学主流。为了确保教学质量,突出康复护理学科学性、社会性、实用性的特点,我们将护理核心胜任力本位思想引入护理本科生的实践教学中进行改革,以培养学生核心胜任力为导向,采用"教师主导-学生主体"的教学模式,从教学目标、教学内容、教学方法和教学评价进行探索,并取得良好的教学效果,为今后康复护理学实践教学提供实践经验。     

儿科整体护理教学初探

整体护理已在我国各地医院推广实行 ,如何更快地培养整体护理人才 ,是每个临床教师都值得探讨的问题。我校从 1997年秋季新招护理专业即在临床各科开展整体护理教学。笔者认为上好儿科护理学中的整体护理 ,首先是儿科护理教师护理观念应转变 ;其次是优化教学方法 ,加强模拟病人、书写护理病历的教学 ;最后还应重视理论和实际相结合 ,加强临床实践工作 ,把护理程序更好地应用到实际中去     

PBL教学法与传统教学法在儿科护理学教学中的应用比较

为探讨PBL教学法在儿科护理学教学中的应用,以提高儿科护理学的教学质量,选取学院2010级1个护理专科班,在儿科护理学中的部分内容进行了PBL教学和传统教学的比较,通过单元测试和问卷调查,发现PBL教学方法有利于护理学生综合素质的提高,应该与传统教学方法有机结合起来。     

整体护理中对患儿家长的心理护理

随着医学模式的转变和护理学的发展,护理模式也由以疾病为中心的功能制护理发展到以病人为中心的整体护理。在儿科开展整体护理,就是开展以满足患儿的各种需要为目的的优质护理。以马斯洛的需要层次理论来看,人的需要分为五层:生理的需要,安全感的需要,爱和归属感的需要,尊重的     

整体护理模式下儿科护士建立良好护患关系的体会

随着世界卫生组织提出"2000年人人享有卫生保健"的全球战略目标,护理学的发展进入了"以人的健康为中心"即整体护理时代.整体护理是以病人为中心,以护理程序为指导,满足病人的需要为目标,将护理业务工作和管理工作系统化的新型模式.新时期新形势下,儿科护士如何建立良好的护患关系,有如下的经验及护理体会:     

护理程序在产科中的应用

随着医学模式的转变和护理学的发展,开展“以整体人的健康为中心的整体护理”已成为当前护理学发展的趋势。我们应用护理程序[1]来安排产科护理工作,对每一位孕妇进行护理评估,确立护理诊断,制定护理计划单,实施护理措     

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.