多媒体课件制作中应把握的几个问题

目前,多媒体辅助教学在大中专院校方兴未艾,多媒体课件广泛应用于各类课程教学之中。多媒体课件制作已逐渐为大多数教师所熟悉和掌握,一批具有专业特色的多媒体课件应运而生,但同时也存在一些尚待解决的问题。要真正发挥多媒体辅助教学的作用,必须从多媒体课件制作抓起,坚持效益性、创新性、整体性和多样性有机结合的原则,把握好以下几个问题。     

多媒体辅助教学在医学免疫学教学中的实践

多媒体辅助教学已成为深化教育改革、推动教育现代化的必要手段。就多媒体辅助手段在医学免疫学教学实践中的优势和存在问题、解决方法作出探讨,以期充分发挥多媒体教学的优势和作用,提高教学质量。     

交际法与多媒体辅助外语教学在商务英语课堂教学中的应用

多媒体辅助英语教学优势的列举，旨在说明多媒体辅助教学技术的应用可以有效地解决现今商务英语教与学中普遍存在的问题。作者依据交际教学法的原则，结合案例，说明如何在商务英语课堂上合理使用多媒体辅助英语教学，同时也指出多媒体在课堂教学使用中存在的一些问题。只有在商务英语教学中适时适当合理地使用多媒体辅助教学手段，才能真正培养学生在听、说、读、写方面的交际能力。     

多媒体辅助教学在卫生统计学中的应用

引进多媒体辅助手段,是卫生统计学教学模式的一次变革.总结了两年来在实施多媒体辅助教学过程中的体会,分析了多媒体辅助教学对教师和学生提出的新要求以及在实施过程中应注意协调解决好的几个问题.     

多媒体辅助教学在医科“兴趣-创新”模式中的应用初探

目的 探讨多媒体辅助教学在医科“兴趣-创新”模式的应用效果.方法 随机抽取2008级五年制临床专业学生32人为实验组,随机分为4个小组(每组8人),在外科手术学教学中应用综合多媒体辅助教学；同班其余30人为对照组沿用传统外科手术学教学,学期结束时运用双盲法对实验组与对照组进行同期测试；自行设计调查表,对实验组学生进行问卷调查.结果 对两组同学进行理论考试、实习测评及总体评分,实验组与对照组学习效果的总体评价有差异有统计学意义(P＜0.05).医科“兴趣-创新”模式教学中应用综合多媒体辅助教学对提高实验组学生的分析问题、解决问题能力、临床逻辑思维能力效果显著,总体评价良好.结论 学生在医科“兴趣-创新”模式教学中应用综合多媒体辅助教学学习中分析问题和解决问题能力有较大提高,大部分同学能适应综合多媒体辅助教学学习,其效果令人满意.     

化学多媒体辅助教学中的思考

目的探讨如何科学地、合理地选择媒体辅助教学。方法多媒体辅助教学在认识和操作上还有待实践、探索和处理好几个关系:①与传统教学方式的关系;②大容量和高效益的关系;③实验仿真和真实性的关系;④教学内容和教学重点的关系;⑤多媒体辅助教学的节奏问题。结果正确掌握和运用多媒体辅助教学,促使其在课堂教学中达到高信息、高效益的目标。     

多媒体课件在药理学教学中存在的问题

多媒体课件由于其自身的优势，成为医学基础课教学的主要辅助手段。根据实际应用中出现的问题，充分肯定多媒体课件在教学中存在优势的同时，指出在医学基础课教学中存在的问题及有效的解决方法。     

PowerPoint在中医内科护理学教学中的应用点滴

目的探讨计算机辅助《中医内科护理学》课堂教学的利弊。方法运用PowerPoint软件制作电子幻灯片，再结合联机的大屏幕投影输出设备，辅助课堂教学。结果应用计算机辅助教学可以使教学形式新颖直观，教学效果事半功倍。结论在中医临床护理课的教学中，虽然多媒体课件介入课堂教学大大地提高了教学效果，但也存在一些问题，因此需正确处理好现代教育媒体和传统教育媒体的关系。     

解剖学多媒体教学存在的问题及对策探讨

以计算机为基础的多媒体辅助教学,已经普遍应用于解剖教学活动之中.但在实际运用中,还存在很多违背认知规律的不足之处.因此,只有对多媒体辅助教学正确定位并合理应用,才能在实际教学活动中起到画龙点睛的作用.该文依据调查结果,探讨了医学生对多媒体教学手段应用的态度和意见,并对几个影响教学效果的突出问题进行分析,从而提出相应的解决方法,以寻求一条适合医学形态学知识传播的理想途径.     

中药药剂学多媒体辅助教学探微

目的：探讨中药药剂学多媒体辅助教学的应用体会。方法：结合中药药剂学专业课教学特点，分析制作中药药剂学多媒体课件的方法、在中药药剂学教学中的优势及存在问题。结果：合理制作、应用中药药剂学多媒体辅助教学，可提高教学效果，但也存在一定问题。结论：多媒体课件是教学辅助手段，制作、应用必须因材施教，合理搭配，密切联系实践，重点突出，配合多种教学手段，能真正体现它的优势。     

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.