局部解剖学实验课教学进行科研小论文撰写训练的尝试

目的提高学生对局部解剖学实验课的学习兴趣及动手能力并培养学生初步的科研能力。方法在局部解剖学实验课上,根据辅导教师所拟与临床相关的命题,学生对所有标本进行局部解剖测量并在教师的指导下查阅文献,完成科研论文的撰写。结果学生对论文撰写整个训练过程兴趣浓厚,态度严谨,论文完成情况良好。结论科研小论文的撰写训练是培养学生的科研能力及提高局部解剖学实验课教学质量的有效途径之一。     

临床医学五年制解剖学实验课的改革与实践

为了培养学生的动手能力、分析问题和解决问题的能力，我们对临床医学五年制解剖学实验课教学大纲、教学计划、教学内容及教学方法进行较系统改革，使解剖学实验课形成一门独立的解剖学实践技能课。系统解剖学理论课集中在多媒体教室讲授，观察实物标本的实验课有所压缩；局部解剖学理论课在具有多媒体的解剖学大实验室讲授并有所压缩，局部解剖学实验课过去观察实物标本改为局部解剖实验操作课并增加学时，学生分组操作总结后由教师进行小结。操作强调课前预习，课后要求写出实验报告。如有变异在老师指导下用数码相机拍摄下来，利用多媒体让学生自己报告并让学生都来观察。实验效果初步证明，实验课教学改革可以巩固前面的系统解剖学理论课和实物标本观察课，有利于培养学生动手能力、思维能力、综合分析能力及解决问题的能力，有利于调动学生的学习积极性。     

提高中医专业学生论文撰写能力的教学改革初探

针对目前中医学类专业学生本科期间科研论文撰写能力欠缺的现状,通过对中医学本科生迫切需要提高论文撰写能力的必要性做出分析,并提出将科研思维及撰写论文的能力培训进行前置的教学改革对策.具体做法为设置并培训专职的论文撰写教师,将中医药论文撰写相关培训正式纳入中医学类本科期间选修课,通过科学安排课时,以论文设计、撰写、投稿、修稿技巧以及相关信息为授课内容,并对学生进行相应的课外训练,使得中医学类本科生能够尽早熟悉和初步掌握科研论文的基本格式和撰写过程,避免论文撰写的盲目性,在锻炼其文字归纳与逻辑推理能力的同时,促进学生在本科期间科研思维的形成,为中医药人才的培养提供一定的帮助.     

局部解剖学实验课教学改革的几点体会

作者根据多年教授局部解剖学实验课的教学经验,结合医学院校学生和局部解剖学教学的特点,在如何能更好地引导医学生理解和把握局部解剖学的人体各分区的正常形态结构特征,位置毗邻,层次关系及其临床意义上,在如何培养医学生独立获得知识、独立解决问题和提高科研兴趣、自主学习与动手的能力上,做了一些实验课的教学改革,带动了学生们的学习积极性,收到了很好的教学效果,教师们也从实践中获取了宝贵的教学经验。     

构建当代医学生科研素质的培养体系

上海医学院注重培育医学生的创新能力和科研素质,通过创建激励和保障机制,构建了以“全程导师制一课程体系改革一科创平台开放”三位一体的当代医学生科研素质培养体系。2002年-2008年,学生完成自行设计实验及撰写相应论文265篇、综述36篇。2003年以来,医学院90％以上学生参加过各种科研能力训练活动,其中158名优秀学生获得了各种科创项目的立项支持,近5年在国内外医学学术刊物上发表论文和综述90篇。上海医学院的教师也积极参与研究相关课题,撰写并发表相关论文52篇。     

七年制医学生科研能力的训练途径

科研能力的训练是七年制培养目标的主要内容之一。上海第二医科大学在七年制学生培养中，与复旦大学建立合作教学，使学生打下良好的理科基础和具有一定的科学实验素等；装理科、医科基础和临床实习分两轮进进教学，为完成学位论文打下扎实基础；实行基础教学、临床医学课程及课题三段式导师制，强化科研能力训练。同时，加强学位论文的选题、开题和答辩工作。由于把科研能力训练贯穿在全过程，保证了七年制的培养质量。     

273名本科护生科研能力的培养

①目的探讨招生规模扩大条件下提高护理本科生科研能力的方法。②方法对我系1999~2000级两届护理本科生,通过改进课程设置,成立学生科研小组,毕业科研训练等方式,改革本科护生科研能力培养方法。③结果学生毕业前独立完成了选题、科研设计及毕业论文撰写,且都包含了统计学处理。④结论科研小组和导师制对提高护理本科生的科研能力有效可行。     

学生实验报告中存在问题的剖析

实验课不单是对前人劳动的简单重复 ,它是高校学生进行科学实验基本训练的必修课。撰写合格的实验报告是学生应当具备的科学实验能力之一 ,也是实验课所应承担的具体的培养训练任务之一。　　撰写实验报告主要是训练学生的综合思维能力和文字表达能力 ,学生现在在实验课中练习写实验报告 ,就是他们以后在科学研究和工作实践中撰写研究成果报告或科学论文的模拟训练。这种能力的高低直接影响到学生毕业以后在科学实践中的具体工作能力。在实验课中不能写出合格的实验报告 ,甚至报着应付态度 ,这既影响了实验课的教学效果 ,同时也失去了对学生…     

医学生习作论文撰写指导初探

医学生习作论文撰写指导初探马昶云，李建美，尹雪艳，李永萍，杨永林，和虹，何泉（云南大理医学院６７１０００）科研能力培养及论文撰写，是当代大学生应具备的基本功。近年来我们在临床医学专业本科的教学中安排了论文撰写课，重点讲授个案报告书写问题，并要求学生在...     

本科生科研训练新模式的探索和思考——以哈尔滨医科大学药学院为例

哈尔滨医科大学药学院十分重视本科生科研训练。从2011年开始,药学院以本科生综述论文大赛活动为平台,开展本科生科研训练活动,鼓励学生进入科研课题组,接触第一线科研,并通过学习科研设计和撰写综述论文等科研训练过程,开拓本科生科研思维、培养创新能力、提高综合素质。经过三年的探索,药学院已初步建立起一个本科生科研训练的新模式。     

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.