眼视光学专业本科设置眼科显微手术学5年教学实践研究

将眼科显微手术学列为5年制眼视光学专业本科学生限修课程，通过5年教学实践研究及问卷调查表明，学生普遍认为开设该课程及时、实用，能有效地提高其专业学习兴趣，临床实习动手能力提高明显。眼视光学专业本科生开设眼科显微手术学课程，是学科发展和完善学科建设的需要，是让学生尽快适应临床工作的重要基础，具有必要性和可行性。     

眼视光学专业课程实验教学的课程建设和教学实践

眼视光是一门以保护人眼视觉健康为主要内容的医学学科,是临床医学的重要组成部分。在我国眼视光学教育起步较晚,创立于上世纪80年代,目前在我国开办眼视光学本科教育的高校仅有10余所。我校于2004年创办了5年制本科眼视光学专业,目前已进入专业课程教学阶段。为使我校的眼视光专业教育符合培养现代眼视光人才的素质教育,培养的人才能满足当代社会对应用型人才的需求,我们十分重视眼视光专业的课程建设,尤其在实验教学方面进行了一系列的探索和实践。1精心设置实验课程,突出专业特点1·1合理安排教学程序:实验教学的目的是为了使学生巩固和强化所学专业知识,更重要的是为了训练学生的实践操作技能,培养学生的专业知识的整合运用能力。我系于第六学期开设眼视光学专业课程,共有9门课程。在实验教学安排上,实验课程教学与理论课程教学相对应(见表1)。第六学期学生已经上完解剖、组胚、药理等基础学科,这时我们开设《眼科学基础》作为基础课与专业课程的衔接,使学生掌握眼的结构与功能、生理、病理、药理,眼病的检查、诊断和治疗的基本方法,这样学生在原有的基础知识上学习眼科基础知识可达到事倍功半的效果,且为学习眼科临床打下良好的基础。在第七学期开设《眼科学临床...     

走向世界的温医眼视光学

１９８８年我院成立了全国第一个眼科视光学系并开设眼视光学专业，开始培养眼视光学高级医学专业人才；１９９２年，卫生部在我院建立视光学研究中心；１９９３年，眼视光学专业由专科升格为五年制本科；１９９７年，成立了眼视光学院。风雨历程整十载，艰苦创业谱新篇。...     

眼视光学硕士研究生临床眼科学Seminar教学法应用初探

努力提高眼科学的临床能力与素质是当今眼视光学硕士研究生培养的核心内容之一。作为一种西方教学范式，“seminar”教学法在学生能力、素质与创造性培养方面备受推崇。温州医学院眼视光学院创新性地将此试应用于眼视光学硕士生临床眼科学教育，在培养高质量的复合型眼视光学高级专门人才领域进行了有益探索。     

眼视光学本科课程设置专业导论课的实践和思考

分析眼视光学专业导论课程内容安排和教学模式，并总结教学经验，提出开设多元化模式的专业导论课程教学，对激发学生学习兴趣、稳定学生专业思想、明确学习目标、做好人生职业规划等有重要的导向作用。建议开放导论课程作为专业招生指导。     

眼视光学博士生设置眼科学导论课程的可行性探索

作为眼视光学人才培养的最高层次,眼视光学博士生培养质量优劣直接关乎眼视光学这一新兴边缘学科的发展未来。根据眼视光学学科特色与培养要求,立足于博士生个体差异,2009年始我们开设了眼科学导论这一全新课程,积极倡导个性化教育,收到理想效果。文章从教学内容、教学方法、教学效果评价与考核等层面对这一新课程的初步实践做一介绍。     

我国眼科视光学教育的现状与思考

从上世纪末期才刚刚起步的眼科视光学高等教育，由于充分参考了西方国家不同教育模式的优缺点，已初步创建了一个有自身特色的新型教学模式。但从整体上看，目前眼科视光学专业培养的毕业生，在数量上和质量上都与人们对眼保健的需求存在较大差距。因此，完善学生的知识结构，提高学生的临床技能，培养学生的信息化处理能力和初步的科研素养，就成了现代眼科视光学教育的重点。探索性地思考了我国眼科视光学教育的未来发展。     

眼科学国家精品课程建设的实践与思考

眼科学是临床医学专业学生医学类课程中一门专业性极强又不可或缺的课程,如何在有限的教学时数下使学生更好地掌握临床需求的眼科专业知识和技能,这成为教学工作的重心和难点。温州医学院眼视光学院眼科学是国家精品课程,围绕“教学设置统一、多教学点分布、教学资源共享”三位一体的教学模式,在国家精品课程的规范性、示范性、共享性上进行了积极的实践探索和思考,与各兄弟院校分享实践的有益经验和取得的成效。     

眼视光医学、医学影像学作为特设专业入选高校临床医学类本科专业目录

日前,教育部颁布《普通高等学校本科专业目录(2012年)》(以下简称"新目录")。其中,由我校领衔倡导的眼视光医学(100204TK)、医学影像学(100203TK)作为特设专业归属临床医学类,授予医学学位;眼视光学(101004)作为基本专业归属医学技术类,授予理学学位。眼视光学是由我校首创的新兴学科,它将传统的眼科与现代视光学相结合,形成了被国际学术界称为"中国温州模式"的现代眼视光学模式。眼视光学的人才培养模式准确把握了社会发展、人民生活水平不断提高后,对提高生活质量的需求,在二十多年的发展中,获得了广泛的认可和赞誉,其临床属性的优势不断凸显。     

借助眼视光实验教学优势和特色提高临床医学实验教学水平

温州医学院眼视光教学实验平台的特色之一在于有机融合眼科学和视光学知识,充分利用学科优势积聚各类社会资源建设教学实验平台,实现实验教学理念和方法的创新。借助特色学科的教学实验平台优势,带动临床医学专业眼科学实验教学的进步,对医学实验教学改革和创新做出了积极的示范。以面向临床医学专业学生开设眼科学实验教学情况为例,提出如何借助优势学科的特色和特点,推进临床实验教学理念转变和教学水平的提高。     

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.