面向计算思维的医学院校计算机课程教学法的应用研究

为满足学生计算思维能力培养的需求,根据计算学科对医疗人员重要的影响,采用小规模限制性在线课程(Small Private Online Course,SPOC)的优质网络教学资源与以学生为中心的翻转课堂优势教学相结合的教学法。针对医学院校计算机课程的教学现状和存在的问题,阐明制订以计算思维能力培养为导向的教学目标的重要性。借鉴SPOC与翻转课堂优质教学方法,提出面向计算思维的SPOC翻转课堂教学法在医学院校计算机基础课程中的应用研究,阐述具体的教学措施策略,培养出具备计算机思维和技能的医学人才。     

翻转课堂引入断面解剖学教学的作用机制与可行性探讨

翻转课堂是信息技术高度发展与传统课堂现实困境、学生个性化学习需求相结合的一场课堂革命。本文仔细追溯了翻转课堂产生与发展的背景,全面分析了断面解剖学的课程特点、教学现状以及新时代大学生的个性特征,多途径探讨了翻转课堂引入断面解剖学教学的作用及其机制;在此基础上,笔者认为断面解剖学课程十分适宜开展翻转式教学。     

儿科学网络在线课程结合翻转课堂的混合式教学模式建设

混合式教学已经成为当今高等教育教学信息化改革的重要内容,其中,儿科学网络在线课程结合翻转课堂的混合式教学模式课是以网络在线课程、翻转课堂以及在线交流平台为核心内容,通过网络课堂教学结合线上作业、测验、讨论和考试,最大程度调动学生的学习积极性以达到最优化的课程效果。本文重点介绍了复旦大学《儿科学》网络在线课程结合翻转课堂的混合式教学模式的建设情况及成效。     

翻转课堂应用于医学遗传学的实践与思考

【】 翻转课堂作为一种新的教学模式为医学遗传学教与学的发展提供了新的思路。本文对翻转课堂应用于大学医学遗传学教学的可行性进行分析,提出总体思路、可行方案,并在大一《医学遗传学》课程教学中实施和应用,最后对翻转课堂教学效果进行分析和总结。指出翻转课堂改善了学生被动学习的状态,是提升教学效果和调动学生学习积极性的有效方法。     

以Java语言为基础优化医学院校计算机类选修课的改革探索

医学院校以C语言为基础的计算机选修课程面临诸多问题：一方面,C语言与后续课程衔接差,与专业课程结合程度低,导致学生选修兴致不高,选修人数少;另一方面,计算机类选修课程多而杂,不但连续性差,而且占用课时多,亟待组合优化。提出以Java语言为基础选修课,优化组合不同计算机基础选修课的思想和实现方案。不但优化组合了不同选修课程,压缩了课时,提高了学生的选修兴趣;而且结合医学专业特点,增加了课程的实用性和可扩展性。     

设置教学目标对翻转课堂秩序的影响

翻转课堂,是指在信息化教学环境下,课程教学工作人员提供以教育教学视频为主的学习资源,学生们在课前对这些学习资源进行学习,教师和学生在课堂上共同完成作业答疑、学生相互协作探索研究和交流等活动的一种新颖的教学模式[1-2]。有些学者认为教学视频并不能作为翻转课堂的核心,对传统教育教学流程的颠覆[1-3]以及立足于“以学生为中心”的思索才是翻转课堂的真正含义,翻转课堂的成功主要得益于探索性的研究学习和课程项目的预习带来的主动学习的态度[1,4]。     

五年制高职C语言教学改革初探

C语言是五年制高职计算机专业的一门基础编程语言，也是一门核心课程，但几年来的教学实践表明，学生普通认为本门课程难以理解，对其没有兴趣，从而导致教学效果不理想。如何在C语言的教学中培养五年制高职学生的学习兴趣，对提高教学质量至关重要。本文针对这一问题提出了一些C语言教学的改革措施，以提高学生的学习兴趣。     

翻转课堂在高校计算机公修课教学中的应用研究——以《多媒体设计》课程教学为例

在对翻转课堂教学模式介绍的同时,以新乡医学院开设的《多媒体设计》网络课程为例,分析了网络课程教学中遇到的问题;在此基础上提出翻转课堂教学设计模型,并在《多媒体设计》课程教学中实施和应用,最后对翻转课堂教学效果进行分析和总结;指出通过翻转课堂改进单一的网络教学模式,以寻找传统教学和网络教学的最佳结合点,是提升高校计算机公修课教学水平的一种有效方法。     

翻转课堂教学模式在住院医师规范化培训心电图教学中的应用

目的:探索翻转课堂教学法在住院医师规范化培训(简称住培)心电图教学中的应用价值。方法:60名我院参加住培的学生随机分成两组(每组30人):翻转课堂组和传统课堂组。分别于课程结束后1周和6个月考核学生的心电图读图技能,并问卷调查学生对翻转课堂的满意度及其心电图学习投入时间。结果:传统课堂组和翻转课堂组6个月测试时学生得分均低于1周测试时(P<0.05),但传统课堂组学生得分下降幅度高于翻转课堂组(P<0.05)。翻转课堂组学生课前预习阶段、课后远期学习花费时间均长于传统课堂组学生(P<0.05),而课后1周内两组学生复习时间差异无统计学意义(P>0.05),与传统课堂教学比较,翻转课堂教学并不提高课程后1周成绩,却显著减少了6月后的成绩的下降度,显著延长了课前预习和课程后远期学习时间。学生对翻转课堂教学方法持积极正面态度。结论:翻转课堂可以提高住培医师远期的心电图判读技能,促进学生自我学习心电图的兴趣和积极性。     

基于人体解剖学微课程的翻转课堂教学研究

微课程和翻转课堂是近年来发展较快的新型教学形式,文中把微课程和翻转课堂结合在了一起,从概念入手,介绍了基于人体解剖学微课程的翻转课堂框架建立、目标确定、内容选择和评价实施等,提出了一种较新的人体解剖学教学模式,以提高教学质量。     

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.