预防医学专业本科实验教学改革探讨

目的:对预防医学专业本科实验教学进行改革,提高实验教学质量。方法:把预防医学各专业课程的实验课内容整合为一门《预防医学实验教程》独立设置,在实验教材、教学内容、教学方法、实验考核模式及加强实验室管理等方面进行了改革。结果:通过对预防医学专业本科实验教学改革,提高了学生的创新意识及综合实验能力。结论:实验整合对实验教学具有促进作用,有利于预防医学专业创新人才的培养。     

在住院医师规培中加强辅助生殖技术教学与生殖医学人才培养

近年来,住院医师规培学员的培养已成为热点关注问题,而生殖医学专业人才的培养更成为重中之重。辅助生殖技术教学仍存在一定的问题,如专业师资队伍不健全、专业化系统培训不充分、教学方式陈旧老套等。在住院医师规培中加强辅助生殖技术教学能够很好地解决上述问题,从而强化生殖医学人才的培养,最终培养出高素质的生殖医学专业人才。     

关于预防医学实验教学改革的几点思考

目前我国的预防医学教育改革虽已取得了显著成就,为２１世纪医学事业的振兴奠定了坚实基础,但发展水平及人才培养模式尚不能适应现代化建设的需要。为此,我们对我院预防医学实验教学的改革进行了探讨。１　预防医学实验教学工作存在的问题１．１　对实验课教学重视不够,实验室人员培养不足。长期以来,受传统观念的影响,我国的医学教育比较重视疾病治疗而忽视预防医学,预防医学的实验教学及实践工作就更加不受重视。我院的预防医学实验课教学分为临床医学专业的《卫生学》和预防医学专业的各门专业课,工作繁重。预防医学专业成立后师…     

担任生殖医学专业临床带教工作的体会

生殖医学是21世纪最具发展前景的学科,我国对生殖医学专业人员的需求数量庞大,并逐年递增。加强生殖医学专业教育人才的培养,是解决我国生殖医学人才缺乏问题的重要环节之一。担任生殖医学临床教学的教师要不断加强学习,与国内外科研前沿结合,采用多样化的教学方式,从而激发学生的学习兴趣;并充分利用临床病案,进行互动式教学,在提高临床手术技能的同时,加强科研能力的培养。同时,还应注重加强医学生的人文素质教育,提高医学生修养,以培养高素质的生殖医学专业人才。     

关于医学高职生理实验课的新设计

实验教学是教学体系的重要组成部分，是培养学生创新素质的重要环节，是培养实用型人才的重要途径。随着医学高职教育的改革不断深入，医学高职教学培养目标、教学任务的确立，传统的生理实验教学内容方法和手段已不适应。因此，需在生理实验教学中对高职医学专业的实验课程进行了重新定位和设计。     

预防医学实验中心建设思路及实践

预防医学是实践性很强的应用学科,实验教学是培养预防医学专业能力的重要途径,我校预防医学实验教学现况难以达到培养现代卫生防病人才的要求。通过加强病因检测综合实验室建设,完善生物学效应检测实验室,建立社区为基础的开放式预防医学实验教学平台,不断完善我院预防医学实验中心实验室建设。通过实验中心的建设,为培养学生的实验操作技能和创新能力,也为逐步提高教师的实验教学水平提供更好的平台。     

预防医学专业医学统计学实验室规范化管理与应用

结合预防医学专业医学统计学实验室规范化管理及应用状况,从有效发挥实验室在预防医学专业实验教学中的作用、提高教学效率、增强教学效果、拓宽学生视野、提高学生学习兴趣等方面进行分析及论述。     

设计性实验在环境卫生学实验教学中的探索与实践

环境卫生学是预防医学专业的主干专业课,通过对实验教学中设计性实验教学改革情况的总结,发现了实施过程中存在的问题及一些注意事项,确定了今后改进的方向,进一步明确设计性实验是培养创新型医学人才的一个可行的教学手段。     

以课题形式替代预防医学专业课程部分实验教学的研究

为了培养应用型预防医学人才,提高学生的创新能力以及分析问题、解决问题的能力,长沙医学院在2006级本科预防医学专业实施了以课题形式替代主要专业课程部分实验教学的改革.本文介绍了教学改革的实施情况,包括修订预防医学专业人才培养计划,改革传统的实验教学模式,在达到各课程教学大纲要求的前提下,适当减少理论课授课的学时数,增加综合性、创新性实验环节的实践教学,即以课题形式替代预防医学专业课程部分实验教学.教学改革取得了较好的效果,提高了学生的综合分析问题、解决实际问题的能力,培养了学生的创新意识和初步的科研能力.     

医学机能学虚拟实验室的构建与应用

医学机能学实验教学是培养医学生实践能力的重要课程,目前存在着教学方法单一、教学手段落后等问题。针对传统实验教学模式的弊端,进行实验教学改革,探索建立、应用数字化医学机能学虚拟实验室,与传统实验室有机整合,丰富实验教学手段,提高教学质量,更好的培养学生实践能力、创新精神和科研兴趣。     

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.