模拟法庭在卫生法教学中的应用

卫生法教学在学生实务能力培养方面存在不足,模拟法庭教学法对此具有明显优势,引入该方法也具备可行性。卫生法学课程可以从课程开设模式、教学案例的选择、教学方法的运用和评价体系的确立四个方面着手,构建一套引入模拟法庭教学法的具体方案。     

任务驱动法在卫生法教学中的应用

任务驱动是实施探究式教学模式的一种教学方法.目前在计算机课程的教学中被普遍采用.对任务驱动教学法在卫生法教学中的应用进行初步的探索,有利于构建教学情境,营造宽松的学习环境,激发学生的学习兴趣,能够充分调动学生的学习主动性、创造性.     

论卫生法教学中的案例教学法

案例教学法是英美法系国家广泛使用的一种法学教学方法,其注重培养学生对知识的运用能力。卫生法学是医学与法学融合的新兴交叉学科,在卫生法教学中借鉴和运用案例教学法有其自身的特性。本文就卫生法教学中教学案例的选择、案例的合理运用、案例教学的中误区作了初步的探讨。     

模拟情景教学法在内外科护理学实践教学中的应用

目的 了解模拟情景教学法在内外科护理学实践教学中的应用效果,为教学方法的改革提供依据.方法 在实施内外科护理学模拟情景实践教学后,以整群抽样法抽取某职业技术学院2005级高职护生4个班共194人,发放调查问卷,调查模拟情景教学法与单项操作练习法激发学习兴趣等19项内容.对教师进行教学方法的改进意见等方面的访谈.结果 调查发现,在激发学习兴趣、认识到知识不足、促进学科知识的联贯、促进综合素质的提高等方面,模拟情景教学法与单项操作练习法比较均有统计学意义(P＜0.05).结论 模拟情景教学法有助于护生整体护理观念、团队能力、创新及实践能力的培养,提高学习兴趣.在内外科护理学模拟情景实践教学中,应加强应急能力的训练.     

目标与情景联合教学法在急诊护理带教中的应用

目的 探讨目标与情景模拟联合教学法在临床护理教学中的应用效果.方法 采用目标与情景模拟联合式教学法,引用目标教学流程实施急诊临床实习教学管理,急诊目标教学流程依次为人科教育、入班提问、出班检查、带教教学、专科指导、教学训练、出科考核.操作能力及情景教学相结合.结果 学生的理论及操作成绩明显提高.结论 目标与情景模拟联合教学法能提高护生临床思维能力及分析解决问题等综合能力,锻炼了实践操作技能,激发了护生的主观能动性,提高了护生综合素质和学习效果.     

多种教学法在七年制医学生内科见习中的实践与探索

内科学是一门重视实践过程的学科.在医学七年制学生见习中,针对具体教学内容进行归类,选取PBL教学法、小组讨论式教学法、EBM教学法或模拟教学法等方式,给学生营造活泼的教学氛囤,提高他们在教学过程中主动参与和积极思考的意识,取得良好的教学效果.多种教学法的选择实施利于培养具有独立思维和实践能力的高素质人才.     

卫生法学教学中应注意的几个问题

卫生法学是以卫生法作为研究对象，主要研究卫生法的产生和发展，卫生法的渊源、本质，卫生法的范畴、内容；卫生法的表现形式和作用，卫生法的实施和诉讼，卫生法在国家法律体系中的地位，以及与其他部门法的相互关系等等。卫生法学教学现状在改革开放以来，各方面都取得了较好的成绩，但同时卫生法学教育从内容到形式、从理论到实践还存在许多问题与不足。     

“TDL-PBL-SSL”综合教学法在制药专业中试实践教学中的应用

制药专业是一门应用性学科,其教学过程应该以学生为主体,而传统教学方法采用单向传授的方式,不利于培养学生的综合能力.相比之下,任务驱动教学法、以问题为基础的教学法、情境模拟教学法均非常适合实践性较强的教学活动,但各有优缺点,不适合直接套用于制药专业中试实践教学.本着取长补短的原则,文章综合三种教学方法的优势,建立“TDL-PBL-SSL”综合教学法,探索其在制药专业中试实践教学中的应用,阐述相关设计方案和实施过程,并讨论实施“TDL-PBL-SSL”综合教学法的合理性、必要性和迫切性.     

PBL联合情景模拟教学法在妇产科护士规范化培训教学中的应用

目的：探讨PBL联合情景模拟教学法在妇产科护士规范化培训教学中的应用效果;方法：选取2022年1月至2022年6月我院妇产科护士30名为本次研究对象,通过对PBL教学联合情景模拟教学法实施前后进行分析,比较在实施前后护士规范化理论知识和临床护理操作成绩;结果：护士在实施PBL联合情景模拟教学法后理论考试和实践操作考试成绩显著高于实施前,实施前后护士规范化成绩相比差异有统计学意义(P<0.05);结论：与传统教学法相比,PBL联合情景模拟教学法能更有效提高规培护士的理论及实践操作综合能力。     

《精神卫生法》于综合医疗机构之解

《中华人民共和国精神卫生法》(下称《精神卫生法》)于2013年5月1日实施.此法立法内容涉及面广,其中部分法律条文对非精神专科医疗机构的医疗管理做出新规定. 外科治疗需过伦理 《精神卫生法》第四十三条规定:“医疗机构对精神障碍患者实施下列治疗措施,应当向患者或者其监护人告知医疗风险、替代医疗方案等情况,并取得患者的书面同意;无法取得患者意见的,应当取得其监护人的书面同意,并经本医疗机构伦理委员会批准:导致人体器官丧失功能的外科手术;与精神障碍治疗有关的实验性临床医疗.实施前款第一项治疗措施,因情况紧急查找不到监护人的,应当取得本医疗机构负责人和伦理委员会批准.禁止对精神障碍患者实施与治疗其精神障碍无关的实验性临床医疗.”     

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.     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.