PBL教学法在中医内科学教学中的应用研究

目的：探讨PBL教学法对中医内科学教学效果的影响。方法：选择本院2008级中医学本科生126人为研究对象,随机分成采取PBL教学法的一班（试验组）和采取LBL教学法的二班（对照组）,采用期末进行闭卷考试的方式进行教学效果评估。结果：两组学生的客观题成绩之间差异无显著性差异（P〉0.05）;而接受了PBL教学法的学生在代表学生理解能力、综合分析判断能力、应用能力的主观题上的成绩明显优于对照组（P〈0.01）。结论：PBL教学法有利于培养学生的理解能力、综合分析判断能力、应用能力,能提高中医内科学教学的质量。     

PBL教学法在胃肠外科护理带教中的应用

目的：探讨PBL教学法对提高胃肠外科护理带教效果的作用。方法：将在胃肠外科实习的100名护生随机分为对照组和观察组,对照组采用常规教学法,观察组采用PBL教学法,比较两组护生在理论考试、操作考试成绩和学生对PBL教学法的评价的差异。结果：观察组的理论考试成绩、操作考试成绩均显著优于对照组（P〈0.05）,大部分学生对PBL教学法的评价良好。结论：与常规教学法相比,PBL教学法更能提高带教质量,有助于培养综合能力。     

基于网络环境的PBL法与LBL教学法在方剂学教学中的应用比较

目的：探讨基于网络环境的PBL教学法在方剂学教学中的应用效果。方法：将不同年级两个中医班随机分为基于网络环境的PBL教学班和传统教学法LBL班,学期结束后通过学生和教师问卷调查以及教改测评考试评价教学效果。结果：PBL班学生在满意率、方剂理解记忆及灵活运用和综合素质等方面积分均显著高于LBL班（P〈0.05或P〈0.01）;教改测评考试PBL班学生考试成绩高于LBL班（P〈0.05）。结论：基于网络环境的PBL教学法能显著提高学生学习方剂学效果。     

PBL教学法在生物化学检验理论教学中的应用

目的探讨PBL教学法在生物化学检验理论教学中的应用效果。方法从2005级检验医学专业本科学生中,随机选择两个班分成实验班和对照班,实验班采用PBL教学法授课,对照班采用传统灌输式教学法授课。学习结束时对两个班进行理论考试和问卷调查。结果实验班考试成绩明显优于对照班(P<0.01)。结论PBL教学法能有效激发学生的学习积极性,提高学生分析问题与解决问题的能力、自学能力、语言表达能力、创新性思维能力等,有利于综合素质的提高,值得推广。     

PBL教学法在《儿科护理》教学中的应用

目的了解PBL教学法在《儿科护理》教学中的应用效果。方法选择2005级护理专科生1、2班为改革班，3、4班为传统班。改革班采用PBL教学法，传统班采用传统教学方法。结果改革班考试成绩优于传统班。结论能有效地训练学生发现问题、解决问题的能力，有助于创造力的培养。     

PBL教学法在医学高职高专院校病理学实验教学中的应用

在医学高职高专院校的病理学实验教学中,引入PBL教学法.对采用PBL教学法的实验组和采用传统讲解式教学法的对照组进行比较,结果 表明,采用PBL教学法的实验组学生的考试成绩有提高,且PBL教学法在培养学生综合能力方面获得学生肯定.结论:PBL教学法对培养学生综合能力有一定效果,值得进一步推广.     

高级护理专业病理学教学模式探讨

目的探讨不同教学模式在高级护理专业病理学教学中的应用效果。方法选择高级护理专业3年制大专2个班的学生作为教学对象,一个班（对照班）采用传统教学法,一个班（实验班）采用PBL（problem-based-learning）教学法。并采用考试成绩和问卷调查相结合的形式,进行教学效果评价。结果实验班学生考试总成绩明显高于对照班,存在显著性差异（P〈0.05）,同时实验班学生分析问题和解决问题的能力及表达能力明显提高。结论 PBL教学法能够提高学生的学习兴趣和学习效率,有助于培养学生分析问题、解决问题的能力及表达能力,值得在医学教育中实施和推广。     

PBL教学法在儿科护理学教学中的应用研究

目的探讨PBL教学法在儿科护理学教学中的应用效果。方法将2008级护理专业121名学生随机分为两组,实验组62人,采用PBL教学法;对照组59人,采用传统的教学法。结果采用PBL教学的实验班考试成绩优于非实验班考试成绩(P＜0.01),实验班各项调查内容均明显优于非实验班。结论 PBL教学法比传统的教学法能明显提高儿科护理学的课堂教学质量,提高学生学习积极性及综合能力。     

结合综合讨论的PBL教学法在药理学教学中的应用

目的为提高药理学教学质量，本文将“基于问题的学习（Problem-based learning，PBL）”教学模式与传统教学模式（Lecture-based learning，LBL）和综合讨论相结合，研究新方法在药理学教学中的作用。方法选取75名2005级临床医学系学生，进行结合综合讨论的PBL教学法与单纯PBL教学法及LBL教学法进行对比研究，课程结束后采用统一试卷进行考试以评价教学效果，并对学生进行问卷调查以评价学生的学习态度及学习动力。结果结合综合讨论的PBL法试验组理论考试成绩显著优于PBL组及LBL组，PBL组与LBL组考试成绩差异无显著性，而前两者学生学习态度及学习动力明显好于LBL组。结论结合综合讨论的PBL教学法在药理学理论教学中优于单纯PBL法和LBL教学法，值得进一步研究和推广。     

PBL教学法在生物化学教学中的初步应用与探讨

目的探讨以问题为基础的学习法(PBL)在生物化学教学中的初步应用并对其效果进行了评价。方法在生物化学教学中,选取105名2003年入学的生物医学工程专业学生,随机编为3个班,每班35人,前2班采用PBL教学法,后1班采用传统讲授法(LBL),对其效果进行比较并进行了问卷调查。结果实验组的两次考试成绩均高于对照组(P<0.01),PBL教学法能够显著提高学生的学习兴趣和综合分析问题的能力,促进自学,加强师生之间的交流与沟通。结论PBL教学法优于传统讲授法,在生物化学教学中值得推广。     

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.