专科医校局部解剖学教学与临床结合的几点建议

局部解剖学为重要的医学根基课,尤其与临床外科学关系更为密切,为了使解剖教学给临床外科打下坚实的基础,现将局部解剖教学与临床外科结合的问题及其改革谈点看法。 一、解剖教学现状分析 目前我国大、中专医学专业的解剖教学仍以系统解剖学教学为主,局部解剖学内容较少,缺少外科实用解剖学内容,学员也无解剖尸体的操作机会,加之一般的大、中专学校解剖教学在教学内容和教学方法上都不能适应培养实用性人才的需要,     

人体解剖教学与临床结合初探

为配合解剖教学改革,解剖学系在教学中提出了人体解剖教学与临床全方位结合的教学体系,通过转变教学理念、调整教学安排、实行多样化教学方式和与国外一流医学院校交流等措施,并开展了“面向临床的解剖学讲座”,不仅巩固了解剖学教学内容,还强调了所学知识在临床中的应用,初步取得了良好的效果.     

数字解剖融合慕课的线上线下混合式教学在系统解剖学教学的实践

系统解剖学是医学的基础课程,由于术语繁多,结构复杂抽象,教学学时又不断压缩,所以成了学生心目中具有挑战性的学科.随着信息化时代的到来,学生的学习习惯和获取知识的方式发生很大改变,因此需要探索新的教学模式来适应这种变化.混合式教学是把传统的面对面课堂教学的优势和e-learning(即网络化或者数字化教学)的优势结合起来,通过多元化教学方式的融合,实现优势互补[1].近年来,许多高校在解剖学教学中探索了混合式教学模式,融合的方式多采用线上慕课与线下课堂的融合[2,3],但对数字解剖的应用不足.本教学团队探索了在系统解剖学教学中应用数字解剖、慕课与课堂教学相融合的方式,将数字解剖应用于线上与线下教学,以期提高教学质量,供同行在教学改革中借鉴.     

解剖学与临床全方位结合的教学实践

解剖学教学必须与临床全方位结合才能使学生真正的在以后的临床工作中受益,进一步提高临床医生的医疗水平,同时也可以促进解剖学科的发展、提高本学科教师的理论实验水平。本文从转变教学理念、增加临床教学内容、加强集体备课、课堂上使用临床问题引导激发学生学习解剖的兴趣、课内课外多种教学方法的采用等方面,全方位把解剖的教学与临床结合起来,取得了良好的教学效果。     

浅谈大体解剖的教学特点与学习方法

我校临床医学本科解剖学教学总学时数平均为200学时。为了更有效地利用这有限的学时,提高教学质量,我们参照国内,外部分高校的解剖教学模式并结合我校具体情况,从1999级开始将解剖学课程设置由原来的“系统解剖”和“局部解剖”改为“大体解剖”和“神经解剖”。大体解剖(140学时)与神经解剖(60学时)教学分别在第2、3学期进行。目前,这种课程设置模式已顺利地实施了三届。现根据我们三年来的教学实践经验和体会。对大体解剖的教学特点和学习方法进行简要总结。以供解剖学界同行商榷及学员学习参考。     

外科医师看局部解剖学教学

局部解剖学作为联系基础医学与临床医学之间的桥梁,在医学课程中占有非常重要的地位。如何改进局部解剖学的教学方法,提高教学效果一直是医学教学中不断摸索的一个课题。为探索局部解剖学教学的新路子,我校从１９９９年开始试行临床医师讲授部分局部解剖学课的尝试。本人作为普外医生,担任局部解剖中腹部解剖授课教师,现就如何改进局部解剖课教学效果谈一些粗浅的体会。１　临床医师讲授局部解剖学课的利弊临床医师尤其是外科医师,在经过若干年的临床实践后,对局部解剖学的重要性有更深的理解和体会。如果没有扎实的解剖学基础,想出…     

在解剖教学中注重培养学生的动手能力

解剖学是新生入校后接触到的第一门医学基础课，同时，也是一门实践性较强的课程。学好解剖学，不仅为临床课学习奠定良好的基础，而且对从事临床工作具有指导作用。目前，医学教育改革着重强调培养“实用型”人才，这对医学生的动手能力又提出了很高的要求。我校解剖教研室老师就解剖教学中动手能力培养的重要性进行了调查论证，并提出了自己的一些看法。     

做好遗体捐献,促进解剖教学改革

做好遗体捐献接受工作是确保这项新生事业不断发展的重要保障。北京协和医学院遗体捐献接收站不仅为解剖教学提供了合法、稳定和高质量的宝贵尸源,也开拓了人体解剖学与临床结合的教学改革新思路,使传统刻板的解剖教学焕发出朝气,成为深受同学喜爱的、与临床结合并带有时代特色和创新内容的解剖课。     

微创临床局部解剖学教学体系的建立和探索

目的随着临床医学中微创手术的广泛开展,传统局部解剖学的教学模式明显不切合于现在的临床应用,我们在近3年的局部解剖学教学中,尝试建立基础与临床相结合的临床微创局部解剖学教学体系,实现了医学生培养上的多赢。方法在北京大学医学部的3个年级临床医学专业的医学生中,分成传统局部解剖学(局解组)和微创局部解剖学(微创局解组)。微创局解组同学借助模拟腔镜等微创手术器械,开展微创临床解剖学的教学。结果与传统局解组相比,微创局解组同学在学习兴趣,学习的主动性,知识的牢固性,解剖动手能力,临床思维能力,解剖和临床知识的互补性,讨论及交流能力和师生互动等方面均有不同程度的提高。结论微创解剖学教学体系不仅能够满足医学生尤其是临床医学生早期接触临床微创手术及手术器械的需要,并且还可以促进解剖学老师深入了解临床手术的进展,有利于进一步明确教学目的,并促进了基础解剖与临床进展的交流。     

中国解剖学会1996年学术年会文摘汇编尚有少量出售

中国解剖学会1996年学术年会文摘汇编(解剖学杂志1996年19卷增刊)内容丰富,刊登有人类学;体质调查.应用解剖.断面解剖.实验形态,比较解剖,变异畸形.大体解剖技术方法,教学;神经解剖学的特邀报告.神经通路、     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.     

A comparative study of the effects of dimebon,obsidan, finoptin,and cordaron on the functional state of ischemic focus and size of necrotic zone in experimental myocardial infarction

Dimebon, an antihistamine agent, exerts a moderate antianginal effect, improving the function of ischemic focus in the myocardium and decreasing the necrotic zone in experimental myocardial infarction. Dimebon is less active than obsidan, finoptin (except for the size of the necrotic zone), and cordaron. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 122, No. 12, pp. 642–644, December, 1996     

Effects of sex steroid hormones on lipid peroxidation and glutathione antioxidant system in rat skin

Effects of estradiol and testosterone on the intensity of lipid peroxidation and contents of glutathione redox system components in the dermis and epidermis of rat skin were studied. Only estradiol induced considerable dose-dependent and tissue-specific biphasic antioxidant effects on the skin. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 128, No. 12, pp. 663–666, December, 1999     

Adhesion and growth of CaCo2 cells on surface-modified PEEK substrata

A series of surface-functionalized poly(ether ether ketone) (PEEK) films has been prepared by selective wet-chemistry; they are hydroxylated polymer (PEEK-OH) obtained by reduction, aminated polymer (PEEK-[]-NH2) prepared by coupling a diisocyanate reagent to PEEKOH (PEEK-[]-NCO) followed by hydrolysis, and carboxylated and aminocarboxylated polymers (PEEK-[]-GABA and PEEK-Lysine) resulting from the coupling of aminoacids to PEEK-[]-NCO. The aminated and carboxylated substrata promoted the adhesion and growth of CaCo2 cells in the presence of serum. Fibronectin (FN), an extra-cellular matrix protein, has been covalently fixed and/or adsorbed on various PEEK substrata, in the presence or not of a polymeric surfactant (Pluronic F68). The performances of the FN-grafted substrata (PEEK-[]-FN(1) and PEEK-[]-FN(2)) were significantly higher than those of reference substrata simply coated with FN (PEEK-OH(+FN)(1) and (2), PEEK-[]-NH2(+FN)(1) and (2)), considering the adhesion and spreading of CaCo2 cells in the absence of serum. Moreover, the stability of the adherent cells on the FN-adsorbed substrata dramatically depended on the experimental conditions applied during the PEEK coating with FN.