PACS/RIS系统在医学影像学教学中的优势

目的评价将PACS/RIS系统应用于医学影像学教学中的优势。方法利用PACS/RIS系统进行医学影像学的临床教学,与传统的教学模式相比较,发现优势。结果运用PACS/RIS系统进行教学后减轻了教师的劳动强度,激发了学生的学习兴趣,极大的提高了教学效率和质量。结论 PACS/RIS系统在教学中具有很大的优越性,在医学影像学教学中发挥重要的作用。     

基于教学PACS系统的医学影像网络考试系统的升级及评价

目的探索医学影像网络考试系统的升级改造及其在影像学习自测和实践考试中的应用效果。方法开发和升级基于独立的教学PACS系统的网络考试系统,通过资源共享方式对学生日常学习中的教学自测和学生实践教学中的考核测试的应用效果进行评价。结果在成功开发独立的影像网络教学考试系统的基础上,完成对其试题库的病例补充及难度等级的升级,对读题界面、阅片工具的升级,对试卷管理、自动组卷、自动阅卷的升级,对学生自测和考试人员管理模块的升级。调查显示,除考试时间满意度较前降低,读片形式满意度与前持平外,学生对图片清晰度、所设问题和考试对实践的指导意义方面满意度均显著提高(P<0.01)。结论网络考试系统的升级使得考试阅片更加贴近实战化,考试内容和信息更加丰富,应用于医学影像教学考核中具有一定的先进性。     

PACS系统在呼吸内科实习教学中的应用实践

目的 探讨PACS系统在我院呼吸科实习教学中的作用.方法 通过完善教学环节,重视临床实习生的影像教学,结合PACS系统在呼吸系统疾病中开展问题式教学,并在学生出科考试中运用PACS系统调阅影像资料.结果 通过在实习学生中运用PACS系统进行教学管理,提高了学生学习的积极性,完善了教学各环节,促使我科教学向现代化医学教学模式方向发展.结论 合理运用PACS系统在呼吸系统疾病中诊断,能有效提高学生学习的积极性,使学生学习方式向学习-工作实践-再学习-再工作实践的学习模式转变.     

基于PACS的网络教学在医学影像学实习中的应用

目的评价应用医学影像图像与传输系统(PACS)在医学影像学实习中的优越性。方法利用PACS构建医学影像学实习病例库,建立多媒体网络实习教室,学生使用浏览软件阅读图像并借助软件多种功能分析图像。结果减轻了教师劳动强度,激发了学生学习兴趣。结论基于PACS的计算机网络教学改变了医学影像学实习传统的教学方法,实现了影像教学的实时化、多样化,对提高教学水平和促进教学改革具有重要意义。     

PACS在医学影像诊断学教学中的作用

目的:探讨医学影像图像与传输系统(PACS)在医学影像诊断学教学中的重要性。方法:利用PACS构建医学影像诊断学教学数据库,建立多媒体网络实习教室,学生使用浏览软件阅读图像并借助软件多种功能分析图像。结果:减轻了教师的劳动强度,教学效果事半功倍,提高了学生的学习效率和质量。结论:PACS改变了医学影像诊断学传统的教学模式,对于提高医学影像诊断学的教学水平和教学质量具有重要意义。     

基于PACS的影像教学系统在影像教学中的应用

目的：研究基于图像存储与通讯系统（picture archiving and communication system,PACS）的医学影像教学系统的构建及应用。方法在多媒体实验室安装教学PACS服务器,终端电脑安装PACS软件及医学影像诊断报告系统,学生可调阅影像病例、书写诊断报告,提交报告后,教师可进行审核批阅。结果为医学影像学专业学生建立了一种数字化实验教学环境。结论基于PACS的影像教学系统的应用,提高了学生学习的积极性、主动性,有利于培养学生的临床实践能力。     

翻转课堂结合PACS在放射诊断学教学中的应用

课时数量过少、学生基础知识薄弱、学生学习兴趣低下一直困扰着放射诊断学教学。目前,翻转课堂已经成为教学改革的热点,PACS系统也已成为影像诊断临床与教学的有效平台。本研究分析并提出将翻转课堂和PACS相结合的教学构想：教师课前设定教学目标、制作教学视频和任务清单;学生分组进行课前学习;课中学生交流学习成果、开展组间讨论、应用PACS系统阅读病例,教师对重点和难点进行讲解;课后进行综合成绩评估。期望通过以上教学设计,提高学生学习兴趣,改善学生学习效果,培养学生自主学习能力和拓宽其临床思路;并为放射诊断学教学改革提供经验。     

医学院校PACS教学方法在影像教学中的应用

目的探讨PACS教学系统在影像教学中的应用价值。方法将2003级同一班级的40名影像医学专业学生按照学习成绩排列,采用随机分组的方法分成两组,采用PACS系统教学和传统多媒体教学的各20名。对相同内容进行教学,课后发放调查问卷并进行授课内容的考试阅片,以PACS多媒体教学效果的评价。结果①通过问卷调查,学生认为PACS系统教学方法优于多媒体教学方法（P〈0.01）。②采用PACS系统教学的学生成绩优于采用传统多媒体教学的学生成绩（P〈0.01）。结论PACS教学有利于提高学生的学习兴趣和学习效率,并有利于学生提高学习成绩。     

PACS在医学影像实验教学中的应用

为探讨医学影像学实验教学的有效方法,总结近几年将PACS系统应用于医学影像实验教学的实践。结果显示,PACS能丰富医学影像学实验教学的多媒体课件,明显提高教学质量和教学效率,帮助学生加深对于各种影像学征象的理解与掌握,明显提高了学生学习的积极性,大大减轻了教师的工作量。     

翻转课堂结合PACS系统在放射诊断学教学的应用探讨

课时数量过少、学生基础知识薄弱、学习兴趣低下一直困扰中医院校的放射诊断学教学。目前,翻转课堂已经成为教育改革的焦点,PACS系统也已成为影像诊断的平台,但在放射诊断学教学领域将两者结合较为少见。该文主要介绍翻转课堂和PACS系统特点,分析了两者结合的可行性,提出了将两者结合的教学构想,即教材、课程、教师及学生的课前准备;教师做好目标设定、视频制作和任务清单的课前设计;学生分组进行课前学习;课中学生交流学习成果、组间讨论、应用PACS系统阅读病例,教师对重点和难点进行讲解;课后进行综合成绩评估。通过以上教学改革,以其达到提高学生学习兴趣、改善学习效果、培养学生自主学习能力和拓宽临床思路,为放射诊断学教学改革提供经验。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.