雷公藤对哮喘小鼠气道炎症的抑制作用

Objective: To investigate the effect of Tripterygium polyglycosid on establishing airway eosinophil infiltration and related airway hyperresponsiveness of asthmatic mice. Methods: A mature murine asthmatic model was made with ovabulmin sensitized and challenged C57BL/6 mice. Forty mice were divided into four groups with 10 mice in each group: mice sensitized and challenged with saline (WS group), mice sensitized and challenged with ovalbumin (WO group), mice sensitized and challenged with ovalbumin and treated with Tripterygium polyglycosid (TP group) and Dexamethasone (DXM group). The mice were intraperitoneally injected with 20 μg chicken ovabulmin emulsified in injected alum on days 0 and 14, then were challenged with an aerosol generated from 1% ovabulmin on days 24, 25 and 26. Tripterygium polyglycosid was injected intraperitoneally at 50 mg/kg on days 25, 26 and 27 after ovabulmin challenge. Dexamethasone was administrated to mice at 2 mg/kg on day 21, 23 before ovabulmin challenge. The airway hyperresponsiveness, mucus production, eosinophils in parabronchial area and bronchoalveolar lavage fluid and the level of interleukin-5, granulo-macrophage clone stimulating factor in bronchoalveolar lavage fluid were measured as indexes of inflammation. Results: Tripterygium polyglycosid treatment after ovabulmin challenge completely inhibited eosinophil in?ltration in bronchoalveolar lavage fluid [(0.63±0.34)×104 vs. (75.0±14.8)×104, P<0.05] and the peribrochial area (12.60±3.48 mm2 vs. 379.0±119.3 mm2, P<0.05),mucus overproduction in airway (2.8±1.7 vs. 7.1±5.6, P<0.05), and ncreased interleukin-5 levels in bronchoalveolar lavage fluid (28.8±2.8 pg/mL vs. 7.5±3.5 pg/mL, P<0.05). Meanwhile, Tripterygium polyglycosid treatment after ovabulmin challenge also partially inhibited airway hyperresponsiveness. The level of granulo-macrophage clone stimulating factor in bronchoalveolar lavage fluid didn''t change with drugs intervention. Conclusions: The administration of Tripterygium polyglycosid could inhibit the established airway inflammation and reduce the airway hyperresponsiveness of allergic asthmatic mice. It provides a possible alternative therapeutic for asthma.     

Therapeutic Effect of Integrative Traditional Chinese and Western Medicine on 51 SARS Patients and Its Influence on Their TLymphocyte Subsets

Severeacuterespiratorysyndrome(SARS)isanewlyariseninfectiousdiseasewithrespiratorytractasthechiefpathwayoftransmission.Thisisespecial lytrueforSARSpatientsofseveretypeduetoitsse riouscondition,whichresultsinhighmortalityandgreatdifficultiesinitstreatment.InordertoexploretheeffectivewaysintreatmentofSARS,clinicalstudiesontreatmentofSARSbyintegrativeChineseandwesternmedicine(ICWM)havebeencarriedoutbytheauthorsandthepreliminarysummaryisre portedasfollows.METHODSClinicalMaterials　　 T…     

Clinical Evaluation of Integrative Chinese and Western Medicine in Treating SARS

Objective:To evaluate the effective treatment with integrative Chinese and western medi-cine(ICWM)of severe acute respiratory syndrome(SARS).Methods:The 65 cases of SARS patientswere treated with ICWM and 37 cases with western medicine(WM)alone as the control in our hospitalfrom March 11 to April 30,2003.The results were analyzed,with T subset profile tested for all the 102patients.Results:Sixty-five cases of SARS patients treated with ICWM included 52 mild cases of whom 51cases were cured(98.1％)and no patient died.As to the 13 severe cases in this group,9 were cured(69.2％)and 2 died(15.4％).Of the 37 cases treated with WM alone,16 out of the 18 common cases werecured(88.9％)and 10 out of the 19 severe cases were cured(52.6％),with the other 9 died(47.4％).Comparison between the two groups(P=0.061)showed the difference was close to the value for statisti-cal significance.But considering that the number of samples was small,more cases are needed fot furtherstudy.The immune function examination:in cases     

TNP-470和MMC联合应用对鼠结肠癌生长和肝转移的作用

目的：研究O-(氨乙酰-氨甲酰基)烟曲霉醇（TNP-470）和丝裂霉素（MMC）联合应用对结肠癌生长和肝转移的抑制作用。 方法：建立裸鼠结肠癌的原位生长和肝转移模型,随机分为对照组、TNP-470组、MMC组及联合用药组（TNP-470+MMC）。 结果：4个组瘤重分别为(499±247)、(478±180)、(275±80)和（255±65）mg,肝转移率分别为87.5%、25.0%、75.0%和12.5%,与对照组比较联合用药组抑制作用最明显（P<0.01）,且治疗后各组裸鼠活动良好,无明显体重减轻。 结论：TNP-470与MMC联合应用对结肠癌的生长及肝转移的抑制有协同作用,且未加重TNP-470引起的体重减轻等毒副作用。     

Effect of Antisense Oligodeoxynucleotide of Vascular Endothelial Growth Factor C on Lymphangiogenesis and Angiogenesis of Pancreatic Cancer

In order to investigate the effect of antisense oligonucleotide (ASODN) of vascular en-dothelial growth factor C (VEGF-C) on lymphangiogenesis and angiogenesis of pancreatic cancer, antisense and scamble-sense oligonucleotide of VEGF-C were constructed, and the model of nude mice with orthotopically xenografted human pancreatic cancer cells (Panc-1) was established. Thirty nude mice were randomly divided into 3 groups: PBS control group (group A), scramble-sense con-trol group (group B) and antisense group (group C). All nude mice were treated once every 2 days as 3 times per week, for 3 weeks (oligonucleotide 10 mg/kg every time). After treatments were com-pleted, ELISA method was used to examine the concentration of VEGF-C in plasma and immunohis-tochemical method to examine microvessel density (MVD), lymphtic vessel density (LVD) of pan-creatic cancer. The results showed that the expression of VEGF-C was inhibited significantly in group C. The concentrations were 237.5±41.5, 221.5±52.3 and 108.6±14.9 pg/mL in groups A, B and C re-spectively (P<0.01). LVD in groups A, B and C was 13.8±2.1, 12.4±1.9 and 4.2±1.6 respectively (P<0.01). MVD in groups A, B and C was 27.5±8.7, 25.9±4.2 and 19.4±5.6 respectively with no sig-nificant difference among the groups (P>0.05). It was suggested that VEGF-C ASODN decreased the expression levels of VEGF-C in nude mice with orthotopically xenografted human pancreatic cancer, and it could inhibit lymphangiogenesis, but had no significant effect on angiogenesis.     

贝伐单抗联合TNP-470治疗结肠癌的实验研究

目的观察贝伐单抗联合血管生成抑制剂TNP-470治疗裸鼠结肠癌移植瘤的疗效,二者是否有协同效果。方法随机将48只大肠癌裸鼠分为对照组(A组)、贝伐单抗组(B组)、血管生成抑制剂(C组)、贝伐单抗与血管生成抑制剂联合组(D组),A组于左侧腋部皮下注射0.9%生理盐水30mg/kg,B组于左侧腋部皮下注射贝伐单抗5mg/kg,C组于左侧腋部皮下注射血管生成抑制剂TNP-470 30mg/kg,D组于左侧腋部皮下注射贝伐单抗5mg/kg和TNP-470 30mg/kg,1次/d,连用14d,至治疗结束时处死裸鼠,测量皮下移植瘤的长短径,分析各组间肿瘤体积差异的显著性;测量皮下移植瘤重量,计算抑瘤率;用细胞凋亡检测试剂盒测定裸鼠移植瘤凋亡水平,免疫组化检测结肠癌转移瘤血管内皮生长因子(VEGF)的表达和肿瘤微血管密度(MVD)。结果各实验组肿瘤的生长明显受到抑制,裸鼠皮下移植瘤瘤重、抑瘤率,D组和A组、B组、C组比较差异均有统计学意义(P<0.01),且B组、C组和A组之间差异亦有统计学意义;B、C、D组均可诱导移植瘤的凋亡,且差异有统计学意义;D组中的VEGF表达及MVD计数较A、B、C组均明显降低,差异有统计学意义。结论贝伐单抗与血管生成抑制剂TNP-470联合治疗结肠癌裸鼠皮下移植瘤比贝伐单抗或TNP-470单药治疗具有更强的抑瘤作用,二者联和应用,抗肿瘤效应明显增强。     

Endothelial nitric oxide synthase traffic inducer in the umbilical vessels of the patients with pre-eclampsia

The expression of endothelial nitric oxide synthase traffic inducer （NOSTRIN） was examined in the umbilical vessels of the patients with pre-eclampsia （PE） to explore its possible role in the pathogenesis of PE. The NOSTR1N rnRNA in umbilical tissues was determined by RT-PCR. The eNOS activity in umbilical vessels was spectrophotometrically detected. NO2 /NO3, the stable metabolic end products of NO, was measured by using nitrate reductase. RT-PCR showed that the expression level of NOSTRIN was significantly higher in women with PE than in the normal group （P〈0.01）. The activity of eNOS was significantly decreased in PE group [（12.83±3.61） U/mg] than in normal group [（21.72±3.83） U/mg] （P〈0.01）. The level of NO2-/NO3- in PE patients （27.53±7.48） pmol/mg was significantly lower than that of normal group （54.27±9.53） μmol/mg （P〈0.01）. The significant negative correlation existed between the expression of NOSTRIN and the activity of eNOS in umbilical vessels of women with PE （r=-0.58, P〈0.01）. It was concluded that the level of NOSTR1N expression was increased in umbilical vessel of women with PE, indicating that it may be involved in the pathogenesis of PE.     

基于薄层CT影像的3D虚拟重建及打印技术在“网络云+双轨”教学中的应用研究

目的 探索基于薄层CT影像的3D虚拟重建及打印技术在“网络云+双轨”教学中的应用前景。方法 选取2021年4月至2022年4月期间在空军军医大学第二附属医院见习的医学学员共120名作为研究对象,分为试验组和对照组各60名。试验组采用3D虚拟重建及打印技术辅助的“网络云+双轨”教学;对照组采用“网络云+双轨”教学。经过6个月学习后,通过闭卷考试、技能操作、演讲答辩和问卷调查4种方式比较教学效果。采用SPSS 23.0进行t检验和卡方检验。结果 试验组在出科考试中,理论知识考核（84.25±5.53）分、操作技能考核（87.68±5.72）分,均优于对照组的（79.43±6.69）分、（82.97±5.32）分,差异有统计学意义（P<0.001）。试验组在演讲[（44.90±2.56）分]与答辩[（45.83±2.62）分]两个环节中的成绩均高于对照组的（41.88±2.71）分、（43.85±2.56）分,差异有统计学意义（P<0.001）。在调查问卷中,试验组见习学员的实践能力、主动学习能力、表达能力和实习积极性的评分均显著高于对照组（P<0.001）,获取信息能力的评分高于对照组,差异均有统计学意义（P<0.001）。结论 3D虚拟重建及打印技术辅助下的“网络云+双轨”教学可显著提升学员的客观学习效果与主观学习能动性,具有较高的教学应用与推广价值。     

基于症状管理理论的思维导图结合情景模拟教学在老年症状护理教学中的应用

目的 评价基于症状管理理论（symptom management theory, SMT）的思维导图结合情景模拟教学方法在老年症状护理教学中的应用效果,为提高老年症状护理教学质量提供依据。方法 将2022年8月至2023年4月在北京协和医院老年科实习的护生80人纳入研究,根据入科先后顺序分为对照组及试验组,每组40人。对照组采用传统教学,试验组采用基于SMT的思维导图结合情景模拟教学。对比分析两组护生一般资料、培训考核成绩及教学质量满意度情况。采用SPSS 22.0统计软件进行t检验和卡方检验。结果 两组学员在年龄、性别、学历、学习成绩、就读学校等一般资料上差异无统计学意义。试验组老年症状护理理论考核成绩[（86.57±8.41）分vs.（80.83±9.16）分,P=0.018]、综合技能考核成绩[（91.26±7.29）分vs.（81.92±8.64）分,P<0.001]高于对照组。试验组教学过程[（24.52±1.56）分vs.（20.18±0.98）分,P<0.001]、教学方法[（24.49±1.72）分vs.（20.65±1.02）分,P<0.001]、教学效果[（24.35±1.19）分vs.（20.01±0.86）分,P<0.001]、教学内容[（24.31±1.83）分vs.（20.27±1.21）分,P<0.001]、总体满意度[（97.67±2.80）分vs.（81.11±2.53）分,P<0.001]均高于对照组。结论 基于SMT的思维导图结合情景模拟教学在老年症状护理教学中具有明显效果,能够提升实习护生的理论水平、综合技能水平及教学质量满意度。     

PBL联合情景模拟在护生针刺伤护理教学中的应用

目的 探讨基于问题的教学（problem-based learning,PBL）联合情景模拟教学在护生针刺伤护理教学中的应用效果。方法 选取某医科大学护理学专业2020级和2021级本科生共123人作为研究对象。2020级本科生60人作为对照组,采用PBL教学方法;2021级本科生63人作为试验组,采用PBL联合情景模拟教学法。比较两组护生的理论成绩、技能考核成绩和针刺伤相关知识、态度和行为问卷（needle-stick injury knowledge,attitude and practice questionnaire,KAP）结果。采用SPSS 25.0进行t检验、卡方检验和秩和检验。结果 试验组理论成绩、技能考核成绩[（84.43±5.03）分、（88.40±4.26）分]高于对照组[（80.30±4.81）分、（83.55±5.84）分]（P<0.001）;试验组KAP问卷的知识、态度、行为[（14.46±1.03）分、（52.59±3.09）分、（67.37±4.28）分]均高于对照组[（13.18±1.23）分、（48.05±3.06）分、（62.17±3.92）分]（P<0.001）。结论 PBL联合情景模拟教学法可以有效提高在校护生针刺伤防护知识、操作水平,增强护生对针刺伤重视态度,促进针刺伤防护行为。     

Effect of Yangqixue Qufengshi Recipe on rheumatoid arthritis model mice under different genetic backgrounds

Objective: To study the effect of Yangqixue Qufengshi Recipe (YQXQFS) on rheumatoid arthritis (RA) model mice under different genetic backgrounds.Methods: Collagen Induced Arthritis (CIA) were established on HLA-DR4 transgenic (TG) mice and non-transgenic (NTG) mice, which partly were raised with YQXQFS, and the onset day of CIA, the level of type II collagen (C II)-reactive antibodies and the pathological scores of CIA were assessed.Results: Under HLA-DR4 TG background (compared with NTG mice), the earlier onset day of CIA (11.22 ± 3.35 days vs 16.56 ± 4.75 days,P<0.05) and higher level of C II-reactive antibodies (0.2274 ± 0. 1390 μg/ml vs 0. 1101 ± 0.0560 μg/ml,P<0.05) were observed, but the pathological scores of CIA remained unchange. YQXQFS could not influence the onset day of CIA and the level of CII -reactive antibodies, but had a certain effect on the total pathological scores (6.56 ± 3.43 scores vs 11.11 ± 5.64 scores) and bone erosion (0.22 ± 0.44 scores vs 1.67 ± 1.50 scores) of CIA on NTG mice (P<0.05), NTG YQXQFS group compared with NTG experimental group.Conclusion: YQXQFS had a certain effect on RA model, but had no significant effect on HLA-DR4 related CIA.     

PBL教学在肝胆外科专业型研究生教学中的实践研究

目的 探讨以问题为基础的学习（problem based learning,PBL）在肝胆外科专业学位研究生教学中的应用效果。方法 将重庆医科大学附属第一医院肝胆外科接收的同一年级共60名专业学位研究生作为研究对象,学生随机分为PBL组和传统授课（lecture-based learning,LBL）组,对比PBL组和LBL组的培训效果。采用SPSS 25.0统计软件进行t检验和卡方检验。结果 PBL组学生在培训期间笔试成绩[（90.3±4.5）分 vs. （85.2±7.1）分,P<0.05]、技能操作成绩[（92.3±4.9）分 vs. （86.3±7.9）分,P<0.05],以及学生所表现出的科研能力、临床能力、组织能力、查阅文献能力、协同合作能力、语言表达能力等综合能力[（85.0±7.5）分 vs. （73.0±9.1）分,P<0.05]均较LBL组明显提高,总评成绩也较LBL组更高[（90.2±3.2）分 vs. （83.3±3.9）分,P<0.05]。同时,PBL组学生的满意度较LBL组更高（83.3% vs. 56.7%）。结论 在专业学位研究生教学中应用PBL教学可提高教学质量。     

Role of Low Dosage Arsenic Trioxide on Pulmonary Dendritic Cells in Asthmatic Mice

Chinesescholarshaveachievedhighcompleteremissionrateinpatientswithacutepromyelocyticleukemia(APL),includingthatwithalltransretinoicacid(ATRA)resistance,byapplyingarsenictrioxide(As2 O3 )withoutcausingsuchsideeffectasbonemarrowinhibition,anddemonstratedthatitsmostimportanttherapeuticmechanismistoinduceapoptosisofAPLcells,whichisanotherstrikingfindingafterthatofATRA(1).Althoughitsthera peuticmechanismremainsunknown,recently,weobservedthroughaprimarystudythattheairwayin flammationofasthmati…     

TNP-470与阿霉素联合使用治疗小鼠膀胱癌

目的观察血管形成抑制剂TNF-470与化疗药物阿霉素联合应用抑制小鼠膀胱癌的协同作用.方法分别予TNP-470、阿霉素、TNP-470 阿霉素治疗TN39膀胱癌荷瘤小鼠,观察肿瘤生长及血管形成、细胞凋亡情况.结果治疗后12 d,TNP-470、阿霉素及TNP-470 阿霉素治疗组抑瘤率分别为46.3%、21.4%及56.5%,TNP-470组微血管密度明显减少、凋亡指数增多,阿霉素组凋亡指数增多,TNP-470 阿霉素组凋亡指数进一步增加.结论TNP-470与阿霉素治疗小鼠膀胱肿瘤,有明显的抗肿瘤协同作用,其机理可能是通过抑制血管形成及化疗药物细胞毒性作用而促使肿瘤细胞凋亡进一步增加.     

C57BL/6J小鼠慢性束缚应激抑郁症模型的建立

目的 通过慢性束缚应激(CRS)建立C57BL/6J小鼠抑郁症模型。方法 C57BL/6J小鼠经体重、糖水偏好、旷场实验初筛后从中选择20只小鼠并随机分为正常对照(NC)组和CRS组2组,每组10只。对CRS组小鼠进行连续21 d,每天4 h的束缚刺激,并最终进行糖水偏好检测和强迫游泳检测。结果 CRS组小鼠在水中不动的时间为(131.70±21.65)s,明显长于NC组的(68.88±8.43)s(P=0.0304)。CRS组小鼠0～24 h和0～48 h的糖水偏好百分比分别为(66.21±3.24)%和(73.25±1.50)%,均明显低于NC组的(79.46±3.85)%(P=0.0196)和(80.20±2.26)%(P=0.0248)。结论 通过慢性束缚应激成功建立C57BL/6J小鼠抑郁症模型。     

谦卑型导师模式在手术室带教中的应用及分析

目的 探讨谦卑型导师模式在手术室实习护生带教中的应用效果。方法 选择济宁医学院附属医院总院区手术室 2020年8月至2021年6月40名实习护生作为对照组,2021年8月至2022年9月46 名实习护生作为试验组。对照组接受常规导师模式带教,试验组采用谦卑型导师模式带教。比较两组护生理论知识与操作技能考核成绩,以及建言行为、自我效能感、谦卑型导师感知教学效果。采用SPSS 19.0进行t检验、卡方检验和相关分析。结果 出科时,试验组护生理论知识（93.86±3.53）分、操作技能考核成绩（90.90±5.68）分,均高于对照组（P<0.001）。护生建言行为评分试验组（35.22±7.60）分,高于对照组的（30.43±5.96）分（P=0.002）。护生自我效能感评分试验组（28.17±5.03）分,高于对照组的（24.38±3.39）分（P<0.001）。护生谦卑型导师感知评分试验组（37.04±4.34）分,高于对照组的（26.33±6.63）分（P<0.001）。护生谦卑型导师感知与建言行为（r=0.89,P<0.001）、自我效能感（r=0.72,P<0.001）、操作技能成绩（r=0.66,P<0.001）、理论知识成绩（r=0.39,P=0.007）呈正相关。结论 谦卑型导师模式在手术室带教中应用效果显著,提高了护生的理论知识与操作技能考核成绩,促进了谦卑型导师的形成,加强了护生建言行为和自我效能感的教学效果。     

Different optical properties between human hepatocellular carcinoma tissues and non-tumorous hepatic tissues <Emphasis Type="Italic">In Vitro</Emphasis>

There has been an ongoing search for clinically acceptable methods for the accurate,efficient and simple diagnosis and prognosis of hepatocellular carcinoma(HCC).Optical spectroscopy is a technique with potential clinical applications to diagnose cancer diseases.The purpose of this study was to obtain the optical properties of HCC tissues and non-tumorous hepatic tissues and identify the difference between them.A total of 55 tissue samples(HCC tissue,n=38;non-tumorous hepatic tissue,n=17) were surgically resected from patients with HCC.The optical parameters were measured in 10-nm steps using single-integrating-sphere system in the wavelength range of 400 to 1800 nm.It was found that the optical properties and their differences varied with the wavelength for the HCC tissue and the non-tumorous hepatic tissue in the entire wavelength range of research.The absorption coefficient of the HCC tissue(1.48±0.99,1.46±0.88,0.86±0.61,2.15±0.53,0.54±0.10,0.79±0.15 mm-1) was significantly lower than that of the non-tumorous hepatic tissue(2.79±1.73,3.13±1.47,3.06±2.79,2.57±0.55,0.62±0.10,0.93±0.16 mm-1) at wavelengths of 400,410,450,1450,1660 and 1800 nm,respectively(P<0.05).The reduced scattering coefficient of HCC tissue(5.28±1.70,4.91±1.54,1.26±0.35 mm-1) and non-tumorous hepatic tissue(8.14±3.70,9.27±3.08,2.55±0.57 mm-1) was significantly different at 460,500 and 1800 nm respectively(P<0.05).These results show different pathologic liver tissues have different optical properties.It provides a better understanding of the relationship between optical parameters and physiological characteristics in human liver tissues.And it would be very useful for developing a non-invasive,real-time,simple and efficient way for medical management of HCC in the future.     

LIC模式对临床医学专业学生岗位胜任力的影响

目的 探索与传统科室轮转实习相比,纵向整合临床实习（longitudinal integrated clerkship,LIC）模式是否更有利于提升临床医学专业学生的岗位胜任力及实习满意程度。方法 选取2018年6月至2019年6月在哈尔滨医科大学附属第一医院进行毕业实习的72名学生,分为试验组和对照组,每组36名学生。试验组采用LIC模式,对照组采用传统科室轮转临床实习。实习结束后,对两组学生进行岗位胜任力评价。学生通过客观测试进行医学理论知识及临床基本能力评价,学生本人及带教教师对学生岗位胜任力其他五项进行评分。此外,对两组学生进行实习安排满意度问卷调查。采用SPSS 23.0统计软件进行t检验和卡方检验。结果 客观测试及学生自评显示,试验组学生的医学理论知识、临床基本能力、医学职业精神、医患沟通能力、团队合作能力、文献检索能力、科研能力得分分别为（8.02±1.11）（7.63±0.90）（7.74±0.56）（8.10±1.06）（7.84±0.62）（6.25±0.60）（4.26±0.88）,均明显高于对照组的（7.50±0.97）（6.93±0.73）（7.31±0.78）（7.22±0.60）（7.11±0.69）（4.78±0.84）（2.46±1.20）,差异有统计学意义（P<0.05）。试验组带教教师评价其医学职业精神、医患沟通能力、团队合作能力、文献检索能力、科研能力得分分别为（8.03±0.74）（7.95±0.73）（7.96±0.75）（4.84±0.84）（4.53±1.03）,高于对照组的（6.59±0.70）（6.87±0.67）（6.95±0.69）（3.30±0.69）（2.70±1.05）,差异有统计学意义（P<0.01）。试验组对课程安排满意度、师生互动满意度、自身提升满意度、临床工作顺畅度四方面分数分别为（7.17±0.91）（7.08±0.69）（7.28±0.45）（7.72±0.82）,高于对照组的（6.56±0.84）（6.28±0.82）（6.36±0.49）,（6.81±0.71）,差异有统计学意义（P<0.01）。结论 与传统科室轮转实习模式相比,LIC模式更有助于提高临床医学专业学生的岗位胜任力,有望成为取代传统科室轮转的新型临床实习模式。     

基于深度教学理念在眼战伤早期急救护理教学中的应用研究

目的 探讨深度教学理念引导下的眼战伤早期急救护理教学应用效果。方法 64名参加眼战伤早期急救护理培训的眼科护士被分为两组,对照组26人,观察组38人。对照组理论部分采用清单式自主学习,操作技能采用传统示教法;观察组基于深度教学的理念,从促进理解、启发反思、沉浸式体验3个维度进行教学设计并实施理论和实践教学。对比分析两组护士一般资料和实施前、后理论成绩,操作成绩及护士核心能力得分情况。采用SPSS 22.0进行t检验和卡方检验。结果 两组护士在年龄、眼科工作年限、学历、职称等一般资料上差异无统计学意义。实施前两组护士理论成绩、操作成绩和护士核心能力得分比较差异均无统计学意义;实施后观察组护士理论成绩[（90.13±5.87） vs. （81.73±4.68）,P<0.001],两项操作成绩[（95.63±2.81） vs. （87.31±4.51）,P<0.001];[（96.24±2.74） vs. （89.08±4.50）,P<0.001]均优于对照组;观察组护士核心能力量表的评判性思维得分[（34.00±1.93） vs. （30.58±3.01）,P<0.001]和临床护理能力得分[（32.13±1.65） vs. （28.35±2.28）,P<0.001]优于对照组。结论 基于深度教学理念的教学模式有助于提升眼科护士关于眼战伤早期急救的相关知识、急救技能、临床反思及护理能力,利于提高军队临床护士的思想觉悟和练兵备战意识。     

目标管理引导多模式教学在肿瘤科规培护生带教中的应用研究

目的 探讨目标管理引导多模式教学在规培护生带教中的应用效果。方法 采用整群抽样法将2019年4月至2020年4月某三甲医院肿瘤内科39名规培护生作为对照组,采用常规带教;2020年6月至2021年6月肿瘤内科40名规培护生作为试验组,应用目标管理引导多模式教学。研究两组理论及操作考核成绩、教学满意度、评判性思维能力及护患沟通能力的差异。应用SPSS 20.0进行t检验和卡方检验。结果 试验组理论考试[（86.17±3.74）vs.（83.92±4.93）]及操作考核成绩[（92.83±2.19）vs.（90.74±3.52）] 均高于对照组,差异均有统计学意义（P<0.05）。试验组教学满意度高于对照组[（46.10±2.96）vs.（42.67±2.45）],差异有统计学意义（P<0.05）。评判性思维方面,求知欲和分析能力方面差异有统计学意义（P<0.05）;护患沟通能力方面,除收集信息差异无统计学意义外,其余差异均有统计学意义（P<0.05）。结论 目标管理引导多模式教学可提高规培护生理论及操作技能能力、护患沟通能力及教学满意度。