医学生非智力能力状况调查与培养对策

医学生的非智力能力高低对学习起着重要作用。本文对长江大学医学院1 511名医学生的非智力能力现状进行了调查,结果表明:医科大学生非智力能力总体表现出良好的态势,但其内部因素的发展却不平衡。具体表现为:①男女生非智力能力之间存在显著性差异;②本科生与专科生非智力能力之间存在显著性差异;③高年级与低年级学生非智力能力之间存在显著性差异。本文对调查结果进行了分析,并提出培养医科大学生非智力能力的若干意见与建议。     

医学生创造意识调查与培养研究

为了解医学生创造意识（非智力）状况，对长江大学医学院1511名在校大学生进行了调查。结果表明：医科大学生创造意识水平总体看来表现出积极的趋势，但其内部因素的发展却不平衡。①男女创造意识存在显著性差异，P＜0．01；②本科生与专科生创造意识水平存在显著性差异，P＜0．01；③高年级与低年级创造意识水平存在显著性差异，P＜0．01。针对调查结果进行了分析，并提出从学校、教师和学生三方面入手培养医科大学生创造力的意见与建议。     

医学生校园人际关系的现状分析与思考

目的：了解医学生人际关系的状况。方法：采用自编的“医学生人际关系调查问卷”对456名学生施测，结果：医学生交友态度在不同年级、南方与北方存在显著性差异，对于校园人际氛围，贫困生与非贫困生不满意度存在显著差异；对于师生关系．不同年级、贫困生、独生子女存在显著差异；对于宿舍人际关系，不同年级存在差异：结论：校园人际关系对医学生的学习、生活影响是至关重要的，应针对医学生的心理特点，实施有效的人际交往心理教育：     

浅谈实习医学生的道德要求

实习医学生是指在教学医院进行临床实习的医科大学生。由于实习医学生扮演着学生和实习医生的双重角色，必然有特殊的道德要求。实习医学生的道德要求是：1勤奋学习精于医业医学是一门深奥的科学，“道在至微，变化难极”。如不勤奋学习，精极医源，是难以成为一名称职的医务工作者的。实习是高等医学教育的重要组成部分，也是医科大学生大学生活的重要组成部分。从根本上讲，实习医学生依然是一名学生。而学习则是学生的天职，是对学生的起码要求。从学校到医院，只不过是医科大学生的学习环境发生了变化，而学习这一基本要求并没有因环境…     

医科蒙古族汉族大学生心理健康状况比较研究

目的：了解医科大学生的心理健康状况并进行民族、性别的比较。方法：采用ＳＣＬ－９０量表进行测查并进行统计分析。结果与结论：医科大学生ＳＣＬ－９０各因子均值都高于全国常模，有１９１％的学生存在较严重的心理卫生问题；汉族学生的心理卫生问题较蒙古族学生严重；女生的心理卫生问题较男生严重；人际关系、忧郁、强迫化是医科大学生主要的心理卫生问题。     

新冠疫情期间线上教学背景下医学生自我调节学习能力与学业成就的关系研究

目的：探索新冠疫情下线上教学期间医学生的自我调节学习(self-regulated learning, SRL)能力以及其与学业成就的关系，为开展线上学习、提高医学生SRL能力和学业成就提供依据。方法：应用SRL量表对中国医科大学临床医学生进行网络问卷调查，分析SRL能力与学习成绩间的关系。结果：每天自学时间越长、父亲受教育程度越高以及对线上教学满意度越高的学生SRL得分越高；学习成绩与SRL及各维度得分存在显著相关性，SRL能力越强，学习成绩越好，SRL各维度能力之间亦存在显著正相关。结论：SRL能力对医学生学习成绩具有正向预测作用，教育者可通过提升教师教学水平、改善学习环境、提供更多优质教学资源等方法提高医学生SRL能力及学业成就。     

医科大学生职业兴趣现状调查

目的 分析医学生职业兴趣倾向,提出择业指导建议.方法 采用霍兰德中国职业兴趣量表对某医学院642名在校医学生进行职业兴趣现状调查.结果 医科大学生的职业兴趣倾向于调研型和社会型;性别不同的医科大学生职业兴趣上存在着显著差异;不同家庭来源的医学生,在艺术型职业兴趣方面有显著差异;方差分析表明各专业学生在实际型、调研型和事业型三类职业上的有显著差异.结论 医科大学生对自我职业兴趣倾向认知不够,需要通过多种途径帮助医学生作出正确的职业选择.     

团体心理咨询对医科大学生心理健康水平的影响研究

本研究以医学院四个年级的医学生为研究对象，采取修补试验设计的方法，应用团体咨询技术，对医科大学生的健康信念、自信心和心理健康水平进行干预。统计结果显示：团体咨询对医科大学生改善人际关系，去除躯体症状，克服抑郁、敌对、恐怖、偏执等方面；有良好的作用。特别是对大学一年级新生顺利度过适应期，健康地开始大学生活和对遭遇生活压力事件的医科大学生的心理调试有积极的作用。该研究提示，团体咨询是高校大学生心理健康工作可采取的一种有效的方法，对于“发展性心理咨询”有积极的效果。     

医学生挫折承受力调查及对策研究

目的了解医学生挫折承受力现状，寻找提高方法。方法采用挫折承受力问卷对大学生进行调查。结果医学生挫折承受力呈中等水平，低于非医学专业学生的挫折承受力水平，且存在显著性差异；男女医学生挫折承受力总分无显著性差异，但男生在面对挫折时的外在行为表现与女生有显著性差异。结论在教育实践中应加强对医学生进行挫折教育。     

高等医学院校的素质教育与医科大学生的全面发展

本文阐述了高等医学院校的素质教育与医科大学生的全面发展的深刻内涵。认为：高等医学院校的素质教育是医科大学生全面发展的途径和手段；医科大学生的全面发展是高等医学院校素质教育的目标和任务。并就高等医学院校素质教育的落实提出了一些建议。     

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.     

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.     

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.