体验式教学法应用于外科护理教学提高护生人文关怀能力的探讨

目的将体验式教学法应用于外科护理教学以提高护生人文关怀能力,满足临床对护理人才的需求。方法整群随机抽取我校4年级两个班高职护生,通过抽签方式分为对照组和实验组。外科护理教学中,对照组采用传统教学法,实验组采用体验式教学法,即按照基础体验、观察和思考、展示和总结、实际应用4个环节组织教学。结果实验组护生人文关怀能力量表总分高于对照组,差异具有显著性(P<0.01);实验组外科护理学考核成绩高于对照组(P<0.05),护生自主学习和综合分析能力明显提高。结论体验式教学法是培养护生人文关怀能力的有效方法。     

基于培养护生人文关怀能力的基础护理学实验教学设计与实践

目的：探讨基础护理学实验教学设计中融入关怀教育对培养护生人文关怀能力的效果.方法：将120名护理本科生随机分为实验组和对照组各60名.对照组采用传统的实验教学方法,实验组在技能操作训练基础上,将人文关怀教育融入教学各环节.教学结束后对两组护生教学效果进行评价.结果：实验组护生关怀意识和关怀能力显著高于对照组（P＜0.05）;实验组护生对实验教学持肯定态度.结论：融入文关怀教育于护理实践教学中有助于护生关怀意识和关怀能力的提高.     

课程思政对护生人文关怀能力影响的研究

目的探讨课程思政对护生人文关怀能力的影响。方法采用整群抽样方法选取我院2018级护理专业两个自然班的大专生为研究对象,随机分为实验组和对照组。对照组采用传统教学方法,实验组对实训课教学方法、考核方式进行改革。实验组护生在课程前后进行人文关怀能力问卷调查并进行自身对照比较,课程结束后将实验组与对照组护生护理技能成绩进行比较。结果实验组护生课程前与课程结束后人文关怀能力总分比较,差异有统计学意义(P<0.05),两组护生的护理技能考试成绩比较,差异有统计学意义(P<0.05)。结论将课程思政元素融入护生的基础护理学实训教学中,培养了护生的人文关怀意识和能力,充分发挥了课程思政的育人功能,为高职护生人文关怀教育提供了新的思路和方法。     

体验式教学法在社区护理学教学中的应用效果分析

目的 在社区护理学教学中应用体验式教学法,评价对学生人文关怀能力、职业认同水平的影响及教学效果.方法 采取抽签法,随机将遵义医药高等专科学校2019级护理1班61名学生作为实验组,2班64名学生作为对照组.实验组采用体验式教学法,对照组采用传统讲授法.在社区护理学教学前后调查两组人文关怀能力和职业认同水平,并比较两组对...     

基于人文关怀的护理临床路径在护生实习前综合实训教学中的应用

目的探讨基于人文关怀的护理临床路径在护生实习前综合实训教学中的应用效果。方法采用随机抽样法,抽取我校2016级护理专业两个班护生为研究对象,将两个班随机分为对照组和实验组,对照组采用传统实训教学方法,实验组采用基于人文关怀的护理临床路径实训教学方法。实训开始前和结束后分别向实验组护生发放调查问卷,比较护生实训前后人文关怀情况;实训结束后对两组护生进行综合考核,比较两组护生考核成绩,包括理论知识、技能操作、人文关怀及临床分析能力4个模块。结果实训后实验组护生人文关怀情况较实训前有明显改善(P<0.001),实验组护生综合考核成绩高于对照组。结论将基于人文关怀的护理临床路径融入实训教学,能有效提升护生人文关怀能力、临床分析能力与实训教学质量。     

人文关怀结合体验式教学在呼吸与危重症医学科实习护生教学中的应用

目的　探讨人文关怀结合体验式教学在呼吸与危重症医学科实习护生教学中的应用。方法　选取2019年7月至2020年12月在首都医科大学附属北京朝阳医院呼吸与危重症医学科进行实习的全日制本科护理专业实习生100人作为研究对象。按实习护生进科的先后顺序分为对照组和研究组,每组50人。对照组采用传统教学,研究组采用人文关怀结合体验式教学。实习结束后通过人文关怀素养能力自评量表测量实习护生的人文关怀行为,通过自行设计的教学效果评价表对教学效果进行评价。采用SPSS 22.0进行t检验和卡方检验。结果　研究组实习护生人文关怀素养能力在技能、沟通、尊重、理解和奉献5个方面得分均高于对照组,差异有统计学意义（P<0.05）。研究组实习护生在人文关怀素养能力、护患沟通能力、自主学习能力、分析解决问题能力、敏锐观察力、应急反应能力、评判性思维能力、团队协作能力共8个方面的教学效果评价均优于对照组,差异有统计学意义（P<0.05）。结论　人文关怀结合体验式教学有助于呼吸与危重症医学科实习护生提高人文关怀素养能力,提高临床实践综合能力,改善临床教学质量。     

病例导入式教学法在精神科护理学教学中的应用

目的探讨病例导入式教学法在精神科护理学教学中的应用及效果。方法将我院2011级三年制大专护理专业4个班随机分为对照组（n=118）和实验组（n=124）,每组两个班,对照组采用传统教学法,实验组采用病例导入式教学法,课程结束后,比较两组精神科护理学理论考核成绩及护生对教学效果的评价。结果实验组理论考核成绩及护生对教学效果的评价优于对照组（P〈0.05）。结论病例导入式教学法有助于提高精神科护理学教学质量,可作为精神科护理学的有效教学形式。     

体验式教学对护理本科生人文关怀能力及评判性思维能力的影响

目的探究体验式教学对护理专业本科生人文关怀能力的培养和产生的作用,以及对评判性思维产生的影响。方法采用便利抽样的方法整群选取某高校护理学院2015级护理本科生2个班81名学生为对照组,2016级护理本科生2个班86名学生为试验的对象。在实际教学过程中,对照组采用传统的教学方式,试验采用体验式教学方式,观察比较两组护理本科生学期结束时人文关怀能力及评判性思维能力情况。结果干预前2组护理本科生人文关怀能力及评判性思维能力比较差异无统计学意义(P>0.05)。干预后试验组护理本科生人文关怀能力及评判性思维能力均高于对照组(P<0.01)和干预前(P<0.01);对照组干预后护理本科生人文关怀能力高于干预前(P<0.01),而评判性思维能力干预前后比较差异无统计学意义(P>0.05)。结论体验式教学法有助于提高护理本科生人文关怀能力和评判性思维能力,是一种较理想的基础护理学教学方法。     

人文关怀结合体验式教学在呼吸与危重症医学科实习护生教学中的应用

目的探讨人文关怀结合体验式教学在呼吸与危重症医学科实习护生教学中的应用。方法选取2019年7月至2020年12月在首都医科大学附属北京朝阳医院呼吸与危重症医学科进行实习的全日制本科护理专业实习生100人作为研究对象。按实习护生进科的先后顺序分为对照组和研究组, 每组50人。对照组采用传统教学, 研究组采用人文关怀结合体验式教学。实习结束后通过人文关怀素养能力自评量表测量实习护生的人文关怀行为, 通过自行设计的教学效果评价表对教学效果进行评价。采用SPSS 22.0进行t检验和卡方检验。结果研究组实习护生人文关怀素养能力在技能、沟通、尊重、理解和奉献5个方面得分均高于对照组, 差异有统计学意义(P<0.05)。研究组实习护生在人文关怀素养能力、护患沟通能力、自主学习能力、分析解决问题能力、敏锐观察力、应急反应能力、评判性思维能力、团队协作能力共8个方面的教学效果评价均优于对照组, 差异有统计学意义(P<0.05)。结论人文关怀结合体验式教学有助于呼吸与危重症医学科实习护生提高人文关怀素养能力, 提高临床实践综合能力, 改善临床教学质量。     

叙事教育在培养护理本科生人文关怀品质中的应用

目的探讨在基础护理学理论教学中融入叙事教育教学法对护生人文关怀品质的影响。方法采用整群抽样的方法选取长治医学院2013级护理本科生150名作为研究对象,随机分为对照组和实验组。对照组在教学中按常规教学,实验组采用关怀叙事教学模式,为期1年。教学干预结束后根据护士人文关怀品质调查问卷表和护生平均理论成绩评价两组教学效果。结果教学干预后实验组护生人文关怀品质总分及4个维度得分明显高于对照组(P<0.01),实验组和对照组护生平均理论成绩比较差异有统计学意义(P<0.05)。结论护理教师在护理专业课程理论教学中使用叙事教育教学法,有利于培养护生的人文关怀品质。     

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.