论信息化教学模式的构建——信息化教学模式的定义与构成要素分析

在分析"信息化教学模式"已有定义、构成要素和分类研究的基础上,对"信息化教学模式"的基本内涵做了进一步评述,以期为实际教学中的信息化教学模式构建提供理论指导。     

白芍提取物及其有效成分抗氧化活性的研究

目的考察白芍粗提物及其有效成分五没食子酰基葡萄糖(pentagalloylglucose,PGG)抗氧化活性。方法用乙醇为提取剂超声提取白芍中有效成分PGG;用高速逆流法分离纯化PGG;用高效液相色谱及质谱法分析、鉴定PGG;以维生素C(vitaminc,Vc)为阳性对照,用1,1-二苯基-2-苦基苯肼自由基法(1,1-diphenyl-2-picrylhydrazyl,DPPH)和Fe3+-三吡啶三吖嗪法(ferricreducing-antioxidant power,FRAP)法评价白芍粗提物及PGG的抗氧化活性。结果从白芍中分离纯化得到PGG,其纯度为95.7%。DPPH实验表明,白芍粗提物及PGG对DPPH自由基均有较强的清除作用,其残留率的IC50为PGG<白芍粗提物白芍粗提物>Vc。FRAP实验结果表明,与白芍粗提物及Vc相比较,PGG抗氧化作用最强,尤其在浓度较低(如10μg/mL)时,其FRAP值大于白芍粗提物并远远大于Vc;当浓度增大时,各物质FRAP值均增大,抗氧化能力增强。但Vc增加得更为显著,在100μg/mL时,Vc的FRAP值为420.8μmol/L,已接近白芍粗提物的FRAP值,但仍低于PGG的FRAP值567.1μmol/L。结论中药白芍中含有抗氧化有效成分PGG,PGG的抗氧化作用远大于阳性对照药Vc,PGG将有可能成为一种潜在的天然高效抗氧化剂,具有广泛的临床应用前景。     

常规开胸与胸腔镜下治疗早期胸腺瘤的临床研究

目的比较常规开胸与胸腔镜下治疗早期胸腺瘤的临床效果,探讨胸腔镜下治疗早期胸腺瘤的可行性及优越性。方法回顾分析96例常规开胸（40例）和胸腔镜（56例）治疗的早期胸腺瘤患者,观察两种治疗方式的术后临床情况和并发症情况的差异。结果胸腔镜组与常规开胸组相比,手术时间、术后拔管时间和术后住院时间短,术中出血和术后胸腔积液引流量少,差异有统计学意义（P〈0.05）;胸腔镜组发生并发症的例数少于常规开胸组,差异有统计学意义（P〈0.05）;随访期间,胸腔镜组无复发和转移者,常规开胸组出现1例。结论胸腔镜较常规开胸治疗早期胸腺瘤具有明显优势。     

口服药物对增生性糖尿病视网膜病变术后康复效果的影响

目的：观察口服羟苯磺酸钙片联合依帕司他片,对增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)玻璃体切割手术后患者康复效果的影响。

方法：在PDR玻璃体切割手术后患者知情同意的情况下进行随机分组,分为术后药物干预组及对照组,术后2d; 3,6,9,12mo随访视力及眼底情况,并进行比较。

结果：药物干预组视力恢复及保持较好,且黄斑水肿消退情况明显优于对照组。

结论：PDR患者玻璃体切割手术后,积极口服保护视网膜的药物进行干预有利于视力的提高和眼底的康复。     

影响单病种住院费用的多因素分析

目的：研究单病种住院费用的影响因素，探讨降低医疗费用的方法。方法：调查６种疾病的３４项指标，周ＳＰＬＭ统计软件处理分析。结果：病情、病程、费别和年龄等对医疗费用有明显的影响，药品和住院天数为主要影响因素。结论：缩短住院时间，控制用药和合理用药则能降低医疗费用。     

阿托伐他汀钙治疗老年心力衰竭合并阵发性房颤的临床观察

目的：观察阿托伐他汀钙治疗老年心力衰竭合并阵发性房颤的临床疗效及安全性。方法：将149例老年心力衰竭合并阵发性房颤患者随机分为对照组（73例）和治疗组（76例）。对照组患者给予常规治疗;治疗组患者在对照组治疗的基础上给予阿托伐他汀钙20mg,1次／晚。两组患者疗程均为1年。评价两组患者的临床疗效;观察两组患者治疗前后甘油三酯（TG）、胆固醇（TC）、心输出量（CO）、左心室射血分数（LVEF）及左心房内径的变化;观察两组患者房颤和缺血性事件的发生率及不良反应发生情况。结果：治疗组患者总有效率显著高于对照组,两组比较差异有统计学意义（P〈0．05）。治疗后,治疗组患者TG、TC和左心房内径均显著低于对照组,CO、LVEF显著高于对照组,两组比较差异均有统计学意义（P〈0．05）。治疗组患者阵发性房颤复发率、转为持续性或永久性房颤发生率、缺血性事件发生率均显著低于对照组,两组比较差异有统计学意义（P〈0．05）。治疗期间两组患者均未见明显不良反应发生。结论：阿托伐他汀钙治疗老年心力衰竭合并阵发性房颤具有较好的疗效,且安全性较好。     

Effects of alcohol restriction on ambulatory blood pressure,heart rate,and heart rate variability in Japanese men

We investigated the effects of alcohol restriction on ambulatory blood pressure (BP), heart rate, and heart rate variability in 33 Japanese male volunteers (37 ± 1 years, mean ± SE), who were all habitual drinkers. Subjects were told either to keep their usual drinking habits for 3 weeks (usual alcohol period), or to reduce alcohol intake by at least half of their usual drinking amount (reduced alcohol period). The ambulatory BP, heart rate, and electrocardiographic R-R intervals were measured during a 24-h period with a portable recorder on the last day of each period. A power spectral analysis of R-R intervals was performed to obtain the low-frequency (LF) and high-frequency (HF) components. The percentage of differences between adjacent normal R-R intervals >50 msec (pNN50) was also calculated. The amount of ethanol intake was significantly reduced from 70 ± 5 mL/day in the usual alcohol period to 19 ± 3 mL/day in the reduced alcohol period (P < .0001). The daytime systolic BP was significantly lower in the reduced alcohol period than in the usual alcohol period by 4 ± 1 mm Hg (P < .05). The daytime and nighttime heart rate was significantly lower in the reduced alcohol period than in the usual alcohol (P < .001 for each). The pNN50 and the HF component were significantly higher in the reduced alcohol period than in the usual alcohol period (P < .0001 for each). The LF/HF ratio was significantly lower in the reduced period than in the usual period (P < .01). These results demonstrate that 3-week alcohol restriction produced reductions in ambulatory systolic BP, heart rate, and the index of sympathovagal balance, and augmentations of parasympathetic indices of heart rate variability in Japanese male drinkers.