SP联合CBL在骨外科临床实践教学中的应用研究

目的探讨标准化病人(standard patient,SP)结合案例式教学(case-based learning,CBL)在骨外科临床实践教学中的应用效果。方法选取2018—2019学年于我院骨科实习的南京医科大学2014级临床医学专业学生50人作为研究对象。随机将其均分为试验组和对照组两组,每组各25人。试验组采用SP+CBL相结合教学方法;对照组采用传统CBL授课方法。在教学结束后,请所有参与试验的学生对课程进行评价,并从理论和操作两方面对学生进行考核。结果两组学生的理论考试成绩无明显差异,不具统计学意义(P>0.05)。但试验组学生的临床技能操作考核成绩高于对照组(P<0.01)。试验组学生对SP+CBL教学在激发学习兴趣、增强解决实际问题能力及提高骨外科实践教学质量等方面的满意度显著高于对照组(P<0.01)。结论SP+CBL教学优于传统CBL教学,可以显著提高学习的积极性,有助于提高骨外科临床实践教学的效果。     

标准引领下医学人才培养过程规范建构与实践

近年来,我国职业教育办学规模已实现跨越式发展.进一步加强内涵建设,提升育人质量将成为职业教育可持续发展的基本路径.标准建设是检验学校人才培养质量的重要依据.文章通过构建标准建设基本路径,基于健康产业发展需求,分析医学人才过程中的重要环节,完善专业人才培养方案,优化课程体系,制定包括课程、课堂教学、实践教学、临床教学等各...     

动态血糖监测优化预混胰岛素治疗效果的临床观察

目的 观察iPro2回顾式动态血糖监测优化2型糖尿病预混胰岛素的治疗效果.方法 选取40例应用预混胰岛素的患者,随机分为观察组、对照组各20例,对照组在常规SMBG基础上行糖尿病教育,观察组应用美国美敦力公司生产的iPro2回顾式动态血糖监测系统对患者进行个体化糖尿病教育,并观察两组空腹血糖(FBG)、餐后2 h血糖(...     

Improved quantification of protein in vaccines containing aluminum hydroxide by simple modification of the Lowry method

Aluminum (Al) components in vaccines are known to act as adsorbents that interfere with accurate protein quantification by the Lowry method. Therefore, certain modifications based on the characteristics and compositions of the vaccine are required for determination of protein contents.We investigated the effects of an additional centrifugal separation and found that protein contents were overestimated by up to 238% without centrifugation through a collaborative study performed with hepatitis B vaccines containing Al. However, addition of a centrifugation step yielded protein concentrations that were similar to the actual values, with small coefficients of variation (CVs). Proficiency testing performed in 11 laboratories showed that four laboratories did not have satisfactory results for vaccines containing aluminum hydroxide, although all laboratories were proficient in protein analysis when samples did not contain aluminum hydroxide. Incomplete resuspension of aluminum hydroxide solution with alkaline copper solution was the major cause of insufficient proficiency in these laboratories.     

Primary insomnia patients’ performances during simulated car following and urban driving in the afternoon

According to epidemiological studies, insomnia is associated with an increase in risk of traffic accidents. Recent investigations revealed that patients with insomnia had driving performance impairment under monotonous conditions. However, it is unclear whether other driving abilities may be impacted by insomnia, especially those needing more attentional resources than those involved in monotonous driving. Other findings revealed that impaired performances are more likely to occur with the increase of cognitive demands. However, such tests did not reflect difficulties in situations of everyday life expressed by patients with insomnia, such as driving in an urban environment with traffic and critical situations. Therefore, behaviour in situations encountered in everyday life has to be explored. The aim of the present study was to assess driving performances of patients with insomnia in daily routine tasks such as urban and car‐following tests. For this purpose, 15 patients with insomnia and 16 good sleepers performed an urban test of driving with original risk scenarios and a car‐following test during the middle afternoon. No significant behavioural difference between patients with insomnia and good sleepers has been found in both the urban test and the car‐following test, showing that patients with insomnia have no impairment in behaviour implicated in daily contexts driving tasks of short period of time performed in the late afternoon. Although our results provide a first step towards knowledge of behavioural performance during daily routine driving tasks in patients with insomnia, future studies are needed using on‐the‐road driving tests and/or different population of patients with insomnia before generalisation.     

中药注射剂不良反应分析及防治对策

中药注射剂（TCMI）在临床应用广泛,疗效确切,但随着其应用的发展,不良反应也日益被关注。有关TCMI不良反应报道的不断增加,人们越来越担心其安全性,TCMI的发展正面临着前所未有的严峻挑战,如何以理性的态度来看待TCMI及其安全性,为TCMI寻找符合时代精神、切合科学发展规律的道路是目前中药研究者的迫切任务。本文通过分析TCMI常见不良反应的表现及产生原因,对药物组成、安全性、有效性、药物经济学、质量标准、与化学药的联合应用和TCMI的上市后的再评价问题提出相应的建议,为提高TCMI质量及安全合理用药提供参考,减少其临床应用中不良反应的发生。     

Correlations between stress,anxiety and depression and sociodemographic and clinical characteristics among outpatients with heart failure

AimTo describe and investigate correlations among anxiety, stress and depression and identify their relationship with sociodemographic and clinical characteristics of patients with heart failure.

大骨瓣减压加颞肌切除术对大面积脑梗死的疗效

目的探究分析标准大骨瓣减压联合颞肌切除术在大面积脑梗死患者中的临床治疗效果。方法从2016年12月-2018年11月我院收治的大面积脑梗死患者中抽选46例,采取数字随机分配法分为两组。试验组24例,采取标准大骨瓣减压联合颞肌切除术治疗,对照组22例,采取单纯标准大骨瓣减压术治疗,对比两组患者临床治疗效果。结果试验组中线回复(11.37±2.11)^15.09±2.79mm,对照组中线回复(12.24±3.31)^16.22±3.11mm,试验组中线回复情况优于对照组,死亡率(33.33%)明显低于对照组(63.64%),P<0.05,差异具有统计学意义。结论在大面积脑梗死患者中采取标准大骨瓣减压联合颞肌切除术治疗能够有效改善脑梗死情况,降低病死率,临床治疗效果显著。     

Report From the American Society of Transplantation Conference on Donor Heart Selection in Adult Cardiac Transplantation in the United States

Cardiac transplantation remains the only definitive treatment for end‐stage heart failure. Transplantation rates are limited by a shortage of donor hearts. This shortage is magnified because many hearts are discarded because of strict selection criteria and concern for regulatory reprimand for less‐than‐optimal posttransplant outcomes. There is no standardized approach to donor selection despite proposals to liberalize acceptance criteria. A donor heart selection conference was organized to facilitate discussion and generate ideas for future research. The event was attended by 66 participants from 41 centers with considerable experience in cardiac donor selection. There were state‐of‐the‐art presentations on donor selection, with subsequent breakout sessions on standardizing the process and increasing utilization of donor hearts. Participants debated misconceptions and established agreement on donor and recipient risk factors for donor selection and identified the components necessary for a future donor risk score. Ideas for future initiatives include modification of regulatory practices to consider extended criteria donors when evaluating outcomes and prospective studies aimed at identifying the factors leading to nonacceptance of available donor hearts. With agreement on the most important donor and recipient risk factors, it is anticipated that a consistent approach to donor selection will improve rates of heart transplantation.