基于学生需求的医学文献检索课教学改革

结合学生意见和建议,总结分析了医学文献检索课教学中存在的问题,针对这些问题提出了改进教学硬件设备、改变教学方式、开通多种课后答疑和辅导途径、强化学生的信息技能、完善课程考核形式等改革措施。     

基于xMOOC模式的校园公开课程参与者角色剖析

以目前国内外MOOC建设中存在的问题为切入点,结合校园公开课程在线学习的特殊性,采用文献综述及理论分析的方法对高校校园公开课程开展的xMOOC模式进行了探讨,重点剖析了学习者、教师、执行体系以及观察者这四种参与角色,发现存在角色定位不准确甚至缺失的情况,并对高校校园公开课xMOOC开展提出了建议。     

临床医学八年制信息检索课两段式教学探索

从教学内容、教学组织、教学模式、教材建设、考核方式等方面介绍了近年来针对临床医学专业八年制开设两段式信息检索课教学的实践情况,以卷面成绩、专题调研报告完成情况及小组回报情况和学生的反馈等角度分析了教学效果,并提出了要注重分阶段教学内容的有效衔接、检索课题的筛选和精炼、任课教师的选拔和培养等进一步提高课堂教学效果的措施。     

Neighbourhood disadvantage and individual adversities in adolescence and total alcohol consumption up to mid-life—Results from the Northern Swedish Cohort

This study tests if neighbourhood socioeconomic disadvantage and family social and material adversities during adolescence are independently related to total alcohol consumption from adolescence through to mid-life. Self-reports from the Northern Swedish Cohort (effective sample=950) at ages 16, 18, 21, 30 and 42 was combined with register data on the socioeconomic composition of neighbourhoods at age 16. Total volume of alcohol consumed between age 16–42 was estimated based on the five survey waves, and self-reported social and material adversities were computed as composite variables. Neighbourhood socioeconomic disadvantage at age 16 was associated with alcohol consumption age 16–42 for men but not for women. Social adversities at age 16 were associated with alcohol consumption age 16–42 for both women and men, but material adversity or parental class was not. In conclusion, neighbourhood socioeconomic disadvantage in adolescence has a significant relationship with later alcohol consumption among men, even independently from individual factors. On family level, social factors but not socioeconomic factors in adolescence independently predict later alcohol consumption.     

14例食管癌放疗后复发再程放疗的疗效观察

目的:观察食管癌放疗后复发再程放疗的疗效.方法:对14例再程放疗的食管癌患者采用Varian 23EX电子直线加速器适形放疗,1.2Gy/次,2次/日,总剂量DT33~62Gy,放疗2~3周.结果:10例病变消退(8例食道黏膜恢复,2例癌性狭窄,采用球囊扩张扩大食道,可正常进食),无效3例病灶扩大,1例发生呕血,死亡;未发生放射性脊髓炎,有不同程度放射性食管炎;1年存活率50.00%、2年存活率28.57%.结论:放疗后复发再程放疗,有助于消除食管癌复发症状,改善患者生存质量,安全可靠,但仍有部分患者难获显著疗效.     

Environmental exposures,breast development and cancer risk: Through the looking glass of breast cancer prevention

This review summarizes the report entitled: Breast Cancer and the Environment: Prioritizing Prevention, highlights research gaps and the importance of focusing on early life exposures for breast development and breast cancer risk.     

通过教学反思来提高外科临床实验课的教学效果

实验教学是医学生从理论到实践过渡的重要环节,实验技能水平能直接反映医学生的各项素质发展,同时也能检验其临床综合能力。教学反思是提高教师教学能力和水平的重要环节,本文就外科临床实验课中教学反思的意义、过程、成分和方法作一论述,以期提高教师教学能力及水平。     

Quelles indications d’hospitalisation d’un patient avec addiction ? Application du modèle des pathologies chroniques. Une étude de validité apparente

IntroductionThe medical identification of an addiction (use disorder) often results in inpatient admission with a view to its definitive suspension. However, for other chronic diseases, inpatient admission is indicated for specific situations and the objective is not the definitive suspension of the chronic disease. Our goal was to clarify addiction as a chronic disease and to determine explicit indications for inpatient admission.MethodThree-stage face validity study: (1) from the analysis of consensual definitions, search by the subset theory whether addiction can be considered as a chronic disease; (2) Develop generic indications for inpatient admissions based on the analysis of chronic disease care pathways validated by the HAS (French Health Agency) and apply them to addiction; (3) Validate by Delphi expert consensus method the determined indications.ResultsStep (1) showed that the definition of addiction allowed to include it in that of chronic disease. Step (2) determined 7 indications for inpatient admission of a patient with a chronic disease, and its application to addiction identified 15 indications for inpatient admission of a patient with addiction. In step (3), the Delphi method yielded consensus on 14 of the 15 indications.ConclusionBy clarifying addiction as a chronic disease, we were able to determine 14 indications for inpatient admission of a person with an addiction and to distinguish them from the long-term care of addiction. These explicit indications can help the general practitioner or community psychiatrist to better manage patients with addiction on the basis of their expertise with chronic diseases management.     

不同病程2型糖尿病患者甲襞微循环状态比较

目的:观察不同病程2型糖尿病(T2DM)患者甲襞微循环障碍程度。方法:600例住院T2DM患者,依病程分为新诊断组、3月～5年组、6年～10年组和>10年组。选取30例健康体检者为对照组。用徐州产HD-WX-10型微循环显微仪,在22～24℃室温下,检测所有对象的左手无名指,观察甲襞微循环形态、流态和袢周状态,并对各组加权积分值、不同程度异常率和部分指标异常进行统计学分析比较。结果:(1)不同病程各组T2DM患者甲襞微循环形态、流态和袢周状态积分均高于对照组,以管袢减少、白微栓、渗出和出血等改变较明显(P<0.01),中度异常患者比例较高。(2)病程10年以内各组患者积分值、部分指标异常率及异常程度无统计学差异(P>0.05)。(3)>10年组患者甲襞微循环流态及袢周形态积分和总积分较其它组增加(P<0.05),中度异常患者比例较高(P<0.01),管袢明显减少,白微栓和渗出显著增多(P<0.01)。结论:T2DM患者存在微循环障碍,病程>10年者较重。