医用电子直线加速器在使用中应注意的安全性问题及对策

简要介绍了医用电子直线加速器在日常使用工作中应注意的一些安全性问题，并提出了相应的解决对策和建议，为同行们在医用电子直线加速器的安全管理和使用操作提供参考。     

肠结核和克罗恩病临床病理改变的比较

目的：探讨肠结核和克罗恩病（Crohn＇s disease,CD）在临床、内镜、病理表现方面的差异及抗酸染色法对于肠结核和克罗恩病鉴别诊断的价值.方法：选取30例肠结核和25例克罗恩病,分别比较二者的临床表现及并发症、内镜下表现、病理表现,同时进行抗酸染色镜检.结果：①并发症：腹腔脓肿在CD更加常见（P＜0.05）②内镜：肠腔狭窄、卵石征和节段性改变在CD更加常见（P＜0.05）;③病理：肉芽肿,尤其是干酪性肉芽肿和肉芽肿的融合在肠结核中更加多见（P＜0.05）;④抗酸染色镜检在肠结核的阳性率仅为20%,而在CD中无一例检出.结论：肠结核和克罗恩病两病在临床表现、内镜下表现及病理表现方面均存在很多相似性,二者的临床鉴别诊断存在着很大的困难,但综合各项指标并仔细加以鉴别,也可以将两者区分开来.     

Ophthalmology Services at Student-Run Free Clinics: A National Survey

ImportanceStudent-run free clinics (SRFCs) primarily service the uninsured and are a unique way for medical students to gain hands-on exposure to ophthalmology. The free clinic model takes many different forms- some with episodic and longitudinal models-- and this is mirrored in corresponding eye services.ObjectiveTo describe SRFC ophthalmology services nationwide.DesignThis was a telephone survey study administered from June through July of 2018.SettingThis study surveyed medical school SRFC clinics across the United States.ParticipantsSurvey request was sent to 19 SRFCs previously identified as having ophthalmology services via internet search. Fourteen SRFCs (73%) participated; participants were either student clinic leaders or medical directors. One respondent no longer had a distinct eye clinic so was excluded from relevant results.Main Outcome and MeasureCharacteristics of ophthalmology SRFCs including participants, frequency of sessions, common diagnoses treated, and challenges encountered were assessed through this survey.ResultsOn average, each SRFC provided 5.15 hours per month of ophthalmology services. The mean number of medical students involved per session was 8.7. Lack of infrastructure to ensure adequate patient follow-up and faculty recruiting were cited as the main challenges in providing ophthalmology services. Most SRFC leaders indicated exposure to ophthalmology and practice with the exam as the main experiences that students sought and achieved. The most common conditions treated were refractive error (92.3%) and diabetic retinopathy (69.2%).ConclusionThere are a small number of SRFCs that have ophthalmology services, and they share common features in terms of participants, staffing, and, barriers to sustainability. Ophthalmology services at SRFCs offer a unique venue for medical students to gain exposure to an under-represented field in medical school curricula. The growth of this critical venue for medical student training could be enhanced by recruitment strategies aimed at ophthalmology faculty with a strong interest in service and teaching.     

浅谈医学留学生胃肠外科教学的体会及思考

随着我国综合国力的不断提升,到我国学习临床医学的外国留学生日益增多,留学生教育已成为高等医学教育的重要组成部分。为适应医学留学生胃肠外科教学需要,结合留学生教学实践,本文提出制订合适的教学内容与方法,编写专用英文教材,加强教师英语口语表达能力并加强师生沟通。在传授知识的同时,还应注重临床实践能力的培养和医德医风的教育。实践表明,上述措施对提高教学质量有一定帮助。