生理药动学模型预测扑热息痛的人体血药浓度

目的:建立扑热息痛在大鼠体内的血流限速生理模型,预测其在人体内的血药浓度。方法:根据药物在体内血流限速的转运特征,基于acslXtreme环境搭建生理药动学模型的仿真模拟平台;搜集大鼠、人的生理参数,结合文献报道中的数据,验证模型的有效性,进而代入人的生理参数预测药物在人体血液中的经时变化,并与已发表文献数据进行比较验证模型推广的可行性。结果:建立了1个五室血流限速模型,预测值与文献报道值相关性良好。结论:模型可以准确预测扑热息痛在大鼠的药时过程,但模型外推至人还需要进一步对模型结构和参数进行调整和优化。     

PBL导师在功能神经外科教学的定位与教学技巧

基于问题的学习(Problem Based Learning,PBL)教学法正逐步应用于国内临床教学。在功能神经外科研究生的临床教学中应用PBL教学法,并获得良好效果。作为PBL导师在教学中的定位极为重要。PBL导师要明确PBL教学法的宗旨,在教学过程中,不进行相关知识的传授,对学生因材施教。运用教学技巧达到教学目的同样重要。首先要进行角色的转换,由示范教导转变成倾听者。在授课前,导师要做好课前准备,了解每位同学的特点并结合小组每位成员的能力,努力控制课上讨论的进度和深度。目的是使每位学生得到提高,学会发现问题及解决问题。     

Human papillomavirus vaccination in Auckland: Reducing ethnic and socioeconomic inequities

Background

The New Zealand HPV publicly funded immunisation programme commenced in September 2008. Delivery through a school based programme was anticipated to result in higher coverage rates and reduced inequalities compared to vaccination delivered through other settings. The programme provided for on-going vaccination of girls in year 8 with an initial catch-up programme through general practices for young women born after 1 January 1990 until the end of 2010.

Objective

To assess the uptake of the funded HPV vaccine through school based vaccination programmes in secondary schools and general practices in 2009, and the factors associated with coverage by database matching.

Methods

Retrospective quantitative analysis of secondary anonymised data School-Based Vaccination Service and National Immunisation Register databases of female students from secondary schools in Auckland District Health Board catchment area. Data included student and school demographic and other variables. Binary logistic regression was used to estimate odds ratios and significance for univariables. Multivariable logistic regression estimated strength of association between individual factors and initiation and completion, adjusted for all other factors.

Results

The programme achieved overall coverage of 71.5%, with Pacific girls highest at 88% and Maori at 78%. Girls higher socioeconomic status were more likely be vaccinated in general practice.

Conclusion

School-based vaccination service targeted at ethic sub-populations provided equity for the Maori and Pacific student who achieved high levels of vaccination.     

Effects of alcoholism and continued abstinence on brain volumes in both genders

Background: Alcohol abuse has detrimental effects on cerebral function, metabolism, and volume. Some of these effects were found to be at least partially reversible with continued abstinence. Furthermore, it has been reported that there are different effects of alcohol on brain volumes for women compared with men, but the results concerning the interaction between alcohol dependence and gender are inconsistent. With this study, we aimed to further investigate this question by examining the global gray matter (GM) and white matter (WM) changes as well as regional and local GM changes detected by voxel‐based morphometry (VBM) in male and female alcoholic patients a few weeks after detoxification and the corresponding changes in a subgroup of these patients 3 months later. Methods: A total of 50 patients, consecutively admitted for alcohol withdrawal treatment, participated in this study and were followed up for at least 3 months into abstinence. High‐resolution structural images were processed with SPM8 using an optimized VBM protocol. Results: Global cerebrospinal fluid (CSF) volume was increased and WM and GM volume decreased equally in male and female patients. A gender by diagnosis interaction was found neither for global nor for regional volumes or VBM data. VBM whole brain analysis yielded a significant GM volume loss in the patient group in the cingulate gyrus and the insula in both hemispheres. Region of interest analysis for the initial and 3 months follow‐up scans yielded significant gains in regional volumes, particularly the cingulate gyrus and the insula in the group of abstinent patients, whereas no volume change at all is found in the patients who had relapsed. Conclusions: Our study confirms widespread cerebral volume loss in recently detoxified alcoholics. The effects of alcohol dependence seem to have equally adverse effects on brain morphometry in males and females.     

基于工作过程的情景模拟教学法在内科学实践教学中的应用

目的 探讨基于工作过程的情景模拟教学法在内科学实践教学中的应用效果.方法 将124名学生分为2组,实验组62名学生采用基于工作过程的情景模拟教学法,对照组62名学生采用传统教学法.结果 实验组与对照组学生内科学理论考试成绩差异无统计学意义,技能考试成绩差异具有统计学意义,实验组学生成绩明显优于对照组学生.结论 基于...     

高校学生失眠症常见证型及中医辨证治疗

目的：研究高校失眠学生的中医证型分布规律,探讨相应的辨证治疗方法.方法：根据《中药新药临床研究指导原则》,将就诊的高校失眠学生分为肝郁化火型、痰热内扰型、阴虚火旺型、心脾两虚型、心胆气虚型五型,将其证型分布与北京地区普通失眠人群相比较,同时分析高校失眠学生的性别、年龄和学历特征,并研究高校失眠学生辨证论治的经验.结果：108例高校失眠学生数据分析表明,女性患病率高于男性（P＜0.05）;研究生患病率高于本科生（P＜0.05）;在证型分布上,高校失眠学生心脾两虚型比例高于普通失眠人群（P＜0.05）,而阴虚火旺型比例低于普通失眠人群（P＜0.05）.结论：高校学生中,女生、研究生更容易罹患失眠.高校失眠学生中医证型分布与普通失眠人群的差异,可能与其年龄特点和学习压力有关.     

基于工作过程的综合实训教学法在手术室护理强化训练中的应用

目的探讨基于工作过程的综合实训教学法在手术室实习前强化训练中的应用效果。方法抽取2010级护理1班、涉外1班共95人为观察组,采用基于手术室工作过程的综合实训法;2010级护理2班、涉外2班共95人为对照组,采用传统教学法。比较两组理论＋实践＋角色扮演综合评分,并设计问卷调查学生满意度。结果观察组考核成绩为（84．29±7．58）分,对照组考核成绩为（77．55±10．24）分,两组比较差异有统计学意义（t=3．76,P〈0．01）。问卷调查结果提示100．0％的学生接受基于工作过程的综合实训法。结论基于工作过程的综合实训教学法用于实习前强化训练,可缩短与临床手术室护理的差距,可使学生在实习期间尽快适应手术室临床实习工作。