医学本科生导师制实施的必要性及过程分析

在高等教育的大众化和普及化阶段,本科生导师制彰显出精英教育的品质与价值,是培养个性化人才和创新型人才的重要模式与机制。随着时代的发展,医学教育的模式应该以精英教育为其主要的教学模式,导师制在医学教育中的运用不但可以促进精英人才的培养,而且还可以促进医学人才创新思维的培养。因此,实行本科生导师制是紧扣时代发展的需要,是加强医学生综合素质的需要,是深化培养模式改革,推进教育创新的需要。     

IL28B Genotype Does Not Correlate with HIV Control in African Americans

Background: HIV‐1 natural viral suppressors (NVS) are individuals that control HIV replication without antiretrovirals (also know as HIV elite controllers). We have recently shown that these individuals have an elevated rate of hepatitis C virus (HCV) clearance. Given the association of IL28B genotype, specifically the rs12979860 single nucleotide polymorphism (SNP) based CC genotype, with HCV clearance, we studied its association with HIV control in 172 African American HIV subjects and 173 race‐matched controls. Findings: The frequency of the CC genotype was 12.5% in the NVS, 14.7% in the LVL (“low viral load” cohort with 400–20,000 HIV‐1 RNA copies/mL), 17.8% in the MHVL (“medium/high viral load” cohort with >20,000 HIV‐1 RNA copies/mL), and 11.6% in an HIV‐negative cohort. There was no statistical significance in the CC genotype distribution between these cohorts (p= 0.48 between the NVS and non‐NVS HIV positive controls, p= 0.85 between NVS and HIV‐negatives). We also did not observe any association between CC genotype distribution and HIV RNA viral load, as a continuous measure. Conclusions: The IL28B CC genotype does not account for the noted HIV control in our specific NVS cohort. Further studies will be needed to determine if a common genetic factor can primarily account for any joint clearance of HCV and control of HIV. Clin Trans Sci 2011; Volume 4: 282–284     

Dietary supplements and medications in elite sport – polypharmacy or real need?

The aim of this study was to describe qualitatively and quantitatively dietary supplements (DS) and medication use in elite athletes. Athletes (n=912; age 23.9±6 years; 72% male) reported medications and DSs taken within 3 days before doping control. We analyzed data collected from 2006 to 2008, indentified and classified substances. Total of 74.6% athletes reported use of at least one substance, 61.2% took DS (3.17 per user) and 40.6% took medications. Among users, 21.2% reported the use of six and more different products, and one took 17 different products at the same time. Majority of medication users took non‐steroidal anti‐inflammatory drugs (NSAID) (24.7%), and 22.2% used more than one NSAID. We found no gender differences in DS use (P=0.83). Individual sport athletes used more DS (P<0.01). Our study showed widespread use of DS and drugs by elite athletes. Consumption of DS with no evident performance or health benefits, demonstrated the need for specific educational programs focused on DS use. Amount, quantity and combination of the reported products raised concern about the risk of potential side effects.     

Prolift盆底重建术治疗重度盆腔器官脱垂的疗效评价

目的 评价应用Prolift全盆底重建术治疗重度盆腔器官脱垂的临床效果.方法 45例POP-Q分度为Ⅲ度和Ⅳ度的盆腔器官脱垂患者施行保留子宫的Prolift全盆底重建术,术后定期随访,以POP-Q分度为客观疗效评价指标,以对手术满意度的视觉模拟评分（VAS）为主观疗效评价指标.结果 手术时间（86.3±28.1） min,术中出血量（178.5±53.8） ml,术后平均住院（6.8±2.4）d,随诊6～18个月,治愈率为97.8%（44/45）.术后1个月、3个月、6个月、1年的POP-Q分度测量值与术前比较差异均有统计学意义（P＜0.05）,术后1个月、3个月、6个月、1年的VAS与术前比较差异均有统计学意义（P＜0.01）.结论 Prolift全盆底重建术安全、微创、有效、并发症少,术后生活质量明显改善,值得临床推广.     

国内外医院预约诊疗服务系统现状及发展策略分析

对比分析目前国内外预约诊疗系统建设和投入应用的现状,剖析国内预约诊疗系统存在的问题,进而提出相应对策,包括加大社会宣传力度,建立患者预约就诊诚信约束体系,提高预约号源数量,规范医生出诊等,为卫生管理部门建设预约诊疗服务系统提供决策依据。     

抑制素与妇女围绝经期综合征

抑制素是一种糖蛋白激素,在妇女主要由卵巢产生,它可以调节促卵泡生成素分泌。文章综述了抑制素的生理功能,与妇女围绝经期综合征发病机理的关系,对妇女围绝经期分期的影响,以及中医药治疗围绝经期综合征对抑制素的调节作用的研究概况。     

Coordinate linkage of HIV evolution reveals regions of immunological vulnerability

Cellular immune control of HIV is mediated, in part, by induction of single amino acid mutations that reduce viral fitness, but compensatory mutations limit this effect. Here, we sought to determine if higher order constraints on viral evolution exist, because some coordinately linked combinations of mutations may hurt viability. Immune targeting of multiple sites in such a multidimensionally conserved region might render the virus particularly vulnerable, because viable escape pathways would be greatly restricted. We analyzed available HIV sequences using a method from physics to reveal distinct groups of amino acids whose mutations are collectively coordinated ("HIV sectors"). From the standpoint of mutations at individual sites, one such group in Gag is as conserved as other collectively coevolving groups of sites in Gag. However, it exhibits higher order conservation indicating constraints on the viability of viral strains with multiple mutations. Mapping amino acids from this group onto protein structures shows that combined mutations likely destabilize multiprotein structural interactions critical for viral function. Persons who durably control HIV without medications preferentially target the sector in Gag predicted to be most vulnerable. By sequencing circulating viruses from these individuals, we find that individual mutations occur with similar frequency in this sector as in other targeted Gag sectors. However, multiple mutations within this sector are very rare, indicating previously unrecognized multidimensional constraints on HIV evolution. Targeting such regions with higher order evolutionary constraints provides a novel approach to immunogen design for a vaccine against HIV and other rapidly mutating viruses.     

大型综合性医院提高预约门诊率方式方法的研究

目的：通过对某大型综合性医院预约门诊现状进行调查分析,发现预约门诊率低的症结所在,提出更加合理的门诊预约挂号方法。方法：采用问卷调查法随机获取挂号患者的各项资料信息;通过医院HIS系统及预约网络系统获得全院全部预约挂号及总体挂号数据。用Excel 2003对数据进行对比比较。结果：预约号投放比例小、预约挂号相关信息覆盖面窄、患者的挂号习惯问题、预约就诊者首选专家号等是造成预约挂号率低的客观因素。结论：有效的预约就诊宣传、多元化的预约就诊方式、预约患者优先就诊以及分时段预约挂号等是提高预约就诊的有效手段。     

我院预约挂号问卷调查及分析

目的：改进医院预约挂号服务工作,进一步满足患者需求。方法：以2009年12月在某院门诊就诊的患者为调查对象,采用封闭式问卷调查设计,由被调查者在无记名的情况下独自完成答题。并采用Epi Data 3．0软件进行数据录入,采用SPSS13．0进行统计分析,计数资料采用卡方检验。结果：78．2％的患者愿意采取预约挂号的方式就诊,但宣传广度和深度的不足以及传统习惯的存在成为制约其发展的主要阻力;北京患者对于预约挂号的知晓率较高于外地患者;电话预约和网络预约是患者比较喜欢的预约方式．结论：广大患者对于预约挂号的推出是非常欢迎的,设置更为便捷的取消预约渠道是降低爽约的基本保障。