医学生心理健康教育面临的挑战

随着知识经济、信息时代的到来以及医学事业自身的不断发展、现代医学模式转变、医学院校的心理健康教育的状况等都对医学院校的心理健康教育提出了严峻的挑战。面对挑战,医学院校应充分重视心理健康教育,大力开展和加强心理素质教育,提高医学生的心理素质。     

Removal of laryngeal mask airway: airway complications in children,anaesthetized versus awake*

The laryngeal mask airway (LMA) must be inserted during deep anaesthesia. There are no guidelines concerning the removal of LMA, i.e., in awake or anaesthetized patients. The aim of this randomized prospective study was to compare the incidence of respiratory complications after LMA removal in anaesthetized or awake paediatric patients. Sixty children (ASA PS I or II), ranging from 4 months to 12 years of age, were studied. In patients breathing spontaneously, anaesthesia was induced and maintained with nitrous oxide, oxygen and halothane. Patients were randomly divided into two groups: group 1 removal of LMA in awake patients, or group 2 removal of LMA in anaesthetized patients, i.e., in patients receiving halothane at an alveolar concentration of 2 MAC adjusted for age and oxygen for 5 min. In both groups, patients received 100% oxygen after removal of LMA. After removal the incidence of respiratory complications was highest (P < 0.05) in group 1. Therefore, in healthy children undergoing elective surgery, the authors conclude that it is safer to perform the LMA removal in anaesthetized patients.     

《太医院先生案》考

近来发现一本朝鲜朝宫庭医名录本，暂题名为《太医院先生案》．结合其他文献介绍了宫庭医的情况，并介绍了名录本的文例．这将对朝鲜朝医学史研究有一定的价值     

Health-seeking behavior and the meaning of medications in Balochistan, Pakistan

A wide variety of health care options--home-based, indigenous, and cosmopolitan--exists in northern Balochistan, Pakistan. This paper examines health-seeking behavior in the area of mother and child health for villagers in this pluralistic medical setting. The analysis of a specific series of illness episodes shows that the majority of cases obtain treatment from different medical systems for a single episode. Interest in medications takes precedence over practitioners, and the meaning the villagers attach to such substances is explored. Long-established patterns of behavior relating to indigenous medicine continue to occur when cosmopolitan medicine is utilized. Information presented here helps to explain problems in utilization of cosmopolitan pharmaceuticals and delineates areas for future health programme activity.     

THE ACCEPTANCE OF COMPUTER ASSISTED LEARNING BY MEDICAL STUDENTS

The use of computer assisted learning (CAL) in the medical undergraduate curriculum is increasing. Little is known regarding the acceptability of CAL among medical students. The present study was conducted to investigate the possible anxiety generated by and the acceptability of CAL among medical students. One hundred and twenty-six students completed a questionnaire after using n software package which has been written as an adjunct in teaching urology. The present study demonstrates that there was little anxiety experienced by the students when using CAL and furthermore that there was a high level of acceptance for this type of instruction. This is encouraging for medical educators involved in producing multimedia packages for teaching medicine and surgery.     

开展卫勤指挥员任职培训的教学实践和体会

近几年来,第二军医大学卫生勤务学系承担了大量卫勤指挥员的任职培训任务.通过几年的理论研究和实践摸索,在教学的组织、管理、实施、保障等方面积累了一些经验,获得了一些具体的体会.我们认为要做好卫勤指挥员的任职培训教学必须明确培训目标,科学制定教学方案,精心安排教学内容,做好施训教员的培训,并在教学中注重合理运用教学方法,特别是要做好下部队调研,切实提高教学实效.     

An Educator''s Guide to Teaching Emergency Medicine to Medical Students

There is a need for every medical school graduate to handle emergencies as they arise in the daily practice of medicine. Emergency medicine (EM) educators are in a unique position to provide students with basic life support skills, guidance in assessing the undifferentiated patient, and exposure to the specialty of EM during all years of medical school. Emergency physicians can become involved in a variety of education experiences that can supplement the preclinical curriculum and provide access to our specialty at an early stage. A well-designed course in the senior year allows students to develop critical thinking and patient management skills that are necessary for any medical career path. It can ensure that all medical students are exposed to the skills essential for evaluating and stabilizing the acutely ill patient. To implement this type of course, learning objectives and evaluation methods must be set when the curriculum is developed. An effective course combines didactic and clinical components that draw on the strengths of the teaching institution and faculty of the department. A structured clerkship orientation session and system for feedback to students are essential in nurturing the development of student learners. This article provides an approach to assist the medical student clerkship director in planning and implementing EM education experiences for students at all levels of training, with an emphasis on the senior-year rotation.     

77例慢性心力衰竭住院病例药物治疗分析

目的:评估循证医学心血管疾病成果是否普及到小城市医疗中心.方法:采用回顾性住院病例77例分析,按年度统计对比.结果:77例次慢性心力衰竭(CHF)患者药物治疗仍以传统治疗为主,ACE抑制剂应用大幅度提高,β-受体阻滞剂应用极少,醛固酮拮抗剂未见应用.结论:循证医学成果已影响到小城市医疗中心,但推广范围及力度不够,β-受体阻滞剂是薄弱环节,靶剂量概念仍有待进一步提高.     

Detecting possible vaccine adverse events in clinical notes of the electronic medical record

The Vaccine Safety Datalink (VSD) is a collaboration between the CDC and eight large HMOs to investigate adverse events following immunization through analyses of clinical data. We modified an existing system, called MediClass, that uses natural language processing to identify clinical events recorded in electronic medical records (EMRs). We customized MediClass so it could detect possible vaccine adverse events (VAEs) generally, and gastrointestinal-related VAEs in particular, in the text clinical notes of encounters recorded in the EMR of a large HMO. Compared to methods that use diagnosis and utilization codes assigned to encounters by clinicians and administrators, the MediClass system can both find more adverse events and improve the positive predictive value for detecting possible VAEs.