线上线下混合式教学在医学院校高等数学教学中的实践研究

目的 为解决医学院校学生高等数学学习难度大、学时紧、学生学习兴趣差、接受程度低等困扰高等数学学习的问题,积极开展线上线下混合式教学模式。方法 选取2022级临床医学专业、生物医学工程专业、信息管理与信息系统专业共6个班级243名学生作为研究对象（试验组）,采用自制线上学习资源与中国大学MOOC教学资源结合的线上线下混合式教学模式。课前根据教学内容设置教学目标、上传教学资源,利用超星学习通平台发布课前学习任务,帮助学生课前预习。课中教师面授,并在学习通平台发布课堂提问、随堂测验等,检验课上学习效果,方便教师掌握学生学习情况,及时进行教学调整,帮助学生顺利完成课上学习。课后在超星学习通平台上发布课上授课视频及课后习题讲解等,辅助学生巩固课上学习。并分班建立课程QQ群,方便课后与学生沟通、辅导答疑。采用SPSS 20.0软件进行t检验。结果 线上线下混合式教学有效提高了学生课上的参与度,极大地调动了学生的学习热情,课上平均师生互动由每节6次提高到10次;课上出勤率由原来的93.93%（232/247）提高到97.94%（238/243）;作业按时提交率由原来的92.71%（229/247）提高到96.71%（235/243）。课程教学完成以后,学生的期末综合成绩由（81.27±4.56）分提高到（89.52±3.42）,差异有统计学意义（t=8.25,P<0.001）。结论 线上线下混合式教学的采用,不仅对学生学习成绩有良性作用,而且更大程度地激发了学生学习高等数学的热情。后续期待学生应用数学解决实际问题的能力进一步提高。     

福建地区公共卫生硕士培养模式的调查研究

目的　为了解公共卫生硕士（master of public health,MPH）培养现状,建立更好的培养体系,提高其培养质量。方法　通过对福建地区多所学校的公共卫生在校学生、教师、公共卫生工作者进行"公共卫生硕士培养模式"问题的问卷调查,收集相关数据后,应用SPSS 13.0进行数据处理。结果　调查结果显示,51.54%（67/130）的调查对象喜欢MPH专业,且随工作时间的增加对其了解程度逐渐增加。但在调查对象对MPH培养体系所培养的能力与工作年限相关性上差异无统计学意义,89.23%（116/130）的调查对象表示需要进一步细化MPH培养方向,MPH培养模式成果评价的净推荐值为-53.07%。结论　目前公共卫生硕士培养已经取得一定成绩,但公共卫生硕士培养体系的构建需要更多深入研究。     

住院医师规范化培训与临床实习并轨模式下临床实习生满意度调查

目的　通过开展住院医师规范化培训与临床实习并轨模式下临床实习生对科室和带教教师的满意度调查,探求如何进一步推进临床实习工作。方法　采用整群抽样方式,自行设计量表,量表内容包括：教学工作重视程度、实习安排合理性、教学活动开展情况、教学活动开展质量、出科考核情况、带教教师医德医风示范性、教师带教态度及教师理论知识的传授情况、教师指导医疗操作情况、教师病历修改情况等。对2018年7月至2019年6月某医院临床专业实习生开展问卷调查。采用SPSS 22.0进行两独立样本的t检验或秩和检验方法,多组数据分析采用方差分析。结果　共发放调查问卷1 230份,收回1 195份,有效回收率97.15%。该医院临床实习生总体满意度为（9.62±0.39）分。实习生对带教教师医德医风示范性的评价最高[（9.75±0.78）分],对各科室教学活动开展质量的评价最低[（9.52±1.15）分],各项评价之间差异有统计学意义（F=7.30,P<0.001）。结论　各教研室、各科室在医院推行住院医师规范化培训与临床实习并轨模式下,按要求完成各项带教任务,但教学质量和内涵建设有待加强。     

Do vegetarians have a normal bone mass?

Public health strategies targeting the prevention of poor bone health on a population-wide basis are urgently required, with particular emphasis being placed on modifiable factors such as nutrition. The aim of this review was to assess the impact of a vegetarian diet on indices of skeletal integrity to address specifically whether vegetarians have a normal bone mass. Analysis of existing literature, through a combination of observational, clinical and intervention studies were assessed in relation to bone health for the following: lacto-ovo-vegetarian and vegan diets versus omnivorous, predominantly meat diets, consumption of animal versus vegetable protein, and fruit and vegetable consumption. Mechanisms of action for a dietary component effect were examined and other potential dietary differences between vegetarians and non-vegetarians were also explored. Key findings included: (i) no differences in bone health indices between lacto-ovo-vegetarians and omnivores; (ii) conflicting data for protein effects on bone with high protein consumption (particularly without supporting calcium/alkali intakes) and low protein intake (particularly with respect to vegan diets) being detrimental to the skeleton; (iii) growing support for a beneficial effect of fruit and vegetable intake on bone, with mechanisms of action currently remaining unclarified. The impact of a vegetarian diet on bone health is a hugely complex area since: 1) components of the diet (such as calcium, protein, alkali, vitamin K, phytoestrogens) may be varied; 2) key lifestyle factors which are important to bone (such as physical activity) may be different; 3) the tools available for assessing consumption of food are relatively weak. However, from data available and given the limitations stipulated above, vegetarians do certainly appear to have normal bone mass. What remains our challenge is to determine what components of a vegetarian diet are of particular benefit to bone, at what levels and under which mechanisms.     

188例重症肌无力患者生活质量研究

目的分析重症肌无力(MG)患者的生活质量。方法纳入2013-03-2014-06在唐都医院神经内科就诊的MG患者188例,应用重症肌无力量化评分(QMGs)评估患者病情严重程度,采用36项简明健康状况调查表(SF-36)评估患者生活质量,采用汉密尔顿抑郁量表(HDRS)和汉密尔顿焦虑量表(HARS)评估抑郁和焦虑症状。比较不同教育水平、职业、眼肌型重症肌无力(ocular MG,OMG)症状、胸腺情况等患者间SF-36评分的差异,并对QMG评分、年龄、HARS和HDRS得分与SF-36两项复合得分进行多元线性回归分析。结果高级教育组在躯体疼痛项得分高于初级教育组(P0.05),学生组在生理机能项(P0.05)和生理角色功能项(P0.05)得分均高于脑力劳动组,学生组在生理角色功能项得分亦高于体力劳动组(P0.05);学生组在生理复合得分(PCS)项得分高于按照职业分组的其他3组(均P0.05);OMG组在精神复合得分(MCS)项得分高于全身型重症肌无力(generalized MG,GMG)组(P0.05)。较高的QMGs、HARS得分和高龄可以预测较低的PCS得分,较高的QMGs和HARS得分可预测较低的MCS得分。结论影响MG患者生活质量的因素包括年龄、教育水平、职业、胸腺情况、MG的类型和GMG的类型、疾病的严重程度和心理障碍。较高的QMGs和HARS得分可以预测较低的PCS和MCS得分,年龄大可预测较低的PCS得分。     

Islet cell antibodies in the Japanese population and subjects with Type 1 (insulin-dependent) diabetes

Summary Islet cell antibodies were studied in 1,112 non-diabetic adults, 473 normal school children and 162 Type 1 (insulin-dependent) diabetic patients in a Japanese population. The prevalence of islet cell antibodies was 0.5%, 0.4% and 32%, respectively. Most islet cell antibodies positive subjects with Type 1 diabetes had short duration of the disease. No patients who had over 10 years from the onset had islet cell antibodies. Six non-diabetic adults with islet cell antibodies were followed for 4 years. Only one with Hashimoto's thyroiditis showed a diabetic pattern in her oral glucose tolerance test. However, none developed overt insulin-dependent diabetes until 1984. Two out of these six subjects continued to be positive for both islet cell antibodies and antithyroid antibodies or antinuclear antibodies. Islet cell antibodies in the remaining four patients disappeared during the second year. It is difficult to predict the onset of Type 1 diabetes by islet cell antibodies in non-diabetic individuals because they may be transient.     

武警某部战士吸烟情况调查及分析

目的 了解武警某部战士吸烟现状及对吸烟的相关认知、态度及行为倾向,为有针对性地开展部队控烟工作提供参考.方法 利用自行设计的吸烟问卷调查表,调查武警某部260名集训新兵及217名老兵的吸烟现状及对吸烟的危害认知、态度及行为倾向,并分析它们之间的关系.结果 战士总体吸烟率为37.32％(178/477),老兵吸烟率62....     

心理痛苦温度计用于恶性肿瘤患者的研究

目的评估美国国立综合癌症网推荐的心理痛苦温度计在中国癌症患者中的临床应用情况,了解中国癌症患者心理痛苦的现状及其相关因素。方法使用心理痛苦温度计对3所医院的143例癌症患者进行问卷调查。结果癌症患者心理痛苦得分为4.69±1.97,中重度心理痛苦占73.43%。不同诊断、年龄、学历、付费方式患者的心理痛苦得分比较,差异有统计学意义(均P<0.05);情绪问题、躯体问题显著影响患者心理痛苦(P<0.01,P<0.05)。结论心理痛苦温度计适用于中国临床,能及时发现患者心理痛苦的程度及原因,为临床医护人员进行个体化的心理干预提供依据。