Impact of Student- Versus Instructor-Directed Case Discussions on Student Performance in a Pharmacotherapy Capstone Course

Objective. To evaluate the impact of incorporating student-directed (SD) vs instructor-directed (ID) active learning on student performance in a pharmacotherapy capstone course.Design. This 9-credit course was redesigned from exclusively ID case discussions to a format in which half were SD and half were ID. Student performance on evaluation questions derived from SD sessions was compared with that from ID sessions.Assessment. Overall, students (n=299) performed better on ID-session questions than on SD-session questions (78.7% vs 75.3%, correctly answered, respectively; p<0.001). For written evaluations, students performed better on ID-session questions than on SD-session questions (79.8% vs 73.9%, respectively; p<0.001). For verbal evaluations, students performed better on SD-session questions than on ID-session questions (79.5% vs 74.5%, respectively; p<0.001). After the course revision, student confidence regarding their ability to think critically, solve problems, make decisions, and pursue lifelong learning was high, and student and faculty feedback was positive.Conclusion. Student performance in a pharmacotherapy capstone course remained acceptable when a combination of SD and ID active learning was used, but the addition of SD learning did not translate to better performance on course evaluations.     

一例恶性肿瘤晚期患者由住院至居家全程照护模式的探索实践

通过为1例晚期肿瘤患者提供由住院到居家无缝隙对接的全程照护,以远程医疗为媒介,为居家患者提供症状控制指导、舒适护理指导、心理灵性的支持以及最后的哀伤辅导。真正做到全人、全家、全程、全团队的“四全照顾”。最终做到患者善终、家人善别、生者善生。     

佛山市高明区2015—2018年疑似预防接种异常反应监测分析

目的：通过对比注射康柏西普后对非缺血型视网膜静脉阻塞患者视力的改善作用，评价康柏西普对本病的短期临床疗效、安全性及相关危险因素。方法：选取2016年12月至2017年12月从发现自觉症状到就诊的病程小于12个月的在我科就诊的病例，确诊为非缺血型视网膜静脉阻塞的患者（共43例），将所有研究对象根据病程长短，分为病程小于3个月组（A组）16例患者，病程3-6个月组（B组）13例患者，6-12 个月组（C组）14例患者。所有患者同时行玻璃体腔内注射康柏西普，三组均先注射1次，之后每1个月随访测定眼压、BCVA、CMT。结果：初诊视力与治疗后视力差异有统计学意义(P＜0.05）；初诊黄斑水肿高度与治疗后差异有统计学意义(P＜0.05）；性别、年龄与视力预后疗效无统计学意义（P>0.05）；治疗前的眼压相比较，三组内的各随访点均没有统计学差异（P>0.05）。结论：玻璃体腔内注射康柏西普治疗本病疗效确切；病程长短对本病的治疗效果有较大影响，越早期治疗效果越佳。     

《药物分析》课程本科教学改革和思考

目的　分析《药物分析》课程在当今药学本科教育培养过程中的现状，探索《药物分析》课程在新时代药学教育背景下的教学改革与创新，构建符合药学培养要求、满足社会市场需要的复合型药学人才培养模式。方法　第一阶段，开展教学改革的建议和需求调查；第二阶段，开展《药物分析》课程改革探索与实践；第三阶段，教学效果评价。结果　需求调查显示《药物分析》课程的教学内容、课程设计、教学手段亟须进一步优化和拓展。结论　该课程通过调整教学内容、拓展教学手段、创新多元化实践教学、融入"课程思政"建设等，激发了学生的学习兴趣和创新精神，强化了学生理论素养和实践能力，培养了其国际化视野和崇高的职业道德。     

Natural course of keratoacanthoma and related lesions after partial biopsy: Clinical analysis of 66 lesions

There is some confusion regarding the classification of keratoacanthoma (KA) and related lesions that have crateriform architecture. We examined the clinical courses of 66 KA lesions and related lesions after a partial biopsy to clarify the nosological concept of KA. We histopathologically classified these lesions into five types: (i) KA at various stages (53 lesions); (ii) KA‐like squamous cell carcinoma (SCC) (3 lesions); (iii) KA with malignant transformation (3 lesions); (iv) infundibular SCC (5 lesions); and (v) crateriform SCC arising from solar keratosis (2 lesions). We analyzed the clinical course in each group. The regression rate of KA was 98.1% and that of KA‐like SCC/KA with malignant transformation was 33.3%. No regression was observed in either infundibular SCC or crateriform SCC arising from solar keratosis. Thus, KA is a distinct entity that should be distinguished from other types of SCC with crateriform architecture based on the high frequency of regression. The regression rate of 33.3% in KA‐like SCC/KA with malignant transformation indicated that KA lesions with an SCC component still have the potential for regression. However, this result also indicated that KA is biologically unstable, and some KA tend to evolve into conventional SCC with a gradual loss of the capacity for the spontaneous regression. Infundibular SCC and crateriform SCC arising from solar keratosis are fundamentally different from KA, not only according to the histopathological findings but also based on the biological properties.     

Acute effects of alcohol on brain perfusion monitored with arterial spin labeling magnetic resonance imaging in young adults

While a number of studies have established that moderate doses of alcohol increase brain perfusion, the time course of such an increase as a function of breath alcohol concentration (BrAC) has not yet been investigated, and studies differ about regional effects. Using arterial spin labeling (ASL) magnetic resonance imaging, we investigated (1) the time course of the perfusion increase during a 15-minute linear increase of BrAC up to 0.6 g/kg followed by a steady exposure of 100 minutes, (2) the regional distribution, (3) a potential gender effect, and (4) the temporal stability of perfusion effects. In 48 young adults who participated in the Dresden longitudinal study on alcohol effects in young adults, we observed (1) a 7% increase of global perfusion as compared with placebo and that perfusion and BrAC are tightly coupled in time, (2) that the increase reaches significance in most regions of the brain, (3) that the effect is stronger in women than in men, and (4) that an acute tolerance effect is not observable on the time scale of 2 hours. Larger studies are needed to investigate the origin and the consequences of the effect, as well as the correlates of inter-subject variations.     

从“脾虚湿盛”论治痛风全程体会

痛风和高尿酸血症已经成为严重威胁人类健康的多发病、常见病。西药治疗虽然对病情控制效果显著,但容易反复,并且长期用药对肝肾功能影响较大,常伴有胃肠道不良反应、皮炎等不良反应。笔者根据中医对痛风病因病机相关理论的整理认识,结合临床实践认为,“脾虚湿浊内阻”是痛风发作的病机关键,治疗重视究其本,将健脾燥湿法应用于疾病分期的全过程,取得满意疗效。     

新型冠状病毒肺炎疫情下生理学线上教学的探索与反思

面对新型冠状病毒肺炎疫情向课堂教学提出的挑战，齐齐哈尔医学院生理学教学团队构建了基于"小规模限制性在线课程（small private online course，SPOC）+同步直播"的混合式教学，开展线上教学。经过团队成员的共同努力，开展线上教学4周以来教学秩序稳定，教学效果良好。本文以236名2019级护理本科生生理学教学为例，介绍了疫情形势下线上教学的教学设计、实施措施、教学效果以及教学反思，为进一步推进疫情防控期间医学高等院校线上教学工作提供实践经验。     

护理学基础国家级精品资源共享课的建设

目的通过护理学基础国家级精品资源共享课的建设实践,进一步探索培养专业基础扎实、动手能力强的实用型护理人才的有效途径。方法根据《教育部关于国家精品开放课程建设的实施意见》文件精神及我校精品资源共享课的建设标准,对护理学基础课程教学内容、教学方法两方面进行了深入研究与改革。结果实验组护理本科生对教师的总体评价明显高于对照组(P0.01);实验组护理本科生理论与操作考核成绩均高于对照组(P0.01或P0.05)。结论护理学基础国家级精品资源共享课的建设促进了该课程教学质量的提高,提示在课程建设过程中要基于学校自身优势与特色,进行不断挖掘与创新,才能取得精品资源共享课建设的实效,实现学校人才培养的目标。