现代化医院呼唤现代服务模式

当前我们正在向建设基本现代化医院迈进,在注意硬件建设的同时,不要忽略软件建设。硬件建设需要大量投入,较易见成果;而后者无需大量财力投入,只需转变医院人的思想观念,就能使医院明显改观。     

以问题为中心的病案教学法在临床核医学中的实践

目的 设计以问题为中心的病案小组讨论教学法，在临床核医学核素治疗见习的教学实践中进行验证和评价。方法 总结近几年在临床核医学见习带教中的问题与缺陷；以病案引入问题，教师引导，进行小组讨论；评价教学效果。结果 临床核医学及其教学具有不同于其它临床学科的鲜明特点和规律；经改革的教案，收到学生和教师的良好反馈。结论 以问题为中心的病案小组讨论教学法，切合临床核医学见习实际，有效可行。     

Basic sciences in problem-based learning and conventional curricula: students' attitudes

The purpose of this study was to compare the attitudes toward basic sciences of students in a preclinical problem-based curriculum and a conventional lecture-based curriculum at the end of their second year of medical school. The results showed that the PBL class had more positive attitudes toward basic sciences than students in the conventional class. These results may reflect a learning environment where students meet many scientist role models as teachers and where basic science is learnt in the context of clinical problems.     

Brain dysfunction in social drinkers

Thirty-four social drinkers who had referred themselves to the Regional Brain Damage Unit for assessment of the effects of drinking alcohol were compared with 42 volunteer control subjects of equivalent age but with low alcohol intake, using two 'learning' tests — the Rey Auditory Verbal Learning Test (RAVLT) and the Austin Button Maze. The Maze Test gave no evidence of disorder, but the two groups were significantly different on the RAVLT. No abnormalities in standard cognitive tests were apparent. These results suggest that a deficit in learning ability may be an early feature of the brain dysfunction associated with excessive alcohol consumption.     

A questionnaire examining learning in general practice

Vocational training is a key element of professional development in general practice. Learner-centred approaches to teaching bring a need for greater understanding of the individual learning styles and preferences of trainees. This paper reports the findings of a pilot study undertaken to determine factors that may influence learning among general practice trainees. A questionnaire survey of 261 trainees in six regions in the UK was carried out to explore attitudes to a series of themes identified in semi-structured interviews with trainees at the end of their training. Six distinct subscales were identified using principal components analysis. These are named 'Learning from Patients', 'Openness to Criticism', 'Negative Attitudes', 'Desire for Clear Guidelines', 'Peer Support', and 'Academic Approach'. Males scored significantly higher on 'Academic Approach' (   P < 0.05  ). Each of the subscales reflects themes that permeate the atmosphere of general pratice training. Further work is required to establish relationships between the subscales and the outcomes of learning and to explore the implications for continuing professional development. The questionnaire is an instrument that may prove useful in the future investigation of learning in general practice.     

Learning and sexual deficiencies in transgenic mice carrying a chimeric vasoactive intestinal peptide gene

The molecular mechanisms responsible for behavior are largely unknown. A state of the art model, paving the path from genes to behavior, is offered by transgenic animals. Candidate molecules are classic neuropeptides, such as vasoactive intestinal peptide (VIP). Transgenic mice harboring a chimeric VIP gene driven by the polyoma promoter were produced. Behavioral studies revealed learning impairment and prolonged retardation in memory acquisition in the genetically altered animals. Furthermore, reduced performance was observed when the male transgenic mice were tested for sexual activity in the presence of receptive females. Surprisingly, radioimmunoassays showed an approx 20% decrease in the VIP content of the transgenic mice brains. To directly assess genetically reduced VIP content as a cause for learning impairment, transgenic mice carrying diphtheria toxia-encoding sequences driven by the rat VIP promoter were created. These animals had reduced brain VIP and exhibited deficiencies in learning abilities, strongly supporting an important neurobiological function for VIP in vivo.     

Differential effects of kindling and kindled seizures on place learning in the morris water maze

There is some controversy about the role of long-term potentiation (LTP) in spatial learning. The authors have found that triggering generalized kindled seizures with stimulation of the perforant path disrupts spatial learning in the Morris water maze but that kindling per se does not affect spatial learning. It is suggested that abnormal electrical activity induced by high-frequency stimulation of the perforant path may have been responsible for the disruption of spatial learning previously attributed to LTP saturation.     

基于支持向量机的脊柱离体组织电阻抗识别

目的 测量不同脊柱组织的电阻抗,基于支持向量机建立电阻抗数据的组织分类算法并验证算法的准确性,寻找不同组织电阻抗分类阈值。 方法 取离体脊柱组织,应用电化学分析仪采集10~100 kHz频率范围内皮质骨、松质骨、脊髓、肌肉、髓核的电阻抗。将两只猪采集的数据集分别作为训练集和测试集,应用主成分分析降维至二维数据,训练和验证基于支持向量机(SVM)建立的分类算法,应用集成学习的方法计算不同组织分类的电阻抗阈值。 结果 5种组织在10~100 kHz的测量频率内,电阻抗值差异有统计学意义(P<0.001)。应用主成分分析降维的数据集建立的支持向量机分类算法识别不同组织的准确率为100%。应用集成学习建立的多个分类器计算出了不同组织的电阻抗分类阈值。 结论 基于支持向量机可以实现脊柱术区组织电阻抗的准确识别,有望应用于临床协助医生提升组织识别准确率。     

The Drosophila Mutant tetanic Interacts with a Gene Complex Including the Structural Locus of K+ Channels and Shows Altered Dephosphorylation and Learning

The tetanic (tta; X.-52.6) mutation has been isolated on the basis of its sensitivity to extradoses of the normal Shaker gene complex (ShC) where the K+ channel la is encoded. The mutant shows up to threefold elevation of the membrane bound protein phosphatase type 1 (PP1) activity in body extracts, probably due to reduced levels of the PP1 specific inhibitor 2 (I-2). By contrast, PP1 activity in the head is only half of the normal value. In addition, tta fails to perform normally in a negative reinforcement olfactory paradigm. The functional relationships between phosphorylation, K+ currents, phosphatase activity and modulation of synaptic activity during learning and memory are discussed in the light of their possible genetic links.     

妊娠中晚期暴露于可卡因对子代海马发育的影响

目的　建立妊娠中晚期暴露于可卡因的小鼠动物模型 ,研究可卡因对子代海马的发育是否具有影响以及这种影响在可卡因诱发的神经行为异常发病机理中可能所起的作用。方法　运用水迷宫方法观察可卡因对子鼠青春期空间辨别能力的影响 ,分别采用甲苯胺蓝染色技术和免疫组织化学结合图象分析技术观察海马中锥体细胞和神经胶质细胞的发育情况。结果　妊娠中晚期暴露于可卡因的小鼠子代在青春期海马锥体细胞极性紊乱 ,发育不良 ,未迁移到正常位置 ;神经胶质细胞数目减少。水迷宫结果显示可卡因可引起子代寻找平台的潜休期延长。结论　妊娠中晚期暴露于可卡因可引起子代青春期海马发育异常 ,这可能在可卡因引起子代空间辨别能力下降的发病机理中起着重要作用。