对“肾为欠、为嚏”的浅见与实践

文章先对《黄帝内经》中肾为欠、为嚏进行探讨,并在实践中得到体悟。进一步认识到人体是一个整体,五脏六腑互联互动,互为表达,也就是五行生克关系。五行学说是中医理论的重要组成部分,活学活用五行学说,才能以我知彼,以表知里,以观过与不及之理,见微得过,用之不殆。     

Shared learning in practice placements for health and social work students in East London: a feasibility study

A voluntary organisation providing family support and mental health services carried out an enquiry into the feasibility of setting up placements in primary care for students from professional qualifying courses in community nursing, social work and occupational therapy to experience shared practice learning in their placement. Consultation with a range of courses from two universities in London and with GP practices and other primary care agencies in East London established that there was wide support for the idea from practitioners, managers and academic teachers. It was recommended that a small number of pilot placements be set up. It was acknowledged that the diversity of placement requirements across the spectrum of professional education is a limiting factor in bringing students together for practice learning. The authors suggest that in the longer term, the development of an interprofessional approach to practice learning will require structural changes to professional courses so as to bring their placement requirements more into line with each other.     

Patients,diagnoses and processes in general practice in the Nordic countries. An attempt to make data from computerised medical records available for comparable statistics

Objective - To try out a collection of a standard set of data from computerised medical records. Design - Retrospective extraction of ordinary patient record information put into the computer by general practitioners. Setting - Encounters in office hours in strategically selected practices or health centres in Denmark, Finland, Iceland, Norway and Sweden. Subjects - 59 general practitioners and a total study population of 97475 persons. Main outcome measures - Proportions, crude and specific rates of encounters, diagnoses and processes. Results - In a 4-week period there was a threefold difference in the office encounter rates between the participating sites in the Nordic countries. Gender and age patterns were similar despite these differ ences. An access to several different denominators revealed diverse patterns of referring to the specialist, prescribing, ordering blood tests, X-rays and physiotherapy. Data from computerised medical records agree well with earlier studies in the Nordic countries using other methods. Conclusions - This survey demonstrates that valid and reliable data for routine statistics are available from computerised medical records in general practice. The major obstacle extracting more epidemiological data from computerised medical records is caused by information in the databases not being uniquely linked to episodes of care.     

Cost-effective osteoporosis treatment thresholds: the United States perspective

Summary A United States-specific cost-effectiveness analysis, which incorporated the cost and health consequences of clinical fractures of the hip, spine, forearm, shoulder, rib, pelvis and lower leg, was undertaken to identify the 10-year hip fracture probability required for osteoporosis treatment to be cost-effective for cohorts defined by age, sex, and race/ethnicity. A 3% 10-year risk of hip fracture was generally required for osteoporosis treatment to cost less than $60,000 per QALY gained. Introduction Rapid growth of the elderly United States population will result in so many at risk of osteoporosis that economically efficient approaches to osteoporosis care warrant consideration. Methods A Markov-cohort model of annual United States age-specific incidence of clinical hip, spine, forearm, shoulder, rib, pelvis and lower leg fractures, costs (2005 US dollars), and quality-adjusted life years (QALYs) was used to assess the cost-effectiveness of osteoporosis treatment ($600/yr drug cost for 5 years with 35% fracture reduction) by gender and race/ethnicity groups. To determine the 10-year hip fracture probability at which treatment became cost-effective, average annual age-specific probabilities for all fractures were multiplied by a relative risk (RR) that was systematically varied from 0 to 10 until a cost of $60,000 per QALY gained was observed for treatment relative to no intervention. Results Osteoporosis treatment was cost-effective when the 10-year hip fracture probability reached approximately 3%. Although the RR at which treatment became cost-effective varied markedly between genders and by race/ethnicity, the absolute 10-year hip fracture probability at which intervention became cost-effective was similar across race/ethnicity groups, but tended to be slightly higher for men than for women. Conclusions Application of the WHO risk prediction algorithm to identify individuals with a 3% 10-year hip fracture probability may facilitate efficient osteoporosis treatment. The authors comprise the National Osteoporosis Foundation Guide Committee.     

病理学开放性实验教学的探索与实践

实验教学是病理学教学的重要组成部分，我系不断探索和改革实验教学方法、手段，建立开放性实验教学模式，使学生学习的主动性加强，提高了教学质量。     

医学电子学教学改革实践与探索

医学电子学已成为高等医学院校的选修或必修课程，但目前的教学状况阻碍了教学质量的提高，其教学改革势在必行。本文首先分析了医学电子学的教学现状，然后结合我院在医学电子学的教学内容和教学方法两方面所作的改革，提出了未来医学电子学教学改革的方向——加强师资培训和改善教学条件。     

PBL教学法在药理学教学中的实践和探索

目的：在药理学教学中，对PBL教学法进行初步实践和探索。方法：在郧阳医学院2004级本科麻醉班，对PBL教学法进行初步尝试，并通过问卷调查的方式对教学情况进行初步分析。结果：PBL教学在学生的学习态度、能力与素质及专业知识学习等方面，与传统教学比较均有极显著性差异。结论：PBL教学明显优于传统教学。     

案例教学在《公共关系学》教学过程中的实践与思考

在《公共关系学》的教学中运用案例教学，可以取得较好的教学效果．从实践出发，试对案例教学的必要性、案例教学的运用作深入剖析，并就进一步完善《公共关系学》的案例教学进行了探讨．