PBL教学模式在预防医学教学中的应用

目的探讨PBL教学模式在预防医学教学中的应用,提高预防医学的教学质量。方法通过问卷调查的方法了解学生对该教学模式的认可程度并对教学效果进行评价。结果PBL教学组的考试成绩及及格率高于传统教学组(P<0.01)。结论该教学法可激发学生的学习兴趣,让学生有针对性地去探索并运用理论知识,以提高分析和解决问题的能力,促进学生对知识的掌握和运用,达到最终的教学目标。     

Localization of substance P- and enkephalin-like immunoreactivity in relation to catecholamine-containing cell bodies in the cat dorsolateral pontine tegmentum: an immunofluorescence study

The distribution of tyrosine hydroxylase-, substance P- and enkephalin-immunoreactive neurons in the cat dorsolateral pons was studied using the indirect immunofluorescence method of Coons. To allow for the visualization of substance P- and enkephalin-immunoreactive cell bodies, colchicine was injected either in the ventricular space or in the cerebral tissue. The distribution of the tyrosine hydroxylase-immunoreactive cell bodies corresponded with the well-known distribution of catecholamine cells in this area of the brain. The observation of adjacent sections treated separately with tyrosine hydroxylase- and enkephalin-antiserum revealed that most catecholaminergic cells contain enkephalin-immunoreactivity. In addition to this catecholamine-enkephalin cell population, a moderate number of substance P-immunoreactive cell bodies was found in dorsolateral pons. The peribrachial nuclei were found to be densely supplied with substance P- and enkephalin-immunoreactive fibers, whereas the medial subdivisions, which contain the majority of the catecholamine cells in the dorsolateral pons, display a moderate number of immunoreactive fibers. These results are suggestive of interactions between peptide-containing and catecholaminergic neurons and also between-peptide-containing and non-catecholamine-containing neurons in the cat dorsolateral pons.     

Lack of shared lymphocyte-stimulating determinants between H-2I and HLA-D/DR using mouse primed lymphocyte typing cells

A number of anti-H-2 alloantisera containing antibody reactive with I region gene products (Ia) of the major histocompatibility complex cross-react with determinants expressed by human peripheral blood B lymphocytes. Such data have led to the conclusion that Ia and DR antigens share cross-reacting determinants. We have attempted to generate mouse primed T lymphocyte populations specific for defined I region gene product determinants which concomitantly recognize DR determinants on human peripheral blood leukocytes in primed lymphocyte typing (PLT) analysis. Mouse PLT cells were generated in primary MLC using strain combinations identical to those in which positive mouse/human cross-reacting antisera have been obtained. The resulting PLT cells exhibited strong, yet specific, secondary MLC responses against mouse cells expressing the Ia determinants used as the primary stimulus. In contrast, when examined on panels of human peripheral blood leukocytes, no reactivity was detected. This lack of cross-reactivity suggests that mouse T cells primed toward Ia determinants do not regularly recognize cross-reacting determinants of DR or D-associated antigens expressed on human PBLs. Consequently, mPLT cells are not a useful reagent in defining HLA-D region polymorphism.     

人体解剖学PBL教学模式的实践与思考

人体解剖学是研究正常人体形态结构的科学，是学习生理学、病理学和各临床学科的基础课程。解剖学名词多、内容繁杂、逻辑推理少，多以描述性语言为主，在传统的教学方法下，如何活跃课堂气氛、调动并激发学生的学习兴趣，一直是困扰教师的一个难题。为此，作者在2006级护理学本科专业的系统解剖学教学中，对传统的教学方式进行了一些改革性尝试，即结合授课内容，进行了小规模、阶段性的以问题为基础的学习模式（problem-based learning，PBL）的教学实践，收到了良好的效果，但也暴露了一些问题。本文就此次采用PBL教学模式的经验和存在的问题进行了总结。     

Direct estimation of the frequency of human cytotoxic T lymphocytes and their precursors following in vitro allosensitization

Cell mediated lympholysis (CML) has been proposed as an in vitro model of the rejection process that results from transplantation of allogeneic tissue. To date, the absolute frequencies of cytotoxic T lymphocytes (CTL) and their precursors (CTL.P) have not been directly estimated in man because of technical difficulties. Through optimizing the conditions for radiometric detection of 51Cr release and the attendant improvement in CML sensitivity, direct CTL frequency estimates have been determined in peripheral blood (PBL), spleen (SPL), and lymph nodes (LNC) after in vitro allostimulation using unrelated human cells and limiting dilution assays. The mean frequency of CTL generated from PBL is 1 in 826 cells (0.121% +/- 0.101%) which, from preliminary experiments, is significantly greater than that generated from either LNC or SPL (p less than 0.05). With restimulation of primed cells on day 10, the frequency of CTL generated from PBL was increased 400%. The CTL.P frequency (0.0064% +/- 0.0050%) was approximately 5% of the corresponding CTL frequency. The CTL.P frequencies were found to be minimal estimates as both accessory "filler" cells and T cell growth factors increased the level of detection of CTL.P an average of threefold. The limiting cell dilution assay as detailed in this report should be a powerful tool for defining the cellular requirements and related factors necessary for optimal induction of a CTL response and should provide the means for determination of the immunogenetic requirements and the allospecificity of human cytotoxic lymphocytes.     

Association between HLA and Japanese patients with rheumatoid arthritis

Japanese patients with rheumatoid arthritis (RA) were observed to have a statistical association with HLA-DR4, MT3. Strong association between the clinical severity of RA and HLA was also observed. Male patients had a stronger association with HLA than female patients. Males are more resistant to RA than females. This suggested that the threshold of liability for RA is higher in males than in females. Japanese patients with RA with systemic vasculitis were negative for HLA-Bw44 and had antilymphocytotoxic autoantibody, indicating that RA with systemic vasculitis is different in etiology from RA without systemic vasculitis.     

PBL教学模式对预防医学生课程教学效果的系统评价

目的 系统评价PBL教学模式对预防医学生课程教学效果的影响。方法 检索PubMed、CNKI、WanFang Data、CBM和VIP数据库,搜集PBL应用于预防医学生教学的RCT研究,采用R软件（3.6.2版本）进行Meta分析。结果 共纳入23篇文献,包括2 108例研究对象。Meta分析结果显示,PBL组预防医学生的理论成绩［ SMD =1.13,95% CI (0.65,1.60)］、实践操作成绩 ［ SMD =1.27,95% CI (0.91,1.63)］、教学满意度［ RR =1.33,95% CI (1.17,1.52)］、学习兴趣［ RR =1.61,95% CI (1.37,1.89)］、自主学习能力 ［ RR =1.63, 95% CI (1.39,1.92)］、团队协作能力［ RR =2.11,95% CI (1.54,2.89)］、解决问题能力［ RR =1.58,95% CI (1.36,1.83)］均显著优于LBL组。亚组分析结果显示PBL联合教学组预防医学生的理论成绩［ SMD =1.27,95% CI (0.46,2.09)］、实践操作成绩［ SMD =1.39,95% CI (0.82,1.96)］、团队协作能力［ RR =2.27,95% CI (1.41,3.64)］均优于单独使用PBL组,PBL在毒理学课程中对提高预防医学生的理论成绩［ SMD =1.44,95% CI (1.10,1.79)］和实践操作成绩［ SMD =1.16,95% CI (0.74,1.59)］效果均较为显著。结论 PBL对预防医学生的教学效果具有显著影响;PBL联合教学比单独使用PBL的教学效果更显著;未来需纳入更多严谨的试验设计来验证其应用效果。     

不同带教模式在神经内科护理教学中的应用效果评价

目的研究不同带教模式在神经内科护理教学中的应用效果。方法选取2018年6月—2019年7月期间在该院实习的62名护士为研究对象,随机均分为两组,对照组采用传统教学,观察组采用PBL教学,观察两组的教学效果。结果实施后观察组护理实习生的理论知识分数(93.72±1.13)分与对照组护理实习生的理论知识分数(85.92±2.75)分相比较高,差异有统计学意义(t=14.607,P<0.001),观察组护理实习生的实践操作分数(95.25±2.43)分与对照组护理实习生的实践操作分数(84.36±4.64)分相比较高,差异有统计学意义(t=11.576,P<0.001),护生对教学的评价教学评价差评率0.00%与对照组19.35%相比较低,差异有统计学意义(χ2=4.613,P=0.032)。结论不同带教模式应用在神经内科护理教学中效果不同,PBL教学与传统教学相比较好,能够有效地提高护理实习生的理论和实践能力,受到了护理实习生的一致认可,值得在临床中应用。     

沙培林增强人外周血淋巴细胞抗瘤效应的探讨

为了研究沙培林对人 PBL杀瘤活性的影响 ,探讨沙培林增强人 PBL 杀瘤产应的最适浓度和时间 ,使用不同浓度沙培林分别诱导正常人和肺癌患者 PBL于不同时间杀伤 K56 2和 Raji细胞 ,并以 MTT法测定其对肿瘤细胞的杀伤率。结果显示 ,不同浓度的沙培林增强 PBL杀瘤作用的效应不同 ,在 0 .0 2 KE/ml、72小时时杀瘤率最高 ,浓度过度或过低免疫活化作用均不理想     

儿科教学中PBL与剖析病例法相结合的教学模式探索

对PBL与剖析病例法相结合的教学模式在儿科见习教学中的应用进行了初步探索。从这一教学模式的设计理念、实施方法、效果评价及目前条件下存在的问题进行了探讨，为儿科临床教学改革积累了经验。