学习科学视域下医学院校ESP课程体系的生态构建

医学院校研究生的ESP课程（English for specific purpose）兼具自然及社会双重属性,注重专业应用型语言的学习及实践,构建具备职业、社会境脉特征的英语教学生态体系是探索医学院校高水平医学生英语语言应用能力的有效途径。本文基于设计的实施研究理念,设计与构建了情景仿真式课程模式,实施了任务型语言教学,完成了混合式关联课堂体系模式的探讨与融合性教师角色的分析。在课堂实践基础上,将创新课程理念与ESP课程生态体系构建有机结合,进一步指导学习科学视域下课程的设计与实施,验证了ESP课程体系生态构建的可行性。     

超声引导竖脊肌平面阻滞与胸椎旁神经阻滞用于胸腔镜肺叶切除术患者术后镇痛的临床对比研究

目的探究与分析超声引导竖脊肌平面阻滞与胸椎旁神经阻滞用于胸腔镜肺叶切除术患者术后镇痛的效果。方法选取浙江省衢州市中医医院自2016年12月至2018年12月收治的经胸外科就诊的胸腔镜肺叶切除术患者156例,采取随机数字表法分为竖脊肌平面阻滞组与胸椎旁神经阻滞组,每组各78例,竖脊肌平面阻滞组给予超声引导竖脊肌平面阻滞处理,胸椎旁神经阻滞组给予超声引导胸椎旁神经阻滞处理,对比两组的阻滞范围、不同时间点下静息、咳嗽时的视觉模拟评分(VAS)、术后24-48 h内镇痛泵按压的次数、吗啡的用药量以及不良反应发生率。结果通过采用冰块法对阻滞范围进行测量时发现,竖脊肌平面阻滞组在接受阻滞20 min之后,17例患者为T2~T6脊神经支配区域,22例患者平面为T2至T7脊神经支配区域。胸椎旁神经阻滞组在接受阻滞20 min之后,全部78例患者的平面为T2至T7脊神经支配区域。两组患者术后12 h镇痛泵按压的次数及吗啡的用药量相比无明显差异(P>0.05)。两组患者术后6 h、12 h静息、咳嗽时的VAS评分无明显差异(P>0.05)。竖脊肌平面阻滞组相比于胸椎旁神经阻滞组而言术后24 h、术后28 h静息、咳嗽时的VAS评分较低,组间差异具有统计学意义(P<0.05)。竖脊肌平面阻滞组相比于胸椎旁神经阻滞组术后24h的镇痛泵按压的次数较少,吗啡的用药量较少,组间差异具有统计学意义(P<0.05)。两组患者皮肤瘙痒、恶心呕吐以及呼吸抑制发生率无明显差异(P>0.05)。结论超声引导竖脊肌平面阻滞相比于超声引导胸椎旁神经阻滞用于胸腔镜肺叶切除术患者中能够发挥较强的术后镇痛效果,且不会增加不良反应,安全性较高。     

Functional iron deficiency and diastolic function in heart failure with preserved ejection fraction

Background

Functional iron deficiency (FID) is an independent risk factor for poor outcome in advanced heart failure with reduced EF, but its role in heart failure with preserved EF (HFPEF) remains unclear. We aimed to investigate the impact of FID on cardiac performance determined by pressure–volume loop analysis in HFPEF.

Methods

26 HFPEF patients who showed an increase in LV stiffness by pressure–volume (PV) loop analysis obtained by conductance-catheterization, performed exercise testing, echocardiographic examination including tissue Doppler and determination of iron metabolism: serum iron, ferritin and transferrin saturation. HFPEF patients who provided ferritin < 100 μg/l or ferritin of 100–299 μg/l in combination with transferrin saturation < 20% were defined as having FID. In 14 patients the expression of transferrin receptor was determined from available endomyocardial biopsies.

Results

Fifteen out of 26 HFPEF patients showed FID without anemia. Compared to control subjects and HFPEF patients without FID, HFPEF patients with FID showed an up-regulation of the myocardial transferrin receptor expression (p < 0.05). No differences between HFPEF patients with and without iron deficiency were found in heart dimensions, systolic and diastolic function obtained by PV-loop and echocardiography analysis. According to the linear regression analysis, LV stiffness was correlated with peak oxygen uptake (r = − 0.636, p < 0.001) but not with the ferritin level or transferrin saturation. No relation was found between FID and exercise capacity. The association of LV stiffness with exercise performance was independent from the level of iron deficiency.

Conclusion

In non-anemic HFPEF patients, cardiac dysfunction and impaired exercise capacity occur independently of FID.     

ESP‐102, a combined extract of Angelica gigas,Saururus chinensis and Schizandra chinensis,protects against glutamate‐induced toxicity in primary cultures of rat cortical cells

It was reported previously that ESP‐102, a combined extract of Angelica gigas, Saururus chinensis and Schizandra chinensis, significantly improved scopolamine‐induced memory impairment in mice and protected primary cultured rat cortical cells against glutamate‐induced toxicity. To corroborate this effect, the action patterns of ESP‐102 were elucidated using the same in vitro system. ESP‐102 decreased the cellular calcium concentration increased by glutamate, and inhibited the subsequent overproduction of cellular nitric oxide and reactive oxygen species to the level of control cells. It also preserved cellular activities of antioxidative enzymes such as superoxide dismutase, glutathione peroxidase and glutathione reductase reduced in the glutamate‐injured neuronal cells. While a loss of mitochondrial membrane potential was observed in glutamate treated cells, the mitochondrial membrane potential was maintained by ESP‐102. These results support that the actual mechanism of neuroprotective activity of ESP‐102 against glutamate‐induced oxidative stress might be its antioxidative activity. Copyright © 2009 John Wiley & Sons, Ltd.     

ESP全自动血培养仪评价

目的:评价全自动血培养仪(ESP-128)的应用情况。方法:采用前瞻性分析方法,用不同浓度的22种细菌,对血培养仪报警时间及报警率的评估。结果:设定的100瓶标本50h内全部报警,最短报警时间为2.1h,最长报警时间50h。细菌浓度为1.0×106cfu/ml的标本,24h内全部报警;浓度为1.0×104cfu/ml的标本,24h内报警率100%;浓度为1.0×102cfu/ml标本,24h内报警率79%;浓度为1.0×10cfu/ml标本,24h内报警率为73%。结论:ESP-128无论是从报警时间、报警率(包括营养要求高的苛养菌的报警率)都较理想,而且操作简单、结果快速准确。     

医药类本科学生学术写作摘要英语语言分析

搜集本科药学类学生毕业论文英文摘要进行语言研究与分析,主要研究其英语摘要的语言特征及表达中所存在的问题,结果表明：语块使用少,但其中三词语块相对较多;学生写作中语言表达冗长、复杂、句型单一;所使用的动词时态、语态混乱;相关表达中词汇使用欠妥,具有明显的口语化倾向。研究结果将不仅对基础阶段的大学英语写作教学有借鉴作用,而且对于第二阶段的专业英语教学具有启示意义。     

赴英高级护理助理项目对医学英语教学的启示

目的:探讨在加强医护专业英语课程的必要性和方法.方法:分析赴英国高级护理助理医护专业英语对医专英语存在的问题,探讨加强医护专业英语教学方法.结果:提出了几点科学有效的教学方法.结论:医护专业加强英语教学和学生的综合能力提高学校的竞争力是至关重要.     

Proteolytic activity of cysteine protease in excretory-secretory product of Paragonimus westermani newly excysted metacercariae pivotally regulates IL-8 production of human eosinophils

This study investigated the effect of the excretory-secretory product (ESP) of Paragonimus westermani newly excysted metacercariae (PwNEM) on IL-8 production of human mature eosinophils. Treatment of eosinophils with lower concentrations (0.3 and 1 microg/ml) of the ESP significantly (P < 0.01) induced IL-8 production, whereas treatment of cells with higher concentrations (3 and 10 microg/ml) did not. This effect of the ESP was concentration-dependent. Interestingly, the amount of IL-8 production released into the culture supernatants was inversely correlated with the rate of eosinophil survival. When eosinophils were cultured with the same concentrations of the ESP for 24 h, the ESP resulted in eosinophil death in a dose-dependent manner. To investigate whether high proteolytic activity of proteases in the ESP could cause little production of IL-8, 10 microg/ml of ESP was pretreated with heat at 100 degrees C for 10 min or 56 degrees C for 30 min to reduce its proteolytic activity. IL-8 production of eosinophils incubated with heat-treated ESP was markedly increased comparable to that of cells treated with the lowest concentration used in this study. These findings suggest that the protease in the ESP of PwNEM pivotally regulates IL-8 production by controlling of eosinophil survival, depending on the amount of ESP released in vivo. Thus, the cysteine protease in the ESP of PwNEM could provide a novel role to control recruitment of inflammatory cells in larval-infected lesions in human paragonimiasis.