以计算机为基础的教学(CBE)在护理领域的应用现状

随着计算机和网络技术的普及应用，以计算机为基础的教育(Computer Based Education，CBE)特别是多媒体课件的应用在护理教育中越来越受重视。然而，我国CBE在护理领域的应用尚处于起步阶段，也存在着一些缺陷和不足，有待于进一步完善。     

New advances in the pathophysiologic and radiologic basis of the exstrophy spectrum

The exstrophy–epispadias complex is a rare spectrum of anomalies affecting the genitourinary system, anterior abdominal wall, and pelvis. Recent advances in the repair of classic bladder exstrophy (CBE) and cloacal exstrophy (CE) have resulted in significant changes in outcomes of surgical management (including higher continence rate, fewer surgical complications, and better cosmesis) and health-related quality of life in these patients. These noteworthy changes resulted from advances in the pathophysiological and genetic backgrounds of this disease and better radiologic assessment of the three-dimensional anatomy of the bony pelvis and its musculature. A PubMed search was performed with the keyword exstrophy. The resulting literature pertaining to genetics, stem cells, imaging, tissue engineering, epidemiology, and endocrinology was reviewed. The following represents an overview of the advances in basic science understanding and imaging of the exstrophy–epispadias spectrum and discusses their possible and future effects on the management of CBE and CE.     

CBE理论在高职药理学教学中的应用研究

将CBE理论引入到高职药理学教学中,以提高教学效果。按CBE教学模式的要求,将培养学生“能力”作为教学的中心任务和基本的归宿,制定基于CBE的药理学课程标准,编写教学计划,制作教师资源包和学生学习包,教学中引入多种教学方式,拓展学习并改革考核方法。实践证明,该教学模式的探索取得了一定成效,促进了学生能力的拘建和自学能力提升,教学向“以学生为中心”转变,促进学生主动学习,真正形成“教学相长”的良性循环。     

A cluster randomized,controlled trial of breast and cervix cancer screening in Mumbai,India: methodology and interim results after three rounds of screening

Cervix and Breast cancers are the most common cancers among women worldwide and extract a large toll in developing countries. In May 1998, supported by a grant from the NCI (US), the Tata Memorial Hospital, Mumbai, India, started a cluster‐randomized, controlled, screening‐trial for cervix and breast cancer using trained primary health workers to provide health‐education, visual‐inspection of cervix (with 4% acetic acid‐VIA) and clinical breast examination (CBE) in the screening arm, and only health education in the control arm. Four rounds of screening at 2‐year intervals will be followed by 8 years of monitoring for incidence and mortality from cervix and breast cancers. The methodology and interim results after three rounds of screening are presented here. Good randomization was achieved between the screening (n = 75360) and control arms (n = 76178). In the screening arm we see: High screening participation rates; Low attrition; Good compliance to diagnostic confirmation; Significant downstaging; Excellent treatment completion rate; Improving case fatality ratios. The ever‐screened and never‐screened participants in the screening arm show significant differences with reference to the variables religion, language, age, education, occupation, income and health‐seeking behavior for gynecological and breast‐related complaints. During the same period, in the control arm we see excellent participation rate for health education; Low attrition and a good number of symptomatic referrals for both cervix and breast.     

Skin testing with an aqueous extract of cotton bract

Airway challenge with cotton bract extract (CBE) causes reversible bronchospasm in most volunteers never before exposed to CBE or the textile industry. Lung function abnormalities develop slowly after inhalation with a maximum effect reached within 2 hours and lung function slowly improving thereafter. When CBE was injected intradermally in three naive subjects with negligible airway response to CBE, we observed an initial wheal-and-flare reaction within minutes followed by erythema and subsequent induration that persisted for 24 to 48 hours. Microscopic examination of skin biopsy specimens obtained during the course of these reactions revealed edema in the early phase followed by perivascular infiltration of a mixed cellular nature in the subsequent stages of the reaction. Degranulation of mast cells was noted throughout the course of the reaction. These findings indirectly suggest that a nonspecific inflammatory reaction initiated by mast cell-derived mediators and sustained by the presence of infiltrating cells may be responsible for some of the airway effects observed in byssinosis.     

Intracellular pH regulation in heart

Intracellular pH (pH_i) is an important modulator of cardiac excitation and contraction, and a potent trigger of electrical arrhythmia. This review outlines the intracellular and membrane mechanisms that control pH_i in the cardiac myocyte. We consider the kinetic regulation of sarcolemmal H⁺, OH⁻ and HCO₃⁻ transporters by pH, and by receptor-coupled intracellular signalling systems. We also consider how activity of these pH_i effector proteins is coordinated spatially in the myocardium by intracellular mobile buffer shuttles, gap junctional channels and carbonic anhydrase enzymes. Finally, we review the impact of pH_i regulatory proteins on intracellular Ca²⁺ signalling, and their participation in clinical disorders such as myocardial ischaemia, maladaptive hypertrophy and heart failure. Such multiple effects emphasise the fundamental role that pH_i regulation plays in the heart.     

Can Breast Self-examination and Clinical Breast Examination Along With Increasing Breast Awareness Facilitate Earlier Detection of Breast Cancer in Populations With Advanced Stages at Diagnosis?

Breast cancer is the most common form of cancer among women worldwide. Early detection is central to improving disease outcomes. Three main screening methods – mammography, breast self-examination (BSE), and clinical breast examination (CBE) – have been developed and tested in Western nations. There is ongoing debate regarding the efficacy of BSE and CBE in terms of mortality reduction, and a number of international organizations no longer recommend them as screening methods. In technically less developed countries, however, where women are usually diagnosed with breast cancer at advanced stages and younger ages, the benefits of BSE and CBE might outweigh the harm and facilitate early detection of breast cancer. This paper reviews the history of BSE and CBE and discusses their value as early detection methods. It can contribute to informed decision-making by health policy-makers and clinicians who are involved in breast cancer screening in the developing world to improve women’s well-being.     

CBE教学模式在检验医学专业实习生实习中的应用

将CBE教学模式应用在检验医学实习生专业实习中可以提高实习生的职业综合能力,并激发了学生的学习兴趣和积极性,能有效提升检验医学实习生的操作应变及临床能力,尽快满足岗位要求,以达到上岗操作准确无误,临床沟通主动高效的目的。本文作者以血细胞形态镜检操作为例,在某三甲医院检验科实习生中分组培训,探讨了CBE教学模式在检验医学实习生专业实习中应用效果。