案例教学法在护理本科专业组织学与胚胎学教学中的实施与体会

组织学与胚胎学为护理本科专业学生必修课.在教学过程中采取＂学生为主体、教师为主导＂的案例教学法,激发学生的主观能动性,注重学生创新能力培养.在案例教学过程中,也发现一些问题：学生素质不一、学习目标不明确以及教师教育理念滞后等.因此,在护理本科专业组织学与胚胎学实施案例教学过程中,引导学生确立学习目标,积极思考,注重团队合作,全面调动学生学习的积极性和主动性.教师在更新教学观念的同时,提倡奉献精神,注重自身素质的培养和提高.     

Climatic effects in Central Europe on the frequency of medical treatments of dairy cows

In the present study, the relationship between the temperature–humidity index (THI) and the incidence of medical treatments in lactating dairy cows in Lower Saxony, Germany, was investigated. Records of all veterinary-treated cases over 2 years (2003 and 2005) from eight Holstein–Friesian dairy herds raised in loose-housing systems (55 to 170 cows per herd) were evaluated. After exclusion of management-dependent and climate-independent cases, a total of 5547 treatments were analyzed. Treatments were clustered into the following groups: metabolism, fertility, udder and foot/leg. Meteorological data were compiled from the nearest weather station (average distance ± s.d. 39 ± 13 km). Hourly temperatures and relative humidity values were used to calculate the THI, which was divided into classes. Out of the total number of treatments, 37.4%, 32.9%, 21.6% and 8.1% belonged to metabolism, udder, fertility and foot/leg, respectively. Data were analyzed with a mixed model that included THI class, season and year as fixed effects and farm as random effect. In general, incidences were neither affected by the year (P > 0.05) and season (P > 0.05) nor by THI classes (P > 0.05). In tendency, incidences of metabolic treatments increased with increasing THI and incidences of udder treatments increased with decreasing THI. In conclusion, indications of moderate heat stress during summer months in Central Europe were found in the present study, although THI and season did not affect the different disease complexes significantly.     

医学研究生临床生化专题全英教学的改革与实践思考

为培养高质量国际化有才能的医学研究生,对于已经学习过生物化学的国际医学留学研究生,开展了以与临床密切相关的生物化学专题为主要教学内容的全英文授课的教学实践和课程建设,取得了很好的教学效果.临床生化专题全英教学课程也可能适用于国内生物化学和医学相关专业的研究生,在今后的教学实践中需要继续研究和探索,以提高国内医学相关研究生的专业综合素质.     

肝胆外科住院医师规范化培训教学探讨

住院医师培训是医学教育中重要环节之一,是提高临床医疗水平的关键。因此,如何探索科学、合理的住院医师培养方案,已成为临床医学教育探索的重要课题。本文对肝胆外科住院医师规范化培训的实践进行了总结分析,希望对提高肝胆外科住院医师规范化培训效果起到一定的促进作用。     

Bioreactors in tissue engineering—principles,applications and commercial constraints

Bioreactor technology is vital for tissue engineering. Usually, bioreactors are used to provide a tissue-specific physiological in vitro environment during tissue maturation. In addition to this most obvious application, bioreactors have the potential to improve the efficiency of the overall tissue-engineering concept. To date, a variety of bioreactor systems for tissue-specific applications have been developed. Of these, some systems are already commercially available. With bioreactor technology, various functional tissues of different types were generated and cultured in vitro. Nevertheless, these efforts and achievements alone have not yet led to many clinically successful tissue-engineered implants. We review possible applications for bioreactor systems within a tissue-engineering process and present basic principles and requirements for bioreactor development. Moreover, the use of bioreactor systems for the expansion of clinically relevant cell types is addressed. In contrast to cell expansion, for the generation of functional three-dimensional tissue equivalents, additional physical cues must be provided. Therefore, bioreactors for musculoskeletal tissue engineering are discussed. Finally, bioreactor technology is reviewed in the context of commercial constraints.     

关于在神经外科实习教学中采用Web-CPBL教学模式的探讨

在医学生临床实习带教过程中,神经外科实习教学由于其教学内容具有专业性强、信息量大、知识更新快的特点,与其它专业相比更具难度,教学效果往往难达到预期水平。Web-CPBL教学模式,是将传统的PBL教学理念与网络信息技术有机融合,延伸和发展出的一种新型教学模式。在神经外科实习教学中,巧妙得当的借力于网络资源平台,有助于打破临床师资缺乏、实操场地不足的局限,能更充分的发挥PBL教学的优势。此模式在培养和锻炼医学生临床思维能力的同时,也帮助他们尽早养成主动学习、善于协作、乐于共享的良好学习习惯,提高其医学人文素养。     

专科层次临床医学专业课程建设效果调查分析

目的:了解临床医学专业课程建设情况,总结专科层次临床医学专业教育教学的主要成绩,查找专业建设存在的问题,为专科层次临床医学专业教育教学改革提出改进意见。方法:对我校2013届(应届生)306名、2011届和2012届(往届生)333名专科层次临床医学专业毕业生进行问卷调查,主要调查内容包括:课程内容、课程资源和课程评价。结果:专科层次临床医学专业毕业生认为本专业核心课程知识和技能模块设计合理,且应届毕业生认可度高于往届毕业生;对专业类纸质图书、纸质期刊等课程资源满意度高,认为专业类精品课程、教学视频等课程资源需要进一步改善;毕业生对专业知识考评认可度较高,应届生认可度优于往届生。结论:专科层次临床医学专业课程建设效果较好,特别是课程内容安排和课程评价合理,但在专业技能训练和课程资源建设方面需重点加强。     

Focus: The Aging Brain: Palliative Care and the Humanities: Centralizing the Patient at the End of Life

Palliative care is a quickly growing facet of modern medicine. While scientific advancements have broken new ground for the possibilities of end-of-life care, sensitive treatment of the patient as an individual has lagged behind and has frequently led to an unsatisfactory experience for patients, families, and the medical community at large. This essay argues that centralizing patients during the terminal phases of treatment by using humanistic perspectives has the potential to bring new meaning and improved effectiveness to patients and physicians alike.     

Perfil clínico y mortalidad a 90 días de los pacientes centenarios atendidos en servicios de urgencias hospitalarios

ObjectivesTo determine the clinical profile and to develop a model to predict 90-day mortality in centenarian patients attended in emergency departments (ED).MethodologyThis was an observational, retrospective, multicentre cohort study including patients > 99 years attended in 5 ED in the Community of Madrid from January to December 2012. Demographic variables were recorded, as well as, comorbidities, cognitive, functional, social basal status, geriatric syndromes, acute episode, and hospital and social resources use, and 90-day mortality.ResultsThe study included 209 patients aged 101 years (SD 1.7) of whom 161 (77.0%) were female. Sixty four (32.5%) had severe comorbidity (Charlson index ≥ 3), 101 (49.8%) on multiple medication, 100 (52.6%) had cognitive impairment, 82 (42.3%) had severe functional dependence, 85 (40.7%) were institutionalised, and 190 (94.5%) had a geriatric syndrome. Dyspnoea (26.8%), followed by falls (12.4%) were the most common causes of attendance. One hundred and eighteen (56.5%) were admitted, and 58 out of 174 (33.3%) died in the first 90 days. The model to predict 90-day overall mortality included male sex (OR 2.42 95% CI = 0.97-6.04; P = .059), emergency care in the previous 3 months (OR 4.08 95% CI = 1.26-13.16; P = .019) and the hospitalization by index event (OR 8.63 95% CI = 3.25-22.9; P < .001) and this model had an area under ROC curve of 0.776 (95% CI = 0.70-0.85; P < .001).ConclusionsCentenarian patients attended in ED had a significant frailty and one in three cases died in the first 90 days after being attended, and this was associated with male sex, emergency care in the previous 3 months, and hospitalisation.     

水质微生物学检验实验模块的教学探索与实践

我校采用模块化教学形式开展水质微生物学检验实验教学。该模块由菌落总数测定、总大肠菌群测定及生理生化反应测试以及大肠菌群的血清学测试3个单元实验组成。实验内容以国家标准《生活饮用水标准检验方法——微生物指标(GB/T 5750.12-2006)》规定的程序进行编排。在教学过程中,注重模块实验的标准化操作,让学生树立标准化意识;通过连贯的模块化实验将卫生学检验实验转换为带有基础性的细菌分类学实验,在培养学生微生物学检验操作能力的同时,让学生系统地学习大肠杆菌的各种分类学鉴定方法。该模块的考核形式是学生参照专业机构的检验报告出具校园湖水的水质检验报告以及提交研究论文。水质微生物学检验实验模块的教学改革提高了学生的微生物数量研究能力和细菌分类研究能力,有利于学生开展创新型研究。