医学生科研创新能力培养“3+X”模式的探索与实践

针对长期以来培养医学生的科研创新能力主要依靠零散的课外科研活动、受众面窄、没有系统性课程教学及其相关制度保障、致使对医学生科研创新能力培养明显乏力低效这一共性瓶颈教学问题,自2002年起,汕头大学医学院生物化学与分子生物学教学团队,在“科教相辅相佐”、“以学生为中心”、“以问题为导向”等先进教育理念指导下,倚重汕头大学医学院“医者之心”系列课程与书院育人文化之特色,发挥汕头大学的生物学、基础医学和临床医学一级学科均拥有本/硕/博/博后完整人才培养体系之优势,联合其他相关专业教学团队,在建立充分体现医学生科研创新能力培养内涵,覆盖医学本科5年全过程的核心课程体系的基础之上,历经20载的不懈努力,补充修善,成功构建了“3+X”模式,着力培养医学生的科研创新能力。所谓“3”意指对医学生的“全人培养”、“全程培养”和“全方位培养”。所谓“X”意指针对“3+X”模式运行效能的若干个验证性维度,主要包括组织医学生参加各种形式的全国大学生创新实验研究大赛、国际大学生学术研讨会,由医学本科生作为第一作者撰写发表学术论文等。培养医学生科研创新能力的成效十分显著,为有效解决上述共性瓶颈教学问题提供了一个有重要借鉴价值的范例。     

基层医院输血科工作现状及改进

输血是现代医学中重要的抢救、治疗手段,临床输血是一门极其复杂的学科。血液及其制品的管理是一项科学的系统工程,是保证血液质量、提高医疗用血效率、促进输血事业和科研技术水平不断发展的关键。输血科是医院的重要部门,具体负责临床用血的技术指导和技术实施,确保贮血、配发血和其他科学、合理用血措施的执行,其基本目的是将血液及成分安全、有效、合理而便宜的输注给需要的病人并取得疗效。输血科如何履行好职能,保证临床输血安全、科学、合理、有效,已成为当前基层医院首先需要解决的问题。本文就基层医院输血科的工作状况进行了分析,并提出完善规章制度,严格执行操作,更新输血观念,科学合理用血,开展业务新技术,保证输血有效性等相应整改措施,在实际运行中取得可喜的成绩。     

Human guinea pigs and the ethics of experimentation: the BMJ's correspondent at the Nuremberg medical trial.

Though the Nuremberg medical trial was a United States military tribunal, British forensic pathologists supplied extensive evidence for the trial. The BMJ had a correspondent at the trial, and he endorsed a utilitarian legitimation of clinical experiments, justifying the medical research carried out under Nazism as of long term scientific benefit despite the human costs. The British supported an international medical commission to evaluate the ethics and scientific quality of German research. Medical opinions differed over whether German medical atrocities should be given publicity or treated in confidence. The BMJ''s correspondent warned against medical researchers being taken over by a totalitarian state, and these arguments were used to oppose the NHS and any state control over medical research.     

Government Regulations and the Use of Drugs

I have tried to trace the new drug development pattern from 1766, when Withering obtained his medical degree, to the present.The role of governmental authority as defined by the 1962 Kefauver-Harris amendments to the 1906 law and the subsequently issued regulations has been summarized. Four phases of testing in man have been detailed.Something of the scientific or research capability of the pharmaceutical industry has been presented.It is concluded that in the period of over two hundred years of medical education in the United States, the university hospital has become more and more the focus of medical research, teaching and practice in the community. The safety and effectiveness in the use of drugs in the future will depend upon the liaison and rapport of the industry physicians, government officials and the university hospital teacher-clinical investigators (phase 1 and 2) in designing the most critical studies of the safety and effectiveness of new drugs.Whether the medical profession as we know it will participate more in the future than has been possible since 1962 in mass clinical trial (phase 3) before new drug approval by governmental authority remains to be seen.The final approbation or disapproval of a drug after NDA approval (phase 4) will continue to be in the hands of the participating physician as long as he can establish scientifically that the drug is the best possible agent for him to use in healing the sick and comforting the dying.     

High-priority research directions in genetics and the breeding of the sugar beet (Beta vulgaris L.) in the 21st century

High-priority research directions for the genetics and breeding of the sugar beet in the 21st century were developed with consideration of the available scientific achievements of domestic and foreign scholars. These directions unite the classical and molecular approaches to solving the problems of increasing the effectiveness of sugar beet breeding carried out on a genetic basis, and they correspond to the contemporary level of scientific research. Seven such directions are proposed.     

医院科研管理与创新对转化医学实施的推动作用

转化医学是近年来国际医学界推崇的一个重要医学理念,正日益成为生命科学和医学研究关注的热点。转化医学已不仅强 调临床医学与基础医学的结合,而且涉及多个学科之间的融会贯通。因此,医院科研管理的支持和重视程度转化医学实施的主要 动力,而科研项目的创新性、可行性是决定转化医学研究立项的关键。我院自2010 年成立转化医学研究中心以来,已将多项成果 成功转化并应用于临床实践,为生命科学研究领域中人类健康计划的发展提供了借鉴。本文结合我院实际,分析科研管理对转化 医学成果实施的促进作用,为医疗机构的科研管理人员提供参考。     

A historical chronology of teaching physiological sciences to medical students in Hungary

Starting from the second half of the 18th century, a brief chronology of teaching medical physiology and pathophysiology in Hungary is given in this article. Even when the major milestones of this history are only identified, one can recognize several significant achivements that may inspire the present and coming generations to develope and enrich this inheritance of high values. These achivements involve--inter alia--influential scientific "schools" founded by eminent professors, outstanding institutions of basic medicine, recognition of the relevance of the integrative approach in medical education, close relationship between teaching and scientific research, high-standard theoretical and practical training, teaching based on excellent domestic and foreign textbooks, extensive international relationships and experience.     

如何指导医学生撰写医学综述

医学综述是在全面、正确理解文献的基础上,对某一段时间内的某一研究专题进展进行客观总结和论述。学会撰写医学综述可以进一步加强学生对研究领域最新发展动向的了解,对医学生临床诊疗及科研能力的提高有着非常重要的意义。作者结合自身及其导师多年来指导医学生的教学经验,将医学综述的撰写方法技巧进行总结归纳,包括在综述的写作过程中如何正确的选择研究专题、科学合理的检索和整理文献以及最终将自己的见解准确表述等。     

NIH initiative to balance sex of animals in preclinical studies: generative questions to guide policy,implementation, and metrics

In May of 2014, the NIH Director together with the Director of the Office of Research on Women’s Health announced plans to take a multi-dimensional approach to address the over reliance on male cells and animals in preclinical research. The NIH is engaging the scientific community in the development of policies to improve the sex balance in research. The present, past, and future presidents of the Organization for the Study of Sex Differences, in order to encourage thoughtful discussion among scientists, pose a series of questions to generate ideas in three areas: 1. research strategies, 2. educational strategies, and 3. strategies to monitor effectiveness of policies to improve the sex balance in research. By promoting discussion within the scientific community, a consensus will evolve that will move science forward in a productive and effective manner.     

我国本科护理专业开设循证医学课程的现状

循证医学是二十一世纪医学实践的新模式,是指导临床医生和医学生进行科学医疗实践的一种工具,又是实现临床医生终生自我教育的一种好的方法。循证医学的理念和方法对护理专业的影响,必将促进护理向科学化护理迈进,而循证医学教育是促进护理人员掌握循证医学知识和技能的关键,本文重点论述了我国本科护理专业开设循证医学课程的现状以及存在的主要问题。     

From cell cycle regulation to angiogenesis: dialogue between the basic and clinical sciences

Basic research in biological and medical disciplines has revealed fundamental aspects of the differentiation of single cells as well as the development of multicellular organisms. The combination of knowledge of intracellular and intercellular pathways controlling development and homeostasis in higher organisms is the key to understanding certain diseases that are associated with abnormalities in these pathways and developing strategies for fighting them. Today's high scientific output in a rapidly growing number of scientific journals requires great effort to keep up with the latest developments outside one's specialization. The tenth international conference of the International Society of Differentiation (ISD) therefore was a great opportunity for scientists of diverse fields of biological and medical research to learn about the latest developments in even remotely related branches of research and opening new perspectives. The authors have tried to conserve this spirit in reviewing main aspects of research presented at the conference.     

On the lack of consensus over the meaning of openness: an empirical study

This study set out to explore the views and motivations of those involved in a number of recent and current advocacy efforts (such as open science, computational provenance, and reproducible research) aimed at making science and scientific artifacts accessible to a wider audience. Using a exploratory approach, the study tested whether a consensus exists among advocates of these initiatives about the key concepts, exploring the meanings that scientists attach to the various mechanisms for sharing their work, and the social context in which this takes place. The study used a purposive sampling strategy to target scientists who have been active participants in these advocacy efforts, and an open-ended questionnaire to collect detailed opinions on the topics of reproducibility, credibility, scooping, data sharing, results sharing, and the effectiveness of the peer review process. We found evidence of a lack of agreement on the meaning of key terminology, and a lack of consensus on some of the broader goals of these advocacy efforts. These results can be explained through a closer examination of the divergent goals and approaches adopted by different advocacy efforts. We suggest that the scientific community could benefit from a broader discussion of what it means to make scientific research more accessible and how this might best be achieved.     

医学院校本科生进行基础科研能力培养的意义

随着我国科学技术的迅猛发展,生命科学领域对专业人才的需求愈加迫切,要求亦愈加严格。部分医学院校为适应目前我国对基础科研工作者的需求现状,积极调整医学与生命科学专业本科生专业设置,改善完善课程设置,在本科生中有计划的进行科研训练,对学生毕业后的选择就业去向或者进一步深造具有重要指导作用,培养具有科研能力的高素质的医学从业人员,有助于推动医疗卫生事业的发展。     

Science in the Service of Patients: Lessons from the Past in the Moral Battle for the Future of Medical Education

Medical schools instill a classic moral standoff in which the responsibility for the betterment of the patient stands at odds with the responsibility for the betterment of society. In critical ways, the latter, in the form of a robust research and technology-driven enterprise, has taken precedence over the former, resulting in harm to patients and individual dignity. This tradeoff can be traced to Abraham Flexner, the father of American medical education. In the wake of the Flexner report, American medicine set out on a course of exponential scientific advancement, but the mistreatment of research subjects and the erosion of the doctor-patient relationship in a health care system that is increasingly unaffordable, complex, and impersonal suggest that such progress has come at a price. Recent efforts by medical schools to emphasize humanism in their curricula and admissions processes have shown promise in orienting the values of academic medicine toward the individual patient’s well-being.     

神经细胞尼氏体染色方法改良

组织细胞的染色无论在病理学诊断还是在科学研究与教学工作中,都具有重要的意义和使用价值。为了更好的研究神经组织,方便医学诊断、科研和教学工作,对3种常见尼氏体染色方法包括硫堇、甲苯胺蓝、吉姆萨染色法做了一些改良。改进的尼氏体染色法能够使脑组织切片更清晰美观,更有利于科研工作者对神经组织及尼氏体的研究。     

高压氧的应用进展

高压氧逐渐被广泛的应用于多个医疗实践领域。作为一种特殊的治疗手段,临床医生会为他们的病人提供这种治疗选择,但对其机制却不十分了解。通过对高压氧作用机制详细阐述,为临床医生在医疗实践中提供科学依据。通过全面阐述高压氧的临床应用、并发症及禁忌症,更全面、系统的了解高压氧这种治疗手段,全面评估高压氧的治疗安全性。因高压氧具有增加氧输送、免疫功能和改变血液流变学的复合效应,而且安全性较高,用于治疗创伤、栓塞、感染等多种疾病。突发性耳聋是耳鼻咽喉科常见的急症,患者主要表现为突然发生的不同程度的感音神经聋,影响患者的生活。因目前突发性耳聋的病因尚不明确,治疗方案多种多样,如激素、抗凝药物、抗病毒药物等,但疗效均为得到肯定,无有效的统一治疗方案。通过分析评价多个随机对照试验,发现高压氧治疗可明显改善突发性耳聋(Sudden hearing loss,SHL)的听力下降,希望能为临床医生的治疗提供科学依据。可能存在其他的尚未发掘的治疗领域,期待临床上有更多的相关研究。     

科学典故在组织胚胎学教学中的应用

人体组织胚胎学是一门医学形态学课程,也是医学生进入人体奥秘大门的一把重要钥匙,但形态结构中繁多的记忆内容常常让学生感到学习枯燥,因而更需要授课教师通过不同形式的教学策略引导学生领会其中的乐趣和科学意义。在众多的教学方法和教学手段中,适当引用教学内容相关的科学典故和科学名人,能在潜移默化中培养学生的学习兴趣,理解相关的理论知识,改善教学效果。本文作者整理了一些组织胚胎学教学内容相关的科学典故及其在教学中的应用,供同行交流和医学生参考学习。     

Using mathematical models to understand the AIDS epidemic

The most urgent public-health problem today is to devise effective strategies to minimize the destruction caused by the AIDS epidemic. This complex problem will involve medical advances and new public-health and education initiatives. Mathematical models based on the underlying transmission mechanisms of the AIDS virus can help the medical/scientific community understand and anticipate its spread in different populations and evaluate the potential effectiveness of different approaches for bringing the epidemic under control. Before we can use models to predict the future, we must carefully test them against the past spread of the infection and for sensitivity to parameter changes. The long and extremely variable incubation period and the low probability of transmitting the AIDS virus in a single contact imply that population structure and variations in infectivity both play an important role in its spread. The population structure is caused by differences between people in numbers of sexual partners and the use of intravenous drugs and because of the way in which people mix among age, ethnic, and social groups. We use a simplified approach to investigate the effects of variation in incubation periods and infectivity specific to the AIDS virus, and we compare a model of random partner choices with a model in which partners both come from similar behavior groups.     

抑郁症治疗的循证医学研究进展

循证医学是近年来国际上临床医学领域迅速发展起来的新学科,已成为当前国际医学研究中的热点之一,是指对病人的诊 断、治疗、预防、康复和其他决策应建立在当前最佳临床研究证据,是遵循证据的临床医学,强调收集最佳证据。其理念的科学性 和有效性迅速渗透到医学领域的众多学科,循证精神卫生也相继提出并发展。抑郁症是由各种原因引起的以抑郁为主要症状的 一组心境障碍或情感性障碍,近几年能够有效运用循证医学方法为治疗抑郁症寻找最佳临床证据,制定循证诊疗指南成为了临 床医生的迫切要求。本文就抑郁症治疗方面的循证医学研究进展做一综述。     

Research at the European Synchrotron Radiation Facility medical beamline.

The application of synchrotron radiation in medical research has become a mature field of research at synchrotron facilities worldwide. In the relatively short time that synchrotrons have been available to the scientific community, their characteristic beams of UV and X-ray radiation have been applied to virtually all areas of medical science which use ionizing radiation. The ability to tune intense monochromatic beams over wide energy ranges differentiates these sources from standard clinical and research tools. At the European Synchrotron Radiation Facility (Grenoble, France), a major research facility is operational on an advanced wiggler radiation beamport, ID17. The beamport is designed to carry out a broad range of research ranging from cell radiation biology to in vivo human studies. Medical imaging programs at ID17 include transvenous coronary angiography, computed tomography, mammography and bronchography. In addition, a major research program on microbeam radiation therapy is progressing. This paper will present a very brief overview of the beamline and the imaging and therapy programs.