“医学微生物学”本科实验教学中生物安全的落实与实践

"医学微生物学"实验课的主要实验材料是病原微生物,因此实验室生物安全是本课程区别于其它实验课程的重要特征之一。因条件限制,我校以前的"医学微生物学"实验课只能安排在不具备生物安全防护等级的普通实验室中进行,不仅存在安全隐患,也使一部分内容不能正常进行,使医学微生物实验教学的发展遇到了瓶颈。为解决这一矛盾,本研究通过医学微生物学教学师资队伍的培训、实验室硬件条件升级改造以及对课程内容涉及的菌(毒)种及其配套软件建设等一系列措施,建立了具有北京大学医学特色的"医学微生物学"实验教学新体系,保证了微生物实验室生物安全相关法规条例的落实及实验教学的正常进行。     

情景模拟教学法在医学实验室生物安全培训中的探讨

实验诊断学是基础医学与临床医学间的桥梁性学科,实验教学是实验诊断学重要的环节之一,医学实验室是医学教学与研究的重要基地,为保障医学生的人身安全,提升实验室生物安全防范意识与能力,生物安全培训至关重要。采用情景模拟教学法设置生物暴露现场,带教老师负责教学组织的实施,学生角色扮演,针对生物安全的培训展开探讨,并在教学后进行总结与评估,从而提高医学生的学习兴趣及判别能力,有利于医学生对于生物安全的防范意识和处理能力的提高,为今后临床工作做好安全保障。     

微生物学类研究生创新技能培养体系的探索——以南京农业大学为例

探讨南京农业大学"微生物学研究方法与技术"专项培训体系的构建,重点阐述建设内容、建设方式及教学成效。该培训体系分为5个功能模块,每个模块由专题讲座和实验技能培训两部分内容组成。通过该培训体系的训练,研究生能熟练掌握大型仪器设备的应用、操作、维护等相关知识,培养了良好的实验技能、严谨的实验作风、认真的科学态度,具备了基本的科学研究能力和科学研究品质,是提高研究生创新能力和实践能力的有效途径。     

医学病毒学生物安全三级动物实验室的建立

目前国内多个机构已建立了BSL-3实验室,这些实验室能够满足细胞水平和动物水平的病原微生物实验活动.医学病毒学生物安全三级动物实验室(ABSL-3)可分为小动物实验室和中(大)动物实验室.小动物实验室主要开展小鼠、大鼠、仓鼠等啮齿类动物的感染性实验活动;中(大)动物实验室主要开展小型猪、猴等实验.动物三级实验室特别是开展中(大)动物实验的高等级实验室,其实验室布局,设备设施,管理体系及流程会有很大的差别.本文从使用者的角度,通过所在机构医学病毒学生物安全三级动物实验室(ABSL-3)的建设与实践,对于筹备和建立以及使用过程中的所面对的问题以及应对,进行了提炼和归纳,分析和探讨,旨在为建设和使用医学病毒学高致病性生物安全三级动物实验室提供借鉴和参考.     

分子实验技能课程教学模式初探

目的:探索适合临床研究生的分子实验技能课教学模式,提高研究生科研思维能力和实验技能。方法:根据临床研究生的特点,以学生为主体,注重学生科研思维的培养,运用多样化的教学手段,对研究生临床分子实验技能课程的教学方法进行探索。结果:通过实验技能课的学习与培训,临床研究生科研思维能力得到很大的提升,对医学实验研究兴趣增加,取得了很好的教学效果。结论:多元化教学模式比较适合临床研究生实验技能课的教学。     

病原生物学专业本科生创新型人才培养中的生物安全问题

探讨病原生物学专业在医学本科生创新型人才培养过程中的生物安全问题。通过实验前的生物安全教育、实验进程中的规范操作以及实验之外的管理体系建设3个方面全程监管实验室生物安全, 以保障本科生参加科研实验的安全性。     

关于高级别生物安全实验室若干管理要素的探讨

目前,我国已有两家生物安全四级实验室和五十多家生物安全三级实验室完成建造并通过实验室认可。生物安全管理体系的技术要素和管理要素是确保高级别生物安全实验室生物安全的关键。本文探讨了高级别生物安全实验室区别于其他体系实验室(如ISO 17025检测和校准实验室与ISO 15189医学实验室)的若干个特征性管理要素,这些要素包括潜在污染的周期性评估、失活验证实验、分子诊断实验的无生物风险的阳性对照、微生物的不同封闭措施及生物安全文化。潜在污染的周期性评估与失活验证实验是高级别生物安全实验室日常管理的强制性措施。分子诊断实验的无生物风险的阳性对照与微生物的不同封闭措施应用于微生物实验(尤其是病毒学实验)从而降低暴露风险。生物安全文化应全面施行,以预防生物安全事件的再次发生。     

医学研究生急救技能掌握情况的初步调查

目的了解医学研究生对急救技能的掌握晴况和对培训的态度。方法对我校2008-2011年入学的458名医学研究生急救技能掌握情况进行调查,并对4项技术（徒手心肺复苏、止血、包扎、固定与搬运）进行技能考核。发放调查问卷,了解对急救技能培训的需求情况。结果医学研究生急救技能掌握普遍较差,4项技术平均合格率为27．3％;心肺复苏技能培训合格率为55．6％。92．3％的医学研究生认为急救技能非常重要,89．5％希望定期得到急救技能培训。结论医学研究生急救知识与技能掌握较差,应定期对他们进行急救技能培训。     

疾病预防控制系统及医疗微生物实验室生物安全管理探析

目的:探寻医疗微生物实验室生物安全管理以及疾病预防控制系统的建设。方法:分析当前生物安全出现的原因及预防措施,采用列举的方法,对相关体系的完善提出建议。结果:由于传染病毒具有扩散块、毒力强的特点,因此生物安全的建设逐步受到社会的重视,其中疾病控制、疾病预防系统的建设及实验室的医疗安全检测具有格外重要的意义。通过调查发现,加强二者的安全管理,必须加强五个方面的建设,即严格遵守疾病控制系统与实验室安全管理规定,对有关的实验设备进行完善与升级,对实验室病菌实验严格把控,对医疗人员、技术人员及检验人员进行定期的安全培训,对实验室废弃物进行管理。讨论:由于当前传染病毒的危害越来越严重,因此,关注生物安全,完善相关的体系建设具有十分重要的意义,国家及医疗部门需要对此给予足够的重视。     

生物检定实验室质量体系建设及考虑要点

完善的实验室质量体系是保证检测结果可靠性的关键。本文主要介绍实验室质量体系建设的基本要求,并针对生物检定实验室的特点,结合世界卫生组织疫苗质量管理实验室质量体系培训的内容,介绍生物检定实验室质量体系建设的考虑要点。主要内容涉及人员与培训、生物安全、仪器设备的校准、验证和维护、实验方法验证、实验结果超出质量标准规定的处理、标准品管理、实验室内部审核与年度审评等。     

Career development of McMaster University medical graduates and its implications for Canadian medical manpower.

A study was undertaken of the career paths and decisions, and the factors influencing the decisions, of the first six graduating classes of McMaster University''s medical school. Climate and geography, preference for urban or rural living and influence of spouse were the factors that most influenced the location of practice, although the graduates who moved to the United States considered economic factors important too. Nearly one third of the specialists were practising in the United States. Personal challenge and positive clinical experience in the field were the major influences on choice of medical field. Graduates entering a specialty were more likely than those entering primary care to consider encouragement of others, a positive example set by medical school faculty members, working hours and research experience in the field as important influences on their choice of medical field. Data are needed on the career decisions, and the factors affecting them, of the graduates of all Canadian medical schools if Canadian medical manpower planning is to be realistic.     

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。     

Cognition of and Demand for Education and Teaching in Medical Statistics in China: A Systematic Review and Meta-Analysis

BackgroundAlthough a substantial number of studies focus on the teaching and application of medical statistics in China, few studies comprehensively evaluate the recognition of and demand for medical statistics. In addition, the results of these various studies differ and are insufficiently comprehensive and systematic.ObjectivesThis investigation aimed to evaluate the general cognition of and demand for medical statistics by undergraduates, graduates, and medical staff in China.MethodsWe performed a comprehensive database search related to the cognition of and demand for medical statistics from January 2007 to July 2014 and conducted a meta-analysis of non-controlled studies with sub-group analysis for undergraduates, graduates, and medical staff.ResultsThere are substantial differences with respect to the cognition of theory in medical statistics among undergraduates (73.5%), graduates (60.7%), and medical staff (39.6%). The demand for theory in medical statistics is high among graduates (94.6%), undergraduates (86.1%), and medical staff (88.3%). Regarding specific statistical methods, the cognition of basic statistical methods is higher than of advanced statistical methods. The demand for certain advanced statistical methods, including (but not limited to) multiple analysis of variance (ANOVA), multiple linear regression, and logistic regression, is higher than that for basic statistical methods. The use rates of the Statistical Package for the Social Sciences (SPSS) software and statistical analysis software (SAS) are only 55% and 15%, respectively.ConclusionThe overall statistical competence of undergraduates, graduates, and medical staff is insufficient, and their ability to practically apply their statistical knowledge is limited, which constitutes an unsatisfactory state of affairs for medical statistics education. Because the demand for skills in this area is increasing, the need to reform medical statistics education in China has become urgent.     

Radiation oncology in Canada: the increasing manpower crisis.

Cancer has been the second most common cause of death in Canada for decades, and its nonsurgical management has largely been carried out by radiation oncologists for many years. Most of these specialists are not Canadian medical graduates, and the supply of suitably trained radiation oncologists is steadily diminishing in relation to the increasing numbers of patients referred to regional cancer centres. Consequently, the workload of each radiation oncologist has steadily increased to a level well beyond that recommended internationally, and it is still increasing. Unless more Canadian graduates can be attracted into the field, and unless more staff positions can be created in virtually all Canadian regional cancer centres, the high quality of patient care, teaching and research offered by radiation oncologists will suffer irreparably and will probably never recover to its former internationally recognized level. In this paper the author recommends ways in which to increase the number of radiation oncologists, though to be effective they will require the collaboration of provincial governments, medical schools, provincial cancer foundations and the medical profession.     

Insulin Resistance,Hyperleptinemia, and Obstructive Sleep Apnea in Launois‐Bensaude Syndrome

Objective: Launois‐Bensaude Syndrome (LBS) is a very rare cause of obesity, characterized by a symmetrical accumulation of a very large number of lipomata in different regions of the body, excluding the face, the forearms, and the shanks. Obesity is known to be closely associated with insulin resistance, hyperleptinemia, and obstructive sleep apnea (OSA). We were interested in studying whether these conditions are also present in patients with obesity due to LBS with a similar frequency as in patients with “simple” truncal obesity. Research Methods and Procedures: We performed polysomnography and hyperinsulinemic euglycemic clamp studies and measured serum leptin in three patients with LBS and in six patients with “simple” truncal obesity, matched for sex and body mass index (LBS group, 36.39 kg/m²; controls, 35.82 kg/m²). Results: Polysomnography revealed severe OSA in one LBS patient with marked “horsecollar lipomata.” In the other LBS patients, no OSA could be demonstrated. The leptin levels of the two groups were comparable (LBS group, 36.39 μg/liter; controls, 37.18 μg/liter) and the insulin responsiveness index was also comparable in the two groups (LBS group, 3.47 μmol/kg · minute; controls, 3.79 μmol/kg · minute). Discussion: Patients with LBS demonstrated similar metabolic features in terms of insulin sensitivity and hyperleptinemia as patients with “simple” truncal obesity. LBS is not strictly associated with OSA.     

生物化学检验技术实验教学与开放式综合实验设计初步效果探讨

目的:探讨生物化学检验技术实验教学(Experimental biochemistry inspection teaching,EBIT)与开放式综合实验设计(Open comprehensive experiment design,OCED)的初步效果,为EBIT教学提供新型选择方案。方法:选择2012届我们所带教医学检验专业的2个班级111例学生作为研究对象,分别归入观察组和对照组,其中观察组56例,对照组55例。对照组EBIT中予以传统的模式,观察组则采用OCED模式。对比两组实验成绩、教学效果的满意度。结果:观察组的合格率显著高于对照组,差异有统计学意义(P<0.05)。观察组对教学效果的满意度显著高于对照组,差异有统计学意义(P<0.05)。结论:OCED方式应用于EBIT过程中,可获得较好的教学效果,值得推荐。     

Requirements of British universities for higher medical degrees.

OBJECTIVE--To examine the requirements and opportunities for obtaining a doctor of medicine or master of surgery degree from a university in the United Kingdom other than the graduate''s own, particularly in the case of foreign graduates. DESIGN--Review of regulations governing the award of doctor of medicine and master of surgery degrees in British universities. SETTING--All 19 universities in the United Kingdom offering clinical courses. MAIN OUTCOME MEASURE--Availability of degrees to graduates of other universities. RESULTS--Opportunities for obtaining a degree differed widely among the medical schools, one university (Edinburgh) not admitting graduates of other universities in any circumstance. Of the remaining universities, none would consider a graduate who had not worked in the area where the medical school was located. CONCLUSION--The wide differences in opportunity among the medical schools may put some foreign graduates at a disadvantage compared with other graduates. This problem may become more severe as the number of graduates from the European Community who settle in Britain increases.     

神经内科硕士研究生临床和科研能力的培养

临床医学硕士研究生阶段是培养临床和科研思维能力的重要阶段,从某种意义上说是人生和医疗生涯的关键时期。神经内科硕士研究生不仅应该具有一定的临床工作能力,还应具有一定的科研能力。临床工作能力培养包括临床基本功的培训,基本理论的加强和基本技能的培养,临床思维能力的培养及医患沟通能力的培养等多个方面。科研能力包括文献阅读能力、科研思维能力和论文写作能力等。这样,硕士研究生毕业后不仅能够诊治神经内科常见病和多发病,会思考临床工作中的问题,更重要的是能想办法探索和解决这些问题。这也是硕士研究生和本科生的本质区别。因此,研究生阶段是医学生涯一个重要的里程碑,临床和科研能力的培养对个人未来的发展具有十分重要的意义。     

Inbreeding depression influences lifetime breeding success in a wild population of red deer (Cervus elaphus)

Evolutionary and conservation biologists have a long-standing interest in the consequences of inbreeding. It is generally recognized that inbred individuals may experience reduced fitness or inbreeding depression. By the same token, relatively outbred individuals can have greater than average fitness, i.e. heterosis. However, nearly all of the empirical evidence for inbreeding depression comes from laboratory or domestic species. Inbreeding depression and heterosis are difficult to detect in natural populations due to the difficulties in establishing pedigrees. An alternative method is to correlate heterozygosity, which is measured using genetic markers, with a trait related to fitness. The typically studied traits, such as juvenile survival and growth rates, either cover only early life or are weakly correlated with lifetime breeding success (LBS). In this paper we show that heterozygosity is positively associated with male and female adult LBS in a wild population of red deer (Cervus elaphus) on the Isle of Rum, Scotland. To the authors' knowledge, this is the first time that inbreeding depression and/or heterosis have been detected for a trait highly correlated with overall fitness in both sexes in a wild population.     

微生物学课程创新实践教学模式探索

为激发本科生对微生物学的学习兴趣、训练实验技能、拓展创新思维、促进素质教育,我们探索了"课堂讲授—实验课程—课题研究"三位一体、"理论—技能—创新实践"同步训练的微生物学教学模式,首次将研究生引入本科生素质教育中,并在教学方法、手段、考核等方面进行了改革试验,实践证明这一教学模式对主动掌握理论知识、激发创新精神、提高学生素质都有积极的推动作用。