正常人和无睡眠呼吸异常慢病患者睡眠期间的呼吸源性心率变异初步报告

目的:整体整合生理学医学新理论-呼吸循环代谢等系统一体化调控提出了呼吸为循环指标变异性起源的假说,我们对人睡眠期间的呼吸和心率变异分别分析,探索心率变异的起源.方法:本研究回顾性分析了2014年以来行心肺运动试验(CPET)、多导睡眠图(PSG)鼻气流和心电图监测的8例无疾病诊断的正常人和10例无睡眠呼吸异常的慢性疾病...     

医学生物化学课程教学模式与临床课程结合的探索

医学生物化学课程是对人体生命现象进行研究最为先进的基础学科,主要用于研究细胞内各组分的结构和功能以及从整体上研究生物体的代谢、基因遗传等,我国对于医学生物化学课程教学有独特的教学模式。医学生物化学不仅要为护理以后的临床课程打好基础,而且也与临床护理工作息息相关。因此,本文研究了医学生物学课程教学模式与临床课程的衔接,具有一定的借鉴意义。     

1991年度生命科学的资助范围(部分)

人体生理学是研究人体生命活动规律的科学。它是生命科学的重要组成部分,是医学科学的基础。疾病及其发生、发展是人体功能由正常转变为异常的状态和过程。只有首先阐明有关人体正常功能的活动和调控规律,才能进一步探讨疾病的发生机制和防治原理,以指导临床实践。因此,生理学与生物化学、药理学、免疫学、病理学和临床各个学科领域的技术和理论基础有着密切的关系。现代生理学的研究主要是按各个功能系统进行的,包括各系统功能活动的规律及调控机     

当代生理学研究的新动向--人体微生态系统的生理功能

我国著名的微生态学家、中国微生态学创始人康白教授最近撰文明确提出“正常微生物群是一个新的人体生理学系统”。这是一个极有价值的新观点 ,这一新理论的出现将为微生态学和生理学增添新的内容 ,对未来医学将起到重要作用。本文就人体正常微生物群生理学研究的对象和任务、研究的层次、人体正常微生物群所处的环境 ,人体正常微生物群的生理功能、人体微生态系统的调控等问题加以论述 ,供大家参考。1　人体正常微生物群生理学研究的对象和任务人体正常微生物群生理学是当代人体生理学研究的一个新内容 ,它是以人体正常微生物群的生命活动…     

超快速反应聚合物光纤氧测定装置及其用于活体动物机械通气下动脉血氧分压连续动态变化的初步实验报告

目的:我们在中国尝试使用超快反应聚合物光纤氧感受器置入整体活体动物动脉血管,再通过光电转换测定系统以记录活体动物颈动脉PO2(PaO2)连续动态的快速变化,为完善整体整合生理学理论体系中循环参与呼吸调控和呼吸循环代谢一体化调控提供实验依据.方法:①超快反应氧感受器制作、性能及其测定系统标定:在实验室加热总长2 m光纤的...     

生理学发展的动向

(一) 生理学,包括人体生理学和动物生理学,是生物科学中一门较大的学科,它研究人体和动物机体对环境变化的反应与适应,以及组成动物机体各类细胞、器官和系统的机能。与医学(医学生理学)、体育(运动生理学)、劳动(劳动生理学)、国防(空间生理学)、以及农业(昆虫生理学)、畜牧业(家畜生理学)、渔业(鱼类生理学)的实践,有广泛的联系。     

肥厚型心肌病患者在心肺运动中核心指标的特征性研究

目的:肥厚型心肌病(HCM),以心肌肥厚为主要特征的心肌疾病,猝死率高.临床症状表现为呼吸困难、乏力、胸痛等.症状限制性极限运动心肺运动试验(CPET)在整体整合生理和医学(HIPM)理论指导下是唯一评估人体整体功能状态检查,肥厚型心肌病患者在心肺运动中核心数据变化值得进一步探讨.方法:选择2017年4月至2020年1...     

代谢、血液碱化和纯氧影响呼吸调控的人体实验研究I:运动试验*

目的: 在整体整合生理学医学理论的指导下,通过分析正常人运动期间心肺代谢等多系统功能整体整合的连续动态变化,探讨正常环境运动状态下呼吸反应模式的调控机理。方法: 选正常志愿者5名,在美国洛杉矶加州大学Harbor-UCLA医学中心分别进行动脉置管,在常温室内空气状态下完成症状限制性最大极限心肺运动试验(CPET)。在运动过程中,连续测定肺通气指标及每分钟动脉取样的血气分析指标的变化,对CPET期间呼吸气体交换和血气指标的动态变化进行统计分析。结果: 在CPET期间,随着运动功率逐步递增,分钟摄氧量(每呼吸摄氧量×呼吸频率=每搏摄氧量×心率）和分钟通气量(潮气量×呼吸频率)均呈现近于线性渐进性递增(与静息状态比较,P<0.05~0.001);在运动超过无氧阈和呼吸代偿点后,分钟通气量的上升反应更加显著。结论: 人体在运动过程中,为了克服自行车功率计的阻力而发生代谢率改变,呼吸随代谢改变而变化,高强度运动时酸性代谢产物堆积更加加剧呼吸反应。     

生物时钟与能量代谢的整合研究

生物时钟系统是生物界的共有系统。以哺乳动物为例,生物时钟控制着各种生理进程,如睡眠周期、血压、血液激素水平及能量代谢等,使之呈现出以大约24 h为周期的节律性变化。哺乳动物的生物时钟与能量代谢稳态之间存在紧密的联系。该文根据此前的研究将二者间的整合模式归为以下3类:(1)以核受体、转录因子/辅因子及其分子伴侣、非编码RNA等为节点,同时调控时钟与代谢进程,促使二者整合,即"并联型"整合模式;(2)由钟控基因(clock-controlled genes,CCGs)承接生物时钟信号,作为下游效应器进而调控代谢进程,线性化使二者整合,即"串联型"整合模式;(3)以某些代谢物为节点,既能响应上游环境刺激,又能同时调控下游时钟和代谢进程,促使二者整合,即"组合型"整合模式。综上所述,对生物时钟和能量代谢整合的研究为将来从时辰生物学的角度防控及治疗代谢综合征提供了新的思路。     

“四合一”分子医学整合课程的构建与实践

整合课程是将各学科知识横向或纵向组合,注重学生整体思维学习的一种新型课程。整合课程教学方式为跨专业的团队教学,教学特点是注重学生思维能力和学习能力的培养,是当今医学教育改革的趋势。昆明医科大学目前尝试将"以学科为主"的教学模式转化为以"以器官系统为中心"的整合课程教学模式。为顺应这一教育改革的趋势,作者在基础医学课程建设中,将"细胞生物学、医学遗传学、生物化学、分子生物学"四门课程整合为"分子医学"课程。作者就"四合一"分子医学整合课程改革的背景、顶层设计、教学模式、实践中存在的问题等进行讨论。     

Physiology,Hygiene and the Entry of Women to the Medical Profession in Edinburgh c. 1869–c. 1900

Academic physiology, as it was taught by John Hughes Bennett during the 1870s, involved an understanding of the functions of the human body and the physical laws which governed those functions. This knowledge was perceived to be directly relevant and applicable to clinical practice in terms of maintaining bodily hygiene and human health. The first generation of medical women received their physiological education at Edinburgh University under Bennett, who emphasised the importance of physiology for women due to its relevance for the hygienic needs of the family and of society. With the development of laboratory-based science as a distinct aspect of medical education during the later nineteenth century, however, so the direct application of physiology to clinical practice diminished. The understanding of physiology as hygiene was marginalised by the new orthodoxy of scientific medicine. This shift in the physiological paradigm enabled medical women to stake out a specific field of interest within medicine which was omitted from the new definition of physiology as pure medical science: hygiene and preventive medicine. Women physicians were able to take advantage of the shift towards science as the basis of medical theory and practice to define their own specific role within the profession.     

An evaluation of case-based teaching: evidence for continuing benefit and realization of aims

A cross-sectional evaluation of case-based teaching (CBT), a novel physiology learning environment for medical undergraduates, revealed that second, third, and fourth year students, together with their tutors, valued CBT as an experience that met its three major aims. The initiative not only integrated physiology with related basic sciences and clinical medicine but importantly linked students' developing knowledge of theory to practice. CBT was also valued by students as their first introduction to clinical skills, with most tutors believing that it was the nonthreatening environment that helped students gain confidence for their first "real patient" encounters. The greatest support for CBT came from third year medical students, at the crossroads between their preclinical and clinical environments. Fourth year students, now encountering real patients, had moved on to developing their skills in the hospital environment.     

Sleep as a teaching tool for integrating respiratory physiology and motor control

Sleep exerts major effects on most fundamental homeostatic mechanisms. Current data suggest, however, that students of physiology and medicine typically receive little or no formal teaching in sleep. Because sleep takes up a significant component of our life span, it is proposed that current teaching in systems and integrative physiology is not representative if it is confined to functions describing wakefulness only. We propose that sleep can be readily integrated into various components of physiology and medical curricula simply by emphasizing how commonly taught physiological processes are importantly affected by sleep mechanisms. In our experience, this approach can be used to reinforce basic physiological principles while simultaneously introducing sleep physiology into the students' training. We find that students have a general and inherent interest in sleep and related clinical disorders, and this proves useful as an effective means to teach the material. In this paper, examples of how sleep influences motor control and the respiratory system will illustrate these points. These considerations also highlight some important gaps in traditional teaching of respiratory physiology.     

医学生理学国际化教学的实践与思考

留学生教育是我国高等教育的一个不可缺少的组成部分.在留学生医学教育中,作为桥梁课程连接基础与临床医学的生理学是一门非常重要的基础学科.本文结合近年来对留学生生理教学的实践和研究,从国际留学生特点及生理学教学特点出发,通过制定合适的培养目标和课程教学计划,加强教师自身素质培养,提高英语授课质量,运用多种教学方式激发留学生的学习兴趣及能力,加强授课教师与留学生的交流与沟通方面来探索创新生理学国际化的教学.     

Medical physics in radiotherapy: The importance of preserving clinical responsibilities and expanding the profession's role in research,education, and quality control

Medical physicists have long had an integral role in radiotherapy. In recent decades, medical physicists have slowly but surely stepped back from direct clinical responsibilities in planning radiotherapy treatments while medical dosimetrists have assumed more responsibility. In this article, I argue against this gradual withdrawal from routine therapy planning. It is essential that physicists be involved, at least to some extent, in treatment planning and clinical dosimetry for each and every patient; otherwise, physicists can no longer be considered clinical specialists. More importantly, this withdrawal could negatively impact treatment quality and patient safety. Medical physicists must have a sound understanding of human anatomy and physiology in order to be competent partners to radiation oncologists. In addition, they must possess a thorough knowledge of the physics of radiation as it interacts with body tissues, and also understand the limitations of the algorithms used in radiotherapy. Medical physicists should also take the lead in evaluating emerging challenges in quality and safety of radiotherapy. In this sense, the input of physicists in clinical audits and risk assessment is crucial. The way forward is to proactively take the necessary steps to maintain and advance our important role in clinical medicine.     

大数据时代信息化管理平台在医院专科建设中的价值

大数据时代利用信息化管理平台可以优化并规范临床诊疗流程、提升诊疗服务质量与效率、提高科研质量与水平,符合医改对医院精细化管理和循证医学时代精准医疗的要求。此信息化管理平台可以自动获取临床诊疗全程结构化数据,通过顶层设计达到规范医疗文件内容,减轻临床文书工作的目的;通过一次记录同时满足临床科研、运营管理及常规临床文件的需求,对规范化诊疗、临床科研、科室运营管理意义重大,在医院专科建设中有较好的临床应用及推广价值。     

Precision medicine in human heart modeling

Precision medicine is a new frontier in healthcare that uses scientific methods to customize medical treatment to the individual genes, anatomy, physiology, and lifestyle of each person. In cardiovascular health, precision medicine has emerged as a promising paradigm to enable cost-effective solutions that improve quality of life and reduce mortality rates. However, the exact role in precision medicine for human heart modeling has not yet been fully explored. Here, we discuss the challenges and opportunities for personalized human heart simulations, from diagnosis to device design, treatment planning, and prognosis. With a view toward personalization, we map out the history of anatomic, physical, and constitutive human heart models throughout the past three decades. We illustrate recent human heart modeling in electrophysiology, cardiac mechanics, and fluid dynamics and highlight clinically relevant applications of these models for drug development, pacing lead failure, heart failure, ventricular assist devices, edge-to-edge repair, and annuloplasty. With a view toward translational medicine, we provide a clinical perspective on virtual imaging trials and a regulatory perspective on medical device innovation. We show that precision medicine in human heart modeling does not necessarily require a fully personalized, high-resolution whole heart model with an entire personalized medical history. Instead, we advocate for creating personalized models out of population-based libraries with geometric, biological, physical, and clinical information by morphing between clinical data and medical histories from cohorts of patients using machine learning. We anticipate that this perspective will shape the path toward introducing human heart simulations into precision medicine with the ultimate goals to facilitate clinical decision making, guide treatment planning, and accelerate device design.

     

戈壁野营驻训我部开展卫生防病的实践体会

新形势下,做好部队野营训练的卫勤保障工作,深入研究训练伤及其相关疾病的防治,是新时期军事斗争准备卫勤保障的重要内容,也是时代赋予医务人员的崇高责任。随着信息化进程的不断加快,部队完成军事斗争准备各项任务日趋繁重。对广大官兵的身心健康提出了更高标准,发挥健康教育优势,促进官兵健康,必须与时俱进,不断创新。我部采取多种方式、提高官兵自我防护及保健能力,从而促进部队整体全面建设稳步发展。     

Developing a Curriculum for Evolutionary Medicine: Case Studies of Scurvy and Female Reproductive Tract Cancers

Most early evolutionary thinkers came from medicine, yet evolution has had a checkered history in medical education. It is only in the last few decades that serious efforts have begun to be made to integrate evolutionary biology into the medical curriculum. However, it is not clear when, where (independently or as part of preclinical or clinical teaching courses) and, most importantly, how should medical students learn the basic principles of evolutionary biology applied to medicine, known today as evolutionary or Darwinian medicine. Most clinicians are ill-prepared to teach evolutionary biology and most evolutionary biologists ill-equipped to formulate clinical examples. Yet, if evolutionary science is to have impact on clinical thought, then teaching material that embeds evolution within the clinical framework must be developed. In this paper, we use two clinical case studies to demonstrate how such may be used to teach evolutionary medicine to medical students in a way that is approachable as well as informative and relevant.