医患沟通技能培养在生殖医学教育中的实践及体会

目的：探讨医患沟通技能培养对生殖医学教育的作用及效果。方法：选择2010 级临床本科专业两个班级共30 人作为观察 组,进行医患沟通技能培养;另选取同年级的两个班级共28 人作为对照组,进行传统生殖医学教学模式培养。运用自行编制的教 学效果调查问卷及SEGUE 量表对两组学生的教学效果及医患沟通技能进行评价及比较。结果：与对照组相比,观察组的教学效 果有明显优势,学生对生殖医学更感兴趣,使生殖医学的教学更富有启发性,学生处理问题的能力显著增强,学生对生殖医学的 知识掌握程度及综合应用能力显著提高,差异具有统计学意义（P<0.05）;与对照组相比,观察组学生在信息收集、信息给予、理解 病人及沟通结束等四个维度的医患沟通能力显著增强,差异具有统计学意义（P<0.05）。结论：在生殖医学教育中加强医患沟通技 能的培养是一种行之有效的教学方法,值得推广。     

基于杜邦分析法的非营利性医院财务状况分析

随着我国医疗卫生事业的不断发展,医院管理者逐渐把重点转移到医院的经营管理上。针对这一现象,利用杜邦分析法将财务指标进行逐一分析,及早掌握医院的财务状况和经营状况,控制财务风险的发生。     

测定胸腺肽含量几种定量方法的比较

本文用凯氏定氮法、双缩脲法及福林－酚法测定了胸腺肽含量,并加以比较,说明三种方法对其含量测定没有显著差异．在实践中可以根据不同条件选择适当的方法进行实验．     

Multigrid Block Preconditioning for a Coupled System of Partial Differential Equations Modeling the Electrical Activity in the Heart

The electrical activity of the heart may be modeled with a system of partial differential equations (PDEs) known as the bidomain model. Computer simulations based on these equations may become a helpful tool to understand the relationship between changes in the electrical field and various heart diseases. Because of the rapid variations in the electrical field, sufficiently accurate simulations require a fine-scale discretization of the equations. For realistic geometries this leads to a large number of grid points and consequently large linear systems to be solved for each time step. In this paper, we present a fully coupled discretization of the bidomain model, leading to a block structured linear system. We take advantage of the block structure to construct an efficient preconditioner for the linear system, by combining multigrid with an operator splitting technique.     

Teaching ethnic and racial relations: some comments on Michael Banton

Banton's critique of race and ethnic relations highlights differences between the U.K. and the U.S.A. The interplay between ethnic politics and the teaching of the subject in the universities reflects differing reactions to the demise of Marxism, the impact of globalization and the growth of transnationalism. In America, anthropology, economics, cultural studies and conflict resolution have had a mixed impact on the field, but an examination of textbooks over the past thirty years - as well as Banton's prolific scholarship - suggests that most of the core problems remain the same.     

Propofol Binding to the Resting State of the Gloeobacter violaceus Ligand-gated Ion Channel (GLIC) Induces Structural Changes in the Inter- and Intrasubunit Transmembrane Domain (TMD) Cavities

General anesthetics exert many of their CNS actions by binding to and modulating membrane-embedded pentameric ligand-gated ion channels (pLGICs). The structural mechanisms underlying how anesthetics modulate pLGIC function remain largely unknown. GLIC, a prokaryotic pLGIC homologue, is inhibited by general anesthetics, suggesting anesthetics stabilize a closed channel state, but in anesthetic-bound GLIC crystal structures the channel appears open. Here, using functional GLIC channels expressed in oocytes, we examined whether propofol induces structural rearrangements in the GLIC transmembrane domain (TMD). Residues in the GLIC TMD that frame intrasubunit and intersubunit water-accessible cavities were individually mutated to cysteine. We measured and compared the rates of modification of the introduced cysteines by sulfhydryl-reactive reagents in the absence and presence of propofol. Propofol slowed the rate of modification of L240C (intersubunit) and increased the rate of modification of T254C (intrasubunit), indicating that propofol binding induces structural rearrangements in these cavities that alter the local environment near these residues. Propofol acceleration of T254C modification suggests that in the resting state propofol does not bind in the TMD intrasubunit cavity as observed in the crystal structure of GLIC with bound propofol (Nury, H., Van Renterghem, C., Weng, Y., Tran, A., Baaden, M., Dufresne, V., Changeux, J. P., Sonner, J. M., Delarue, M., and Corringer, P. J. (2011) Nature 469, 428–431). In silico docking using a GLIC closed channel homology model suggests propofol binds to intersubunit sites in the TMD in the resting state. Propofol-induced motions in the intersubunit cavity were distinct from motions associated with channel activation, indicating propofol stabilizes a novel closed state.     

Validation of a specific prolylcarboxypeptidase activity assay and its suitability for plasma and serum measurements

Prolylcarboxypeptidase (PRCP, EC 3.4.16.2), a lysosomal carboxypeptidase, was discovered 45 years ago. However, research has been hampered by a lack of well-validated assays that are needed to measure low activities in biological samples. Two reversed-phase high-performance liquid chromatography (RP-HPLC) methods for quantifying PRCP activity in crude homogenates and plasma samples were optimized and validated. PRCP activity was determined by measuring the hydrolysis of N-benzyloxycarbonyl-l-proline (Z-Pro)-Phe. The enzymatically formed Z-Pro and Phe were measured independently under different HPLC conditions. The in-house methods showed good precision, linearity, accuracy, and specificity. Based on Michaelis–Menten constants, Z-Pro-Phe was chosen over Z-Pro-Ala as the substrate of preference. Cross-reactivity studies with dipeptidyl peptidases (DPPs) 2, 4, and 9 and prolyl oligopeptidase (PREP) confirmed the specificity of the PRCP activity assay. The average PRCP activity in plasma and serum of 32 healthy individuals was found to be 0.65 ± 0.02 and 0.72 ± 0.03 U/L, respectively. Both methods can be used to measure PRCP activity specifically in different biological samples and are well suited to evaluate PRCP inhibitors. These well-validated methods are valuable tools for studying PRCP’s role in cardiovascular diseases, stroke, inflammation, and metabolic syndrome.     

青年教师对医学临床课程教学能力现状调查及应对策略研究

如何提高我国临床课程青年教师团队的素质与教学能力,是近年来伴随国内医学教育发展扩大而日益突出的问题。作为当前医学临床课程的教学主力,青年教师的教学能力会对医学临床课程教学效果产生重大影响。但绝大部分临床课程青年教师都毕业于医学院校,未曾接受专业的师范类培训,导致尽管自身临床知识丰富,但教学水平明显受限的情况发生。本研究采取对我院各科室青年临床教师进行问卷调查的方法,深入分析青年教师的临床教学能力现状与问题,并提出改进方案,以使他们能够更快完成青年临床医师与青年临床教师之间的角色变换,提升自身教学能力,进而提高我院临床课程的教学质量。     

LBL结合PBL在物理诊断教学过程中的初步探索

目的:比较传统教学模式和问题教学法及二者结合教学法的不同优劣势,找出物理诊断学最佳教学方法。传统教学模式采用授课为主的教学法(lecture based learning,LBL),单单强调了教师的重要性,而忽视学生的主观能动性,不利于调动和培养学生自学和灵活运用所学知识的能力。问题教学法(Problem-based learning,PBL),其强调学生自身的主观能动性,弱化了教师在教学中的主体地位,学生有偏离教学主线的风险。因而如果将LBL与PBL有机结合在一起,将可能有利于提高学生的学习效率和学习效果。方法:选取97名全科医学本科学员,在物理诊断课程教学过程中,采用完全随机的方法分为2组,采用LBL教学方法组48人,采用LBL结合PBL教学方法组49人,通过分别对理论、实践分层打分,确定优秀、合格、不合格的比率,采用Mann-Whitney U检验最终评定2组教学方法的授课效果。结果:在理论考试中,2组学员在优秀、合格、不合格的分层评定上均无明显差异(P0.05),而在实践考核中,LBL+PBL组学员成绩在优秀这一分层评定中,优于LBL组,差异具有统计学意义(P0.05)。结论:LBL和PBL教学方法结合应用于物理诊断教学中,符合物理诊断教学的特点,更容易被学生接受,对于知识的识记和应用更有好处,从而更利于培养高素质医学人才,值得在物理诊断教学中进一步推广。