根据美国住院医师胜任力模型提出适合中国住院医师培养的胜任力模型,结合国家住院医师规范化培训政策及黑龙江省住院医师培训实施方案对培训内容的要求制定了包含医学知识、临床技能、人文技能、科研教学能力、健康教育及健康促进等相关内容的课程体系.

住院医师规范化培训是提高住院医师核心胜任力、提高医疗服务质量的重要途径,面对医学教育全球化发展,要不断深化和细化住院医师职业化培训体系,从而不断地提高临床医师的整体水平,促进中国医疗服务的现代化发展.总结以核心胜任力为基础的住院医师规范化培训的经验,剖析规范化培训过程中尚存在的问题,提出建设性意见.

手术使用的浓缩血小板是再生医学的创新材料,富血小板血浆(PRP)是第一代富含血小板的浓缩物,已广泛应用于促进软硬组织愈合.富血小板纤维蛋白(PRF)是由法国学者Choukroun等首次提出的新一代血小板浓缩物,较传统富血小板血浆更具有应用优势.冻干法是保存生物制品的常规方法,也是控制支架空隙大小并保存其原有成分的有效手段.本文就于富血小板血浆和富血小板纤维蛋白结合冻干法应用于组织发育与再生作一综述.

目的:通过了解医学本科生对现行临床技能培训的认知与评价,筛选临床技能项目,修订教学计划,建立合理的临床技能培训模式.方法:问卷调查与专家访谈了解医学生临床技能培训的三方认知及评价;校内外专家问卷调研筛选临床技能培训项目;实验性开设技能课程;修订教学计划.结果:筛选出131项临床技能培训项目;建立集中培训与分散培训结合的培训模式;完善配套学习资料.

AIM:To investigate the impact of ovariectomy on mandibular alveolar bone mineral density and periodontal disease.METHODS:Twenty 12-week-old female Wistar rats were randomly assigned into sham surgery (SHAM)group and ovariection(OVX)group (n=10).3 months after surgery,periodontal disease was induced by silk ligature around the neck of the mandibular right first molar for 2 months.Then the rats were sacrificed,Micro-CT scan was carried out to detect the bone mineral density (BMD),trabecular thickness (Tb.Th),bone volume fraction (BV/TV),trabecular separation (Tb.Sp.)and bone surface to bone volume (BS/BV)of mandibular alveolar bone. Alveolar bone height loss (ABHL)was measured on 3D models.RESULTS:5 months after ovariectomy,the values BMD,Tb.Th and BV/TV in OVX rats were lower than those in SHAMrats (P<0.05),whereas the values of Tb.Sp and BS/BV of the OVX rats increased compared with SHAM rats (P<0.05 ).However,no difference was found in ABHL between 2 groups.CONCLUSION:Ovariectomy induces osteoporosis in the mandibular alveolar bone of rats, but has no effect on the alveolar bone height loss of rats with experimental periodontitis.

毕业实习是学生把基础理论知识运用于实践的重要环节,就业形势日益严峻下医学生毕业实习质量受到考研与就业的严重冲击.通过探索分析毕业实习期间相关管理制度、监督与考核办法、培养机制等,进一步完善毕业实习教学管理办法,提高医学毕业生综合素质和整体水平.

目的了解不同教学模式对医学本科生临床技能培养的作用，为临床技能培训标准的建立与培训方案的制定提供可靠依据。方法应用问卷调查法，收集教师对临床技能教学和学生临床技能情况的评价。结论集中培训有利于整体技能水平的提高，分散培训有利于优秀学生的技能水平提高。

肠扭转是外科常见的急腹症之一,发病急、变化快,术前的正确诊断直接关系到患者的预后和生命.随着螺旋CT硬件和软件的飞速发展,多层螺旋CT的三维重建技术被广泛运用于临床,包括在显示肠壁、肠腔和周围结构以及病变血供和血管情况等方面具有较大优势,为急性肠扭转的判断和病因诊断提供了一种新的可靠的检查手段.笔者回顾性分析多层螺旋CT多平面重建技术在外科肠扭转病人中的诊断和应用价值以及对临床选择治疗方案的指导意义.

目的 探讨64排螺旋CT对腹膜后节细胞神经瘤的诊断与鉴别诊断.方法 回顾性分析6例经手术病理证实的腹膜后节细胞神经瘤的64排螺旋CT表现,重点分析动脉期、静脉期及延迟期强化特点.结果 增强扫描动脉期瘤体实质部分渐进性轻微强化6例,瘤体内其他部位呈均匀略高于囊性密度.6例静脉期强化程度均较动脉期略强,较动脉期平均高6～10 HU.结论 64排螺旋CT三期增强扫描及三维重建在腹膜后节细胞神经瘤诊断中有重要价值.

Objective:To evaluate bio-safety of titanium implant and ion release from implant coating via quantitative assessment.Methods:Two different kinds of oral implants were studied in a simulated bionic solution.The release of vanadium ions and aluminum ions at different moments were calculated by the full spectrum of direct plasma atomic emission spectrometer.Quantity of ions released from different coatings were compared.Results:The ionic release tendency and peak value of the two kinds of titanium implants are similar.The tendency of the release of aluminium ion was in an antisine curve and achieve the steady state on the second hour.The final aluminum ion concentration was 0.05 mg/L.The tendency of the release of vanadium ions was in sine curve and achieve the steady state on the sixth hour.The final vanadium ions concentration was 0.0025 mg/L.Conclusion:The quantity of aluminum ion and vanadium ion in the bionic solution of clinical commonly used titanium alloy implant is in trace amount.Barrier function of coating in the process of ion release is limited.

<正>临床科学研究中,很多成果都产生于有价值的病案之中。病案价值与科研紧密相关,科学研究的科学性使得病案的价值更加重要,对病案价值的要求更高,它可以促进病案在价值生成中方法的改革。从病案价值的微观水平上看,每一份病案仅仅是一个病人在住院期间的客观病情自然发展的真实性记录;

Objective: To investigate the relation between PGE2 in expression gingival crevicular fluid of implant and plaque index,gingival index,probing pocket depths. Methods: Peri-implant examination:36 implants with 3mm or greater probing depths comprised the test group,and another 36 healthy ones with probing depths less than 3mm served as the control group. Implant crevicular fluid was collected with periopapers,and the PGE2 levels were evaluated using an enzyme immunoassay kit. T-test and Pearson correlation analysis were used to analyze the data. Result: In the test group, there was significant positive correlation between clinical parameters and the PGE2 levels(P0.05). Significants difference was found in PGE2 level between test group and control group(P0.05). Conclusion: It may be speculated that assaying PGE2 levels are useful diagnostic methods for peri-implantitis.

目的 调查动态轮廓眼压计(Dynamic Contour Tonometer,DCT)眼压及眼脉动幅度(Ocular Pulse Amplitude,OPA)在健康人群中使用时测量值范围.方法 以DCT测量一组健康人(107例)的双眼眼压和OPA,获得该组人群的DCT眼压和OPA值的范围.结果 该组健康人的DCT眼压值范围:右眼(18.02±2.96)mmHg,左眼(17.12±2.94)mmHg;OPA值范围:右眼(2.54±0.91)mmHg,左眼(2.53±0.94)mmHg.配对t检验表明,双眼之间DCT值有显著性统计学差异(t=0.240,P＜0.001),双眼之间OPA值无显著性差异(t=5.294,P=0.811).相关分析显示,双眼OPA值的大小与DCT眼压值之间均无显著的相关关系(右眼:r=0.124,P=0.207;左眼:r=0.133,P=0.180).结论 初步获得了DCT眼压和OPA在一健康人群中的范围,为今后的研究提供了依据。

宋国宾(1893-1956),字恪三,江苏扬州人.他曾在巴黎学医,获博士学位.他先后任震旦大学医学教授,上海医师公会主席,中华医学会业务保障委员会主席等职务[1].在近代医学界为推动医学伦理学的发展做出了重要的贡献.