Clinical teachers' teaching ability and teaching research ability are the key factors affecting the quality of medical education personnel training. Scientifically designed clinical teachers' teaching development will directly improve their teaching and research ability.In December 2017, Qiqihar Medical College started clinical teacher training and designed a learning-research-practice teacher community (referred to as learning-research-practice community).After 4 periods of training, 332 clinical teachers completed the training. Among them, 21.4%(71/332) of clinical teachers have their own college and provincial teaching and research projects; 74.7%(248/332) of the clinical teachers' grasp of the evaluation methods of clinical skills and the norms of clinical teaching; 97.4%(323/332) of clinical teachers were satisfied with the training results. Therefore, the teaching development of learning-research-practice community is conducive to improving the teaching ability and teaching research ability of clinical teachers, which can be further promoted.

学校实施医教协同临床教师教学发展工程,应用社会建构主义理论,培育临床教师学习共同体,引导成员之间的合作交流、知识共享和认同激励,并总结出实施临床教师教学发展工程的6项实践原则,为临床教师教学发展提供更具创新性的组织模式和活动形态.

有针对性加强临床医师的教学能力培养是医疗、技术的传承与发展最重要的保证.临床教师教学发展已经成为医学教育越来越重要的组成部分.但是他们可能缺乏动机,也没有固定规律的学习时间,临床教师发展项目必须要解决这些挑战.学院确定了发展目标和发展重点,设计与实施固定的长期项目,激励临床教师参与活动,设立临床教师医教协同专项教研项目,克服有限的资源困难等,提升了临床教师教学能力.对临床教师发展项目和活动进行评估,保持项目的创新精神和灵活性,将使之成为临床医师教学能力发展的典范.

中国高等教育的产业化发展, 使各高校的师资和招生规模不断扩大, 高校毕业生的就业形势也日益激烈. 对任何一所高校而言, 都希望培养的毕业生有较高的职业素质、有较强的职业竞争力,并能够符合社会需要,为社会所用.要达到这样的教育目标,建设一支高水平、高素质的高校教师队伍是高等教育成败的重要保障和途径.

目的:研究透明质酸对小鼠骨髓来源树突状细胞功能的影响以及回输后荷黑色素瘤小鼠脾淋巴细胞增殖、活化和细胞因子的变化,进而探讨透明质酸诱导的树突状细胞增强荷瘤小鼠免疫功能的机制.方法:体外细胞因子联合诱导培养小鼠骨髓细胞获得树突状细胞(DCs),免疫磁珠分选纯化获得CD11c+树突状细胞,经不同浓度透明质酸(HA)刺激后,采用酶联免疫吸附法(ELISA)检测培养上清液中细胞因子IL-12p70含量.建立小鼠皮下B16黑色素瘤模型,肿瘤局部皮下回输HA孵育DC后检测肿瘤大小,应用ConA检测脾淋巴细胞增殖情况,应用MTT法检测脾淋巴细胞杀伤活性,ELISA法检测脾淋巴细胞分泌的TNF-α和IFN-γ的表达,以单纯DC回输、生理盐水注射以及正常小鼠(无瘤)组作为对照.结果:在10～100 μg/mL范围内,HA以剂量依赖的方式上调DCs分泌IL-12p70.HA孵育DC处理组肿瘤生长明显受到抑制;淋巴细胞增殖反应、杀伤活性和细胞因子TNF-α和IFN-γ的表达明显高于单纯DC组和生理盐水组(P＜0.05).结论:透明质酸可促进小鼠骨髓DC的成熟;透明质酸孵育的DC通过增强荷瘤小鼠的抗肿瘤免疫功能而抑制肿瘤的生长.

Analyzed creativity and the elements of creativity, and on the basis of Sternberg’ s investment theory of creativity and Lewin’ s force field analysis we constructed the creativity assessment framework of clinical students. Then through literature review and focus group discussion we developed the creativity assessment instrument for clinical students’ creativity. At the same time, we hope to provide quantitative evidence for the selection and cultivation of creative talents.

目的:研究护理学专业学位硕士研究生临床实践培养模式,为更好的开展护理硕士教育提供依据.方法:根据前期研究结果确定临床实践能力框架,结合文献研究法和专家论证会制定临床实践培养模式.结果:确定了培养模式内容包括:培养目标、实践时间、实践要求、实践内容与方法等.结论:先进的培养模式是培养高质量研究生的条件,同时可促进兄弟院校的交流和借鉴.

文章以哈尔滨医科大学为例，选取本科专业为预防医学专业的硕士研究生66名，从专业报考、学习情况、与导师的交流情况、职业规划等四方面，了解该校预防医学专业跨专业研究生的学习状态、学习困难及需求等，以期培养出更多高素质的、跨专业的预防医学人才。

Objective To identify the majors of the discipline of nursing,and the specialization areas of the Master of Science in Nursing(MSN)program.Methods A total of 45 experts who met inclusion criteria were chosen to participate in two rounds of consultation regarding to the majors of the discipline of nursing,and the specialization areas of the MSN program through the Delphi method.Results Experts had good initiatives in the study,and the response rates of the survey were 80.00% for the 1st round and 91.67%for the 2nd round;the authority coefficients of experts were 0.85 for the 1st round and 0.89 for the 2nd round.Finally,we were able to determine 19 specialization areas of the MSN program and 16 majors of the discipline of nursing.Conclusion The 19 specialization areas of the MSN program serve as a lamp to many institutions;and the 16 majors help build the structure of the discipline of nur-sing.

目的 探讨人皮肤黑色素瘤组织中肿瘤浸润树突状细胞(TIDc)的抗肿瘤效应.方法 采用光镜、透射电镜和免疫组化方法观察19例手术切除的人皮肤黑色素瘤中TIDC和肿瘤浸润淋巴细胞(TIL)抗肿瘤效应的形态学表现.结果 早期人皮肤黑色素瘤组织中的类高内皮微静脉和淋巴管内、外均可见大量淋巴细胞和树突状细胞集聚和迁移;病变早期TIDC和TIL浸润比晚期明显(P＜0.01).透射电镜下,TIDc大致有两种形态.一种TIDC体积大,表面有许多树枝状突起,核不规则,胞浆内有丰富的细胞器;另一种TIDC突起较少,细胞器也较少.TIDC与肿瘤细胞、TIDC与TIL、TIL与TIL、TIL与肿瘤细胞之间存在多种形式的膜接触.与TIL接触的肿瘤细胞呈凋亡状态.晚期病变组织中TIDC与TIL数量明显减少,于癌巢内常见凋亡的TIDC与TIL.结论 人皮肤黑色素瘤组织中存在不同形态的TIDC与TIL,并通过类高内皮微静脉和淋巴管迁移;TIDC、TIL、癌细胞彼此密切作用,在肿瘤局部即可发生抗肿瘤免疫应答反应,反应程度与肿瘤进展呈负相关.

Objective:To investigate the inhibitory effect of cytokine-induced ldller (CIK) cells on B16 melanoma cells induced by dendritic cells (DCs) loaded with tumor antigen.Methods:DCs and CIK cells were separated and cultured respective- ly,then DCs were loaded with tumor antigen;subsequently half of CIK cells were cultured and induced by DCs loaded with tumor antigen,while others continued to be co-culture with DCs.According to the change of tumor volume and the tumor inhibition rates,inhibitory effect of CIK cells on B16 melanoma cells was estimated.Distribution and morphological characteristics of immune cells in tumor tissue were observed by optical microscopy,electron microscopy and immunohistochemistry.Results:Tumor inhibi- tion rate of DC-CIK cells loaded with tumor antigen (86.57%) was higher than that of either CIK cells (33.34%,P0.05) or DC- CIK cells (61.08%,P0.05).DC-CIK cells with tumor antigen were mainly gathered in the subcutaneous tissue and the tumor tis- sue,especially around the cancer nest.The DC-CIK cells were bigger than the normal lymphocytes and notch always appears on the cellular nucleus observed under TEM.Plenty of active-functioned organelles such as dilated endoplasmic reticulum were ob- served in the cytoplasm of the DC-CIK.Protrusions on the surface of the DC-GIK cells contacted dosdy with the tumor cells. Apoptosis and necrosis of the cells could be widely observed in tumor tissues.Conclusion:Inhibitory effect of DC-CIK loaded with tumor antigen on B16 melanoma is stronger than that of CIK or DC-CIK.

Objective: To study the distributive characteristics of DC and the expressions of E-cadherin and ICAM-1 in muscosal immune mouse model, to discuss the regulative role for E-cadherin and ICAM-1 in the DC migration. Methods: By the method of immunohistochemistry staining and light microscopy, we observed the distributive characteristics of DC in muscosal immune mouse model, analysed the expressions of E-cadherin and ICAM-1. Results: The DC mainly distributed in mesenteric lymph node(MLN), Peyer's patch(PP), and GUT(stomach, jejunum and ileum) of muscosal immune mouse model. The number of DC was larger in the experiment group than that in control group. The expression of ICAM-1 was higher, but lower of E-cadherin in muscosal immune mouse model. The number and area density of experiment group were greater compared with that of control group. Conclusion: The E-cadherin and ICAM-1 may play a critical role in DC migration.

Objective To study the distributive characteristics of DC and the expressions of E-cadherin and ICAM-1 in muscosal immune mouse model,to discuss the regulative role for E-cadherin and ICAM-1 in the DC migration. Methods By the method of immunohistochemistry staining and light microscopy,we observed the distributive characteristics of DC in muscosal immune mouse model,analysed the expressions of E-cadherin and ICAM-1. Results The DC mainly distributed in mesenteric lymph node(MLN),Peyer's patch(PP),and GUT(stomach,jejunum and ileum) of muscosal immune mouse model.The number of DC was larger in the experiment group than that in control group.The expression of ICAM-1 was higher,but lower of E-cadherin in muscosal immune mouse model.The number and area density of experiment group were greater compared with that of control group.Conclusion The E-cadherin and ICAM-1 may play a critical role in DC migration.

Objective To investigate the pathways of the lymphocytes homing in the hemolymph node,through the morphologic study of the high endothelial venules(HEVs) and lymphatic labyrinths in the hemolymph node.Methods We observed the structure of the rat hemolymph node by light microscopy,transmission electron microscopy and scanning electron microscopy.Results There were plenty of the HEVs in the hemolymph nodes.The endothelial cells were thick and process to the lumen.The organelles in the high endothelial cells were plentiful.The lymphocytes were found to adhere or penetrate the endothelial cells and the junction septum of the endothelial cells.In the paracortex of the hemolymph nodes,the tubular or pocket lymphatic labyrinths which were densely filled with small lymphocytes were found.Conclusion The hemolymph nodes are one of the important situations of the lymphocytes homing.

Objective To study on anti tumor activity and effect of Ginseng polysaccharide (Gp) on proliferative function of LAK cells.Methods The B 16 melanoma mouse model for research was established. The IL 2,IL 2 and Gp,Gp were injected into the mice subcutaneously in Ⅰ group,Ⅱ group,Ⅲ group respectively.After treatment,the changes of the tumor were detected.The spleen T cells mixed with IL 2,IL 2 and Gp,Gp were respectively cultured and the effects on proliferative function of LAK cells were observed.Results Gp combined with IL 2 in vivo had significantly anti tumor effect which was much higher than that of LAK cells(P0.05);Gp and IL 2 cultured with T cells in vitro suggested that Gp could induce the proliferation of LAK cells.Conclusion Gp combined with IL 2 therapy is more effective than that of LAK cells in vivo,and Gp could promote the proliferation of LAK cells in vitro.

一、临床医学专业学位试行情况 临床医学研究生教育为开展专业学位试点工作奠定了良好的基础.临床研究生的培养早在1986年就已经提出.当时医学研究生培养只有一种模式--学术型,所有医学研究生都必须完成科研课题,通过科研论文答辩.

公共卫生硕士专业学位(英文名称为:Master of Public Health,英文缩写为MPH)是为适应我国公共卫生事业发展,完善医学学位与研究生教育而设立的新型学位类型.

目的探讨睾丸小叶内淋巴间隙的结构特点.方法灌流固定半薄、超薄切片,光镜和电镜下观察.结果淋巴间隙宽窄不一、相互交通,呈多形性及迷路状.结论淋巴间隙分为管周淋巴间隙及被膜下淋巴间隙,淋巴间隙之间是通过间质组织内大、小不一的孔隙相互交通.

缺血性心肌病属于中医的胸痹心痛范畴,其病因复杂,主要病机为本虚标实,心脾肾等脏腑虚损、功能低下或失调为其本虚基础,血瘀气滞、痰浊、寒积及热结为其标实之因.针灸作为祖国医学不可分割的一部分,具有平衡阴阳,调和气血,疏通经络,调节人体功能的作用.针刺"内关"治疗胸痹临床疗效可靠、合理,我们试图从组化及形态学方面探讨针刺对急性缺血心肌的作用.