在动物实验时加强动物伦理学教育是培养医学生良好医德的重要途径.护士的医德和人文素养品质直接关系到其工作质量.为了解护理学专业学生动物伦理学知识认知现状,文章对其进行问卷调查,就调查结果提出:教师在教学中渗透动物伦理意识;从课程设置、宣传教育、加强培训、营造氛围等方面提出改革建议,通过加强动物伦理学教育,提高学生的医德和人文素养.

机能学实验是医学实验的重要组成部分,也是医学实验教学的核心,因此机能实验学的改革是实验教学改革的重点.培养学生的创新能力已成为当前医学教育改革的重要方向.在机能实验中通过以临床案例为引导,模拟疾病发生发展以及诊疗的全过程,将教学与科研两者有机结合起来,不仅提高了学生的实践能力,还能培养学生的创新能力和科研思维.文章通过从临床专业机能学课程中开展案例驱动教学法的具体实施方案和效果评价等方面进行探讨,使基础和临床、教学和科研资源有机融合,对医学生的主动学习能力、解决问题能力和创新能力都起到了很好的促进作用.

作为医学领域科研人才的后备军,早期培养大学生的科研思维日益受到重视.机能实验学属于基础医学实验,能帮助医学生理解相关课程抽象的理论知识,培养医学生的动手能力、实验技能.文章从教学理念、教学内容、教学过程、教学评价等方面进行深入改革,探索建立医学生科研思维、创新意识、团队精神的机能实验学课程模式.

医学免疫学是一门重要的医学基础课,具有较强的实践性,对培养应用型医学人才临床思维、分析问题、解决问题及创新能力是必不可少的一门课程.文章主要探讨了构建混合式教学模式的具体改革措施,包括线上教学、线下教学及形成性评价方案等方面,贯彻以学生为中心的教学理念,分析混合式教学效果,从而达到优化教学方式方法,提高免疫学教学质量的效果.

整合式教学是医学教育的发展趋势.充分发挥医学实验课的优势,将基础医学中的形态与机能实验相结合建设基础医学整合实验,模拟疾病诊疗的全过程,观察在疾病过程中功能代谢、生化指标、组织切片的变化,整合医学相关课程内容,是医学生早期感知、认识临床疾病较理想的情景,是早期培养医学生发现问题、分析问题、解决问题的基本能力与临床思维模式的有效途径.

目的 了解我国护理人员职业性肌肉骨骼疾患(WMSDs)的患病情况.方法 计算机检索中国知网数据库(CNKI)、万方数据库、维普中文科技期刊数据库、中国生物医学文献数据库(CBM)、PubMed、Cochrane Library、Web of Science,收集国内外关于我国护理人员WMSDs患病率相关文献,检索时限为建库至2019年12月,没有语言限制.由2名研究人员按照文献纳入和排除标准独立筛选文献,并取文献作者、发表时间、总样本量、患病人数、患病率等资料.采用Combie横断面研究评价工具对纳入文献的质量进行评价,采用Rev Man 5.3(Review Manager)软件进行meta分析.结果 共纳入23篇文献,总样本量为16 134人,样本量最大6 674人,最小162人.报道年患病率的文献18篇,周患病率7篇,报道身体各部位年患病率的文献23篇.Meta分析显示,我国护理人员WMSDs的年患病率为79.87％(95％CI: 76％～86％),周患病率为55％(95％CI:38％～72％),护理人员不同部位患病率居于前3位的依次为腰部61％(95％CI:57％～65％)、颈部61％(95％CI: 52％～69％)、肩部53％(95％CI:48％～57％);不同科室的护理人员WMSDs患病情况显示,重症监护室护士WMSDs患病率为89％(95％CI:67％～97％)、外科护士WMSDs患病率为74％ (95％ CI: 63％ ～85％)、内科护士WMSDs患病率为65％ (95％CI: 53％～77％).结论 国内护理人员WMSDs患病率较高,居于前3位的依次为腰部、颈部和肩部;另外,重症监护室护士比其他科室护士WMSDs患病率要高,可能和重症监护室患者病情重、护士经常性的过度弯腰、身体前倾、下蹲和高强度劳动负荷有关.

Objective:To observe the effect of sodium fluoride (NaF) on the expression of phosphatidylinositol-3-kinase/protein kinase B (PI3K/Akt) signal and apoptosis in human osteosarcoma Saos-2 cells.Methods:Saos-2 cells were divided into 0 (control), 5, 10, 20 and 40 mg/L fluoride groups ( n= 3) according to the dose of NaF. The cells were collected after 24 and 48 h of culture in vitro. Western blotting was used to detect the expressions of PI3K/Akt signal and Forkhead transcription factor (FoxO) 1, and the apoptosis level of Saos-2 cells was detected by flow cytometry. Results:There were no significants differences in the expressions of PI3K and Akt in Saos-2 cells at 24 and 48 h ( P > 0.05). At 24 h, the expressions of phosphorylated PI3K (p-PI3K) in 5, 10, 20 and 40 mg/L fluoride groups (0.40 ± 0.06, 0.45 ± 0.02, 0.37 ± 0.06, 0.32 ± 0.06) were higher than that in the control group (0.28 ± 0.04, P < 0.05); at 48 h, the expressions of p-PI3K in 5 and 10 mg/L fluoride groups (0.46 ± 0.06, 0.58 ± 0.03) were higher than that in the control group (0.29 ± 0.04, P < 0.05), and that in the 40 mg/L fluoride group (0.21 ± 0.03) was lower than that in the control group ( P < 0.05). At 24 h, the expressions of phosphorylated Akt (p-Akt) in 5, 10 and 20 mg/L fluoride groups (0.27 ± 0.01, 0.30 ± 0.03, 0.27 ± 0.03) were higher than that in the control group (0.20 ± 0.02, P < 0.05); at 48 h, the expressions of p-Akt in 5 and 10 mg/L fluoride groups (0.42 ± 0.04, 0.60 ± 0.02) were higher than that in the control group (0.27 ± 0.01, P < 0.05), and that in the 40 mg/L fluoride group (0.18 ± 0.02) was lower than that in the control group ( P < 0.05). The expressions of FoxO1 in 10, 20 and 40 mg/L fluoride groups at 24 h (0.38 ± 0.07, 0.41 ± 0.06, 0.47 ± 0.08) were higher than that in the control group (0.34 ± 0.04, P < 0.05). At 48 h, the expressions of FoxO1 in 5, 10, 20 and 40 mg/L fluoride groups (0.36 ± 0.08, 0.37 ± 0.10, 0.54 ± 0.04, 0.73 ± 0.04) were higher than that in the control group (0.28 ± 0.04, P < 0.05). At 24 and 48 h, the apoptosis rates of control group and 5, 10, 20 and 40 mg/L fluoride groups were (2.867 ± 0.583)%, (3.647 ± 0.035)%, (3.773 ± 0.095)%, (5.440 ± 0.325)%, (7.203 ± 0.476)%; (3.707 ± 0.286)%, (4.023 ± 0.241)%, (4.970 ± 0.368)%, (12.473 ± 0.949)%, (19.387 ± 1.892)%, respectively. The apoptosis level of 40 mg/L fluoride group was higher than that of control group at 24 h ( P < 0.05), and that of 20 and 40 mg/L fluoride groups were higher than that of control group at 48 h ( P < 0.05). Conclusion:Fluoride can directly activate the PI3K/Akt signaling pathway in osteoblasts, and then has anti-apoptotic effect.

外科护理学是培养护生护理专业核心能力的重要课程之一,特别是骨科护理部分,其内容丰富、章节多、学习难度大,因此教师如何在教学过程中提高学生的学习主动性、评判性思维能力和综合分析能力显得尤为重要 [1-2].在传统的骨科护理教学中,教师常常采用"教师讲、学生听"的教学模式,学生在课堂上被动接受老师灌输的学习内容,学生不爱听、听不懂,没有学习动力;教师费力讲、讲不透、没有教学动力.

目的 探讨医护合作的延续护理模式在前列腺化疗患者中的应用效果.方法 采用随机数字法将58例前列腺癌化疗患者分为对照组(n=28)和观察组(n=30),对照组患者采用常规护理和出院指导,观察组在常规护理和出院指导基础上实施医护合作的延续护理.比较2组患者治疗依从性 、满意度 、化疗反应 、平均住院天数及化疗后生活质量.结果 观察组患者在治疗依从性 、满意度及生活质量方面优于对照组,差异具有统计学意义(P<0.05).结论 医护合作的延续护理模式能提高前列腺癌化疗患者的治疗依从性和满意度,同时对患者化疗后生理机能 、情感支持和社会活动的具有促进作用.

以技能大赛为平台,激发学生学习专业的兴趣,全面提高了医学生的基础知识及基本技能.对我校机能综合实验学技能大赛的临床医学专业学生的相关课程成绩进行研究,将成绩高于或等于80分定为优秀,低于80分为不优秀,实践表明,技能大赛能促教助学,对于提高教学质量和学生实践创新能力都有很好的推进作用.

机能实验学是一门实践性较强的课程,学生实践技能直接影响教学质量.基于“一带一路”战略背景和发展机遇,以技能大赛为平台,促进教学改革、激发学生学习专业的兴趣,全面提高了医学生的基础知识及基本技能,培养了学生的创新思维、科研能力、团队合作精神,培养出更多优秀的医学专业人才.文章结合新疆医科大学机能综合实验学技能大赛对医学生人才培养的促进作用以及存在的不足等方面进行阐述.

Objective The purpose of this study was to discuss the application value of perfusion defects sign in the suspected malignant cervical lymph nodes.Methods One hundred and sixty suspected malignant cervical lymph nodes from 156 patients were studied by contrast-enhanced ultrasonography (CEUS).These nodes were classified with 4 groups by pathologic results,which were non-tuberculous reactive hyperplasia group,tuberculous group,metastatic group and lymphoma group.The pattern of enhancement and perfusion of lymph nodes and the characteristics of perfusion defects in parenchymal phase were compared.Results About 51.9％ (83/160) of the nodes had perfusion defects in the parenchymal phase of CEUS.The percentages of tuberculous group (90.0 ％,11/47) and metastatic group (73.8％,31/42) were high,while the percentages of non-tuberculous reactive hyperplasia group (23.4％,11/47) and lymphoma group (28.9 ％,11/38) were low.Furthermore,56.7 ％ (17/30) of the tuberculous nodes had bigger perfusion defects (i.e.the ratio of perfusion defects area to the whole area of lymph node ≥50％),while most of the rest of three groups had smaller defects.Conclusions The perfusion defects in parenchymal phase of CEUS can be seen in several kinds of lymphadenopathy,it is necessary to combine the artery phase features for analyzing.The CEUS can offer valuable diagnostic information to discriminate suspected malignant cervical lymph nodes.

医学免疫学是医学院学生的必修基础课之一，是生命科学的前沿学科，也是连接基础医学和临床医学的桥梁学科。医学免疫学理论性强、内容多、教学难度大，针对独立医学院校民汉合班医学免疫学的教学现状，从教学安排、教学手段、教师自身等方面进行思考，提出改进对策。

目的 探讨三维超声联合超声造影观察颈部不典型淋巴结的血流特征.方法 对97例常规超声检查不能提示淋巴结良恶性的颈部淋巴结肿大患者(1 61个淋巴结)行三维超声和超声造影检查.根据最终诊断结果,将淋巴结分为4组:反应性增生组25例(45个淋巴结)、结核组19例(27个淋巴结)、转移瘤组32例(54个淋巴结)、淋巴瘤组21例(35个淋巴结).比较4组淋巴结长径与短径比值(L/S)、门髓质形态、血流类型和超声造影特征.结果 4组间L/S及门髓质形态差异均有统计学意义(P均＜0.05).反应性增生组与转移瘤组L/S差异有统计学意义(P＜0.008),反应性增生组与转移瘤组、转移瘤组与淋巴瘤组的门髓质形态差异有统计学意义(P均＜0.008);其余各组两两比较差异均无统计学意义(P均＞0.008).4组间血流类型、动脉相造影剂进入方式和实质相造影剂分布状态差异均有统计学意义(P均＜0.05).反应性增生组与结核组、反应性增生组与转移瘤组血流类型差异均有统计学意义(P均＜0.008),反应性增生组与结核组、反应性增生组与转移瘤组、淋巴瘤组与结核组、淋巴瘤组与转移瘤组动脉相造影剂进入方式和实质相造影剂分布状态差异均有统计学意义(P均＜0.008);其余各组两两比较差异均无统计学意义(P均＞0.008).结论 三维超声联合超声造影可全面了解淋巴结的血流灌注,可诊断二维声像图特征不典型的淋巴结提供较有价值的信息.

Objective The purpose of this study was to find the features of contrast-enhanced ultrasonography (CEUS) in cervical lymphadenopathy and evaluate the value.Methods One hundred thirty-eight enlarged cervical lymph nodes in 83 patients were studied by CEUS.Analysed the enhancement patterns in each lymph nodes,while the time-intensity curves were evaluated by using contrast quantification software.Results Of the 138 lymph nodes examined,23 were tuberculous,38 were non-specific inflammation,48 were metastasis and 29 were lymphoma.They were confirmed by pathological examination.CEUS showed intense homogeneous enhancement with well-defined hiar artery in most benign lymph nodes(30/38,78.9 ％);intense homogeneous enhancement,absence of hiar artery in most lymphoma(20/29,69.0 ％) (P ＜ 0.01);while inhomogeneous enhancement in most tuberculous and metastases (14/23,60.9％;25/48,52.1％)(P＜0.01).The quantitative analysis by Q-LAB software showed the rise time and time to peak in the non-specific inflammation lymph nodes group and lymphoma group were lower than those in tuberculous lymph nodes group(P＜0.01);the rise time in the metastasis lymph nodes group were lower than those in tuberculous lymph nodes group(P＜0.008).The sensitivity,specificity of CEUS were 76.6％,65.3％.Conclusions The CEUS showed perfusion patterns and features in different cervical lymphadenopathy,and supply further useful information.

随着新疆教育事业的发展,新疆各高校为贯彻落实大学生民族团结教育,相继实行了民汉合班、合宿这种新型管理模式.以新疆医科大学推行民汉合班合宿的角度出发,分析班主任在民汉合班、合宿管理工作中遇到的困难、问题和采取的对策.

浅表淋巴结病变常见有反应性增生、恶性肿瘤的转移、淋巴瘤及结核等,准确鉴别其性质对原发病的诊断、治疗及随访等有重要临床意义.近年随着三维成像技术、弹性成像技术、超声造影及超声引导下淋巴结穿刺等超声新技术的出现,为浅表淋巴结病变诊断提供了更多信息,本文就超声新技术诊断浅表淋巴结病变的价值做一综述.

Objective To study regulatory role of metformin hydrochloride combined with simvastatin in glycometaboism and,metabolism disorder of blood lipid and tumor necrosis factor-α(TNF-α)level in olanzapine-induced obese rats. Methods Sixty SD rats were randomly divided into three groups:model group,observation group(metformin hydrochloride combined with simvastatin)and control group,with 20rats in each group.Control group was fed with normal diet.In addition to the normal diet,model group received gavage with olanzapine(1.2mg/kg),and observation group received gavage with olanzapine(1.2mg/kg),metformin hydrochloride(0.75g/d)combined with simvastatin(10 mg/d).The rat models were established after 4weeks.The levels of fasting plasma glucose,blood lipid and TNF-αwere detected.Results The levels of fasting plasma glucose,total cholesterol,triacylglyserol,low density lipoproteincholesterol and TNF-αwere significantly higher in model group than those in control group and observation group(P 0.01),and high density lipoprotein-cholesterol was lower(P0.01).The levels of fasting plasma glucose,total cholesterol,triacylglyserol and low density lipoprotein-cholesterol were lower in observation group than those in control group(P0.01),and TNF-αshowed no significant difference between two groups(P0.05).Conclusions The combination of metformin hydrochloride and simvastatin can reduce the levels of plasma glucose and TNF-α,as well as regulate the blood lipid levels in the olanzapine-induced obese rats.

目的 了解腮腺常见肿瘤声像图特征,以期有助于腮腺肿瘤的定性诊断.方法 回顾159例患者共计175个腮腺肿瘤声像图,比较腮腺常见良性肿瘤(混合瘤、沃辛瘤)与恶性肿瘤的声像图差异,并评价各指标诊断价值.结果 腮腺肿瘤的形状及血流分级在混合瘤组、沃辛瘤组、恶性肿瘤组三组间差异均有统计学意义(P＜0.017),肿瘤边界在混合瘤组与恶性组、沃辛瘤组与恶性组间差异有统计学意义(P＜0.017),肿瘤内部回声及内部低回声区是否存在短线样高回声在混合瘤组与沃辛瘤组、恶性组与沃辛瘤组间差异有统计学意义(P＜0.017).结论 腮腺肿瘤的边界和形状是评判肿瘤良恶性的重要指标,而肿瘤的内部回声与血流分级在评判良恶性肿瘤时价值一般.

目的 观察奥氮平诱导性肥胖大鼠血清和大脑纹状体肿瘤坏死因子-α (TNF-α)含量的影响.方法 40只SD雄性大鼠随机分为对照组和奥氮平组,各20只,前者采用普通饲料喂养,后者在普通饲粮喂养基础上灌胃奥氮平(1.2mg· kg1)4周建立奥氮平诱导肥胖大鼠.采用酶联免疫测定法测定血清中TNF-α的含量,生化比色法测定血清葡萄糖(FBS)含量,对脑组织采用HE染色观察形态学变化,采用免疫组织化学方法观察两组大鼠脑组织中TNF-α的表达.结果 与对照组比较,奥氮平组大鼠的体重、血糖、血脂和血清TNF-α水平和纹状体TNF-α蛋白表达均有不同程度的升高,差异有统计学意义(P＜0.01).结论 奥氮平可以导致大鼠体重增加,糖脂代谢紊乱,血清及纹状体TNF-α升高,通过调节TNF-α异常变化可能改善奥氮平诱导肥胖大鼠中枢摄食活动.