目的:探讨基于病例汇报的翻转课堂教学法在脊柱外科规培中的作用.方法:将脊柱外科规培医师随机分为实验组和对照组.对照组仅进行传统规范化培训,实验组还需制作课件对术前病例进行汇报和讨论.培训结束时,通过出科考试和调查问卷,获得评价和反馈.结果:实验组住院医师出科考试成绩更高,对培训认可度和满意度明显高于对照组,差异具有统计学意义.结论:基于病例汇报的翻转课堂教学法有助于提高脊柱外科规培的质量.

住院医师规范化培训是医学生毕业后教育中必要的一环,海军基层军医住院医师规范化培训的启动,对于提高基层卫生人员岗位胜任力和提升基层部队卫勤保障能力等方面有重要作用.基层部队军医要具备独立的诊疗能力、特种医学能力和卫勤保障能力等.结合基层部队军医能力需求情况,在地方住院医师规范化培训方案的基础上,对海军基层部队军医住院医师规范化培训方案的优化,从培训阶段的划分、培训内容的细化、人才任用的调整等方面进行了探讨.

目的 探讨军校学员参加基于战术战伤救治的救护大赛的真实感受和情感体验,为进一步完善比赛内容和形式提供参考.方法 对11名参赛选手进行半结构式访谈,用Colaizzi的现象学分析法进行资料处理与分析.结果 提炼出3个主题:个人体验—学员认为大赛形式新颖、训练系统、增长知识;收获与遗憾学员收获了实战技能、发挥了个人智能,但在实战心理方面欠佳;比赛的问题与建议—学员指出考勤松散、赛程不连贯、战术意识薄弱等问题,提出调整训练结构、开展实战化训练、增设海战伤救护模块等建议.结论 军队院校应整合自身资源,搭建实战平台,通过加快基地建设、完善赛程赛制,打造着眼于实战的战伤救治品牌赛事.

This paper retrospectively reviewed the program of soliciting reflective notes on clinical internship among medical students of a military medical university for consecutively 4 years, aiming to find out the positive effects on their clinical practice.It is concluded that writing reflective notes is of great significance for the department of teaching and administration to know more about interns teaching management, to stimulate medical students'' enthusiasm in clinical internship and to preserve and promote clinical records.Therefore, it is an effective teaching management method worthy of popularization.

As a critical part linked with medical practice,clinical medicine and medical research,medical thinking is of great importance to medical students.This article introduced specific contents about cultivation of medical thinking,including the overall thinking,innovative thinking,reverse thinking,dialectical thinking and individual thinking.These contents play an extremely important role in the learning and clinical training of medical students and should be enhanced.

[Absrtact] Objective To investigate the effect of anatomic quantitative target evaluation of class-room teaching on students' professional knowledge learning ability. Methods Twenty-five international students of 6-year program of grade 2013 were chosen as the experimental group, while twenty-seven Chinese students coming from the same class of grade 2013 and fifteen international students of 6-year program of grade 2012 were chosen as two control groups; quantitative and non-quantitative evaluation were imple-mented respectively by classroom questions and answers; teaching effects were evaluated by scales in the separation of teaching and examination, by records of answers for in-class questions and by questionnaire survey; SPSS 20.0 was used to make statistical analysis, one-way ANOVA and Kruskal Wallis test to com-pare the scores of three groups of students, P<0.05 indicates statistic significance. Results Compared with control groups, the accuracy of answers for class questions were improved greatly in the experimental group (2/3~3/4) vs. (1/2) and (2/3~3/4) vs. (1/2) and the average test scores (80.62±5.93) vs. (79.62±5.93) and (80.62 ±5.93) vs. (70.16 ±6.36) of the experimental group students were higher than control groups, the difference was statistically significant between the control group and the control group (P=0.045). ConclusionsQuantitative evaluation of teaching objectives in anatomy class can improve the learning attitude of foreign students and enhance their academic ability.

构建实施以5门中医经典课程为核心,整合优化其他中医学课程的教改方案,按照4个步骤实施教学:分阶段以经典课程统领基础及临床课程;根据学员认知规律和经典课程教学目标,理论教学和专题教学相结合;在增设经典课程实践教学和设立经典带教门诊基础上,实现医学生培养全过程的“识训结合”;针对基层需求,在经典教学中重视中医简便廉验的实用技术培训.由此切实增强学员为军服务能力,提高学员运用中医理论的能力,增强学员进入部队后的适应性.

通过对军队医学院校援外培训教学中授课形式、教学方法和教学评价等方面的调查，提出医学援外培训教育应注意合理安排授课形式、采取灵活的教学方法、提高教师的授课技能、采取适当的学习评价方式，以提高教学质量。

目的了解非内分泌专科住院医生使用胰岛素进行血糖管理的能力,为糖尿病的教学、治疗提供依据,并针对存在问题找出对策。方法设计调查问卷表,主要对住院医生的血糖管理水平认知、胰岛素基本疗效认知、胰岛素使用的了解程度和影响住院医生有效使用胰岛素的因素4个方面进行调查,并搜集相关建议。结果 190位被调查者中有143人（75.26%）未参加过内分泌科轮转工作;住院医生对血糖管理的理论知识掌握不足,回答正确率为41.26%;对胰岛素使用的了解程度较低,仅16.82%的被调查者熟悉糖尿病防治指南,仅有不到30%的住院医生对胰岛素种类、特点及常用胰岛素治疗方案熟悉。影响住院医生有效使用胰岛素的因素有"患者住院时间太短导致血糖难以有效控制"、"非内分泌专科未对住院患者血糖管理给予足够重视"、"不知道如何确定个体化的降糖方案"等。结论院内血糖管理需要得到重视,临床工作迫切需要更加深入地加强住院医生的相关教育。

目的:基于文献分析探讨血府逐瘀汤治疗失眠的主要使用指征及其用药加减规律。方法:检索个案报道,用频次法、层次聚类法分析主要症状和用药。结果:从症状看,血府逐瘀汤所治疗的失眠症以彻夜不眠、神疲倦怠、舌质紫和眩晕等为主。从用药看,血府逐瘀汤原方药物的使用频次最高,并以桃红四物汤为内核,同时配伍夜交藤和酸枣仁,并常用丹参配郁金、琥珀配远志、龙骨配牡蛎等对药以增强安神效果。结论:以血府逐瘀汤为主方治疗失眠症以彻夜不眠、舌质紫为主症,用药以桃红四物汤为内核,并可适当伍用安神药以提高疗效。

从干姜与附子的性味作用特点、脾肾之间关系、水火之间关系等方面的分析出发,探讨了仲景在<伤寒论>中干姜与附子配伍治疗阳气衰微证候的用意,对"附子无干姜不热"的传统观点提出了自己的看法和认识.