目的:探讨医学留学生生理学课程开展案例教学法(CBL)对培养批判性思维的作用.方法:给2个年级留学生分别实行传统教学(LBL)、CBL+ LBL教学法,以期末考试成绩、批判性思维能力测量表评价教学效果.结果:CBL+LBL教学法能显著性提高学生的考试成绩、批判性思维能力总分以及系统化能力、分析能力(P＜0.05).结论:CBL教学法可提高留学生批判性思维.

Objective: To investigate effect of SB203580 on visceral hypersensitivity in the irritable bowel syndrome (IBS) rats. Methods: The IBS rat model was established by neonatal colorectal dilatation (NCI). The visceral hyper-sensitivity was assessed by recording the responses of the external oblique abdominal muscle to colorectal distention. The visceral hypersensitivity were examined after intrathecal injection of SB203580 (p38MAPK inhibitor). Western Blot was used to detect the expression of brain-derived neurotrophic factor (BDNF) in the thoracolumbar and lumbosacral segments of the spinal cord after intrathecal injection of SB203580. Results: Compared with normal control rats, neonatal nociceptive stimulation induced a significant increase of visceral hyperalgesia (P＜0.05) in adult IBS rats. In IBS rats, spike responses of abdominal muscle to 40 and 60 mmHg colorectal distension pressure were inhibited significantly after intrathecal injection of SB203580 compared with before(P＜0.05). However, there was no significant difference between before and after intrathecal SB203580 in controls. After intrathecal injection of 10 μg SB203580, the expression of BDNF in the thoracolumbar and lumbosacral segments decreased significantly in IBS rats (P＜0.05). Conclusion: Intrathecal injection of SB203580 could attenuate visceral hyperalgesia by inhibiting the expressions of BDNF in the thoracolumbar and lumbosacral segments of the spinal cord in IBS rats.

Objective To explore the effects of different dosages of hydrocortisone(HYD)on the visceral hypersensitivity in rats with chronic functional visceral pain generated by neonatal colorectal distention(CRD)and their possible pathophysiological mechanisms.Methods The rat models with chronic functional visceral pain were established by CRD during post-natal days 8 to 14.Control rats did not received CRD.Abdominal withdrawal reflex(AWR)and pain threshold test were measured to evaluate the sensitivity of visceral pain in rats when they were adult(8 weeks);IBS rats were assigned to four groups at random: NS group,low-dose of HYD group,medium-dose group,and high-dose group.Effects of HYD on visceral hypersensitivity was examined by AWR and pain threshold test before and after the tail intravenous injection the drugs.ELISA was applied to test the content of serum cortisol and expression of endorphin(EP)and enkephalin(ENK)in the relevant parts of spinal cord in the rats after administration.Open field test was used to examine the psychological anxiety level of rats.Results(1)The content of serum cortisol was significantly reduced in rats with chronic functional visceral pain when compared with that in control rats(P<0.05);(2)The pain threshold of IBS rats was significantly increased after the injection of medium and low dose of HYD(P<0.05);(3)The content of EP and ENK were significantly increased in the spinal cord thoracolumbar segment after the injection of low-dose of HYD when compared with injection of saline(P<0.05);(4)Open field test showed that the total distance and average speeds significantly increased after low-dose injection of HYD when compared with before injection(P<0.05).Conclusion A certain concentration range of HYD may relieve the pain sensitization and the behavior reaction of anxiety and depression in rats with chronic functional visceral pain.The mechanism may be related to the dynamic expression of EP and ENK in the spinal cord thoracolumbar segment.

采用情绪智力测试量表和科研能力问卷,对福建医科大学三年级临床医学专业本科生进行调查.结果表明,参与创新实验的临床医学本科生科研能力和情绪智力水平测试得分均高于普通学生,建议拓宽医学生参与创新性实验的广度和深度,健全保障机制,完善创新团队,提高医学生科研能力和情绪智力.

采用王才康翻译的情绪智力量表及自编问卷调查临床医学本科生情绪智力水平与科研实践行为.结果显示临床医学本科生的情绪智力总分为(3.94±0.41),男生的情绪知觉和自我情绪管理优于女生;科研实践水平得分为(79.07±19.36);科研实践行为优秀的医学生情绪智力水平较高.情绪智力与科研实践行为两者相互促进,医学院校应加强培养医学生的情绪智力和科研能力,提高医学人才综合素质.

目的:观察母婴分离所致的慢性内脏痛对成年大鼠空间学习记忆能力和旷场行为的影响.方法:模型组大鼠于出生后第3～21 d,每天接受3h母婴分离,对照组大鼠不做分离处理;8周龄时,使用腹壁撤退反射评分和痛阈测定方法筛选出有慢性内脏痛的大鼠;Morris水迷宫检测成年大鼠的空间学习记忆能力;旷场实验评估成年大鼠的旷场行为;Western Blot方法检测大鼠海马脑源性神经营养因子(brain derived neurotrophic factor,BDNF)的表达变化.结果:(1)母婴分离成年大鼠分别在20、40、60、80 mmHg压力下的腹壁撤退反射评分均显著高于对照大鼠(P＜0.05),而其痛阈显著低于对照大鼠(P＜0.05).(2)与对照组相比,母婴分离大鼠水迷宫的寻台潜伏期与平均平台象限滞留时间均无显著差异(P＞0.05).(3)与对照大鼠相比,母婴分离大鼠旷场运动的总路程和总速度无显著差异(P＞0.05),但中心路程和中心路程时间显著减少(P＜0.05).(4) Western Blot结果显示母婴分离大鼠海马内BDNF的表达与对照相比显著降低(P＜0.05).结论:母婴分离所致的慢性内脏痛对成年大鼠空间学习记忆能力和自主探究行为无显著影响,但能引发成年大鼠的心理焦虑,该效应可能与海马BDNF的表达减少有关.

Objective: To investigate the effect of estrogen on the visceral hypersensitivity in female rats with irritable bowel syndrome (IBS). Methods: The model of IBS was established by colorectal distension (CRD) in neonatal rats. The sensitivity of visceral pain was evaluated by abdominal withdrawal reflex(AWR)and response of external oblique muscle of abdomen (EOMA) to graded CRD (i.e. electromyography,EMG). The estrogen in serum was assessed by radio immunoassay. Results: (1) AWR thresholds both in male and female model rats were significantly lower than those in the corresponding control rats.(2) The average AWR scores (20～60 mmHg CRD) in the male model rats were significantly higher than those in the male control rats. The average AWR scores (20 mmHg CRD) in the female model rats were significantly higher than those in the female control rats. (3) The average response of EOMA to 15～45 mmHg CRD were significantly higher in female model rats than those in male model rats. (4) There was positive correlation between EMG and the estrogen levels in the serum of female model rats. Conclusions: Visceral algesic in female model rats was more sensitive than that in the male model rats,which suggests estrogen may be involved in hypersensitivity in female IBS rats.

目的:探讨银杏叶提取物(EGb)对大鼠离体结肠运动的影响及其相关机制。方法:应用离体结肠灌流实验,观察不同浓度的EGb对大鼠离体结肠运动的影响;利用放射免疫分析的方法检测EGb灌胃后大鼠远端结肠和血浆中血管活性肠肽(VIP)含量的变化。结果:在平滑肌浴槽内加入EGb 0.5~50.0mg/L 0.1ml,可使大鼠离体结肠运动出现抑制和兴奋两种不同反应,其中以抑制作用为主,且以10.0mg/L作用最强;VIP1mmol/L可使离体结肠运动受到抑制,再加入EGb10mg/L 0.1ml后,VIP组收缩幅度和张力进一步降低(P<0.05)。EGb10ml/kg灌胃后,放射免疫分析法结果显示,远端结肠组织中VIP的含量明显增加(P<0.05),但血浆中VIP含量没有显著变化。结论:VIP可能通过旁分泌或神经分泌以局部激素或神经递质的方式参与EGb对结肠运动的抑制作用。

Objective To evaluated two models of chronic visceral pain in rats for chronic visceral pain research.Methods Neonatal Sprague-Dawley male rats were randomly divided into three groups:colon irritation(CI) group received colonic irritation once daily from postnatal day 8 to 14,maternal separation(MS) group received maternal separation 3 hours daily from postnatal day 2 to 21,group control was handled in a way similar to group CI except colonic irritation.Abdominal withdrawal reflex(AWR),pain threshold and spike of external oblique of abdomen were used to assess visceral hypersensitivity in adult rats.Results The scores of AWR and the amplitude of electromyogram of external oblique muscle of abdomen in both model groups were significantly higher than those in control(P<0.05).The pain thresholds in both model groups were significantly lower than those in group control.However,there was no significant difference between group CI and group MS(P>0.05).Conclusion Both CI group and MS group can served as models for chronic visceral pain research.

根据在研究生教学中采用课堂讨论的亲身体会,从讨论内容及形式的选取、教师在讨论中的作用等方面用教学的实例阐述了如何在研究生教学中充分发挥课堂讨论的作用,探讨如何利用课堂讨论的教学方法提高研究生的教学质量。

Aim To investigate effects of ginkgo biloba extract (EGb) on the change of gastrointestinal motility and NO content induced by cold restraint stress. Methods Using blue dextran 2000 (DB-2000) as marker, we observed the effects of EGb and stress on gastric emptying and motor activity of small intestine. And the content of NO in plasma and gastrointestinal muscle layer were measured by chemical method. Results Cold-restraint stress can inhibit significantly gastric emptying and motor activity of small intestine in rats,and by contrast EGb can reverse these effects evoked by cold-restraint stress. In the stress groups in the presence of EGb, NO concentrations in plasma makedly decreased compared with the control groups in the absence of EGb. Conclusion EGb can mediate directly gastrointestinal discord by cold restraint stress, NO might take part in the effect.

目的探讨银杏叶提取物(EGb)对豚鼠离体结肠运动的影响及其机制.方法制备豚鼠离体结肠肠段标本,通过灌流给药的方法观察不同浓度EGb、银杏黄酮等对离体结肠收缩活动的影响.结果 EGb (0.5～50.0 mg/L)可对结肠自主活动产生抑制和兴奋两种不同的影响,其中以抑制作用为主.EGb也可部分拮抗由ACh、5-HT引起的结肠运动的增强效应;并协同血管活性肠肽(VIP)、无钙Kreb液灌流引起的抑制作用;对γ-氨基丁酸、肾上腺素引起的结肠运动抑制效应无显著影响;用M受体阻断剂阿托品预处理可部分阻断EGb对结肠自主活动的影响.银杏黄酮(0.01～0.1 mg/L)可使豚鼠离体结肠运动抑制,且表现一定的剂量依赖性.结论 EGb对豚鼠结肠运动的影响可能是通过影响5-HT、ACh、VIP等肠神经系统递质的释放,经M受体介导以及对平滑肌的直接作用等多种途径实现的.银杏黄酮可能是EGb发挥抑制作用的有效部位.

目的:探讨银杏叶提取物(Extract of Ginkgo biloba,EGb)对豚鼠游离结肠平滑肌细胞的直接作用机制.方法:用含1g/L Ⅰ型胶原酶及0.1g/L大豆胰蛋白酶抑制剂的消化液,消化获得游离的豚鼠结肠平滑肌细胞,将不同浓度EGb加入细胞悬液中,用显微镜测微尺随机观察50个细胞长轴变化情况,计算用药前后细胞平均长度.如果:EGb对结肠平滑肌细胞具有舒张作用,在0.11～3.5g/L浓度范围内,EGb对结肠平滑肌细胞的作用呈剂量-效应关系,最大反映浓度为1.75g/L,其舒张效应为12.79%(P＜0.05).EGb预先孵育1 min,可抑制乙酰胆碱(ACh)效应的44.13%(P＜0.01).腺苷酸环化酶激动剂Forskolin可增强EGb的舒张效应,与单独应用EGb组相比较,舒张百分数增加8.87%(P＜0.05).结论:EGb对豚鼠游离结肠平滑肌细胞具有直接作用,这种作用可能与cAMP信号传导通路相关.

为适应新世纪对高素质医学工作者的需求,针对生理学教学中以知识灌注为主的现状,提出在生理学教学中进行思维训练.该文分析了在生理学这门基础机能性学科中进行思维训练的重要性和必要性,着重强调了生理学的思维特点,并结合不同的教学手段和教学设备提出了不同教学阶段进行的思维训练,并在初步的实践中取得良好效果.

银杏叶提取物(EGb)是一种药性温和,疗效肯定,毒副作用极小的天然药物,其单体成分复杂,包括黄酮类化合物,银杏内酯A、B、C、M、J和白果内酯等.