信息技术的飞速发展,使网络课程与学生自主学习的模式成为医学教育发展的必由之路.临床医学教学中医学生的参与至关重要,微课与翻转课堂的有机融合可以更好地促进医学生主动性地学习,充分调动学生学习的积极性及热情,整合各种优质资源,更新学生思想观念,提高医学生的综合素质.

Based on the rapid development of mobile internet ,mobile learning in Chinese medical edu‐cation has a broad prospect for application .T he article briefly introduces mobile internet and mobile learning .Then it analyzes the characteristics of mobile learning and probes into the impact of medical student clinical skills training mode by mobile learning based on mobile internet .

全国高等医学院校大学生临床技能竞赛受到各高等院校的高度重视。当前医疗环境恶劣，医患沟通欠缺，如何以临床技能竞赛为契机，提高医学生人文素质，是教师目前面临的一个重要课题。文章从当前医疗环境，临床技能教育的现状，医学生人文素质的培养来阐述临床技能竞赛带来的思考。

临床思维能力培养是卓越医师培养的重要内容。本文对现代信息技术做了简要介绍，分析了现代信息技术的特点，并就现代信息技术在卓越医师临床思维能力培养中的应用优点进行了初步的探讨。

从美国医师资格考试中的要求出发,对留学生目前临床技能的教学体系、教学方法、实践教学模式等进行改革和思考.改革培养目标,以提高学生综合素质为目标,科学整合基础课程与临床课程.充分利用临床技能培训中心,培养留学生的临床技能.加强医学人文技能教育,培养学生基本的沟通能力和技巧.在留学生的培养中,将PBL(Problem-Based Learning)教学法贯穿始终.模拟CS考核方式,针对性提高学生考试水平.从而形成适应本国国情的留学生临床技能培养模式.

卓越医生教育培养计划的目标是培养高素质医学人才。五年制临床医学本科教育是“5+3”培养模式的关键。本文基于医学人文教育在五年制临床医学卓越医生教育培养中的重要性，拟从课程体系、师资队伍、校园氛围及拓展式教学四个方面探索医学人文教育的实施策略。

目的：分析ECS模拟人在卓越医师临床技能教学中的教学方式和效果。方法：使用ECS模拟人对我校2010级临床医学专业卓越医师班26名学生进行教学训练，另取同班级26名进行传统课堂教学模式的学生为对照组，观察教学效果并进行问卷调查。结果：教学前两组学生考核成绩无明显差别，经ECS教学后实验组学生对临床技能的掌握程度显著提高（P＜0.05），其整体成绩也显著高于对照组（P＜0.05）。结论：ECS模拟人教学有助于提高学生的临床操作能力。

我国卫生事业的发展和医药卫生体制改革对高等医学教育提出了更高要求，卓越医生教育培养计划是为提高医学人才培养质量而实施的改革举措之一。作者针对五年制临床医学人才卓越医生教育培养计划的内涵、目标、培养体系、培养方案和实践途径等方面进行探索和思考，为计划的实施提供了理论基础。

随着我国留学生教育规模逐步扩大，医学留学生教育质量的好坏已成为评价大学办学水平及提升国际影响力的重要指标之一。本文通过对地方医学院校自身特点的分析，拟从留学生立体化教材建设、师资队伍专项培养及教学方式调整三方面探讨留学生教学在地方医学院校的实施策略，为留学生来华教育可持续发展积累经验。

卓越医生的培养是从培养卓越医学生做起，建设一支高素质的高校师资队伍是培养卓越医学生的根本保证。本文对提高师资队伍综合实力建设方面提出了几点建议，即提高人文素养，树立教师道德模范；多途径、全方位提高教师教学能力；着力解决教师的实际问题，创造良好的工作环境。

通过探讨基础仿真模拟技术、高级综合模拟人技术、多媒体教学技术、计算机辅助教学、网络教学等现代教育技术的特点,分析各种现代教育技术手段教学方法的优缺点,提出通过优化组合各技术手段方法,可以实现优势互补,相辅相成,从而建立临床基本技能的立体化教学模式,提高教学效果。

临床技能教学是临床医学教学中的核心内容之一,是高等医学教育的重要组成部分。建立贴近临床,贴近应用的科学、系统的大临床技能教学模式,更符合现代医学教育要求,能确实提高医学生临床技能,使之能尽快适应现实医疗环境。符合现代医学模式下医学人才培养的改革思路。可为临床技能教学模式改革提供借鉴。

To have a theoretic discussion about teaching mode of medical humanities education for Excellent Medical Doctors,establishing the multi-dimensional teaching platforms and the teaching management system,exploring the new and multi-dimensional teaching methods and constructing medical humanities educational bases.Establish the multi-dimensional teaching mode of medical humanities education for Excellent Medical Doctors New way of thinking and help them to have been provided to improve the teaching effect of medical humanities education and ensure the quality of talent cultivation of Excellent Medical Doctors.

国家精品课程建设对提高高校教育教学以及人才培养质量具有重要的作用。通过探索临床技能学培养新模式、推进立体化教学资源建设、改革创新教学方法和手段以及加强硬件环境的建设等措施,为提高国家级精品课程建设的质量和水平提供新的思路和方向。

Objective To investigate the relationship between the levels of serum intercellular adhesion molecules-1(ICAM-1) and the formation of coronary collateral circulation in patients with severe coronary artery stenosis.Method Total 108 patients with at least the stenosis of one vessel ≥95% among three main vessels of coronary artery were consecutively enrolled in the study according to angiographic estimation.Development of collaterals was classified by Rentrop′s method.According to the collateral degree,patients were divided into two groups(a non-CCC formation group:47 patients with grade 0;a CCC formation group:61 patients with grade 2-3).The serum levels of ICAM-1 were also measured.Results Compared with the CCC formation group(243.08±70.90) ng/ml,the levels of serum ICAM-1 with non-CCC formation group(286.38±56.27) ng/ml were increased significantly(P=0.001,P<0.01).Conclusion In patients with severe coronary artery stenosis,the serum levels of ICAM-1 are negatively correlated with CCC formation.

Objective To investigate the effects of diabetes mellitus on coronary collateral circulation and the relationship between serum levels of ADMA and degrees of coronary collateral circulation in diabetes mellitus patients.Methods 112 patients at least with the stenosis of one vessel >95% among coronary artery were consecutively enrolled.The 112 patients were divided into two groups:DM group and NDM group.Development of collaterals was classified by Rentrops method.The levels of ADMA were also determined.Results Compared with NDM group,poor CCC was higher in the DM group(P=0.043,P<0.05),the serum ADMA concentration is also significantly higher than NDM group(P=0.000,P<0.01);Compared with NDM group in poorly developed collateral,the serum levels of ADMA in DM group were significantly increased(P=0.001,P<0.01).Conclusions Diabetes mellitus inhibits the development of coronary collateral circulation in patients with severe coronary artery stenosis,which is related to the serum levels of ADMA.

Clinical skills teaching,an important part of modern medical education,is the key to cultivating the clinical ability,lifelong learning ability and professional qualities of medical students.PBL method combined with humanities quality education adopts students first and foremost reform teaching methods,which is more conducive to medical students' clinical practice ability and conforms to medical student training reform in the modern medical pattern.It can serve as reference for reforms in clinical skills teaching.

【Objective】 To investigate the relationship of serum levels of adiponectin with inflammatory cytokines in sepsis patients.【Methods】 64 severe sepsis patients including 21 cases of pulmonary infection,12 cases of pancreatitis,26 cases of multiple injury and 6 cases of burn were recruited,plasma levels of adiponectin and tumor necrosis factor-α(TNF-α) were measured by enzymelinked immunosorbent assay method(ELISA),plasma levels of C-response protein(CRP) was measured by rate nephelometry.【Results】 Plasma concentrations of adiponectin were significantly lower in sepsis patients(4.87±1.83) than age matched healthy controls(7.97±3.42),while plasma levels of TNF-α and CRP were significantly higher in sepsis patients(68.02±10.64,48.23±9.94) than controls(20.14±5.23 ng/L,8.34±1.21 ng/L).Concentrations of adiponectin was inversely(P 0.01) correlated to the levels of TNF-α and CRP in sepsis patients(Spearman rho=-0.2151,-0.34,P 0.01).【Conclusions】 In patients of severe sepsis,the decreasing levels of adiponectin is most likely contribute to the development of disease,which maybe due to the increasing of inflammatory cytokines,suggesting that the levels of adiponectin is a predicting factor in the outcome of sepsis patients.

Objective To investigate the influence of Advanced Glycation Endproducts(AGEs)on CD40 expression in the human umbilical vein endothelial cell and the effect of Lectin-like oxLDL receptor-1(LOX-1) in this process. Methods HUVEC-12 cells were cultured and incubated with AGEs at different concentrations(0,100、200、400、800 mg/L)for the same time and at the same concentration for different time course(0、6、12、24 h).Pretreated with LOX-1 blocking agent PIA(250 μg/mL),HUVEC-12 cells were cultured with AGEs at 400mg/L for 24 h.The mRNA and protein expression of CD40 in different groups were detected by RT-PCR and Western blotting respectively. Results The expression of CD40 was significantly increased induced by AGEs in a dose-dependent manner within 0-800mg/l for 24h and in a time-dependent manner within 0-24h.Pretreatment with PIA(250μg/mL)attenuated the increased expression of CD40 induced by AGEs but had no effect on the basal expression of CD40. Conclusions AGEs up-regulated the expression of CD40 in a dose-dependent and time-dependent manner.This effect may be related to the mediation effect of LOX-1.

The development of PBL teaching based on simulation teaching system can increase the chance for students to practice clinical skills which overcomes the actual shortcomings in current clinical basic skills teaching, and it can also support the development of clinical thought through the resolution of actual disease problems for students. Such perfect combination of teaching approach and model should be the solid foundation for the all-round improvement of the clinica basic skills for medical talents.