课程考核是医学院校评价学生知识水平的重要手段,是检测教师教学效果和学生学习效果的重要指标,也是影响人才培养质量的关键因素 [1].长期以来,人体解剖学课程多采取期末考核为主的"一卷定成绩"的评价方式,很难反映学生的真实学习水平,学生学习动力不足,制约了学生知识、能力、素质的全面发展,更谈不上创新型人才的培养 [2].

Objective To explore the efficacy of hydromorphone combined with ropivacaine in labor analgesia and its effect on hemodynamics, labor stage and infant outcomes. Methods 126 primiparas were randomly divided into the control group and the observation group, 63 cases in each group. The control group received epidural analgesia ofropivacaine combined with fentanyl, while the observation group received epidural analgesia of hydromorphone combined with ropivacaine. Analgesic effect, Bromag score and Visual Analgesia（VAS） score, hemodynamics, labor stage, maternal and infant outcome and prolactin level were compared between the two groups. Results The total effective rate of analgesia in the observation group was higher than that in the control group（P＜0.05）. There was no significant difference in Bromag score between the two groups（P＞0.05）. The VAS score of the observation group was lower than that of the control group when the cervix is fully open（P＜0.05）. Before analgesia, the hemodynamics of the observation group has no significant difference with the control group（P＞0.05）. When the cervix is fully open the hemodynamics of the observation group had no significant difference with that before analgesia; the control group was higher than that before analgesia（P＜0.05）; the comparison was with P＜0.05 between the two groups. The first stage of labor, the second stage of labor and the total stage of labor in the observation group were shorter than those in the control group（P＜0.05）. There was no statistically significant difference between the two groups in the third stage of labor（P＞0.05）. The natural delivery rate in the observation group was higher than that in the control group（P ＜0.05）. There was no significant difference between the two groups inblood gas of umbilical vein immediately after delivery and Apgar score of newborn within 1 min（P＞0.05）. 24 hours after delivery, the prolactin level in both groups increased（P ＜0.05）, and the prolactin level in the observation group was higher than that in the control group（P ＜0.05）. Conclusion Hydromorphone combined with ropivacaine can relieve the pain of parturient, keep the hemodynamics stable, shorten the labor process and reduce the cesarean section rate.

目的:探讨骨髓间充质干细胞移植促进跨区皮瓣术后血管新生的作用.方法:通过全骨髓差异贴壁法获取骨髓间充质干细胞,进行经90％融合后消化传代扩增,至第3代后行CD29+、CD90+、CD34-以及CD45-细胞免疫表型鉴定后待检,选取40只体质量为300～350g的SD大鼠作为研究对象,并按照数字随机法进行分组,每组各20只,对照组切取大鼠背部一侧跨3个区皮瓣后缝回原处,观察组切取大鼠背部一侧跨3个区皮瓣,缝回原处1h后,以1mL/100g的标准注射骨髓间充质干细胞悬液于尾静脉,浓度:1 ×106个/mL.观察两组SD大鼠1w后的皮瓣坏死率、choke血管的管径.结果:第3代SD大鼠分离培养的骨髓间充质干细胞中CD29、CD34、CD90、CD45的阳性率分别为98.2％,、0.82％、93.5％和2.22％.术后1wSD大鼠对照组皮瓣坏死率为(29.37±4.08)％,choke血管的管径为(182.17±22.24)μm,观察组SD大鼠皮瓣坏死率为(10.29± 3.24)％,choke血管的管径为(225.34±22.19)μm,两组存在显著差异(P＜0.05).结论:骨髓间充质干细胞移植能够有效提高皮瓣新生率,并具有促进choke血管扩张的作用.

Objective: To explore the application effect of case teaching method in the teaching of human anatomy.Method: Selected into the clinical specialty students as experimental subjects.From 2020.09 to 2021.01，select 1 class of students，a total of 67 cases，as the experimental group，using case teaching method.In the time period of 2019.09-2020.01，a class of students with a total of 66 cases was selected as the reference group and the conventional teaching mode was adopted.The final comprehensive scores of the two groups;teaching satisfaction;self-learning ability，problem solving ability，problem discovery ability scores，etc.are researched.Results: (1) The final comprehensive scores of the experimental group were better than those of the reference group，P<0.05.(2) The teaching satisfaction of the reference group was worse than that of the test group，P<0.05.(3) The scores of self-learning ability，problem-solving ability，and problem-finding ability of the test group were higher than those of the reference group，P＜0.05.Conclusion: In the teaching of human anatomy，case teaching method is helpful to improve students' comprehensive performance and cultivate their problem-solving ability.

目的 探讨槲皮素对肺纤维化大鼠肺组织细胞间质转化、炎症及对NOX4-P62信号途径的影响,为进一步阐明槲皮素对肺纤维化的作用机制提供实验依据.方法 将实验大鼠分为对照组、博来霉素组(BLM组)和博来霉素+槲皮素组(BLM+QUE组),分别于造模后第7、14、28天观察各组肺组织外观,利用苏木素-伊红染色法(HE染色)评价肺纤维化情况,蛋白质免疫印迹法(Western blot)检测各组肺组织还原型烟酰胺腺嘌呤二核苷酸磷酸氧化酶4(NOX4)、自噬蛋白P62、核因子κB(NF-κB)的蛋白表达情况,反转录-聚合酶链反应(qRT-PCR)检测人肺腺癌细胞株A549细胞血管平滑肌肌动蛋白(α-SMA)和钙粘附蛋白E(E-cadherin)的mRNA表达水平,酶联免疫吸附法(ELISA法)检测转化生长因子-β1(TGF-β1)、白介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)的水平.结果 BLM组随时间增加大鼠肺纤维化呈进行性加重,BLM+QUE组在第7天时症状较BLM组轻,在第28天时症状明显减轻.BLM组的TGF-β1、IL-1β、TNF-α、NOX4、P62、NF-κB蛋白表达,较对照组明显上升,差异具有统计学意义(P<0.05),BLM+QUE组在第7天时较BLM组低,但无显著差异(P>0.05),但在第14、28天时较BLM组明显下降,差异显著(P<0.05).与对照组比较,加入TGF-β1的A549细胞E-cadherin、α-SMA mRNA的表达分别明显降低和升高(P<0.05);给予槲皮素后,E-cadherin、α-SMA mRNA的表达较TGF-β1组分别明显升高和降低(P<0.05).结论 槲皮素能够抑制TGF-β1对人肺腺癌细胞株A549细胞诱导的间质转化的转变,减轻肺纤维化大鼠的炎症反应,缓解博来霉素所致的大鼠肺纤维化,自噬活性在博来霉素诱导大鼠发生肺纤维化的过程中受到抑制;槲皮素可能通过抑制NOX4-P62信号途径,激活自噬,减轻大鼠肺纤维化.

在高职医学院校课程思政教学中,教师应不断加入新的内容,不断创新与发展.在互联网发展背景下,教师应该将医学课程思政与信息化联系起来,建立网络信息平台,进而提升课程思政教学效果.学习强国平台就是这样一款官方平台,可以为高职医学院校课程思政提供海量的信息资源,优化医学课程思政理论教学,为医学课程思政的创新提供新的平台与发展契机.首先介绍了学习强国平台的基本内涵和功能,其次在借助学习强国平台的优势资源的基础上,提出了学习强国平台融入高职医学院校课程思政教学的有效路径,为医学院校课程教学提供可借鉴的思路.

人体解剖学是一门重要的医学基础课,是一门实践性很强的形态学科.然而,随着高校扩招在校学生明显增多,给教学带来诸多难题.目前,随着多媒体计算机技术、网络技术的发展,教育网络化、虚拟化、多样化和自主化已成趋势[1-2],通过建设教学资源库,并与网络平台进行有机整合,为当下人体解剖学教学质量的提高提供了一个有效的问题解决方案.

目的:跨区皮瓣切取后容易出现远端坏死,本文章主要探讨MCP-1与大鼠背部跨区皮瓣术后存活的关系.方法:建立穿支蒂筋膜皮瓣模型,取30只模型,体重250±30g,分别在术后即刻、术后1天、术后3天、术后5天、术后7天,这5个时间点取choke区组织,分别表示为术后即刻(control)、术后1天、术后3天、术后5天、术后7天.利用Western blot及免疫组化检测MCP-1蛋白的表达及其表达量的变化.结果:MCP-1在术后3天表达量明显高于其他组,P＜0.05,具有统计学意义.结论:跨区皮瓣术后choke区MCP-1蛋白表达的变化与choke血管扩张(动脉发生)具有相关性.

目的:研究卵巢硬化性间质瘤患者进行临床病理特点并分析其诊断要点.方法:选取2017年2月至2018年8月在我校教学医院进行卵巢硬化性间质瘤治疗的10例患者作为研究对象,观察其表现的临床症状,并对其实施超声检查及手术病理学检查等.结果:这些研究对象均经健康体检诊断为卵巢瘤,有6例月经不规律,有2例存在下腹隐痛的症状,有2例没有明有2例属于实性;光镜下:瘤细胞具有相间的丰富区和疏松区,结构为假小叶样.结论:卵巢硬化性间质瘤比较少见,单纯进行临床症状和影像学诊断无法得到准确依据,以手术病理诊断联合诊断可充分保障该部分患者的诊断效果.

Objective: To explore the diagnostic value of magnetic resonance proton spectrum (MRS) on hippocampus lesions in patients with primary epilepsy. Methods: Thirty eight patients with primary epilepsy (epilepsy group) and 30 healthy volunteers (normal control group) were examined by EEG, MRI and MRS. The metabolic products of N-acetylaspartate (NAA), creatine (Cr) and choline (Cho) were quantitatively analyzed through MRS on bilateral hippocampus. Results: There was no abnormal in normal control group by EEG, MRI and MRS. In epilepsy group, there were 30 cases (78.9%) found epileptiform discharges by EEG; there were 15 cases (39.5%) found abnormal in hippocampus by MRI, including 10 cases of bilateral abnormality and 5 cases of unilateral abnormality; there were 35 cases (92. 1%) found abnormal in hippocampus by MRS, including 30 cases of bilateral abnormality and 5 cases of unilateral abnormality. The values of Cho/Cr and Cho/NAA of the abnormal side hippocampus in the epilepsy group were significantly higher than those in the normal side of hippocampus and the normal control group (all P < 0. 001), and the value of NAA/(Cho + Cr) of the abnormal side hippocampus in the epilepsy group was significantly lower than that in the normal side of hippocampus and the normal control group (all P < 0. 001). The value of NAA/(Cho + Cr) of the head of hippocampus was significantly lower than that in the body and the tail of hippocampus in the abnormal side (all P <0. 001). Conclusion: MRS can increase the positive rate of hippocampus lesions in patients with primary epilepsy, and can show the biochemical changes of the hippocampus, which has a high diagnosis value on primary epilepsy.

目的:探讨联用阿托伐他汀与阿司匹林治疗高血压合并动脉粥样硬化的临床效果.方法:将2017年5月至2018年5月期间在某医院就诊的70例高血压合并动脉粥样硬化患者随机分为研究组和对照组.对对照组患者仅使用阿司匹林进行治疗,对研究组患者使用阿托伐他汀联合阿司匹林进行治疗.治疗结束后,对比接受治疗前后两组患者动脉粥样硬化斑块面积及血压水平的改善情况.结果:接受治疗前两组患者动脉粥样硬化斑块的面积、收缩压及舒张压的水平相比,P>0.05.接受治疗后两组患者动脉粥样硬化斑块的面积小于接受治疗前,其收缩压及舒张压均低于接受治疗前,其中研究组患者动脉粥样硬化斑块的面积小于对照组患者,其收缩压及舒张压均低于对照组患者,P<0.05.结论:联用阿托伐他汀与阿司匹林治疗高血压合并动脉粥样硬化可显著缩小患者动脉粥样硬化斑块的面积,降低其血压的水平.

目的:探讨肝内胆管结石合并肝内胆管细胞癌患者的临床特点及预后.方法:选取2013年10月至2015年10月期间菏泽医学专科学校教学医院收治的200例肝内胆管细胞癌患者作为研究对象.将其中合并肝内胆管结石的50例肝内胆管细胞癌患者作为研究组.将其中未合并肝内胆管结石的150例肝内胆管细胞癌患者作为对照组.计算两组患者中不同性别患者所占的比例.比较两组患者血清总胆红素(TBIL)、碱性磷酸酶(ALP)、谷氨酰胺转肽酶(γ-GT)、谷丙转氨酶(ALT)及谷草转氨酶(AST)的水平,观察其进行消化道肿瘤抗原19-9(GA19-9)及甲胎蛋白试验的结果.对两组患者均进行手术治疗,观察其术后不同时间的生存率.结果:研究组患者中女性患者所占的比例、GA19-9试验结果为阴性患者所占的比例均低于对照组患者中相应患者所占的比例,P<0.05.研究组患者中血清ALP水平>119 U/L患者所占的比例、血清γ-GT水平>64 U/L患者所占的比例均高于对照组患者中相应患者所占的比例,P<0.05.研究组患者术后1年的生存率、术后2年的生存率及术后3年的生存率均低于对照组患者,P<0.05.结论:与未合并肝内胆管结石的肝内胆管细胞癌患者相比,肝内胆管结石合并肝内胆管细胞癌患者中女性患者、GA19-9试验结果为阴性患者所占的比例较低,其中血清ALP水平>119 U/L患者所占的比例、血清γ-GT水平>64 U/L患者所占的比例较高,其生存率较低.

硕士研究生教育是我国培养高素质创新型人才的重要环节.人体解剖学专业硕士生毕业后大多就职于高等院校,从事本专业的教学工作.因此,完善培养制度和模式,通过专业学习-实验带教,培养高层次、高质量创新型学术人才.