探讨新时期职业教育背景下中高职贯通护理专业学生的职业认同感及其影响因素.调查显示,职业院校应开设职业认同教育课程,以提高学生对护理专业的了解程度,发现护理职业的益处,最终减少基层护理人力资源的流失.

目的 分析研讨式教学法在高职高专药理学教学中的应用效果.方法 将2017级医学影像技术班105名学生随机分成实验组和对照组.实验组在2个章节的教学中采用研讨式教学法,对照组采用传统式教学法.应用效果采用期末考试 、问卷调查进行综合评价.结果 研讨式教学组学生成绩高于传统式教学组(P<0.05),学生对研讨式教学法的赞同度高,有利于综合能力和综合素质的培养.结论 研讨式教学法在高职高专药理学教学中的应用效果良好,比传统式教学法更有利于医学人才的培养.

基于社会建构主义学习理论,对Moodle课程管理软件进行二次开发,融合即时通信软件微信,构建信息化服务系统——"随身课堂"云平台.通过在平台上建设大量优质数字化教学资源,构建移动化学习环境,对数字化建构主义学习模式进行探索.把以"教"为中心的课堂教学与以"学"为中心的自主学习、协作学习结合起来,根据需要进行项目导向学习、翻转课堂教学、混合教学等.实践证明,该模式教学效果令人满意.

临床病理学在疾病的诊断、治疗及预后判断上起着至关重要的作用,但高职临床医学生普遍缺乏临床病理学的学习.为改善高职临床医学生临床病理素养不足的现状,肇庆医学高等专科学校利用寒假假期在高职临床医学生中开展临床病理见习.经过见习前的充足准备、“临床-病理-临床”见习模式的实施及见习结束后的交流总结,高职医学生充分理解了临床病理学的重要性,初步具备了运用临床病理知识解决临床问题的能力.

Background This meta-analysis was performed to evaluate the efficacy and safety of palonosetron and ondansetron in preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic surgery with general anesthesia. Methods We searched for randomized controlled clinical trials in PubMed, Embase, and The Cochrane Library. Results Nine studies were enrolled in this meta-analysis and showed no statistically significant difference between palonosetron and ondansetron in the prevention of PONV in the first 24 hours after surgery (relative risk [RR], 0.62; 95% confidence interval [CI], 0.35-1.10). Palonosetron more effectively prevented vomiting at various time intervals during the first 24 hours postoperatively than did ondansetron: 0-2 hours (RR, 0.45; 95% CI, 0.26-0.78), 2-6 hours (RR, 0.74; 95% CI, 0.39-1.40), and 6-24 hours (RR, 1.20; 95% CI, 0.55-2.64). No significant differences in side effects were found between palonosetron and ondansetron (RR, 0.67; 95% CI, 0.40-1.14). Conclusion This meta-analysis demonstrated that palonosetron is not more efficacious than ondansetron in the prevention of early PONV. However, palonosetron was more efficacious than ondansetron in the prevention of vomiting after laparoscopic surgery.

目的 研究二苯乙烯苷对人结肠癌细胞增殖及凋亡的作用,并探讨潜在的分子机制.方法 通过CCK8检测二苯乙烯苷对细胞增殖及顺铂化疗增敏的影响;流式细胞仪检测二苯乙烯苷对细胞凋亡的影响,Western blot检测二苯乙烯苷处理细胞后PI3K/AKT通路相关指标的变化.结果 CCK8结果显示,THSG可抑制HCT116和SW480细胞增殖,其对细胞的抑制呈时间和剂量依赖.THSG与顺铂联合运用可增加HCT116和SW480细胞对顺铂的敏感性.流式细胞仪检测结果显示,THSG作用于HCT116和SW480细胞后,细胞早期凋亡率呈剂量依赖递增.Western blot结果显示,THSG可上调PTEN的表达,下调P-AKT、P-IKKβ的磷酸化水平.结论 THSG可能通过抑制PI3K/AKT/NF-κB通路从而抑制HCT116和SW480细胞增殖并促进凋亡.

Objective To investigate the efficacy and safety of ondansetron during cesarean section under spinal anesthesia. Methods We sought randomized controlled trials (RCTs) on ondansetron during spinal anesthesia for cesarean section in The Cochrane Library, PubMed, MEDLINE, and Web of Science from their inception to September 2016. Results Altogether, 21 RCTs were included in this study. Meta-analysis showed that the ondansetron group had a lower incidence of nausea/vomiting and bradycardia than the placebo group during cesarean section under spinal anesthesia [relative risk (RR) = 0.43, 95% confidence interval (CI) (0.36, 0.51) and RR = 0.45, 95% CI (0.26, 0.80), respectively]. There were no significant differences in the incidences of pruritus, hypotension, or shivering during cesarean section under spinal anesthesia [RR = 0.92, 95% CI (0.83, 1.02); RR = 0.72 (0.50, 1.06), 95% CI (0.50, 1.06); and RR = 0.89, 95% CI (0.71, 1.11), respectively]. Conclusion Ondansetron effectively reduces the incidences of nausea/vomiting and bradycardia under spinal anesthesia during cesarean section.

目的 探讨鸦胆子苦醇在非小细胞肺癌A549、H460细胞增殖中的作用.方法 采用四甲基偶氮唑盐(MTT)法检测鸦胆子苦醇对A549、H460细胞的半数抑制浓度(IC50);Hoechst33258染色,倒置荧光显微镜下观察细胞凋亡的形态学变化;通过CCK-8法检测细胞活力;Annexin-V-FITC/PI双染法检测细胞凋亡;Western blot免疫印迹法检测A549、H460细胞Nrf2、Notch1蛋白表达.结果 鸦胆子苦醇处理A549、H460细胞的IC50分别为(0.70±0.03)、(0.47±0.05) μmol/L;流式细胞试验结果显示,鸦胆子苦醇处理后A549、H460细胞凋亡率显著升高,与对照组比较差异均有高度统计学意义(均P＜ 0.01);Western blot检测结果显示,鸦胆子苦醇可降低细胞内Nrf2、Notch1的蛋白表达.结论 鸦胆子苦醇可以抑制A549、H460细胞的生长,其机制可能与抑制Nrf2-Notch1信号轴有关.

Objective To explore the method of three-dimensional reconstruction of fetal bilateral renal artery and its application value of three-dimensional visualization model.Methods One case of 31 weeks fresh fetal bilateral kidney specimens was infused with epoxy resin-titanium dioxide and then casted.Obtained the original two-dimensional CT image data sets through CT thin layer scanning of the casting mold.Reconstructed the three-dimensional model of fetal bilateral renal artery with the Mimics 17.0 software, and the model was compared with the casting mold specimen.Results The casting mold specimen of fetal bilateral renal artery clearly showed the shallow blood vessels, but it was difficult to observe the deep renal arteries.On the contrary,the three-dimensional model of fetal bilateral renal artery could help to observe and measure the deep renal arteries accurately,but it failed to show the shallow blood vessels clearly.Conclusion Based on the advantage of the three-dimensional model fetal bilateral renal artery and casting mold specimens,the direction and distribution of fetal bilateral renal arteries could be displayed with stereoscopic multi-level through the combination of virtual and reality,which may provide a reliable morphological data for anatomy teaching and fetal basic medical research information.

目的:探讨二苯乙烯苷对慢性氟中毒致脑损伤大鼠学习记忆能力、氧化应激的影响.方法:30只大鼠随机分为对照组、模型组、实验组,每组大鼠10只.对照组大鼠给予去离子水自由饮用;模型组、实验组大鼠给予100 mg/L NaF溶液自由饮用,连续饮用12周.实验组给予二苯乙烯苷60 mg/(kg·d)灌胃,对照组和模型组给予等剂量生理盐水.比较各组大鼠逃避潜伏期、游泳时间百分比、穿过原平台次数及血浆SOD和MDA含量变化.结果:与模型组比较,实验组大鼠逃避潜伏期缩短(P<0.05);与模型组比较,实验组大鼠游泳时间百分比增加(P<0.05);与模型组比较,实验组大鼠穿过原平台次数增加(P<0.05);与模型组比较,实验组血浆SOD含量明显增加,MDA含量明显降低(P<0.05).结论:二苯乙烯苷可明显改善慢性氟中毒致脑损伤大鼠学习记忆能力,通过降低MDA含量和提高SOD含量减轻脑损伤.

高职护理教育属于以培养"能力为本位"的教育.高职护理医学基础课程中的"三理"课程包括生理学、病理生理学和药理学.教学重点为理论知识,实验教学隶属于理论教学,其实验内容偏向于验证理论和演示现象,忽略了学生动手能力和创新能力的培养.为了提高高职护理学生各方面的素质,实现综合性人才的培养,通过教学改革将"三理"的实验课程有机整合,独立开展医学机能学实验是必需而紧迫的.

Objective: To investigate the effect of 2,3,5,4'-tetrahydroxy stilbene-2-Ο-β-D-glucoside (THSG) on TGFβ induced epithelial-mesenchymal transition (EMT) in HCT116 cells and further to explore the potential molecular mechanism. Methods: Transforming growth factor β (TGFβ) was used to induce EMT in HCT116 cells, the morphological changes were observed under inverted microscope, and EMT related molecular markers were detected by Western blot. Wound Healing assay, Transwell assay, inverted microscope were performed to detect whether THSG could reverse the motility, migration ability and morphological changes induced by TGFβ, the effect of THSG on EMT-related molecular markers and PI3K/AKT pathway were measured by Western blot. Results: TGFβ treated HCT116 cells transformed from round type to spindle-shaped form, compared with the losing of E-cadherin and increasing of vimentin, N-cadherin. However, combination treatment with THSG neutralized the effect of TGFβ on E-cadherin, vimentin, N-cadherin. Meanwhile, THSG treatment increase the expression of PTEN and suppress p-AKT expression. Moreover, THSG could inhibited TGFβ induced migration and motility ability (F=454.723, P<0.001; F=412.161, P<0.001). Conclusion: THSG can inhibit TGFβ induced EMT in colorectal cancer via PI3K/AKT pathway, and suppress the ability of motility and migration.

目的 探讨新生儿全身动脉系统的三维重建方法及临床意义.方法 采用“环氧树脂-氧化铅”填充剂对1例新生儿解剖标本行全身动脉灌注并铸型,然后行64层螺旋CT薄层扫描,以最大密度投影法(MIP)和容积再现法(VR)重建三维图像.结果 MIP三维图像真实地显示新生儿解剖标本全身主要动脉的走行及分布,连续性强且伪影少;VR三维图像立体感强,三维效果逼真,与血管铸型一致性高.结论 血管灌注铸型与三维重建方法相结合能多层面、多角度、立体化她呈现新生儿全身动脉系统的三维状态,为临床外科和基础医学教学提供形态学基础.

To strengthen higher vocational nursing students' scientific research ability training work and their innovation abil-ity is not only the task which has been put forward by the current era, is also the inherent requirements of higher vocational nursing education reform and internal logic requirements.It’s also the objective requirement of personnel training. It play a great role in nursing teaching. However, Higher vocational medical schools and undergraduate medical colleges has certain difference on the degree of attention to the scientific research and scientific research level. Higher vocational medical schools should work hard to catch-up the large distance between it and the undergraduate medical colleges. Although some students vocational medical colleges has set up scientific research funds.But on the whole, it seems that schools ,especially nursing ma-jor, still don’t enough think highly of cultivating students' scientific research ability and scientific research consciousness, which causing the situation that the proportion of higher vocational nursing students to participate in scientific research work was obviously lower than the proportion of clinical professional students.This paper embark from how to foster research and nursing staff, and what is the problem of higher vocational nursing students scientific research work.And the last ,we present some suggestions and corresponding solutions.

随身课堂是本校自主开发的一种新型移动网络学习平台。肇庆医学高等专科学校生理学课程教学团队通过对随身课堂的二次开发，从教学辅助、教学评价和师生个人知识管理三方面构建了临床医学专业生理学随身课堂，使生理学的学习随时随处想学就学、想问就问，使教学追踪动态达到实时化，很大程度上调动了学生学习的兴趣和热情，变被动学习为主动学习，提高了生理学的教学效率和教学质量。

By redeveloping and integrating Wechat open platform and Moodle,Zhaoqing Medical College built a new comprehensive mobile learning platform called Welearning with abundant teaching resources on the ubiquitous Wechat IMApp.Our physiology teaching team developed the online course of Physiology based on Moodle and used it in teaching assistance,teaching evaluation as well as knowledge management of teachers and students.We have improved the presentation means of mobile learning resources and mobile learner interaction,thus providing a personal and interactive mobile learning environment for learners on their most familiar Wechat IMApp.

目的：观察高脂饮食对大鼠肝组织炎症细胞因子的影响。方法：32只SD大鼠，分成实验组和对照组，实验组高脂饲料喂养；对照组基础饲料喂养；12周后处死大鼠，观察大鼠肝组织病理变化，采用ELISA检测血清TNF-α、IL-6、APN、TGF-β含量，数据采用单因素方差分析。结果：（1）油红O染色可见实验组大鼠肝组织结构紊乱，肝细胞呈现较大的红色脂滴沉积；对照组大鼠肝组织结构正常。（2）与对照组大鼠比较，实验组大鼠血清IL-6及TNF-α水平增加了29.86和48.82%，有显著统计学意义；但实验组与对照组大鼠血清APN及TGF-β没有显著性差异（P>0.05）。结论：高脂饮食会导致肝组织脂肪贮积，NAFLD与TNF-α和IL-6的表达水平密切相关；NAFLD患者的肝纤维化渐进性发展，APN、TGF-β的表达可能与肝纤维化程度有关。

ObjectiveTo explore the protective effect of two styrene glycosides to atherosclerosis due to fluorosis and its mechanism.Methods 60 healthy New Zealand white rabbits were randomly divided into normal control group, model group, positive control group,two styrene glycosides low dose group (low dose group),two styrene glycosides middle dose group (middle dose group),two styrene glycosides high dose group(high dose group) with 10 rabbits in each group.Rabbits in normal control group and model group were givedn the same volume distilled water, rabbits in positive control group were given probucol 250mg/(kg·d),rabbits in low dose group were given probucol 30mg/(kg·d),rabbits in middle dose group were given probucol 60mg/(kg·d),and rabbits in high dose group were given probucol 120mg/(kg·d).Pathological change of the rabbits in each group were observed, and serum lipid levels and plasma apoA1/apoB100 ratio of each group were detected.Results Compared with the normal control group,the TC,TG,LDL-C,HDL-C level of other group were significantly decreased (P<0.05). Compared with the model group,the TC,TG,LDL-C,HDL-C level of positive control group, low dose group, middle dose group, high dose group were significantly decreases (P<0.05).Compared with the positive control group,the TC,TG,LDL-C,HDL-C level of high dose group were significantly decreases (P<0.05).Compared with the normal control group, the plasma ratio apoA1/apoB100 of other group were significantly decreased (P<0.05).Compared with the model group, the plasma ratio apoA1/apoB100 of positive control group, low dose group, middle dose group, high dose group were significantly increases (P<0.05).Compared with the positive control group, the plasma ratio apoA1/apoB100 of high dose group were significantly increases (P<0.05).Compared with the low dose group and middle dose group, the plasma ratio apoA1/apoB100 of high dose group were significantly increases (P<0.05). ConclusionTwo styrene glycosides to atherosclerosis due to fluorosis has a certain protective effect. The mechanism may be related to the regulation of serum lipids and the increase of apoA1/apoB100 ratio in plasma.

目的 了解广东省中小学学校卫生室相关人员及基础设施现状,对其中的问题提出解决的对策. 方法 选取广东省2万多所中小学校,自行设计调查问卷,进行分层抽样调查,比例不小于30％. 结果 广东省中小学学校卫生室设置方面,私立学校明显优于公立学校和民工学校,城区学校在卫生室设置、卫生室面积和取得医疗机构许可证等方面都明显优于乡镇学校.卫生室的设置不足,面积偏小、取得医疗执业许可证的比例很低,中小学之间、城乡之间差异悬殊. 结论 广东省中小学学校卫生室建设配备尚不完全,应尽快采取措施,完善中小学学校卫生室配备,面积及医疗许可等问题,缩小各类别学校及城乡之间的校医基础设施建设差异.

步入21世纪，国家对高等职业教育越来越重视，党的十八大报告提出要加快发展现代职业教育。职业教育的最大特点是产教融合、校院（企）合作，医学职业教育作为职业教育的重要组成部分，如何构建具有自身特色的现代医学职业教育体系是医药卫生类高职高专急需解决的问题。