深度融合信息技术,推动医学教育改革的进一步发展已被医学教育者所广泛接受和认可,文中就多种现代信息技术在医学生临床技能教学中的应用进行了初步的探讨,并对现代信息技术深度融合背景下的医学生临床技能培养模式及发展前景做了展望.

随着技术的不断发展,人工智能在医学诊疗方面的运用越来越广泛,文中阐述了目前人工智能发展的技术水平和特点,对人工智能在医学生临床技能教学中的应用进行了初步探讨,并对人工智能技术在医学教育中的发展前景作了展望.

卓越医生教育培养计划正在深入实施,其中将以学生为中心开展教学、形成学生自主学习能力作为难点着力推进.结合卓医班的改革试点,突出信息技术的应用,支持学生自主学习能力的培养,对临床技能学教学资源进行优化整合,为实现卓医计划项目的实施目标发挥促进作用.

临床技能教学是我国临床医学本科教育阶段的重要内容,是培养学生自主学习和提高学生职业素养的关键环节,更是每个医学生都必须掌握的基本技能.基于问题的学习(problem-based learning,PBL)是使学生在复杂的临床问题中牢固掌握临床基本技能的学习方法和教学模式之一,在国际上已受到广泛认同,因此在国内医学教育界也受到了提倡.由于PBL遵循"以学生为本"的观念,符合现代医学培养模式的思路,总结教师在PBL教学中的定位与职责并阐明教师的多元化作用,有利于推广PBL在卓越医生培养模式下临床技能教学中的应用.

随着社会的进步,传统的医学教育模式难以满足需要,迫切需要改革.以计算机多媒体技术为基础的虚拟仿真教学平台已发展成为新生的医学教育模式,它与诊断学实验教学的结合能提高教学效率和质量,是诊断学教学改革的重要举措之一.

诊断学是医学生必修的一门重要专业课程.如何在诊断学教学过程中选择与构建优化的教学模式与方法,提高教学效果,提升学生的学习兴趣是目前各高校诊断学教学研究的主要方向.本文根据诊断学各章节教学内容的特点,探讨将微课、虚拟仿真以及翻转课堂等信息化教学方式有机运用于诊断学的教学中,有效地促进诊断学教学改革.以期为学生提供丰富的教学资源,提供直观、逼真的学习环境,提高学生动手的机会,锻炼学生的临床思维,调动学生的学习积极性,达到提升诊断学教学质量的目的.

Objective To evaluate the mitomycin C (MMC) treatment on the miRNA expression profile in gastric cancer cells,and provide the theoretical evidences for MMC treatment on gastric cancer.Methods The effects and optimum concentration of MMC were evaluated in the cultured SGC-7901 cells by MMT.The miRNA microarray technique was used for the exploration of miRNA profile of SGC-7901 cells after MMC treatment and the different expression of candidate miRNA was further confirmed by qRT-PCR.Results The inhibition rate of SGC-7901 cells was negatively correlated with the MMC concentration.The 60 miRNAs have changed expression in SGC-7901 cells 48 hours after MMC treatment.Among them,11 miRNAs included miR-498 and miR-1247 were up-regulated,and miR-205* and miR-3924 were down-regulated.Some abnormal expression changes recovered after MMC treatment.Conclusion MMC can regulate the expression of 60 miRNAs including miR-498 in gastric cancer cells.

Objective:To evaluate the association between rs2294008 C＞T polymorphism of prostate stem cell antigen (PSCA) gene and the risk of gastric cancer in East Asian by using Metaanalysis.Methods:A computer-based online search was performed in PubMed,Web of Science,Cochrane Library,Google Scholar,China National Knowledge Infrastructure,Chinese BioMedical Literature database,VlP database and Wanfang database.The case-control studies about the association between PSCA rs2294008C＞T polymorphism and gastric cancer in East Asian before June 6,2016 were collected.The literatures were screened according to the inclusion and exclusion criteria,and the data were extracted after the quality analysis.The Meta-analysis was performed by STATA 14.1 software,and the odds ratio (OR) and 95％ confidence interval (CI) were calculated.Furthermore,the subgroup analysis and Metaregression analysis were used to evaluate the confounding factors,and the sensitivity analysis and publication bias test were performed.Results:A total of 13 case-control studies contained 13 667 patients and 11 868 health controls were included.Meta-analysis showed that the carriers with PSCA rs2294008 CT and TT genotypes had significantly higher risk of gastric cancer as compared with other genotype (OR =1.68,95％ CI:1.43-1.96).The polymorphism distribution of PSCA rs2294008 was significantly different among Chinese,Japanese and Korean populations (P =0.001).Subgroup analyses showed that the risk of gastric cancer on the carriers with PSCA rs2294008CT and TT was significantly increased in Chinese (OR =1.36,95％ CI:1.23-1.49,P =0.004),Japanese (OR =2.61,95％ CI:2.22-3.07,P =0.001) and Korean populations (OR =2.04,95％ CI:1.28-3.27,P =0.012) compared with rs2294008 CC.The sub-group analyses also showed that there was no significant difference in the risk of gastric cancer between the controls from hospitals (OR =1.74,95％ CI:1.23-2.44) and ones from communities (OR =1.64,95％ CI:1.40-1.93).The Meta-regression found the differences in countries and control sources were not the major contribution to the heterogeneity in this analysis (P =0.163,P =0.381).The Begg's funnel plots showed no publication bias (corrected P =0.053),and the sensitivity analysis confirmed the data were steady (OR =1.54,95％ CI:1.45-1.64).Conclusion:The polymorphism of PSCA rs2294008 C＞T is closely associated with the risk of gastric cancer in East Asia.

现代教育技术是培养创新人才的重要手段.随着网络技术的不断进步与信息革命的高速发展,传统教育在先进网络信息技术的冲击下面临着新的挑战.探索适合专业学位研究生的教学模式是专业学位研究生教学研究的重点.虚拟仿真教学是高校教学改革未来发展的一个重要方向,是临床专业学位研究生培养的重要教育手段之一.

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.

临床技能学是从临床技能实践教学的整体出发,以基本临床技能操作与综合临床技能为主要教学内容的实践性课程.及时了解、跟进临床技能学领域的最新理论、最新方法与技术是临床技能学教学中不可或缺的重要组成部分.临床技能学双语网络教学平台的构建对于培养全面发展创新型医学人才有着重要的意义.

目的 分析形成性评价在临床技能学教学中的应用价值.方法 在南华大学2013级临床医学专业学生中,随机抽取一个班的学生作为实验组;另一班的学生作为对照组,实验组在学习过程中进行形成性评价,对照组只进行终结性评价,观察两组的学习效果井对实验组进行问卷调查.结果 实验组学生的学习效果优于对照组,差异有统计学意义(P＜0.05).结论 形成性评价有助于提高学生临床技能学的学习效果.

转化医学是一门新兴的医学科学，旨在促进基础医学研究和临床实践的相互发展。如何在医学教育阶段开始培养医学生的转化医学思维成为各大医学院校面临的重要课题。文章通过诊断学的课程整合、教学方法革新、转化医学师资力量培养等，以阐述如何通过诊断学课程改革培养具有转化医学理念全面发展的医学人才，以促进未来临床医疗水平更快更好地发展。

目的 探讨新诊2型糖尿病(T2DM)患者血浆视黄醇结合蛋白4(RBP4)与亚临床动脉粥样硬化(subAs)的关系.方法 对217例新诊T2DM患者测定血浆RBP4浓度、空腹及餐后血糖、糖化血红蛋白、血脂、空腹胰岛素及颈总动脉内膜中膜厚度(IMT)、髂总动脉IMT、股动脉IMT,分析其subAs的发生情况.结果 合并subAs的T2DM患者平均年龄、空腹胰岛素、血浆RBP4浓度均高于非subAs组患者(均P＜0.05).将患者按RBP4浓度三分位数分组,随RBP4浓度增加,患者颈总动脉IMT、髂总动脉IMT、股动脉IMT均增加,高浓度RBP4组患者的颈总动脉IMT高于其余两组(P＜0.05);随RBP4浓度增加,subAs患病率也逐步升高,高浓度RBP4组患者的subAs患病率显著高于其余两组(P＜0.05).相关分析显示新诊T2DM患者RBP4浓度与颈总动脉IMT、髂总动脉IMT、体质指数、收缩压、血糖、空腹胰岛素呈正相关.多元逐步Logistic回归分析显示:新诊T2DM患者subAs的发生与血浆RBP4、年龄、低密度脂蛋白胆固醇显著相关.结论 新诊T2DM患者血浆RBP4水平与subAs呈正相关关系,血浆RBP4升高可能是新诊T2DM患者subAs的独立危险因素之一.

Objective To investigate the effect and mechanism of 1,25￣dihydroxyvitamin D(1,25(OH)2D3) on palmitic acid( PMA)￣induced inflammatory cytokines expression in THP￣1 macrophage. Methods The THP￣1 macropha￣ges were cultured and incubated with 1,25(OH)2D3(10 nmol/L) and/or PMA(250 μmol/L) for 6h.The RT￣PCR and ELISA technology were used to detect mRNA and protein expression of inflammatory cytokines including TNFα,IL￣1β,IL￣6 and IL￣10 in different groups.The THP￣1 macrophages were treated with 1,25(OH)2D3 and/or PMA for 60min.The west￣ernblot technology was used to detect the expression of AMPKα1 and AMPKα1 phosphorylation. Results 1,25( OH) 2 D3 obviously abolished the effect of PMA on the expression of inflammatory cytokines including TNFα, IL￣1β, IL￣6 and in￣creased the expression of IL￣10 in THP￣1 macrophages. 1, 25 ( OH ) 2 D3 significantly promoted the phosphorylation of AMPKα1 in THP￣1 macrophages. Conclusion 1,25(OH)2D3 can suppress PMA￣induced inflammatory cytokines ex￣pression in THP￣1 macrophages via regulation of AMPKα1 phosphorylation.

医学人文素质教育在独立学院医学人才培养中具有重要地位。本文通过探索立体化教学方法和教学手段，构建医学人文素质教育的立体化教学体系，为提高独立学院医学生医学人文素质教育的教学效果，保证医学人才培养质量，提供了新的思路和帮助。

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 .

Endothelial-to-mesenchymal transition (EndMT) is a parallel process of epithelial-to-mesenchymal transition (EMT), during which endothelial cells down-regulate the endothelial cells markers and acquire the phenotype of mesenchymal cells including proliferation, migration and collagen synthesize. Recent studies have shown that EndMT plays crucial physiological and pathophysiological roles in regulation of endothelial function, the development and structural remodel of cardiac muscle, cardiac valve and blood vessels. In this review, we summary the function and the regulation of the EndMT, and then discuss the potential roles of the EndMT in cardiovascular diseases including cardiac fibrosis, pulmonary hypertension and arteriosclerotic vascular remodeling, which may provide novel targets for the prevention and treatment of cardiovascular diseases.

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。