如何搞好新形势下的耳鼻咽喉头颈外科教学工作

针对新形势下医学教育的目标及耳鼻咽喉头颈外科学教学特点,对耳鼻咽喉头颈外科学教学内容、教学方法和教学手段予以讨论,以达到提高教学质量、培养新形势下合格人才的目的。     

如何做好耳鼻咽喉头颈外科学的见习带教工作

针对医学教育的目标及耳鼻咽喉头颈外科学见习教学的特点,对耳鼻咽喉头颈外科学见习教学内容、教学方法予讨论,以达到提高见习教学质量,为学生们今后的实习和医疗实践打下良好的基础的目的。     

混合式教学方式在耳鼻咽喉教学中的应用

目的：分析线上线下混合式教学在耳鼻咽喉头颈外科教学中的应用效果。方法：选取2020年8月至2022年12月到我院耳鼻咽喉头颈外科实习的60名本科生,按入科顺序分为实验组30例（线上线下混合式教学）、对照组30例（传统线下教学）。课程结束后分别对理论课成绩、实践操作成绩和教学质量评分进行统计记录。采用SPSS 19.0进行卡方检验和t检验进行统计学分析。结果：实验组专业知识、病史搜集、查体、初步诊断、辅助检查、诊疗方案得分高于对照组,差异有统计学意义（P<0.05）。实验组术前准备、手术部位、手术操作、术后并发症的处理得分高于对照组,差异有统计学意义（P<0.05）。实验组学习兴趣、解决问题能力、临床思维、自主学习、教学模式认可得分明显高于对照组,差异有统计学意义（P<0.05）。结果：混合式教学在耳鼻咽喉头颈外科教学优于传统讲授教学。     

法绘制出幽门螺旋杆菌蛋白质图谱

法国 Hybrigenics公司新绘制成一张蛋白质图谱，揭示出幽门螺旋杆菌体内蛋白质相互作用的关系。专家认为，这一成果将有助于研究这种细菌体内各种蛋白质的功能，寻找胃溃疡等疾病的新疗法。 科学家在 1月 11日出版的英国《自然》杂志上报告说，他们绘制出的这张幽门螺旋杆菌蛋白质图谱，标识了该细菌体内蛋白质之间 1200种可能的相互作用。图谱涉及到了幽门螺旋杆菌体内约一半种类的蛋白质。 幽门螺旋杆菌生存于人胃部幽门部位，是最常见的细菌病原体之一。统计表明，世界一半以上的人口受该病菌感染。胃溃疡、胃炎、胃癌等一系列疾病据认…     

耳鼻咽喉临床见习带教中的难点及对策

耳鼻咽喉科具有不同于其他临床大内科、大外科的特点,临床医师需要较强的动手操作能力,对医学生的临床见习教学至关重要。本文就耳鼻咽喉医学生临床见习中存在的难点进行研究与分析并提出对策。     

PBL教学法在耳鼻咽喉头颈外科临床教学中的应用

探讨以问题为基础的教学法在耳鼻咽喉头颈外科临床带教中的应用;将60名临床实习生按轮转顺序,随机分成PBL教学法实验组和传统教学法对照组,在实习结束后进行相同内容的理论考核和临床技能考核,统计成绩可知,PBL+传统教学法在调动实习生的积极性和主动性、促进理论联系实际、提高临床实践能力以及加快角色转换等方面明显优于传统教学组,PBL教学法可获得良好的教学效果,有必要采用新的教学方法来提高耳鼻咽喉科临床教学效果。     

关于耳鼻咽喉—头颈外科留学生教学实践的思考

近年来一批海外留学生来我校学习临床医学专业。留学生教学工作具有特殊性和挑战性,我们对留学生在耳鼻咽喉—头颈外科学基础理论学习与临床实践进行了有意义地尝试,为更好地进行留学生理论教学和临床带教工作提供参考。     

幽门螺旋杆菌与颈动脉粥样硬化斑块和血浆脂蛋白相关磷脂酶A2水平的关系

目的：对消化科门诊幽门螺旋杆菌感染患者的颈动脉粥样硬化与血浆脂蛋白相关磷脂酶A2进行分析,探讨幽门螺旋杆菌与颈动脉粥样硬化斑块和血浆脂蛋白相关磷脂酶A2浓度的关系.方法：将随机入组的75例幽门螺旋杆菌阳性患者、75例幽门螺旋杆菌阴性患者行颈动脉彩色多普勒检查和血浆脂蛋白相关磷脂酶A2测定.结果：不稳定斑块组血浆Lp-PLA2水平高于稳定斑块组和无斑块组,稳定斑块组血浆Lp-PLA2水平高于无斑块组.差异具有统计学意义（P<0.05）.Hp阳性组患者斑块不稳定性高于Hp阴性组患者的不稳定性,两组之间差异有统计学意义（P<0.05）;Hp阳性组患者Lp-PLA2浓度高于Hp阴性组患者Lp-PLA2浓度,两组之间差异有统计学意义（P<0.05）.结论：1.血浆脂蛋白相关磷脂酶A2水平反映颈动脉斑块的稳定性;2.幽门螺旋杆菌感染与否影响斑块的稳定性;3.幽门螺旋杆菌感染与否影响血浆脂蛋白相关磷脂酶A2水平.     

一例藏区病员颈部树枝异物的护理

正颈部是人体暴露部位,易发生外伤,通常以切割伤和穿通伤为主,常常损伤颈部大血管和神经,以及颈部重要组织,危及生命安全。我院耳鼻咽喉头颈外科于2013-4-18收入一颈部包块的藏区病员,长12cm、直径1cm大小的树枝状异物损伤颈部,且沿颈部组织走行,没有进入咽腔和喉腔,形成穿通伤和切割伤,更没有损伤颈部大的血管、神经及颈部重要的组织,比较少见。病员对颈部有异物也浑然不知,长达一月有余,直到手术时才取出,     

胃溃疡是由幽门螺旋杆菌引起的

胃溃疡是由幽门螺旋杆菌引起的洪昀，王起经过长期努力，幽门螺旋杆菌的研究开始取得成果。经过１０年激烈争论和大量研究，胃溃疡是由幽门螺旋杆菌引起而且是可以用抗菌素药物医治的一种传染病之一学说已经盛行，它曾一度被视为异端。而现在，一些领先的研究人员正在转向...     

The impact of gross anatomy on the future head and neck surgeon

Gross anatomy is not only a rite of passage for medical students as they enter the world of practicing medicine but may also be an unrecognized fork in the road in their pursuit of choosing a medical specialty. Otolaryngology: head and neck surgery tends to be poorly represented in medical school curriculum, often only offered as an elective rotation. However, head and neck anatomy remains a constant in most medical schools, granting some exposure to otolaryngology whether students realize it or not. A common thread among most head and neck surgeons in their decision to pursue this surgical specialty is a love for head and neck anatomy, spawned in that first year gross anatomy course. This first and potentially only exposure to otolaryngology should be optimized, as it can have a profound effect in the selection of otolaryngology as a specialty. This introduction can be facilitated by (1) inviting otolaryngology residents to assist during the dissection of the head and neck, (2) soliciting otolaryngology attending physicians to provide clinical correlation lectures, and (3) anatomy professors should identify students who excel in the head and neck portion of the curriculum and direct them towards otolaryngology mentors. There may be a great missed opportunity if a career in otolaryngology is not discussed with students during the dissection of the head and neck. Anat Sci Ed 2:89–90, 2009. © 2009 American Association of Anatomists.     

Distribution of H.pylori antigens in gastric mucosa and its significance

Objective: To investigate the distribution of H. pylori antigens in the gastric mucosa in patients with H. pylori infection, and the relationship between the distribution and gastric cancer. Methods: Of 112 patients confirmed by pathological study to have chronic superficial gastritis, precancerous changes (chronic atrophic gastritis, intestinal metaplasia or atypical hyperplasia) and gastric cancer, 28 were H. pylori negative and 84 were H. pylori positive. H. pylori antigens in the gastric mucosa were detected by immunohistochemistry. Results: The H. pylori positive group, comprised 12 of 22 (50.0%) in the chronic superficial gastritis group, 22 of 25 (88.0%) in the precancerous changes group and 13 of 35 (37.1%) in the gastric cancer group. The positive rates of H. pylori antigens in the cytoplasm progressively increased, respectively at 0.0% (0/12),63.6% (14/22) and 84.6% (11/13) for the same groups (χ2=19.76, P=0.000); H.pylori antigens were located in the mucus layer and above the neck of the mucosal gland in 9 of 12 (75.0%) cases with chronic superficial gastritis, at the neck of the mucosal gland and the isthmus in 12 of 22 (54.5%) cases with precancerous changes, below the isthmus in 9 of 13 (69.2%) cases with gastric cancer (x2=25.30, P=0.000). In the H. pylori negative group, no H.pylori antigen was observed. Conclusion: With the progression of chronic superficial gastritis→precancerous changes→gastric cancer, H. pylori antigens progressively migrated from the outer part to the inner part of the cell, and from the superficial to the deep gastric mucosa.     

Distribution of H.pylori antigens in gastric mucosa and its significance

INTRODUCTION Helicobacter pylori (H.pylori) was grouped as a class I carcinogen by the International Agency for Research on Cancer in 1994. A direct relation be-tween H.pylori infection and gastric carcinogenesis was demonstrated in 1998 in an experimental animal model (Watanabe et al., 1998). However, the role of H.pylori in human gastric carcinogenesis is sup-ported almost exclusively by epidemiological data and prospective histopathological studies. So far the mechanism of H.pylor…     

胃癌主要危险因素研究进展

胃癌是人体常见的恶性肿瘤之一，其危险因素众多。出门螺杆茵、基因多态性、饮食因素、吸烟及体内微量元素的含量都会影响胃癌的发生。通过综述发现，出门螺杆茵可引起胃癌发病增加；GSTM1、ras、P53等基因可诱导胃癌发生；腌制、熏烤食品及吸烟可引发胃癌；饮酒与胃癌的关系尚不明确。     

脊柱颈前屈程度与颈部运动功能关系的研究

揭示脊柱颈前凸对头颈前屈后伸,左右侧屈活动功能和影响,对大连大学1-4年级109名普通男女学生进行了颈前凸和颈部运动功能的测定,结果显示,男女学生颈前凸的均值达5.31 cm,脊柱颈段异常弯曲者居多,并且随颈前凸的分层加大,颈前凸与头颈屈,头颈侧屈的相关系数较小。     

Diagnosis and treatment of primary spontaneous pneumothorax

Primary spontaneous pneumothorax (PSP) commonly occurs in tall, thin, adolescent men. Though the pathogenesis of PSP has been gradually uncovered, there is still a lack of consensus in the diagnostic approach and treatment strategies for this disorder. Herein, the literature is reviewed concerning mechanisms and personal clinical experience with PSP. The chest computed tomography (CT) has been more commonly used than before to help understand the pathogenesis of PSP and plan further management strategies. The development of video-assisted thoracoscopic surgery (VATS) has changed the profiles of management strategies of PSP due to its minimal invasiveness and high effectiveness for patients with these diseases.     

试谈《颈腱反射》在田径教学中的作用

颈腱反射就是当视觉和头部位置改变时,造成颈部肌肉和颈腱的紧张而产生本能性的反应,使肢体和躯干产生相应的动作,以维持身体常态遭到破坏后的平衡.这种颈腱反射与体育运动有着密切的关系,特别是田径运动的每一个旋转动作都伴随有颈腱反射.     

Evaluation of the effectiveness of 3D vascular stereoscopic models in anatomy instruction for first year medical students

The head and neck region is one of the most complex areas featured in the medical gross anatomy curriculum. The effectiveness of using three‐dimensional (3D) models to teach anatomy is a topic of much discussion in medical education research. However, the use of 3D stereoscopic models of the head and neck circulation in anatomy education has not been previously studied in detail. This study investigated whether 3D stereoscopic models created from computed tomographic angiography (CTA) data were efficacious teaching tools for the head and neck vascular anatomy. The test subjects were first year medical students at the University of Mississippi Medical Center. The assessment tools included: anatomy knowledge tests (prelearning session knowledge test and postlearning session knowledge test), mental rotation tests (spatial ability; presession MRT and postsession MRT), and a satisfaction survey. Results were analyzed using a Wilcoxon rank‐sum test and linear regression analysis. A total of 39 first year medical students participated in the study. The results indicated that all students who were exposed to the stereoscopic 3D vascular models in 3D learning sessions increased their ability to correctly identify the head and neck vascular anatomy. Most importantly, for students with low‐spatial ability, 3D learning sessions improved postsession knowledge scores to a level comparable to that demonstrated by students with high‐spatial ability indicating that the use of 3D stereoscopic models may be particularly valuable to these students with low‐spatial ability. Anat Sci Educ 10: 34–45. © 2016 American Association of Anatomists.     

Study on the serum levels of soluble intercellular adhesion molecule-1 (sICAM-1) in patients with Helicobacter pylori Infection

Objective: To evaluate the interaction between serum levels of soluble intercellular adhesion molecule-1 (sICAM-1) and Helicobacter pylori (H. pylori) infection in patients with chronic gastritis and peptic ulcer. Methods: The serum levels of sICAM-1 in 205 patients with chronic gastric diseases were detected by ELISA method and the status of H. pylori was determined by histologic examination, RUT, 14C - UBT, and serology. The sera obtained from 18 healthy volunteers served as controls. Results: The serum levels of sICAM-1 were significantly higher in patients with H. pylori positive than those of H. pylori negative (889.43±32.52 ng/ml vs. 747.07±30.45 ng/ml, P<0.05). The serum levels of sICAM-1 in patients with mild, moderate and severe infection of H. pylori were 841.68±72.36 ng/ml, 905.43±37.59 ng/ml and 1012.54±49.34 ng/ml,respectively (P<0.05). The serum levels of sICAM-1 proved to be significantly correlated with the density of H. pylori colonization in gastric mucosa (rs =0.316, P<0.001). The serum levels of sICAM-1 in patients with chronic gastritis and peptic ulcer were significantly higher than those in healthy controls (P<0.05). Conclusions: These results indicated that H. pylori infection up-regulates the expression of sICAM-1.     

三联疗法结合微生态制剂治疗幽门螺杆菌感染的临床研究

目的：探讨微生态制剂联合兰索拉唑、克拉霉素片、阿莫西林胶囊在幽门螺杆菌感染治疗中的疗效及安全性。方法：将118例慢性胃炎或消化性溃疡且经快速尿素酶试验、病理切片染色镜检、13C-尿素酶呼气试验检测幽门螺杆菌任何两项阳性患者随机分为联合治疗组60例,常规三联方根除治疗（兰索拉唑＋克拉霉素＋阿莫西林胶囊）加0．35g双歧杆菌片0．7g2次／d,口服,与抗菌药物间隔2h服用,疗程14d。对照组58例,常规三联方根除治疗（兰索拉唑＋克拉霉素＋阿莫西林胶囊）不使用双歧杆菌,疗程14d。治疗结束4周后复查”C－尿素酶呼气试验。比较两组根除率及不良反应发生率。结果：联合治疗组根除率80％,对照组根除率77．5％,两组间差异无统计学意义（P〉．05）,但是联合治疗组不良反应发生率6．7％与对照组不良反应发生率22．4％比较差异具有统计学意义（P〈0．05）。结论：常规三联疗法结合双歧杆菌片在幽门螺杆菌感染治疗中不良作用少,患者依从性较好,值得临床推广和应用。