在计算机课中培养学生的发散思维

计算机课已经成为大学各专业的必修课，有必要在这门应用越来越广泛的课程中加大培养学生的发散思维。本文基于计算机课的学习，探讨了如何培养学生发散思维的问题。     

Tai Ji Quan as an exercise modality to prevent and manage cardiovascular disease: A review

BackgroundRegular exercise is beneficial for adults with cardiovascular disease (CVD) and CVD risk factors. Tai Ji Quan is popular among older adults and may offer additional exercise options. The present article aims to review the scientific literature published within the past decade on Tai Ji Quan as an exercise modality to prevent and manage CVD.MethodsAn electronic literature search of four databases (PubMed, CINAHL, PsycINFO, and AMED) was conducted from April 2003 through March 2013. Studies that examined Tai Ji Quan, were published in English, and specified a target study population of participants with a known CVD condition (e.g., coronary artery disease, chronic heart failure, or stroke) or studies conducted among participants with a CVD risk factor (e.g., hypertension, dyslipidemia, or impaired glucose metabolism) were included.ResultsA total of 20 studies met the inclusion criteria: 11 randomized clinical trials, seven quasi-experimental studies and two cross-sectional studies. The effect of Tai Ji Quan was examined on more than 20 different study variables among persons with coronary artery disease (n = 5 studies), chronic heart failure (n = 5 studies), stroke (n = 4 studies), and CVD risk factors (n = 6 studies). These studies were conducted primarily in Asia (n = 9, 45%) or the United States (n = 8, 40%). Overall, participants enrolled in Tai Ji Quan had better outcomes, though mixed results were reported.ConclusionCollectively, these studies indicate that Tai Ji Quan is a safe form of exercise to prevent and manage CVD. Further research is needed with more rigorous study designs, larger sample sizes, adequate Tai Ji Quan exercise doses, and carefully chosen outcome measures that assess the mechanisms as well as the effects of Tai Ji Quan, before widespread recommendations can be made.     

加长柄人工股骨头置换术治疗高龄股骨粗隆部不稳定骨折15例效果评价

目的：分析和评价加长柄人工股骨头置换术治疗高龄股骨粗隆部不稳定骨折的方法及疗效。方法：本组15例,男10例,女5例;年龄70～90}0,平均79岁。骨折按Evans分类,ⅢA型9例,ⅢB型6例。取髋关节后外侧切口,术中注意保留股骨大、小转子部位的骨折块,用骨水泥固定,争取将其重新复位。由于股骨颈及股骨距骨缺损,在插入人工股骨柄之前可用试模测试。股骨距部位的骨缺损用骨水泥充填重塑,关节腔内置负压引流管48—72h。结果：15例患者均康复出院。住院时间16～24d,平均20d。均获得随访,平均随访时间8个月（6—12个月）,伤口均一期愈合,无感染,无假体松动,无下肢深静脉栓塞发生,无髋关节脱位或半脱位发生,无病人死于手术并发症,12例病人髋关节功能满意。结论：加长柄人工股骨头置换术是治疗高龄股骨粗隆部不稳定骨折的可靠方法,其操作可行,疗效满意,可降低死亡率、改善生活质量。     

葛根素注射液治疗视网膜动脉阻塞疗效研究

本文对葛根素注射液在治疗视网膜动、静脉阻塞及视力近视的临床应用进行了研究分析,经研究发现,葛根素注射液在治疗视网膜动、静脉阻塞疗效很好,优于目前应用的其它药物,同时还可用于治疗近视,对葛根素注射液治疗视网膜动、静脉阻塞的作用机理作了初步探讨.     

金属支架药物涂层释放量的比较

临床应用中的PTCA技术,由于金属支架植入后对血管壁的损伤及异物的炎性反应,可引起内膜增生而导致血管内再狭窄.为解决这一难题,采用药物涂层支架进行控制和预防.通过不同的方式对金属支架表面进行药物涂层,并对药物释放量进行比较.     

股部外伤致肠系膜下动脉栓塞1例

目的:分析股部刺伤与肠系膜动脉栓塞的关系,为防止临床上今后发生类似误诊提供参考;方法:结合临床误诊病例,联系基础医学理论进行分析并行开腹探查;结果:开腹探查证实该例股部刺伤患者急性腹痛乃因肠系膜下动脉的分支———乙状结肠动脉栓塞、乙状结肠坏死所致;结论:股部外伤,尤其是严重刺伤导致大血管破裂并脂肪组织严重损伤时可能引起其他器官脂肪栓塞。     

Coronary arterial spasm in single right coronary artery

We presented a case of anomalous single-coronary artery detected incidentally during routine coronary angiography. A 32-year-old male Chinese patient presented with recurrent pre-syncope and six episodes of syncope. Coronary angiography and coronary-computed tomography (CT)-angiography performed by a dual-source computed tomography (DSCT) revealed that the patient had a single large right coronary artery. A moderately large branch originated from the proximal part of the single right coronary artery and extended to the left, passing the anterior to the pulmonary artery, and divided into the anterior descending artery branch and circumflex branch at the base of the left auricular appendage. The episodes of the syncope were suspected to be caused by coronary arterial spasm, so this patient was on a regimen of 30 mg of diltiazem every 6 h and had no recurrence of syncope during follow-up.     

食管颈段动脉供血体系的解剖学观察

为探讨食管颈段动脉供血体系构筑状况,以期为临床应用补充解剖学资料,利用成、幼尸体25具,红色乳胶灌注后剥离,对其分支吻合进行解剖学观察与系统分析;另取新鲜胎尸25具,其中墨汁灌注20具,钙钴法碱性磷酸酶染色5具后,组织切片,光学显微镜下观测。得出该段食管分支复杂、吻合丰富,各层均存在动脉网,粘膜下层动脉网最为丰富。     

不同频率有氧运动对大鼠离体肠系膜上动脉反应性的影响

目的:研究不同频率的有氧运动对大鼠离体肠系膜上动脉反应性的影响,并探讨其可能的平滑肌钾通道机制。方法:选用8周龄健康雄性Wistar大鼠18只,随机分成三组:安静对照组(SED)、低频有氧运动组(EX-3 d/周)和高频有氧运动组(EX-5 d/周)。运动方案为12周跑台运动,坡度0,°20 m/min,60 min/d。制备去内皮离体肠系膜上动脉血管环,用其测定各组对去甲肾上腺素(NE)、血管紧张素Ⅱ(AngⅡ)、非特异性K+通道阻断剂四乙胺(TEA)、大电导钙激活K+(BKCa)通道阻断剂Iberiotoxin(IbTX)以及BKCa通道开放剂NS1619的反应性变化。结果:各组血管对NE(10-9~3×10-5mol/L)有浓度依赖性收缩,有氧运动组张力增加幅度降低,并且EX-5 d/周张力增加幅度小于EX-3 d/周;AngⅡ(3×10-7mol/L)使血管张力增加,与SED相比,有氧运动组增加幅度明显减小,但EX-3 d/周和EX-5 d/周之间无显著性差异;TEA(3×10-3M)和IbTX(3×10-8M)均诱发血管张力增加,增加幅度EX-5 d/周EX-3 d/周SED;NE(10-5M)引起血管收缩达到最大时,给予NS1619(10-9~10-6M)可诱发血管呈浓度依赖性舒张,有氧运动组舒张反应显著增大,并且EX-5 d/周舒张幅度大于EX-3 d/周。结论:有氧运动可以诱发大鼠肠系膜上动脉的反应性改变,且呈频率依赖性,其中血管平滑肌BKCa通道起着重要作用。     

The Use of Clinical Reasoning Skills in the Setting of Uncertainty: A Case of Trial Femoral Head Migration

Clinical skills and medical knowledge enable physicians to overcome the uncertainty of emergent and rare clinical scenarios. Recently, a growing emphasis on evidence-based medicine (EBM) has flooded medical curricula of universities across the globe with guideline-based material, and while it has given teachers and students new tools to improve medical education, clinical reasoning must be reaffirmed in its capacity to provide physicians with the ability to solve unexpected clinical scenarios. Anatomical education in medical school should have two main objectives: to acquire anatomical knowledge and to develop the skill of applying that knowledge in clinical scenarios. The authors present a clinical scenario in which an unexpected and rare complication occurred during a routine elective hip replacement surgery. The general surgeon presiding over the case, also an anatomy professor, solved the problem using clinical reasoning and anatomical knowledge. It was a clear example of how clinical reasoning is key in approaching unprecedented, rare, or unknown complications. The intention of this scenario is to remind colleagues and medical schools that, although EBM is the standard, educators must uphold sound clinical reasoning to best prepare health care providers for their careers.