中国的人体组成学研究:回顾与展望

人体组成学是人体生物学的分支学科之一,主要研究人体内诸多组分的含量与分布、组分之间的数量关系、在活体中测定人体组分的方法、以及体内外各种因素对组分含量的影响。研究人体组成不仅具有生物学意义,也与提高国民体质、增进健康、治疗疾病密切相关。进入21世纪以来,海峡两岸对人体组成的研究呈快速发展的态势,每年平均发表58篇论文,约占全世界此领域论文总数的3.9%。这表明两岸的人体组成学研究,已在世界上占有一席之地。中国对人体组成的研究主要集中在3个方面：对中国人群身体组成特点的研究、对运动与身体组成关系的研究、以及对疾病与身体组成关系的研究。未来,两岸的人体组成研究应该在多方位发展,特别是研究更多的身体组分（如骨骼肌与内脏脂肪组织）、应用先进的测定方法、以及探讨黄种人的身体组成特点。第9届国际人体组成学研讨会于2011年在杭州举行,这必将进一步促进海峡两岸人体组成学研究的发展。     

Using clinical guidelines to assess the potential value of laboratory medicine in clinical decision-making

IntroductionIt is often quoted that 70% of clinical decisions are based on laboratory results, but the evidence to substantiate this claim is lacking. Since clinical guidelines aim to document best-practice decision making for specific disease conditions, inclusion of any laboratory test means that the best available evidence is recommending clinicians use it. Cardiovascular disease (CVD) is the world’s most common cause of mortality, so this study reviewed all CVD guidelines published by five national/international authorities to determine what proportion of them recommended laboratory testing.Materials and methodsFive leading CVD guidelines were examined, namely the European Society of Cardiology (ESC), the UK National Institute for Health and Clinical Excellence (NICE), the American College of Cardiology (ACC), the Australian Heart Foundation (AHF) and the Cardiac Society of Australia and New Zealand (CSANZ).ResultsA total of 101 guidelines were reviewed. Of the 33 individual ESC guidelines relating to CVD, 24/33 made a direct reference to the use of clinical laboratory tests in either diagnosis or follow-up treatment. The same applied to 15/20 of NICE guidelines, 24/32 from the ACC and 15/16 from the AHF/CSANZ. Renal function and blood count testing were the most recommended (39 and 26 times), with lipid, troponin and natriuretic peptide measurement advocated 25, 19 and 19 times respectively.ConclusionsThis study has shown that laboratory testing is advocated by between 73% and 94% of individual CVD guideline recommendations from five national/international authorities. This provides an index to assess the potential value of laboratory medicine to healthcare.     

高职临床医学专业实习教学与管理问题及对策分析

临床实习的效果直接影响毕业生的专业素养和医疗服务水平。该文通过对高职临床医学专业实习存在的管理体制不健全、理论与实际脱节、实习教学模式与学生需求不符等问题的分析,提出推动医教深度融合、强化实习生在校期间的岗位适应能力培养、结合高职临床专业学生的职业定位、制定合理的实习培养模式等策略,以促进临床实习效果的提升。     

高职临床医学专业学生毕业后去向调查分析——以湖南某高职院校为例

该文通过制定调查问卷,对湖南某高职院校在校的2018级、2019级临床医学专业学生毕业后的去向进行了抽样调查,了解了学生毕业后的去向以及影响学生就业的各类因素,以期为学生毕业提供正确的就业指导。     

创建临床技能实训中心 创新医学人才培养模式

为探讨如何培养较强实践能力高素质的医学人才,进一步提高临床医学教育质量,创新医学人才培养模式,第二临床医学院通过建立临床技能培训中心,开展实施临床见习、实习教学与临床技能培训交互融合的教学方式,构建临床医学教育阶段全程临床能力培养模式;并采取医学生自主训练与教师指导有机结合的教学方法改革;使得医学生的临床实践能力有明显提高。同时建立临床理论与实践综合考评体系,探索了加强医学生临床实践能力培养的有效途径,为培养医学人才提供借鉴。     

大理学院临床医学类学生就业指导课教学反思

临床医学类大学毕业生就业去向相对固定集中,其就业指导具有特殊性。医学生的就业教育与专业教育密不可分,具有较强的个性化特征,由于职业准入条件限制和行业特点,毕业生自主创业较难。大理学院的医学教育是综合院校中的医学教育,其职业生涯规划及就业指导也有其特殊性。对其教学内容、教学管理、师资队伍建设、教材教法等方面存在的问题进行反思和探析,推行“全程化”的教学模式,对于促进临床医学类学生成功就业、提高就业质量具有重要意义。     

Discoverability of information on clinical trial data-sharing platforms

Objective:This study was intended to (1) provide clinical trial data-sharing platform designers with insight into users'' experiences when attempting to evaluate and access datasets, (2) spark conversations about improving the transparency and discoverability of clinical trial data, and (3) provide a partial view of the current information-sharing landscape for clinical trials.Methods:We evaluated preview information provided for 10 datasets in each of 7 clinical trial data-sharing platforms between February and April 2019. Specifically, we evaluated the platforms in terms of the extent to which we found (1) preview information about the dataset, (2) trial information on ClinicalTrials.gov and other external websites, and (3) evidence of the existence of trial protocols and data dictionaries.Results:All seven platforms provided data previews. Three platforms provided information on data file format (e.g., CSV, SAS file). Three allowed batch downloads of datasets (i.e., downloading multiple datasets with a single request), whereas four required separate requests for each dataset. All but one platform linked to ClinicalTrials.gov records, but only one platform had ClinicalTrails.gov records that linked back to the platform. Three platforms consistently linked to external websites and primary publications. Four platforms provided evidence of the presence of a protocol, and six platforms provided evidence of the presence of data dictionaries.Conclusions:More work is needed to improve the discoverability, transparency, and utility of information on clinical trial data-sharing platforms. Increasing the amount of dataset preview information available to users could considerably improve the discoverability and utility of clinical trial data.     

286株鲍曼不动杆菌临床分布及耐药性分析

目的 监测鲍曼不动杆菌临床分布特点及耐药性,为临床鲍曼不动杆菌导致的感染性疾病诊断与合理用药提供理论依据.方法 对2012年1至12月襄阳市第一人民医院门诊及住院部送检标本进行常规细菌分离培养和鉴定,并按照NCCLS标准用K-B法对分离的病原菌进行药物敏感试验,统计分析鲍曼不动杆菌临床分布及耐药性.结果 鲍曼不动杆菌在送检标本中主要来源于痰液（80.07％）,其次是尿液（8.04％）、脓汁（5.24％）等;其耐药性严重,耐药率最低的抗菌药物是亚胺培南,也高达49.30％,对阿米卡星、哌拉西林等其余14种抗菌药物耐药性均大于60.00％.结论 鲍曼不动杆菌分离以痰液标本为主,临床上主要引起呼吸道感染;其耐药性严重,应根据药敏试验结果合理选择抗菌药物.     

Self‐Compassion Among College Counseling Center Clients: An Examination of Clinical Norms and Group Differences

There has been growing interest in the mental health benefits of self‐compassion. This study was designed to establish norms on the Self‐Compassion Scale–Short Form, a popular measure of self‐compassion for individuals seeking counseling, and to examine group differences in self‐compassion based on gender, race/ethnicity, sexual orientation, previous counseling, and psychiatric medication use. Data for this study were collected through the Center for Collegiate Mental Health, a practice‐research network of more than 240 college and university counseling centers.     

Anatomy integration blueprint: A fourth‐year musculoskeletal anatomy elective model

Current undergraduate medical school curricular trends focus on both vertical integration of clinical knowledge into the traditionally basic science‐dedicated curricula and increasing basic science education in the clinical years. This latter type of integration is more difficult and less reported on than the former. Here, we present an outline of a course wherein the primary learning and teaching objective is to integrate basic science anatomy knowledge with clinical education. The course was developed through collaboration by a multi‐specialist course development team (composed of both basic scientists and physicians) and was founded in current adult learning theories. The course was designed to be widely applicable to multiple future specialties, using current published reports regarding the topics and clinical care areas relying heavily on anatomical knowledge regardless of specialist focus. To this end, the course focuses on the role of anatomy in the diagnosis and treatment of frequently encountered musculoskeletal conditions. Our iterative implementation and action research approach to this course development has yielded a curricular template for anatomy integration into clinical years. Key components for successful implementation of these types of courses, including content topic sequence, the faculty development team, learning approaches, and hidden curricula, were developed. We also report preliminary feedback from course stakeholders and lessons learned through the process. The purpose of this report is to enhance the current literature regarding basic science integration in the clinical years of medical school. Anat Sci Educ 7: 379–388. © 2014 American Association of Anatomists.