ＰＢＬ与ＬＢＬ教学法在眼科临床见习教学中的比较研究

为了提高眼科临床见习教学质量,改革传统教学方法,文章对132名2002级学生按专业分组后,分别施之以问题为基础的(PBL)教学法和以授课为基础的(LBL)教学法进行眼科临床见习教学,比较评价两种教学法的教学效果。结果表明,采用PBL教学法的学生测验平均成绩和高分人数及学生对教学效果评价指标的优良率均明显高于采用LBL教学法,从而说明PBL教学法的教学效果明显优于LBL教学法,PBL教学法值得在眼科临床见习教学中推广应用。     

法律诊所式教育可行性对策思考

法律诊所式教育在弥补了传统法学教育的弊端的基础上近年在中国获得了飞速的发展。但是,对其“本土化”的争论引起了人们的思考。法律诊所式教育应该如何适用,影响法律诊所式教育可行性的原因有哪些,本文基于此,结合中国的现实,提出了相应具有实际意义的解决对策,期望对中国的法律诊所式教育的发展做出一定的贡献。     

论诊所式法律教育

诊所法律教育作为一种新型的教学模式,是对中国传统法学教育模式的改革与创新。但是,目前诊所教育在我国确实存在一定的问题,正视这些问题对于发展诊所法律教育,使其具有强大的生命力具有重要作用。     

糖尿病高血糖危象临床治疗体会及分析

目的探讨分析糖尿病高血糖危象的治疗方法和临床疗效。方法回顾分析我院2013年4月至2013年12月治疗的80例糖尿病高血糖危象患者的临床资料,采用随机数字表法分为2组,各40例,两组均充分补液、纠正电角质失调,根据患者情况采取补钾、适量补碱治疗,同时积极寻找和消除诱因,防治并发症,在胰岛素治疗及纠正水电解质酸碱紊乱、防治并发症方面,A组采用胰岛素泵连续皮下输入胰岛素治疗及小剂量胰岛素静滴,部分患者配合血液净化治疗;B组采用静脉滴注小剂量胰岛素及餐前皮下注射胰岛素治疗,对比其疗效。结果两组血糖均显著降低,前后差异具有统计学意义（P〈0．01）,A组平均血糖低于B组,差异具有统计学意义（P〈0．01）,A组出现低血糖概率大于B组,但A组发生血糖反复概率较少,纠正水电解质酸碱紊乱效果较好,并发症少,差异显著（P〈0．01）。结论在补液、补充电解质及小剂量胰岛素治疗,配合血液净化、消除诱因可有效降低糖尿病患者血糖,使其趋于稳定,减少并发症发生,降低病死率。     

Three-stage designs for monitoring clinical trials

Optimal three-stage designs with equal sample sizes at each stage are presented and compared to fixed sample designs, fully sequential designs, designs restricted to use the fixed sample critical value at the final stage, and to modifications of other group sequential designs previously proposed in the literature. Typically, the greatest savings realized with interim analyses are obtained by the first interim look. More than 50% of the savings possible with a fully sequential design can be realized with a simple two-stage design. Three-stage designs can realize as much as 75% of the possible savings. Without much loss in efficiency, the designs can be modified so that the critical value at the final stage equals the usual fixed sample value while maintaining the overall level of significance, alleviating some potential confusion should a final stage be necessary. Some common group sequential designs, modified to allow early acceptance of the null hypothesis, are shown to be nearly optimal in some settings while performing poorly in others. An example is given to illustrate the use of several three-stage plans in the design of clinical trials.     

完善临床医学研究生培养规范探讨

作为临床医学研究生教育,不仅要培养学生的医学科研攻关能力、敏锐的实验洞察能力、严谨求实的科学精神、逻辑推理与判断能力以及开拓进取的创新能力,而且要培养学生的理论与实际最佳结合的实践操作能力,同时还要培养学生良好的医学伦理与职业道德,具备稳定的心理素质等.本文对医学伦理与职业道德、临床医学理论与知识、临床实践技能等方面的培养规范进行了分析.     

Re-inscribing Gender in New Modes of Medical Expertise: The Investigator-Coordinator Relationship in the Clinical Trials Industry

This article analyses the ways in which research coordinators forge professional identities in the highly gendered organizational context of the clinic. Drawing upon qualitative research on the organization of the clinical trials industry (that is, the private sector, for profit auxiliary companies that support pharmaceutical drug studies), this article explores the relationships between predominantly male physician-investigators and female research coordinators and the constitution of medical expertise in pharmaceutical drug development. One finding is that coordinators actively seek to establish relationships with investigators that mirror traditional doctor-nurse relationships, in which the feminized role is subordinated and devalued. Another finding is that the coordinators do, in fact, have profound research expertise that is frequently greater than that of the investigators. The coordinators develop expertise on pharmaceutical products and diseases through their observations of the patterns that occur in patient-participants' responses to investigational drugs. The article argues, however, that the nature of the relationships between coordinators and investigators renders invisible the coordinators' expertise. In this context, gender acts as a persistent social structure shaping both coordinators' and investigators' perceptions of who can be recognized as having authority and power in the workplace.     

Differences in Caregiver Self-Efficacy and Satisfaction Related to Sexual Abuse of Offspring

Research suggests parents of sexually abused children may experience negative perceptions of themselves and their parenting abilities following the victimization of their children, which may influence the recovery process in treatment for these families. This study assessed perceived self-efficacy and parenting satisfaction among female caregivers of sexually abused children and female caregivers whose children were not victimized. Results indicated that caregivers of child victims had significantly lower levels of perceived parenting efficacy than their counterparts. There were no significant differences found between groups with regard to parenting satisfaction. The results highlight the importance of evaluating perceived parenting competence in the treatment of nonoffending caregivers in order to facilitate optimal treatment of the child victim and all members of the family system.     

Proposed best practice for statisticians in the reporting and publication of pharmaceutical industry‐sponsored clinical trials

In this paper we set out what we consider to be a set of best practices for statisticians in the reporting of pharmaceutical industry‐sponsored clinical trials. We make eight recommendations covering: author responsibilities and recognition; publication timing; conflicts of interest; freedom to act; full author access to data; trial registration and independent review. These recommendations are made in the context of the prominent role played by statisticians in the design, conduct, analysis and reporting of pharmaceutical sponsored trials and the perception of the reporting of these trials in the wider community. Copyright © 2010 John Wiley & Sons, Ltd.