网络新技术在口腔医学本科生教学中的应用探讨

微课、慕课、二维码、线上平台等网络新技术作为信息时代教学变革的产物,已引起教育界对课堂教学改革的新一轮讨论和探索。口腔医学教学应将互联网新技术与教学改革有机结合,推动口腔医学教学的信息化变革。本文以口腔医学本科生教学为例,探讨引入微课、慕课、二维码、线上平台等互联网新技术的重要意义及应用策略,以期促进高校教学的改革。

领跑泌尿外科腔内微创新技术

山东省立医院泌尿腔内微创中心是在山东省立医院领导的大力支持下，于2003年6月1日．由金讯波教授创立的中国目前唯一一家独立的泌尿腔内微创医学中心。该中心下设前列腺及肾上腺疾病研究治疗基地、肾积水研究治疗基地、肾脏膀胱肿瘤研究治疗基地、泌尿系统疾病保健诊疗中心，男性外生殖器美容治疗园、山东省卫生厅继续医学教育泌尿腔内微创培训基地等专项领域。这标志着山东省立医院泌尿腔内微创技术已步^国内先进行列，，该中心人才结构台理，发展前景广阔．

A preliminary study on the teratogenesis of dexamethasone and the preventive effect of vitamin B_(12 )on murine embryonic palatal shelf fusion in vitro

Excessive dexamethasone (Dex) administrated into pregnant mice during critical periods of palatal development can produce a high incidence of cleft palate. Its mechanisms remain unknown. Vitamin B12 has been shown to antagonize the tera- togenic effects of Dex, which, however, remains controversial. In this study, we investigated the effects of Dex and vitamin B12 on murine embryonic palatal shelf fusion using organ culture of murine embryonic shelves. The explanted palatal shelves on em- bryonic day 14 (E14) were cultured for 24, 48, 72 or 96 h in different concentrations of Dex and/or vitamin B12. The palatal shelves were examined histologically for the morphological alterations on the medial edge epithelium (MEE) and fusion rates among different groups. It was found that the palatal shelves were not fused at 72 h or less of culture in Dex group, while they were completely fused in the control and vitamin B12-treated groups at 72 and 96 h, respectively. The MEE still existed and proliferated. In Dex+vitamin B12 group the palatal shelves were fused at each time point in a similar rate to controls. These results may suggest that Dex causes teratogenesis of murine embryonic palatal shelves and vitamin B12 prevents the teratogenic effect of Dex on palatogenesis on murine embryos in vitro.

Prospect of Functional Salivary Gland Enhancement with Biomedical Strategies for Head and Neck Cancers

Xerostomia is the main complication inflicting head and neck cancer patients treated with radiotherapy.Conventional treatment is not very effective in alleviating this morbidity.Biomedical strategies such as gene transfer and tissue engineering have made substantial progress that will potentially lead to successful new treatment options for this condition.This report reviews the process of radiation damage to the salivary glands and the advances in functional salivary gland enhancement with these two brand-new technologies.

Laparoscopic fenestration vs open fenestration in patients with congenital hepatic cysts: A meta-analysis

AIM: To determine whether the outcomes of laparoscopic fenestration (LF) were superior to open fenestration (OF) for congenital liver cysts.METHODS: Comparative studies published between January 1991 and May 2010 on Medline (Ovid),Emsco,PubMed,Science Direct;Cochrane Reviews;CNKI;Chinese Biomedical Database,VIP and other electronic databases were searched.Randomized controlled trials (RCTs) and retrospective case-control studies on the management of congenital hepatic cysts were collected according to the pre-determined eligibility criteria to establish a literature database.Retrieval was ended in May 2010.Meta-analysis was performed using RevMan 5.0 software (Cochrane library).RESULTS: Nine retrospective case-control studies involving 657 patients,comparing LF with OF were included for the final pooled analysis.The meta-analysis results showed less operative time [mean difference (MD): -28.76,95% CI: -31.03 to 26.49,P < 0.00001];shorter hospital stay (MD: -3.35,95% CI: -4.46 to -2.24,P < 0.00001);less intraoperative blood loss (MD: -40.18,95% CI: -52.54 to -27.82,P < 0.00001);earlier return to regular diet (MD: -29.19,95% CI: -30.65 to -27.72,P < 0.00001) and activities after operation (MD: -21.85,95% CI: -31.18 to -12.51,P < 0.0001) in LF group;there was no significant difference between the two groups in postoperative complications (odds ratio: 0.99,95% CI: 0.41 to 2.38,P = 0.98) and cysts recurrence rates.CONCLUSION: The short-term outcomes of LF for patients with congenital hepatic cysts were superior to open approach,but its long-term outcomes should be verified by further RCTs and extended follow-up.

The early efficacy of the nedaplatin and megestrol combine chemoradiotherapy to the advanced cervical cancers

Objective： The aim of this study was to investigate the early outcome of the nedaplatin and megestrol combine chemoradiotherapy to the advanced cervical cancer. Methods： Forty-two cases with cervical cancer （FIGO lib to IVa） were divided randomly into two groups, radiotherapy alone （RT group： 21 cases） and radiation combines chemotherapy （nedaplatin and megestrol） （RT ＋ C group： 21 cases）. There was no difference of radiotherapy between the two groups, the RT ＋ C group accepted nedaplatin injection during the radiation weekly, according to 30 mg/m^2 ,these regimen were given for 4-5 weeks. This group was received an oral medicine megestro1160 mg every day during the treatment. Results： The RT ＋ C group： the complete remission rate was 80.9% （17/21）, the partial remission rate was 19.1% （4/21）, the effective rate was 100%. The RT group： the complete remission rate was 38.1% （8/21） and partial remission rate was 32.9% （9/21）, the effective rate was 81.0%. The total effective rate and complete remission rate of RT ＋ C group were higher than RT group. There was significant difference between the two groups. The 1-year survival rates respectively were 100% （21/21） in RT ＋ C group, 80.9% （17/21） in RT group. There was statistically significant difference between the two groups （x^2 = 4.42 〉 3.84, P 〈 0.05）. Conclusion： The nedaplatin and megestrol combine chemoradiotherapy can improve the early outcome of the advanced cervical cancer, and the adverse effects was raised, but that can be endured.

Exploration and practice of English teaching in Stomatology

Stomatology English as an international language in the academic field, it is the basic skill that oral medicine students uses to understand the academic from, master new technologies in clinical, and expand professional horizons. The study targets for the training the ability of applying stomatology English, exploring and practicing in the teaching materials, teacher training, teaching methods and the language application environment, thus forming a ＂three-step＂ stomatology English teaching mode and gaining effective results.

A rabbit model of graded primary mechanical injury to brainstem

Objective： To introduce a new animal model of graded mechanical primary brainstem injury （BSI）. Methods： Altogether 45 rabbits were subjected to BSI by type II biological impact machine designed by the Third Military Medical University. The animals were divided into 4 experimental groups （n=10） and 1 control group （n=5） ac- cording to different magnitudes of impact pressure imposed on the occipital nodule： Group 1,500-520 kPa; Group 2, 520- 540 kPa; Group 3,540-560 kPa; Group 4, 560-580 kPa and Group 5, 0 kPa with 20 kPa increase in each grade. The im- pact depth was a constant 0.5 cm. After injury, the clinical symptoms and signs as well as pathological changes were observed. Results： Rabbits in Group 1 revealed mild physiologi- cal reaction of BSI. They had localized cerebral contusion with punctate hemorrhage and subarachnoid hemorrhage （SAH） was limited to the peripheral tissues at the impact area. In Group 2, obvious physiological reaction was observed. Local pathological lesions reached the superfi- cial layer of brainstem tissues; focal hemorrhage and girdle- shaped SAH in basilar pon were observed under microscope. In Group 3, BSI was more severe with a long respiratory depression. Pathological lesions reached the inner portionof brainstem with massive hemorrhage and the whole brainstem was wrapped by subarachnoid hematoma. In Group 4, most rabbits died due to severe BSI. Pathological lesions deepened to the central brainstem with wide patho- logical change, rapture of the medulla oblongata central canal. Group 5 was the control group, with normal brainstem structure and no lesion observed. Conclusion： This model successfully simulates differ- ent levels ofbrainstem mechanical injury and clearly shows the subsequent pathological changes following injury. It takes two external parameters （impact pressure and depth） and has a similar injury mechanism to clinical accelerating BSI. Moreover it is reproducible and stable, thus being be- neficial for exploring pathophysiological mechanism, diag- nosis and forensic identification of various degrees of BSI.

Epidemiological study of community- and hospital-acquired intraabdominal infections

Purpose： To investigate and analyze the clinical and etiological characteristics of community-acquired intraabdominal infections （CIAIs） and hospital-acquired or nosocomial intraabdominal infections （NIAIs） in a comprehensive hospital, to understand the characteristics, pathogen composition, and drug resistance of CIAls as well as NIAIs, and to provide a reference for clinical treatment. Methods： We collected the clinical data of patients with intraabdominal infections admitted to our hospital from June 2013 to June 2014. In vitro drug sensitivity tests were conducted to separate pathogens, and the data were analyzed using the WHONET 5.4 software and SPSS 13.0 software. Results： A total of 221 patients were enrolled in the study, including 144 with CIAls （55 mild-moderate and 89 severe） and 77 with NIAIs. We isolated 322 pathogenic strains, including 234 strains of gramnegative bacteria, 82 strains of gram-positive bacteria, and 6 strains of fungi. Based on clinical features, NIAIs and severe ClAls presented significantly higher values in age, length of hospital stay, mortality, and the incidence of severe intra-abdominal infection than mild-moderate CIAIs （p 〈 0.05）. There was no significant difference in the prognosis between NIAIs and severe CIAIs. Primary diseases leading to CIAIs and NIAIs mostly were hepatobiliary diseases and gastrointestinal diseases respectively. Bacteria isolated from various types of IAls mainly were Enterobacteriaceae; mild-moderate CIAIs mostly were mono-infection of gram-negative bacteria; NIAIs mostly were mixed infections of gram-negative and grampositive bacteria; and severe CIAls were from either type of infection. The rate of Extended Spectrum β-Lactamase-producing Escherichia coil and Klebsiella pneurnoniae was much higher in NIAIs than in CIAIs （p 〈 0.05）. The antimicrobial drug sensitivity of gram-negative bacteria isolated from NIAIs was significantly lower than that of CIAIs. Conclusion： CIAIs and NIAIs have their own unique clinical features and epidemiological features of pathogens which should be considered during the initial empiric therapy for the rational use of anti- microbial drugs. Regional IAls pathogenic bacteria have their own features in drug resistance, slightly different from some recommendations of 2010 Infectious Diseases Society of America guidelines.