Table of Content

25 August 2014, Volume 31 Issue 4

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Study on the preparation and stability of the lysozyme-stabilized silver nanoparticles

ZHAO Yali,YANG Tao,ZHANG Ying,GAO Hongyun,XI Yanan

2014, 31(4):  1-7,19.  DOI: 10.3969/j.issn.1674-490X.2014.04.001

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Objective We have synthesized silver nanoparticles using protein as the stabilizer and discussed their stability to provide theoretical guidance for their application in biomedical ifeld and daily life. Methods We have presented a one-step approach of chemical reduction to prepare the lysozyme-stabilized silver nanoparticles. Results The stability of lysozyme-stabilized silver nanoparticles was sensitive to the change of ionic strength and the nanoparticles precipitated completely in 10 mmol/L NaCl. The lysozyme-stabilized silver nanoparticles were stable under acidic condition (pH≤6). And the freeze-thawing cycle had a little inlfuence on their stability. Conclusion The stability of lysozyme-stabilized silver nanoparticles is greatly inlfuenced by the surrounding conditions. The variation caused by the stability factors should be considered for use and storage of the lysozyme-stabilized silver nanoparticles.

Correlation and significance of acute organophosphorus pesticide poisoning with CD8+CD28+T cells, CD8+CD28-T cells

PENG Guangjun,YANG Weihong,CAO Guohui,CHANG Haizhe,JIA Xuemei

2014, 31(4):  8-11.  DOI: 10.3969/j.issn.1674-490X.2014.04.002

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Objective To investigate the early blood drug concentration correlations of acute methamidophos poisoning with T lymphocyte subsets. Methods 92 patients with acute methamidophos pesticide taken orally admitted into Affiliated Hospital of Hebei University between January, 2007 to June, 2013 were selected. According to the degree of poisoning, they were divided into mild, moderate poisoning group (54 cases) and severe poisoning group (38 cases), another 92 healthy people who taken physical check-up as control group. Detection and analysis of the relationship between serum drug concentration and toxic CD3+, CD8+, CD8+CD28+, CD8+CD28-were conducted. Results The concentration of blood drug level of severe poisoning group was significantly higher than that of mild and moderate poisoning group (P<0.01). CD3+, CD8+, CD8+CD28+cell number were decreased signiifcantly than that of mild and moderate poisoning group (P<0.01). but the number of CD8+CD28-cells were significantly increased than that of mild and moderate poisoning group (P<0.01). Conclusion The higher the early blood drug concentration of acute methamidophos poisoning, the degree of poisoning is severer, the more seriously impaired the immune cells are.

Infection and drug resistance of pathogens in lower respiratory tract of patients with acute explosion chronic obstructive pulmonary disease

ZHAO Xueqin,YANG Wei,ZHAO Hongxia

2014, 31(4):  12-15.  DOI: 10.3969/j.issn.1674-490X.2014.04.003

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Objective To analyze the distribution of pathogens tract and their drug resistance in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods The sputum samples of 110 AECOPD patients from our hospital and the pathogen species in all samples were tested. The drug sensitivity was determined. Results Of all the pathogens found in AECOPD patients, 50.69% were Gram-negative, 39.33% were epiphytes, 7.87 % were Gram-positive, 33.70% of the patients were co-infected by more than two pathogens. Among the Gram-negative bacilli, the main pathogens included Pseudomonas aeruginosa, Acinetobacter baumannii and Egypt hopes the fungus. Among the Gram-positive cocci, the main pathogens included Staphyloccus aureus and Streptococcus pneumoniae, The results of drug sensitivity test showed that most of the Gram-negative bacilli were more sensitive to imipenem, meropenem, cefepime, ceftazidime,cefoperazone shubatan, pipercillin, pipercillin and tazobactam, levolfoxacin, ciprolfoxacin and aztreonam. The epiphytes were highly sensitive to amphoteric enzyme, lfuconazol, itraconazole and voriconazole, while most of the Gram-positive cocci were more sensitive to vancomycin,linezolid,leicoplanin,cefuroxime,cefotaxime sodium and chloramphenicol. Conclusion Gram-negative bacilli are predominant in lower respiratory tract in AECOPD patients The ratio of mycotic infection and mixed infection are high, to which more attention should be paid. Drug resistance should be considered adequately to be used appropriately.

Clinical effects of Sanjie Snalgesic capsule combined with Mirena in treating uterine adenomyosis

MA Youju,MA Xiaoli

2014, 31(4):  16-19.  DOI: 10.3969/j.issn.1674-490X.2014.04.004

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Objective To explore the clinical effects of Sanjie Snalgesic capsule and mirena in the treatment of uterine adenomyosis. Methods The patients with uterine adenomyosis in our hospital were collected at random,and they were treated with mifepristone, mirena, Sanjie Snalgesic capsule and mirena. The degree of dysmenorrheal, uterine volume, HGB, serum CA125 level of the three groups before and after 3 months treatment were observed. Results After 3 months treatment, the symptoms of three groups were improved effectively. All patients were amenorrhea.The degree of dysmenorrheal, uterine volume, serum CA125 level of the mirena, Sanjie Snalgesic capsule and mirena groups were signiifcantly lower than those in the mifepristone group, otherwise the level of HGB was significantly higher. The degree of dysmenorrheal, uterine volume, serum CA125 level of the Sanjie Snalgesic capsule and mirena group was signiifcantly lower than those in the mirena group. Conclusion The Sanjie Snalgesic capsule and mirena has a good synergy effect in treating uterine adenomyosis, it can improve the clinical effects, reduce the adverse reaction of using myopathy, it is worthy of clinical popularization.

Clinical study of acute cypermethrin poisoning afifliated with acute alcohol intoxication

JU Hailong,LIANG Lu,MA Yueyun

2014, 31(4):  20-22.  DOI: 10.3969/j.issn.1674-490X.2014.04.005

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Objective To determine the effects of plasma concentration of alcohol on blood cypermethrin concentration and the prognosis of the patients when acute cypermethrin poisoning afifliated with acute alcohol intoxication. Methods 60 cypermethrin poisoning cases were divided into mixed cypermethrin group and cypermethrin group , blood samples were taken on admission from patients, the cypermethrin concentration were detected, blood alcohol concentration also detected in mixed group. Sex, age, cypermethrin concentration, mortality rate were analysised, meanwhile, speaman correlation were used to investigate whether associations between alcohol and cypermethrin. Results Compared with patients with no alcohol in their blood, patients with detectable alcohol were more likely to be male, the cypermethrin concentration and death rate were more higher than control group (P<0.05). There was a positive correlation between alcohol and cypermethrin levels. Conclusion Acute cypermethrin poisoning afifliated with acute alcohol intoxication is associated with higher blood concentrations of cypermethrin and increased risk of death.

Comparison of increase of the dose of cisatracurium and rocuronium on the onset time and the clinical duration

WU Yi,LI Yongle,WANG Hongjie

2014, 31(4):  23-26.  DOI: 10.3969/j.issn.1674-490X.2014.04.006

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Objective To study the effects of the increase of the dose of cisatracurium and rocuronium on the onset time and the clinical duration. Methods 120 patients ASAⅠ-Ⅱ, aged 30-55 years, scheduled for elective gynecologic surgery were randomly divided into four groups(n=30). Group A received cisatracurium 0.10 mg/kg(2×ED95). Group B received cisatracurium 0.15 mg/kg (3×ED95). Group C received cisatracurium 0.2 mg/kg(4×ED95). Group D received rocuronium 0.9 mg/kg. Neuromuscular block was monitored by a TOF Watch SX accelerograph. The onset time and the clinical duration were recorded. Results The onset times for group A, B, C and D were (226±57)s, (184±56)s, (135±45)s, (80±25)s seconds respectively. Compared with group A, B, D, there was statistically difference between group C and those groups (P<0.05). The clinical effective time were (33±5)min, (41±8)min, (53±8)min, (42±11)min among group A, B, D, respectively, compared with group A, B, D, there were signiifcant difference between group C and those groups (P<0.05).Conclusion Increasing dose could signiifcantly shorten cisatracurium onset time of intubation. But compared with rocuronium, clinical duration is longer. Cisatracurium is not suitable for short surgical operation. The clinical effects of rocuronium time variability controllability, cisatracurium is better than that of rocuronium.

Clinical studies of different sizes myomectomy during cesarean section

WU Xiaofeng

2014, 31(4):  27-29.  DOI: 10.3969/j.issn.1674-490X.2014.04.007

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Objective To discuss the safety and feasibility of resection in cesarean on different sizes of fibroids. Methods 64 cases with cesarean excision of uterine Leiomyoma (34 cases with small cesarean section, 30 cases with large cesarean section) were selected from January, 2007 to December, 2012 in the study. 60 cases with cesarean section without fibroids during the same period were selected as the control group. Their operating time, intra-operative and postoperative 24h bleeding, anal exsuflfation time after surgery, postoperative morbidity, hospital stay and lochia clean time were compared. Results The surgery time was longer than that of the controls. There were signiifcant difference between the 2 groups (P<0.05). There were not other signiifcant difference between the 2 groups concerning the other related factors(P>0.05). Conclusion Selecting the right case, BOC ifbroid excision cesarean was safe and feasible, and may dispense with the second operation and alleviate the ifnancial burden on the patients.

Yiqiyangwei decoction combined with western medicine in the treatment of chronic atrophic gastritis (Report of 60 cases)

LU Ruixiang,ZHANG Qiuping,HAO Bin

2014, 31(4):  30-33,56.  DOI: 10.3969/j.issn.1674-490X.2014.04.008

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Objective To observe the clinical therapeutic effects of Yiqiyangwei decoction in treating chronic atrophic gastritis. Methods 120 cases were randomly divided into two groups, treatment group and control group. The treatment group were treated with Yiqiyangwei decoction with clarithromycin, amoxicillin and omeprazole. The control group were treated with clarithromycin, amoxicillin and omeprazole. Each treated for 12 weeks. Results Compared with the control group, there was signiifcant difference (P<0.05) in clinical effects and such symptoms as epigastric pain and epigastric fullness. And there was no signiifcant difference (P<0.05) in belching, anorexia and loose stool. Conclusion Applying Yiqiyangwang decoction with clarithromycin, amoxicillin and omeprazole has better therapeutic effects in the treatment of chronic atrophic gastritis in clinical practices.

Association of neutrophil-lymphocyte ratio with left atrial thrombus in patients with nonvalvular atrial ifbrillation

AN Yanxiao,LIU Keye,WANG Yang,LUO Zhiqiang,HAN Zhe,LIU Fulin

2014, 31(4):  34-37.  DOI: 10.3969/j.issn.1674-490X.2014.04.009

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Objective To compare NLR among patients with nonvalvular atrial ifbrillation (AF) with or without left atrial (la) thrombus. Methods 155 patients with nonvalvular AF undergone transthoracic echocardiography (TTE) were selected to assess the presence of la thrombus. Baseline NLR was measured by dividing neutrophil count to lymphocyte count. Results Left atrial thrombus was detected in 16(10.3%) of 155 patients. Mean NLR (2.8 ± 1.2, 2.0 ± 1.1, P=0.023) was significantly higher among patients with la thrombus compared to patients without la thrombus. On multivariate analysis, NLR (odds ratio 1.78, 95%conifdence interval 1.93-4.24, P<0.001) was an independent risk factor for the presence of la thrombus in patients with nonvalvular AF. Conclusion Neutrophil-lymphocyte ratio, an emerging marker of inlfammation, is independently associated with the presence of la thrombus in patients with nonvalvular AF.

Analysis on iodine content in drinking water and iodine nutrition level in different landforms in Yi County of Hebei province

ZHANG Jinguo,WANG Fengmin,ZHANG Baozong,ZHANG Hongjie,ZHAO Ying,ZHANG Yan,ZHANG Yongqiang,SHI Hongjuan,LI Yanguang,HAO Ning

2014, 31(4):  38-42.  DOI: 10.3969/j.issn.1674-490X.2014.04.010

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Objective To investigate the iodine content in drinking water and the iodine nutrition level of different landforms and explore the iodine nutrition status in after iodized salt intervention in different landforms to provide scientific basis for the development of prevention strategies to iodine deficiency disorders. Methods The county was divided into five sampling sections according to azimuth (east, west, south, north and center), one town was randomly chosen in every position of the five. Two mountainous townships were respectively randomly chosen in the western and northern, two hilly townships were respectively randomly chosen in the southern and central, one lfat country townships was randomly chosen in the eastern to investigate and analyze the iodine level in drinking water. Salt iodine level, 8-10 year-old children’s urinary iodine level and goiter in the mountains, hills, falt country three landforms were examined. Results Iodine content in the drinking water were low, the salt iodine content was slightly higher than the current standards edible salt iodine content, children’s urinary iodine was at an more appropriate level, children’s goiter were conformed with the national “eliminate the iodine deficiency disorders standards”in mountains, hills and plains. Iodine contents in water were compared among different landforms, the difference was statistically signiifcant (HC=80.37, P<0.01). Salt iodine level was compared among different landforms, the difference was not statistically signiifcant (HC=0.24, P>0.05). Children’s urinary iodine level was compared among different landforms, the difference was not statistically signiifcant (HC=1.54, P>0.05). Children’s goiter rate was compared among different landforms, the difference was not statistically signiifcant (χ2=0.22, P>0.05). Conclusion Children’s iodine nutrition is at an more appropriate level in the current after Iodine intervention in Yi county, however, iodine contents are very low in drinking water in different landforms in Yi county. In order to safeguard the supply of residents iodine nutrition, we should continue to take iodized salt intervention based integrated interventions.

An investigation report of medical students’ health status in a university of Hebei

WANG Shuojia,YANG Yu,LIU Shufang,LI Yuxin

2014, 31(4):  43-46.  DOI: 10.3969/j.issn.1674-490X.2014.04.011

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Objective To understand physical health status and development trends of medical college students, and provide a scientiifc basis for improving students’ physical health of medical students. Methods 910 medical students selected randomly in Hebei University were conducted with cluster sampling, which had a health check through the self-designed questionnaire. The measurement includes body shape, function, diathesis, and health index. Results Nearly 70%students’ nutritional status was in normal level. The proportion of overweight and obesity was 36.4%among boys while 15.34%girls were low weight. The ratio of lung function was 42.63%in the level of qualified. About half of the students’ grip strength values of body mass index were qualified. Conclusion Most medical students have a normal state of health;however, there is quite a few students’ health condition out of order.

Nursing experience in interventional thrombolysis treatment of superior mesenteric venous thrombosis

ZHAO Xia,HE Tao

2014, 31(4):  47-50.  DOI: 10.3969/j.issn.1674-490X.2014.04.012

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Objective To study the interventional thrombolysis treatment of superior mesenteric venous thrombosis (SMVT) observation and nursing care of patients. Methods 28 patients with SMVT treated between January 2005 and May 2013 were retrospectively analyzed. Results Of those patients, 21 cases were cured, 6 cases improved, 1 case was discharged from our hospital for deterioration. Conclusion The interventional catheter thrombolysis is an effective method for the treatment of SMVT, catheter thrombolysis ifxed stable and effectively can prevent its emergence, and the shift, which is the assurance of successful treatment.

Nursing experience on laparoscopic radiofrequency ablation of solitary renal cell carcinoma

HAO Jie,YU Honglian

2014, 31(4):  51-56.  DOI: 10.3969/j.issn.1674-490X.2014.04.013

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Objective To investigate perioperative nursing experience assisted laparoscopic radiofrequency ablation of solitary renal cell carcinoma. Methods A retrospective analysis of 22 cases of solitary renal cell carcinoma in the Second Hospital of Baoding, patients were all solitary renal cell carcinoma, including three cases of solitary kidney renal cell carcinoma, one case’s kidney had been removed, seven cases with the contralateral kidney cancer metastasis or new cancer, 12 cases with functional isolated. The 22 patients were assisted laparoscopic radiofrequency ablation. Results 22 patients surgical were successed, 1 case experienced secondary to postoperative bleeding, showed failure of conservative treatment, and they were underwent selective renal artery embolization; fistula occurred in 2 cases, one case was improved after 4 weeks of treatment, l case was experienced selective renal artery embolization;renal failure and infection did not occur. Conclusion Thoughtful personalized care is the key measure to the patients with solitary renal cell carcinoma assisted laparoscopic radiofrequency ablation.

Perioperative care of elderly female pelvic reconstruction

ZU Yanhong,LIU Qingge

2014, 31(4):  57-61.  DOI: 10.3969/j.issn.1674-490X.2014.04.014

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Objective To summarize the perioperative nursing of the 62 elderly female under went pelvic reconstruction. Methods Well psychological care of patients, improved the preoperative preparation, postoperative postural guidance, pain care, perineal care, voiding observation, diet and bowel health education, complications observation, discharge instructions and other care measures were conducted. Results 52 patients were cured in (83.9%), 10 patients improved (16.1%). two cases were dysuria after stopping catheter, after re-cathetered the symptoms improved and discharged; one case occurred incontinence during hospitalization, symptoms improved by anti-inflammatory rehydration therapy; one case occurred Mesh erosion after 3 months, after trimming mesh, anti-inflammatory treatment,the symptoms improved; one case appeared deep vein thrombosis after 5d , were discharged after conservative treatment. Conclusion Quality personalized care is a key factor for avoiding relapse to improve the success rate of pelvic reconstruction surgery, reduce complications.

Exploration of nurse hierarchical management model in quality care management

LI Xiaohong,QI Zhongqin

2014, 31(4):  62-65.  DOI: 10.3969/j.issn.1674-490X.2014.04.015

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Objective To investigate the application of hierarchical management approach in nursing management and application of the results. Methods To compare the quality of care before and after implementing hierarchical management, training of nurses and patient satisfaction. Results After the implementation of nurse hierarchical management, quality of care, the rate of training and patient satisfaction has significantly improved. Conclusion The implementation of the hierarchical management nurses, can achieve a reasonable allocation of human resources and scientific management, and promote the steady improvement in the quality of care and continuous improvement, improve patient’s satisfaction.

The current researching situation and thinking about Long-term care of old people

JING Kunjuan,WANG Shuo

2014, 31(4):  66-70.  DOI: 10.3969/j.issn.1674-490X.2014.04.016

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With the continuous development of aging of China’s population and the old becoming older, the long-term care of the old is becoming more and more highlighted, owing to the declining of physical and psychological function in the old. By reviewing 34 related papers, the author review researching conditions about long-term care model, long-term care assessment system, long-term care needs, long-term carers’ protection ,and existed problems and inlfuencing factors and so on. At the same time, the authors come up with ideas of themsevies, aiming at providing a theoretical basis for the government aging-policy making and further research.

Mechanism of gastroesophageal relfux disease pathogenesis and its symptom perception

ZHANG Ke,LIU Junfeng,XIANG Shasha,KANG Meng,DAI Yue

2014, 31(4):  71-74.  DOI: 10.3969/j.issn.1674-490X.2014.04.017

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The pathogenesis of GERD symptoms may have a multifactorial mechanism, in which noxious factors, including acid-pepsin and acid, are involved. The interaction of relfuxed content and esophageal mucosa probably caused by a defective luminal clearance and mucosa barrier mechanisms, would be responsible for visual detectable lesion of esophageal mucosa. The researches of animal models with long time contact of acid content demonstrated that receptors on nerve endings may be involved in esophageal sensitivity and nociception. At the meantime, speciifc chemokine and cytokine may explain the different esophageal subtypes of GERD, partly illuminating the genesis of esophagitis in a subtype. Researches indicate that there are additional neurotransmitters and inlfammatory mediators in GERD patients, the relationship of the esophageal inlfammation and hypersensitivity is still not clear. Moreover, over 70%of GERD patients don’t to be erosive, a subset called non-erosive relfux disease. This summary aims to elucidate the pathogenesis of inlfammatory in GERD to differentiate erosive and non-erosive relfux disease and provide new therapeutic approaches.

The experimental research and clinical application prospect of ischemic postconditioning in brain ischemia

LI Pan,SU Likai,LI Xiaofang

2014, 31(4):  75-80.  DOI: 10.3969/j.issn.1674-490X.2014.04.018

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Ischemic postconditioning is a concept originally defined to contrast with that of ischemic preconditioning. While both preconditioning and postconditioning confer a neuroprotective effect on brain ischemia, preconditioning is a sublethal insult performed in advance of brain ischemia, and postconditioning, which conventionally refers to a series of brief occlusions and reperfusions of the blood vessels, is conducted after ischemia/reperfusion. In recent years, extensive studies show that postconditioning has apparently protective effects. We mainly review the discovery and development, the underlying mechanisms and clinical application of it.

Advances on medication adherence to secondary prevention in patients with coronary heart disease

LI Miaomiao,WANG Yan

2014, 31(4):  81-87.  DOI: 10.3969/j.issn.1674-490X.2014.04.019

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Based on the the research results of medication adherence to secondary prevention in patients with coronary heart disease in recent years at home and abroad, this paper systematically summarizes the deifnition, the present situation, the inlfuencing factors. In conclusion, it also indicates the dififculties and challenge in this ifeld.

Advances on early renal damage biomarkers of contrast-induced acute kidney injury

WANG Xianjun,WU Shangqin

2014, 31(4):  88-90,99.  DOI: 10.3969/j.issn.1674-490X.2014.04.020

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Contrast-induced acute kidney injury(CI-AKI) is one complication of coronary intervention due to the use of contrast medium. Early renal damage caused by contrast medium can be detected through monitoring specific markers. It is important to detect the early renal damage for efficient clinical assessment to provide therapy for contrast-induced nephropathy thus delaying the progression of disease. This article gives an overview of the biomarkers used to detect early renal damage in contrast-induced acute kidney injury.

Training effect evaluation of virtual knee arthroscopy surgery system

WANG Bo,YANG Qun,ZHANG Weiguo,ZHANG Guangqian,SONG Yuan,ZHANG Jun,DONG Lei

2014, 31(4):  91-94.  DOI: 10.3969/j.issn.1674-490X.2014.04.021

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Objective To analyze the training effect of virtual knee arthroscopy surgery system in orthopedists. Methods 36 orthopedists were randomly divided into experimental group (n=20) and control group (n=16). Each group received ordinary theory teaching and surgery probation in 45 days, experimental group received additional virtual knee arthroscopy surgery system training. Evaluating training effect of two groups in 15,30 and 45 days with clinical surgery. Results The surgery score and error count with two groups had no statistical significant (P>0.05) in 15 days. The surgery score of experimental group was significantly higher than control group in 30 and 45 days(P<0.05). The error count of experimental group was signiifcantly lower than control group in 30 and 45 days(P<0.05). Conclusion Virtual knee arthroscopy surgery system can improve orthopedist`s operation skills, better than ordinary training methods.

Construction of the comprehensive practice platform in preventive medicine education of undergraduate

YANG Hongru,ZUO Qun,LIU Suping,MA Lixin,QIN Xinhong,DONG Yuping

2014, 31(4):  95-99.  DOI: 10.3969/j.issn.1674-490X.2014.04.022

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Training qualiifed professionals with comprehensive practical skills is the objective of preventive medicine’s education. Strengthening the reform of experimental teaching is the basis of improving students’ practical skills and abilities. School of Public Health of Hebei University reformed the traditional experimental teaching model, integrated the training materials, and created a comprehensive practice platform, worked out a diversified teaching mode leading by student’s independent learning for basic, comprehensive and innovative experimental teaching aspects, which effectively improved the students' practical sense, innovative thinking and ability.

Surveys on the students satisfaction to learning in local college

YANG Yu,AI Ping,MA Lixin

2014, 31(4):  100-105.  DOI: 10.3969/j.issn.1674-490X.2014.04.023

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Objective To investigate the demand of the medical college students’ learning activities oriented the direction of future education. Methods Questionnaire surveys in combination with in-depth interviews were used to investigate the psychological feelings, demands and opinions of senior students in their school professional study life in local medical college. Results The analysis of the statistic data showed that most of the interviewers of medical students were satisifed to their learning activities. Students thought their medical professional courses study mainly inlfuenced the teaching and learning effects. But the role of other auxiliary factors should not be ignored. Conclusion Student-centered education in college is the effective way to improve teaching effects.