目的 探讨在肝胆外科专业住培医师临床实习中运用以授课、问题和案例为基础的教学法(lecture,problem and case based learning,LPCBL)联合MDT模式的教学作用与成效。方法 70名住培医师在2019年9月—2020年9月期间在广州中医药大学第一...目的 探讨在肝胆外科专业住培医师临床实习中运用以授课、问题和案例为基础的教学法(lecture,problem and case based learning,LPCBL)联合MDT模式的教学作用与成效。方法 70名住培医师在2019年9月—2020年9月期间在广州中医药大学第一附属医院肝胆外科轮转临床实习,按照数字随机表法随机分为A组(MDT教学联合LPCBL,n=35)与B组(采用传统的教学实习模式,n=35),观察两组的教学效果。结果 相比于B组,A组学生的基础理论课成绩及优秀率均更好,差异有统计学意义(P <0.05)。A组学生在带教老师满意度、培养临床逻辑思维、激发学习兴趣、调动学习的积极性、提供参与机会、活跃课堂气氛、知识面得到扩展、专业知识易理解与接受、提升科研协作能力、提高沟通合作能力方面的得分均高于A组学生,差异有统计学意义(P <0.05)结论 将LPCBL联合MDT教学模式引入肝胆外科专业住培医师教学实践中,有助于提高教学质量及满意度。展开更多
Objective: To study the multidrug resistance (MDR) mechanism of lung resistance protein (LRP) gene in hepatocellular carcinoma (HCC), and the relations among the expression of the LRP gene and clinicopathologic featur...Objective: To study the multidrug resistance (MDR) mechanism of lung resistance protein (LRP) gene in hepatocellular carcinoma (HCC), and the relations among the expression of the LRP gene and clinicopathologic features, the influence of α-fetoprotein (AFP), and prognosis of patients who received adjuvant chemotherapy after resection of HCC. Methods: The expression of the LRP gene encoding LRP and mRNA LRP was detected in tissues from 54 untreated patients with HCC, adjacent tissues from 24 patients with HCC and archival paraffin-embedded tissues from 12 patients with posthepatitic cirrhosis. The relationship between the LRP gene expression and the change of AFP level was analyzed in the 24 postoperative HCC patients whose AFP was measured after 2 weeks. All of the HCC patients were followed up. Results: The percentage of positive expression of LRP and mRNA LRP in the 3 tissues was 61.1%, 33.3%, 16.7%, and 75.9%, 37.5%, 33.3% respectively. There was significant difference between the untreated HCC tissue and other tissues (P<0.05). No difference existed between the LRP gene expression and clinicopathologic findings, age, sex, and tumor size (P>0.05), but the expression was related to the degree of differentiation of HCC (P<0.05). The effective rate of AFP in the LRP gene positive expression group or in postoperative chemotherapeutic patients was very lower than that in the negative group (P<0.05). Although the mean survival time of postoperative HCC patients in negative LRP gene expression group was longer than that of positive group, there was no difference between them (P<0.05). Conclusion: LRP gene expression is related to MDR of HCC and initiates the intrinsic MDR. Detection of LRP gene expression is of great guiding significance in accessing chemotherapeutic resistance of HCC. As an index to chemotherapy of HCC, detection of LRP expression provides evidence for making individual chemotherapeutic treatment,and reversing MDR in HCC. Although LRP gene expression correlates with the tumor differential degree (P<0.05), it perhaps does not relate with the prognosis of HCC patients.展开更多
文摘目的 探讨在肝胆外科专业住培医师临床实习中运用以授课、问题和案例为基础的教学法(lecture,problem and case based learning,LPCBL)联合MDT模式的教学作用与成效。方法 70名住培医师在2019年9月—2020年9月期间在广州中医药大学第一附属医院肝胆外科轮转临床实习,按照数字随机表法随机分为A组(MDT教学联合LPCBL,n=35)与B组(采用传统的教学实习模式,n=35),观察两组的教学效果。结果 相比于B组,A组学生的基础理论课成绩及优秀率均更好,差异有统计学意义(P <0.05)。A组学生在带教老师满意度、培养临床逻辑思维、激发学习兴趣、调动学习的积极性、提供参与机会、活跃课堂气氛、知识面得到扩展、专业知识易理解与接受、提升科研协作能力、提高沟通合作能力方面的得分均高于A组学生,差异有统计学意义(P <0.05)结论 将LPCBL联合MDT教学模式引入肝胆外科专业住培医师教学实践中,有助于提高教学质量及满意度。
文摘Objective: To study the multidrug resistance (MDR) mechanism of lung resistance protein (LRP) gene in hepatocellular carcinoma (HCC), and the relations among the expression of the LRP gene and clinicopathologic features, the influence of α-fetoprotein (AFP), and prognosis of patients who received adjuvant chemotherapy after resection of HCC. Methods: The expression of the LRP gene encoding LRP and mRNA LRP was detected in tissues from 54 untreated patients with HCC, adjacent tissues from 24 patients with HCC and archival paraffin-embedded tissues from 12 patients with posthepatitic cirrhosis. The relationship between the LRP gene expression and the change of AFP level was analyzed in the 24 postoperative HCC patients whose AFP was measured after 2 weeks. All of the HCC patients were followed up. Results: The percentage of positive expression of LRP and mRNA LRP in the 3 tissues was 61.1%, 33.3%, 16.7%, and 75.9%, 37.5%, 33.3% respectively. There was significant difference between the untreated HCC tissue and other tissues (P<0.05). No difference existed between the LRP gene expression and clinicopathologic findings, age, sex, and tumor size (P>0.05), but the expression was related to the degree of differentiation of HCC (P<0.05). The effective rate of AFP in the LRP gene positive expression group or in postoperative chemotherapeutic patients was very lower than that in the negative group (P<0.05). Although the mean survival time of postoperative HCC patients in negative LRP gene expression group was longer than that of positive group, there was no difference between them (P<0.05). Conclusion: LRP gene expression is related to MDR of HCC and initiates the intrinsic MDR. Detection of LRP gene expression is of great guiding significance in accessing chemotherapeutic resistance of HCC. As an index to chemotherapy of HCC, detection of LRP expression provides evidence for making individual chemotherapeutic treatment,and reversing MDR in HCC. Although LRP gene expression correlates with the tumor differential degree (P<0.05), it perhaps does not relate with the prognosis of HCC patients.
