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According to the current situation of professional ethics education for pediatric medical students and the needs of social industries, we focus on the construction of a systematic comprehensive curriculum knowledge system and training plan based on child development, formulate specific goals and training systems for pediatric medical students that are in line with the development of modern medicine, clarify the content and education path of pediatric professional ethics education, strengthen the requirements for students' knowledge, ability and quality, improve the process management and policy implementation of talent training, and improve the pertinence and effectiveness of professional ethics education for pediatric medical students, thereby making pediatric medical students to be used to the development trend and environment of the industry.
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There are such problems as the contents of education lag , overemphasising cognition and intellectu-alization, despising practice and system supporting in current medical humanities education practice .We think that the medical humanistic education should adhere to the concept of student -oriented, medical education and human-ities education fusion , the idea of ideological education as the leading factor , the psychological compatibility as the base ,the system strengthening as the security .The medical humanities education mode is not only the response of the main current medical education mode of social alienation and human alienation , but also the surpassing of the object of humane education mode .It fully reflects the personality characteristics of the contemporary medical students , embodies the regularities of nurturing and development of human behavior in medical students .
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Objective To evaluate the roles of positron emission tomography (PET) with N-methyl [11C]2-(4' -methylaminophenyi-6-hydroxybenzathiazole) (11C-PIB) in the early diagnosis of Alzheimer's disease (AD).Methods Six AD patients,7 mild cognitive impairment (MCI) patients and 6 normal controls (NC) were diagnosed and assessed with brain PET with 11C-PIB.The emission images obtained at 5,25 and 45 min after 11C-PIB administration were analysed.Results Using visual analysis to summarize the characteristics of the imagings of each group: comparing to NC,the AD patients show high 11C -PIB up take,and low clearance rate of 11C-PIB at 45 min.The imagings of MCI group show heterogeneous,overlapping with AD and NC group.The statistical analysis shows: in AD group,the standard uptake value (SUV) ratio of parietal lobe,frontal lobe,temporal lobe,occipital lobe and hippocampal at 45 min was 1.91±0.21,2.09±0.41,1.92±0.35,1.66±0.41,1.55±0.28 respectively,and were higher than that of NC group (value being 1.48±0.53,1.57±0.64,1.36±0.53,1.27±0.40,1.17±0.33) with statistical significance,t=8.114,5.620,5.705,3.650 and 2.866,P=0.0001,0.0002,0.0002,0.0045 and 0.0170 respectively.In MCI group,the SUV ratio of parietal lobe,frontal lobe,temporal lobe,occipital lobe and hippocampal at 45 min was 1.48 ± 0.53,1.57 ± 0.64,1.36±0.53,1.27 ± 0.40,1.17±0.33 respectively,and were higher than that of NC group,but there was no statistical significance.Conclusion 11C-PIB PET imaging can differentiate AD patients from normal and anticipate the transformation of MCI patients.
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BACKGROUND:At present, some neurological imaging methods, including MRI, fMRI, 2-(1-(6-[(2-[18F]fluoroethyl)(methyl)amino]-2-naphthyi) ethylidene) malononitrile (18F-FDDNP) positron emission tomography (PET), are helpful but not specific for the diagnosis of Alzheimer disease (AD). 18F-FDG is a special marker of beta-amyloid (Aβ), thus AD can be diagnosed by 18F-FDDNP PET at early period.OBJECTIVE: To evaluate the role of 18F-FDDNP PET in the diagnosis of AD, and establish reliable clinical biological indexes for the diagnosis of AD patients.DESIGN: A controlled analysis.SETTINGS : Department of Geriatric Neurology and Department of Nuclear Medicine, the General Hospital of Chinese PLA. PARTICIPANTS: Patients visiting the General Hospital of Chinese PLA from May 2004 to March 2005 were selected. Informed consents were obtained from all the participants. ① AD group (n =7): (74.88±12.03) years old; Accorded with the criteria related to diagnosis of AD in NINCDS/ADRDA (National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer Disease and Related Disease Association) and revision of Diagnostic and statistical Manual (DSM-Ⅳ, 4th ed.); brain CT or magnetic resonance imaging (MRI) examination displayed that inter-uncus distance of temporal lobes was ≥ 30 mm. ② Vascular dementia group (n =6): (73.83±4.75) years old; Accorded with the diagnostic criteria of NINDS-AIREN (National Institute of Neurological Diseases and Stroke, USA) and DSM-Ⅳ for vascular dementia; Inter-uncus distance of temporal lobes ＜ 30 mm. ③ Control group (n =6): (71.17±3.71) years old; Without rarefaction of white matter; Intelligence examination was normal.METHODS: PET was performed in all the subjects. PET scanner type was SEIMENS ECAT EXACT HR. The tracer selected was 18F-FDDNP which had radiochemical purity higher than 95% and error of radioactivity measurement lower than 10%. The images were collected at 5, 25 and 45 minutes after injection of 18F-FDDNP. Horizontal and coronary tomograms of brain were obtained after reconstruction.MAIN OUTCOME MEASURES: Characteristics of 18F-FDDNP brain PET images.RESULTS: ① In the control group, signs of obvious atrophy of brain were not seen. At about 45 minutes, the radioactivity in cortex and subcortical nucleus groups was essentially cleared and the structures of brain could not be differentiated clearly. ② In the vascular dementia group, brain atrophy and enlargement of ventricular system to various degrees could be seen. The clearance of radioactivity at three time points was similar to that in the control images. ③ In the AD group, the brain was obviously atrophied and the ventricular system was enlarged. The clearance of radioactivity at the three time points was significantly different from the images of other two groups. The radioactivity in cortex and hippocampus was cleared slower. At 45 minutes, the gray matter could still be clearly differentiated from the white matter, but the radioactivity in corpus striatum and thalamus was not higher than that in cortex and much radioactivity retention could be seen in cortex and hippocampus.CONCLUSION: 18F-FDDNP PET brain images can differentiate AD and vascular dementia, and it is an effective imaging index for the diagnosis of AD.
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<p><b>OBJECTIVE</b>To study cognitive function and cerebral metabolic changes in patients with transient global amnesia (TGA).</p><p><b>METHODS</b>Three patients with TGA were given mini-mental state examination (MMSE), revised Wechsler memory scale (WMS-R) examination and magnetic resonance imaging (MRI) scans after they had been diagnosed as TGA. Using (18)F labelled deoxyglucose as tracer, patients were given a positron emission tomography (PET) examination at different periods during recovery.</p><p><b>RESULTS</b>No obvious abnormality was found in MMSE and MRI scans in the three patients. However, WMS-R examination and cerebral PET imaging displayed cognitive dysfunction of varying degrees and low metabolism in local areas related to memory in 2 of 3 patients.</p><p><b>CONCLUSIONS</b>In TGA patients, cognitive function and cerebral metabolic levels are closely correlated with duration of symptoms. It is necessary to stop the TGA attack as quickly as possible early time.</p>
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Aged , Female , Humans , Male , Middle Aged , Amnesia, Transient Global , Diagnostic Imaging , Psychology , Cognition , Magnetic Resonance Imaging , Tomography, Emission-ComputedABSTRACT
Objective To investigate the oligodendroglial cytoplasmic inclusion (OCI) in the central nervous system of multiple system atrophy (MSA) and to evaluate its roles in pathologic diagnosis of MSA.Methods Modified Gallyas Braak staining was used to investigate tissue samples of the brain and the spinal cord of 4 cases with MSA, which were previously diagnosed by clinical and routine pathologic methods. Eight cases with motor neuron disease and 6 cases without nervous system disease were used for control study.Results OCIs were demonstrated by Gallyas barrak method in the white matter of the brain and the spinal cord of 3 cases with MSA. They look like sickle , semilunar , and flame shaped. Their main distributions were transverse fibers of the basis pontine, the white matter of the cerebellum, striatopallidal fibers and lateral column of the spinal cord. While OCIs were not found in the brain and the spinal cord of one case without typical clinical features and pathologic findings. Nor did all of the control cases.Conclusions OCIs may be regarded as pathologic marker of the sporadic forms of MSA. It also suggests that OCIs are related to degenerative process of myelinated fibers in MSA.
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Due to the features of the medical ethics course,the application of PBL in the course instruction helps fulfill the interface between teaching and learning,enhance students' abilities to analyze and solve problems,and reach the goal of cultivating critical and creative thinking of students.