尿蛋白检测的论文

Through the study of animal experiments to observe the United Yishen soup benazepril 5 / 6 nephrectomized rats renal function improved efficacy and reduced TGF-β1 expression in renal tissue and other advantages, and to explore the soup Yishen possible to improve the renal function of mechanism of ：1. Select SPF class healthy adult male SD rats with 50 only as the research object, adaptive feeding one weeks later, 10 randomly selected as the sham-operated group (A group), and the remaining 40 with 5 / 6 nephrectomy CRF-made law the success of model selection criteria in line with the study group 32 rats were divided into B: model group, 8; C groups: benazepril group 8; D group: the Chinese Medicines Board 8; E group: beneficial United kidney soup benazepril group referred to as traditional Chinese and western medicine group 8, together with the A Group of 5 . Successful modeling start after delivery, the groups were given corresponding drugs . The end of the experiment 24 hours after the detection of urinary protein and blood BUN, Scr, RBC, Hb, and renal histology observation and renal tissue TGF-β1 expression general situation: during the experiment, sham-operated rats demonstrated alertness, quick reaction, dense fur, clean and shiny, growth, consumption and the activities had no significant abnormalities, weight gain; model group was significant malnutrition, make them apathetic, slow activity , loss of appetite, fluffy fur, haggard Matte, died in the course of treatment at 2, probably because of renal failure due consideration; benazepril rats than sham-operated group spirit apathetic, slow activity, fur, fluffy; Chinese Medicines large mouse performance and a similar benazepril group; WM rats with sham-operated rats without much difference in general performance, but dry dark . Of blood BUN, Scr impact: benazepril group, traditional Chinese medicine group, in the WM group significantly decreased BUN, Scr level, compared with the model group has significant difference (P <), but still higher than sham-operated group; traditional Chinese and western medicine group and the Chinese medicine group, benazepril group has significant difference (P <); Chinese medicine group and the benazepril group was no significant difference ( P> ).3. Hematology impact: Chinese medicine group and the TCM-WM group was significantly increased blood RBC, Hb, compared with the model group has statistically significant difference (P <), but the difference between the two groups was not significant (P> ); benazepril group compared with the model group was no significant difference (P> ).4. Pathologic changes, acceptance of renal rat subtotal excision were visible matrix hyperplasia, glomerular sclerosis, but the model group compared to the treatment group significantly lesser degree of glomerular sclerosis, one of traditional Chinese and western medicine to renal small ball for the lightest sclerosis; Immunohistochemistry results showed that the treatment group in renal tissue expression of TGF-β1 were significantly lower than model group (P <), and traditional Chinese and western medicine group can reduce the TGF-B1 in renal tissues, with the Chinese medicine group and the benazepril group has statistically significant difference (P <). Conclusion: Yishen soup through Yiqi Jianpi, huoxuehuayu, dampness Xiexin Turbidimetry, CRF can reduce blood BUN, Scr, improve anemia and reduce proteinuria, can be reduced effectively with 5 / 6 nephrectomy-induced CRF rat kidney tissue expression of TGF-β1, thereby reducing the accumulation of ECM, slowing the development of renal fibrosis, and delay the progress of Yishen soup has a good anti-renal fibrosis, but also after the United benazepril better efficacy.

医学生的论文范文

论文常用来指进行各个学术领域的研究和描述学术研究成果的文章，一起来看看医学生的论文，仅供大家参考！谢谢！

摘要 ：针对当前医院检验科带教师资水平低下的现状，提出要从提高带教教师专业水平、改革教学方法及制定规范化的带教流程等方面来切实提高医检验科实习带教水平。

关键词 ：医学检验；实习带教

随着检验医学的快速发展，检验仪器在检验科的应用越来越普及，医院检验科开展的大多数项目都已实现了全自动或半自动化，在有些大医院甚至连样本分检都应用了流水线，这使得现在的检验实习生进入医院实习后几乎沦落为“仪器操作工”，很多实习生反映在生化、临检等专业组实习期间只是从事简单的样本编号、离心、上机等枯燥而没有技术含量的工作，在实习期结束后，大多数学生根本无法进行独立的检验工作，更不要说对检验结果进行分析评价，与预期的实习效果相差很远。如何改变这一现状，笔者经过考察与调研，提出如下几点建议。

一、提高带教教师的专业水平和自身素质

临床实习是医学院校学生将所学的理论知识与临床操作技能相结合的过程，是实习生由学校走向工作岗位必不可少的关键环节，其目的是使实习生在实际工作中学会运用所学的理论知识，提高操作技能，培养分析问题、解决问题的能力[1]。在实习过程中，带教教师起到了至关重要的作用，一个认真负责、学识丰富的带教教师，能让学生终身受益。但是目前普遍存在的现象却是大多数的带教教师理论知识匮乏、知识结构陈旧。

以笔者所在的单位为例，本科室各个专业组除了专业组长，其他工作人员几乎没有任何带教能力，实习生跟着这些老师只是简单地模仿他们的工作流程，根本谈不上理论与实践相结合。甚至有的工作人员自己的工作习惯都是错误的，这样对实习生的临床实习非常不利。随着时代的快速前进，现代医学也得到了飞速的发展，为了适应这种前进与发展，带教教师也需要适时转变观念。

首先必须不断地完善充实自己，一方面要经常阅读专业书籍，更新自己的知识库，系统掌握本专业基本理论和基本技能，另一方面还要经常查阅文献，拓宽自己的知识面，熟悉本专业在国内外的发展动态以及前沿技术。其次，带教教师要提高自身的道德修养，端正工作态度，建立正确的人生观、价值观，摒弃唯利是图的思想观念，树立为患者服务的思想准则，通过自身的言行举止，促使实习生形成内在的学习动力，成为实习生学习的楷模，把实习生培养成为优秀的医学事业接班人。

二、充分调动实习生的学习积极性

学习应该是一个充满乐趣的过程，枯燥的“填鸭”式的教学会让学生产生厌烦的情绪，对教学的基本原理的不理解会使他们缺乏学习的主动性和积极性，不利于他们独立思考，教学效果自然不好，也不利于学生的长期记忆。笔者认为可以从以下两个方面充分调动实习生的学习积极性。

（一）采用病例讨论的方法加强学生的理解记忆

比如在《临床检验基础》关于尿液检验这一章节中讲到试带法尿蛋白检测采用的是指示剂蛋白质误差法，因此尿液pH变化会干扰尿蛋白结果，pH高会出现假阳性，pH低会出现假阴性。学生在学习时由于不理解原因，所以经常会记成相反的结果。因此当我们在实际工作中遇到尿液pH高于8、尿蛋白定性试验为阳性的样本时，为了证明是否是尿液pH干扰导致的假阳性，带教教师可以将这份尿液用生化分析仪进行尿蛋白检测，根据生化分析仪上的阴性结果再反过来向学生阐明尿液分析仪检测尿蛋白的原理，这样就能有助于学生对复杂概念的理解，加深学生的记忆，从而激发学生的学习兴趣。

（二）采用PBL模式进行实习带教

PBL（problem—basedlearning），是1969年由美国神经病学教授Barrows首创的一种以问题为基础，以病案为先导的学习方式[2]。在实习带教之前，带教教师可以先向学生提出问题，然后由学生带着问题有目的地进行学习，因为要回答教师的提问，学生在学习时就会自觉地理解记忆，这样比简单的说教更容易使学生接受。

比如在凝血检验中会遇到很多心血管科的病人要多次检验血浆凝血酶原时间（PT），通过这一现象，向学生提出问题：“为什么这些病人要定期复查这一项目？”带着这样的疑问，学生通过图书馆或网络资源查找相关资料，知道了心脏手术后的病人需要长期口服华法林之类的抗凝药，学习了这类抗凝药的抗凝原理，并且了解了华法林具有明显的个体差异，使用过量易致出血，用量不足又会导致体内血栓形成，所以治疗过程中应定期随访检查国际标准化比值（INR值），而INR值是根据PT计算出来的，因为每个批次的凝血酶原试剂活性不同，这样检测出来的PT结果差异很大，不利于临床疗效的判断，所以每批试剂都会有相应的国际敏感指数（ISI），利用ISI和PT计算出INR，通过这一系列的`学习和理解，学生对于INR的临床意义就会记得非常深刻。

从提出问题到解决问题这一过程中，学生是主动参与的，这样可以充分调动他们的积极性，期间带教教师再配合一些病例讨论加深学生的理解，以使理论更好地与临床实践相结合，得到满意的教学效果。PBL教学模式提倡的是将复杂的网络样结构的医学知识以“疾病”连接起来，将相关学科的基础与临床知识进行重新整合，比如在临床专业中的本周氏蛋白检测，可以与生化专业中尿蛋白电泳检验出的M蛋白带，以及血液科的多发性骨髓瘤进行联合讲解，使不同学科的知识得以交叉，使学生学到多学科的综合知识，而不是片面的、断层的知识，并使学生在有限的时间内学会解决问题的技能和自主学习的能力。

三、建立规范化的带教流程

带教教师的专业水平不一样，对事物的理解能力也不一样，不同的教师其工作习惯、实践经验、心得体会都是不一样的。同样一项工作一个老师这样做，另一个老师却是另外一种做法。例如在临检组实习期间对血涂片进行瑞氏染色时，有的老师说需要染5—10分钟，有的老师却说染2—3分钟就足够了，这让学生感到无所适从，不知道该听谁的，使得临床带教无法规范化、标准化。

为了避免这一现象长期存在，建议科室可以形成一套规范化的实习生带教流程。各个专业组根据本专业的检测项目和工作特点针对不同层次的带教要求写出本专业的带教目标、带教内容、带教方法以及评价要点，形成统一的标准化文件，各带教教师定期对文件进行系统学习，对各自的带教内容做到熟记于心，在这种情况下才能让学生真正体会到心临床实习的重要性，也才能真正认真对待实习过程。

四、定期进行实习带教效果考核

考核是检验教学效果的一种手段，也是对带教工作的有效总结。科学的实习考评制度既可以考核学生的实习效果，也可以衡量带教教师的实习带教水平[3]。我科现有的考核仅仅是对实习生进行的出科考核，并没有对带教教师的操行品德及教学方法进行考核。即使是针对实习生的出科考核，也没有一个统一的标准，有的专业组仅仅是对学生进行口头提问，学生回答问题的完整性、逻辑性无从得知，打分也充满随意性。针对这种现象，应该由科室成立实习带教考核小组，制定详细的考核办法及考核计划，按照计划定期进行考核。

临床实习教学是医学教育极为重要的一个阶段。对临床实习生而言，是他们从学习到工作角色转换的非常重要的中间时期。医疗模式从过去的直觉医学到现在的循证医学，发展到未来的精准医学，对检验人员的要求越来越高。因此，在临床实习中，实习生既要学习医学知识、临床操作技能，又要学习人文知识。临床实习教学质量的好坏对实习生的未来将产生很大的影响，所以规范化的实习教学管理显得非常重要。优秀的带教师资队伍、合理的教学实习计划、完善的教学管理制度、严格的教学实施、科学的考评制度是保证实习质量的关键。

参考文献：

[1]何伟业,蓝红云,杨平英,等.检验科临床实习带教中的几点认识[J].检验医学与临床,2010,7(23):2666.

[2]顾兵,潘世扬,黄佩珺,等.开放实验室及PBL教学在医学检验学实验教学中应用的探讨[J].南京医科大学学报(社会科学版),2008,30(1):69-71.

[3]郑磊,王前.医学检验专业本科生实践教学和管理模式的优化[J].中华医学教育杂志,2010,30(1):35-38.

Objective: Through the study of animal experiments to observe the United Yishen soup benazepril 5 / 6 nephrectomized rats renal function improved efficacy and reduced TGF-β1 expression in renal tissue and other advantages, and to explore the soup Yishen possible to improve the renal function of mechanism of action. Methods: 1. Select SPF class healthy adult male SD rats with 50 only as the research object, adaptive feeding one weeks later, 10 randomly selected as the sham-operated group (A group), and the remaining 40 with 5 / 6 nephrectomy CRF-made law model. 2. After the success of model selection criteria in line with the study group 32 rats were divided into B: model group, 8; C groups: benazepril group 8; D group: the Chinese Medicines Board 8; E Group : Yishen Decoction United benazepril group referred to as traditional Chinese and western medicine group of eight, together with the A Group of 5 Group. 3. Successful modeling start after delivery, the groups were given corresponding drugs decoction. 4. The end of the experiment 24 hours after the detection of urinary protein and blood BUN, Scr, RBC, Hb, and renal histology observation and renal tissue TGF-β1 expression assay. Results: 1. The general situation: during the experiment, sham-operated rats demonstrated alertness, quick reaction, dense fur, clean and shiny, growth, consumption and the activities had no significant abnormalities, weight gain; model group was significant malnutrition, make them apathetic, slow activity, loss of appetite, fluffy fur, haggard Matte, died in the course of treatment at 2, probably because of renal failure due consideration; benazepril rats than sham-operated group spirit apathetic, slow activity, fur, fluffy; medicine the performance of rats with similar benazepril group; WM rats with sham-operated rats without much difference in general performance, but dry dark fur. 2. Of blood BUN, Scr impact: benazepril group, traditional Chinese medicine group, in the WM group significantly decreased BUN, Scr level, compared with the model group has significant difference (P <), but still high in sham-operated group; traditional Chinese and western medicine group and the Chinese medicine group, benazepril group has significant difference (P <); Chinese medicine group and the benazepril group was no significant difference (P> ). 3. Hematology impact: Chinese medicine group and the TCM-WM group was significantly increased blood RBC, Hb, compared with the model group has statistically significant difference (P <), but the difference between the two groups was not significant (P> ); benazepril group compared with the model group was no significant difference (P> ). 5. Pathologic changes, acceptance of renal rat subtotal excision were visible matrix hyperplasia, glomerular sclerosis, but the model group compared to the treatment group significantly lesser degree of glomerular sclerosis, one of traditional Chinese and western medicine to renal small ball for the lightest sclerosis; Immunohistochemistry results showed that the treatment group in renal tissue expression of TGF-β1 were significantly lower than model group (P <), and traditional Chinese and western medicine group can reduce the TGF-B1 in renal tissue Expression, and traditional Chinese medicine group and the benazepril group has statistically significant difference (P <). Conclusion: Yishen soup through Yiqi Jianpi, huoxuehuayu, dampness Xiexin Turbidimetry, CRF can reduce blood BUN, Scr, improve anemia and reduce proteinuria, can be reduced effectively with 5 / 6 nephrectomy-induced CRF rat kidney tissue expression of TGF-β1, thereby reducing the accumulation of ECM, slowing the development of renal fibrosis, and delay the progress of CRF. Fully Yishen soup has a good anti-renal fibrosis, but also after the United benazepril better efficacy.