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多元化教学模式在医学生临床教学中的应用和效果评价

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基础医学与临床 2024年第4期44卷 577-581页

作者：李冉宋桉王林杰段炼朱惠娟李梅夏维波中国医学科学院北京协和医学院、北京协和医院内分泌科、国家卫生健康委员会内分泌重点实验室北京100730

目的了解临床医学生对北京协和医院内分泌科采用多元化教学模式的效果评价和需求反馈。方法向北京协和医学院正在临床轮转的医学生发放问卷,调查医学生对内分泌科教学现状和教学效果的评价,并反馈教学需求。结果共收到有效问卷95份... 详细信息

目的了解临床医学生对北京协和医院内分泌科采用多元化教学模式的效果评价和需求反馈。方法向北京协和医学院正在临床轮转的医学生发放问卷,调查医学生对内分泌科教学现状和教学效果的评价,并反馈教学需求。结果共收到有效问卷95份。医学生对主治医师及带教住院医师的教学能力给予了充分肯定。医学生认为除了病房轮转外,门诊教学很有必要。医学生在内分泌科轮转后对内分泌知识的掌握程度明显提高,参加过教学门诊的医学生对内分泌知识的掌握程度较未参加过教学门诊的医学生明显升高,提示门诊教学具有重要意义。此外,建立内分泌科教学病例集及视频资料库可作为临床教学的重要补充手段。结论门诊教学有助于提升教学效果,未来的教学中可加强医学生的门诊培训,建立内分泌科教学病例集及视频资料库,以提高内分泌科的教学质量。

关键词：内分泌科多元化教学教学效果问卷调查门诊教学

FGF23 and Phosphate Wasting Disorders

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Bone Research 2013年第2期1卷 120-132页

作者： xianglan Huang Yan Jiang weibo xia Department of Endocrinology Key Laboratory of EndocrinologyMinistry of HealthPeking Union Medical College HospitalChinese Academy of Medical Sciences

A decade ago, only two hormones, parathyroid hormone and 1,25（OH）2D, were widely recognized to direct-ly affect phosphate homeostasis. Since the discovery of fibroblast growth factor 23 （FGF23） in 2000 （1）, our understanding of the mechanisms of phosphate homeostasis and of bone mineralization has grown exponentially. FGF23 is the link between intestine, bone, and kidney together in phosphate regulation. However, we still do not know the complex mechanism of phosphate homeostasis and bone mineralization. The physiological role of FGF23 is to regulate serum phosphate. Secreted mainly by osteocytes and osteo- blasts in the skeleton （2-3）, it modulates kidney handling of phosphate reabsorption and calcitriol produc-tion. Genetic and acquired abnormalities in FGF23 structure and metabolism cause conditions of either hyper-FGF23 or hypo-FGF23. Hyper-FGF23 is related to hypophosphatemia, while hypo-FGF23 is related to hyperphosphatemia. Both hyper-FGF23 and hypo-FGF23 are detrimentalto humans. In this review, we will discuss the vathovhvsiology of FGF23 and hvver-FGF23 related renal vhosvhate wasting disorders （4）.

关键词： FGF23 Klotho hypophosphatemic rickets XLH ADHR ARHR ENS OGD NF McCune Albrightsyndrome DMP-1 PHEX

Atypical skeletal manifestations of rickets in a familial hypocalciuric hypercalcemia patient

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Bone Research 2017年第3期5卷 242-249页

作者： Bo Wu Ou Wang Yan Jiang Mei Li xiaoping Xing weibo xia Department of Endocrinology Key Laboratory of Endocrinology Ministry of Health Peking Union Medical College Hospital Peking Union Medical College Chinese Academy of Medical Sciences

Familial hypocalciuric hypercalcemia （FHH） is caused by inactivating mutations in the calcium-sensing receptor （CaSR） gene. The loss of function of CaSR presents with rickets as the predominant skeletal abnormality in mice, but is rarely reported in humans. Here we report a case of a 16-year-old boy with FHH who presented with skeletal manifestations of rickets. To identify the possible pathogenic mutation, the patient was evaluated clinically, biochemically, and radiographicaUy. The patient and his family members were screened for genetic mutations. Physical examination revealed a pigeon breast deformity and X-ray examinations showed epiphyseal broadening, both of which indicate rickets. Biochemical tests also showed increased parathyroid hormone （PTH）, 1,25-dihydroxyvitamin D, and elevated ionized calcium. Based on these results, a diagnosis of FHH was suspected. Sequence analysis of the patient＇s CaSR gene revealed a new missense mutation （c.2279T 〉 A） in exon 7, leading to the damaging amino change （p.I760N） in the mature CaSR protein, confirming the diagnosis of ~H. Moreover, the skeletal abnormities may be related to but not limited to vitamin D abnormity. Elevated ~H levels and a rapid skeletal growth period in adolescence may have also contributed. Our study revealed that rickets-like features have a tendency to present atypically in FHH patients who have a mild vitamin D deficiency, and that CaSR mutations may have a partial role in the pathogenesis of skeletal deformities.

关键词： Ca Atypical skeletal manifestations of rickets in a familial hypocalciuric hypercalcemia patient PTH BMD

Clinical and genetic findings in a Chinese family with VDR-associated hereditary vitamin D-resistant rickets

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Bone Research 2016年第1期4卷 48-54页

作者： Qianqian Pang Xuan Qi Yan Jiang Ou Wang Mei Li xiaoping Xing Jin Dong weibo xia Department of Endocrinology Key Laboratory of EndocrinologyThe Ministry of HealthPeking Union Medical College HospitalChinese Academy of Medical Sciences Department of Endocrinology The First Affiliated Hospital of Shanxi Medical University

Hereditary vitamin D-resistant rickets （HVDRR） is a rare autosomal recessive disorder characterized by severe rickets, hypocalcemia, hypophosphatemia, secondary hyperparathyroidism, and elevated alkaline phosphatase. This disorder is caused by homogeneous or heterogeneous mutations affecting the function of the vitamin D receptor （VDR）, which lead to complete or partial target organ resistance to the action of 1,25- dihydroxy vitamin D~ A non-consanguineous family of Chinese Han origin with one affected individual demonstrating HVDRR was recruited, with the proband evaluated clinically, biochemically and radiographically. To identify the presence of mutations in the VDR gene, all the exons and exon-intron junctions of the VDR gene from all family members were amplified using PCR and sequenced. The proband showed rickets, progressive alopecia, hypocalcemia, hypophosphatemia, secondary hyperparathyroidism, and elevated alkaline phosphatase. She also suffered from epilepsy, which is rarely seen in patients with HVDRR. Direct sequencing analysis revealed a homozygous missense mutation c.122G 〉 A （p.C41Y） in the VDR gene of the proband, which is located in the first zinc finger of the DNA-binding domain. Both parents had a normal phenotype and were found to be heterozygous for this mutation. We report a Chinese Han family with one individual affected with HVDRR. A homozygous missense mutation c.122G 〉 A （p.C41Y） in the VDR gene was found to be responsible for the patient＇s syndrome. In contrast to the results of treatment of HVDRR in other patients, our patient responded well to a supplement of oral calcium and a low dose of calcitriol.

关键词： VDR Clinical and genetic findings in a Chinese family with VDR-associated hereditary vitamin D-resistant rickets

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骨质疏松症防治中的难点和应对

国际内分泌代谢杂志 2022年第3期42卷 165-169页

作者：夏维波中国医学科学院北京协和医学院北京协和医院内分泌科国家卫生健康委员会内分泌重点实验室100730

骨质疏松症(osteoporosis, OP)是一种以骨量减少, 骨微结构破坏, 导致骨脆性增加, 易发生骨折为特征的全身性骨病(WHO, 1994)[1]。OP起病隐匿, 大多数患者并无临床症状, 使得早期发现极为困难, 当出现骨骼疼痛、体型改变, 甚至出现脆性... 详细信息

骨质疏松症(osteoporosis, OP)是一种以骨量减少, 骨微结构破坏, 导致骨脆性增加, 易发生骨折为特征的全身性骨病(WHO, 1994)[1]。OP起病隐匿, 大多数患者并无临床症状, 使得早期发现极为困难, 当出现骨骼疼痛、体型改变, 甚至出现脆性骨折时往往过了最佳治疗时机。因此, 在OP的防治中存在诸多难点, 比如:高危人群的早期识别;OP的诊断标准化;OP的个体化精准治疗等。本文就我国OP的防治难点和对策, 略做浅述, 以期共鸣。

关键词：最佳治疗时机骨量减少精准治疗脆性骨折骨质疏松症早期识别骨微结构破坏无临床症状

《原发性骨质疏松症诊疗指南(2022)》要点解读

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协和医学杂志 2023年第6期14卷 1203-1207页

作者：王永炫李梅章振林夏维波福建医科大学附属三明市第一医院内分泌科福建三明365000 中国医学科学院北京协和医院内分泌科国家卫生健康委员会内分泌重点实验室北京100730 上海交通大学医学院附属第六人民医院骨质疏松和骨病科上海200233

2022年12月,《原发性骨质疏松症诊疗指南(2022)》发布,指南更新了我国骨质疏松症的最新流行病学数据,结合该领域内的循证医学证据及临床实践经验,对骨质疏松症的诊疗作出了最新推荐。本文对该指南的要点进行解读,以期为医务工作者更好... 详细信息

2022年12月,《原发性骨质疏松症诊疗指南(2022)》发布,指南更新了我国骨质疏松症的最新流行病学数据,结合该领域内的循证医学证据及临床实践经验,对骨质疏松症的诊疗作出了最新推荐。本文对该指南的要点进行解读,以期为医务工作者更好地理解和遵循指南提供帮助。

关键词：骨质疏松症流行病学数据治疗解读

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新媒体文化中趣味的区隔与导向

社会科学战线 2019年第7期 146-155页

作者：夏维波吉林师范大学新闻与传播学院

文章以抖音与快手为案例,通过相关调查和文献研究,认为新媒体在商业化竞争中由于对调性的不断强化建构,致使用户社群的趣味不断区隔,乃至出现“歧赏”现象。互联网带来了用户的民主性参与,却强化了大众文化的去中心化趋势,乃至带来文化... 详细信息

文章以抖音与快手为案例,通过相关调查和文献研究,认为新媒体在商业化竞争中由于对调性的不断强化建构,致使用户社群的趣味不断区隔,乃至出现“歧赏”现象。互联网带来了用户的民主性参与,却强化了大众文化的去中心化趋势,乃至带来文化社群审美趣味的对立,对社会主义核心价值观建设提出了深层挑战。新媒体应强化文化责任和导向功能,培养和引导用户趣味,建构积极健康、多元向上的大众文化共同体。

关键词：新媒体文化趣味生产趣味消费趣味导向抖音快手

Case report:Severe skeletal involvement in Xanthoma Disseminatum

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Case report:Severe skeletal involvement in Xanthoma Dissemin...

A Fast Trajectory Optimization of Pinpoint Landing by Chebyshev Pseudospectral and SOCP

中华医学会第七次全国骨质疏松和骨矿盐疾病学术会议

作者： Lu Yuan Mei Li Ou Wang Yan Jiang weibo xia Key Laboratory of Endocrinology Department of EndocrinologyMinistry of HealthPeking Union Medical College HospitalChinese Academy of Medical Sciences

Objective To report a new case on Xanthoma Disseminatum for further understanding of the characterisation of skeletal involvement and treatment of Xanthoma Disseminatum. Method We report a 45-year-old patient presented with a ten year history of xanthoma around the eye and nose,central diabetes insipidus and T2DM,as well as a four year history of pain in the limbs,loosening of teeth and the recent onset of *** gene CYP27A1 was screened by direct sequencing for

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A Fast Trajectory Optimization of Pinpoint Landing by Chebys...