Objective:Acupuncture is an efficient treatment modality for many different training,but the technique can be challenging to master.Identification of the different acupuncture points can now be practiced in a standardized and patient-safe simulation-based environment.We aim to gather additional evidence regarding simulation-based training of acupuncture skills and hope that the simulation-based test developed and will be used for simulation-based mastery learning in future develop.Methods:The aim of this study was to develop a test of acupuncture skills using the TCM(Traditional Chinese Medicine) Meridians & Acupoints Anatomy Teaching Platform and gather validity evidence using Messick’s framework.Novice medical students without prior experience in acupuncture(n=43),intermediate medical students who had finished the mandatory acupuncture course(n=24),and skilled acupuncture doctors(n=17) were included in the study.One-hundred and seven acupuncture points were presented to the participants in identical randomized order and they were asked to identify each point by touching the correct anatomical location on the simulator.The simulator automatically registered the accuracy of participants’ answers.Results:The reliability of the final test(66 acupuncture points) was at a high level with a Cronbach’s alpha of 0.98 and only 16 acupuncture points were needed to ensure a reliability of 0.90.The test could discriminate significantly between all three groups and a credible pass/fail-score of 34 points was determined which resulted in eight out of 43(19%) novices passing the test and only two out of 17(12%)experienced failing the test.These consequences were statistically significant(P <0.001).Conclusion:Based on Messick’s framework we demonstrated strong validity evidence for a newly developed simulation-based test of acupuncture points localization skills.The test can be used as an aid to decide when trainees are ready to progress to more advanced training and clinical practice.Compared with the traditional point
【目的】观察针刺对胰岛素抵抗模型大鼠骨骼肌胰岛素受体底物-1(IRS-1)、胰岛素受体底物-2(IRS-2)和葡萄糖转运蛋白4(GLUT4)的影响。【方法】将32只SD大鼠随机分成正常组、正常针刺组、模型组和模型针刺组,采用葡萄糖氧化酶法、酶联免疫吸附法(ELISA)、实时荧光定量PCR等方法,检测并比较各组大鼠空腹血糖(FPG),血浆胰岛素(FINS),胰岛素敏感性指数(ISI),血清C-肽(C-P),骨骼肌IRS-1、IRS-2、GLUT4 m RNA表达。【结果】模型组大鼠的FPG、FINS、C-P水平较正常组显著升高(P<0.01),ISI,IRS-1、IRS-2、GLUT4 m RNA表达较正常组显著降低(P<0.01);模型针刺组的FPG、FINS、C-P水平较模型组显著降低(P<0.05或P<0.01),ISI,IRS-1、IRS-2、GLUT4 m RNA表达较模型组显著升高(P<0.01)。【结论】针刺可能在基因转录水平对IRS-1、IRS-2、GLUT4产生影响,从而改善PI3K通路的信号转导。
目的:观察针刺对脑缺血大鼠不同时间段神经元凋亡及STAT5表达的调节作用,探讨脑缺血后针刺调节机体自稳态的可能作用机制。方法:SD大鼠造模成功后随机分为假手术组、模型组、针刺组、AG490组和AG490+针刺组,再分为2 h、1 d、3 d、7 d及21 d 5个亚组,与假手术组对照。电凝闭右大脑中动脉复制脑缺血模型,针刺大椎、百会干预。采用透射电镜观察神经元超微结构,TUNEL观测神经元凋亡,原位杂交技术检测STAT5 m RNA含量。结果:透射电镜观察和TUNEL检测细胞凋亡发展趋势相似,在缺血3 d后大鼠神经元凋亡达到高峰。针刺组抗细胞凋亡均优于同时段的其他组别,AG490+针刺组有一定改善作用,模型组和AG490组神经元凋亡明显。脑缺血后2 h^1 d模型组和针刺组STAT5 m RNA升高,AG490+针刺组低于针刺组(P<0.01)。3~7 d针刺组高于模型组(P<0.05),AG490组和AG490+针刺组的含量较低(均P<0.01)。结论:针刺能改善脑缺血细胞凋亡,调节机体自稳态的内在机制可能是通过上调STAT5的水平而实现的。
