“Problem - based learning” has become a teaching model widely used in medical undergraduate classroom teaching. In this model, the answers to questions, relevant facts or concepts are not presented directly by the lecturer. The complex questions raised by students are used as a tool to help students learn relevant concepts and principles. This paper discusses the teaching model based on “problem-based learning”, including “problem-based learning” combined with new technologies (new media, three-dimensional printing technology, wisdom teaching), and other teaching mode (case-based learning, lecture-based learning, etc.), as well as the progress in the application of these patterns in clinical teaching of undergraduate course, and analyzes its advantages and disadvantages, hoping to provide a reference for medical undergraduate teaching mode.
Objective To investigate the factors that affect platelet-rich plasma (PRP) in promoting bone regeneration and repairing. Methods Recent l iterature was reviewed, concerning the preparations of PRP, physiological mechanism and the latest appl ications in orthopedic field. Results PRP, the concentrated body of autologous platelet, was rich in platelets and was the source of autologous growth factors. Many studies had shown that PRP played an important role in promoting bone regeneration and repairing. However, a few experimental results contradicted this point. The reason might be that the biological properties of PRP were influenced by various factors, such as workmanship, vector, activation schemes, working concentration, individual difference. Conclusion The concentration and qual ity of platelet and other related factorsof PRP affect the rel iabil ity of the results and conclusions. So an efficient and stable production method of PRP should beestabl ished.
Objective To observe clinical effects of burn wounds treatment with bovine amnion and to screen the best method of preparing and storing of bovine amnion. Methods From January 2004 to January 2005,We selected randomly 58 patients with superficial Ⅱ° wound, deepⅡ° wound, autografting area for removal of eschars and tangential excision, fetching skin area or residual burn wound . Using auto-control, every burn wound was divided into 3 parts and was treated with 3 dressings: bovine amnion dealt with by 0.1% chlorhexidine（group A）, bovine amnion dealt with by 0.4% glutaraldehyde（group B） and vaseline gauze dressing（group C as control）. The clinical effects were compared between different groupsand the method of preparing and storing bovine amnion was evaluated. Results The dressing texture of group A was softer than that of group B, and its flexibility was fine. The pretreatment was not necessary for dressing in group A. When the dressing was used on burn wounds in groups A and B, painwas slight, but pain was obvious in group C; healing time in groups A and B was much less than that in group C, showing statistically significant difference(P＜0.01). There was no statistically significant difference in healing time between groups A and B (P＞0.05). The infection ratio of burn wound in deepⅡ° wound and residual burn wound of groups A and B is much lower than that of group C, showing statistically significant difference (P＜0.05); in theother burn wounds there was no significant difference (P＞0.05). There was no statistically significant difference between groups A and B (P＞0.05). Conclusion Bovine amnion could make benefit on burn wounds healing, reduce infection ratio of burn wounds, could be used on different kinds of burn wounds. The clinical effect between bovine amnion dealt with by glutaraldehyde and by chlorhexidine is similar. Whereas the latter is more easy to be popularized.
Objective To describe the design and application of an emergency response mobile phone-based information system for infectious disease reporting. Methods Software engineering and business modeling were used to design and develope the emergency response mobile phone-based information system for infectious disease reporting. Results Seven days after the initiation of the reporting system, the reporting rate in the earthquake zone reached the level of the same period in 2007, using the mobile phone-based information system. Surveillance of the weekly report on morbidity in the earthquake zone after the initiation of the mobile phone reporting system showed the same trend as the previous three years. Conclusion The emergency response mobile phone-based information system for infectious disease reporting was an effective solution to transmit urgently needed reports and manage communicable disease surveillance information. This assured the consistency of disease surveillance and facilitated sensitive, accurate, and timely disease surveillance. It is an important backup for the internet-based direct reporting system for communicable disease.
ObjectiveTo investigate the effect of using hemoglobin-revised trauma score (HB-RTS) on predicting mortality risk in trunk injury patients.
MethodsAccording to case control study rules, medical records of patients with trunk injury who were treated between July 2011 and October 2013, were collected. Patients were divided into two groups according to their survival prognosis within 28 days. The HB-RTS, revised trauma score (RTS), and injury severity score (ISS) of the two groups were calculated. The receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) and Youden's index were calculated. And then, we selected the optimal cutoff value using HB-RTS and RTS to predict the trunk injury patients' mortality and calculated their sensitivity, specificity, and accuracy. In the end, the correlation of ISS with HB-RTS and RTS using linear correlation analysis method was analyzed.
ResultsBesides RTS, HB-RTS and ISS in the death group were statistically significant higher than that in the survival group. The AUC of HB-RTS and RTS of the two groups were 0.922 and 0.888, respectively. The sensitivity of HB-RTS and RTS were 91.5% and 83%; and the specificity of HB-RTS and RTS were 95.7% and 76.6%, respectively. The correlation of HB-RTS and ISS was -0.592, while the correlation of RTS and ISS was 0.585.
ConclusionCompared to RTS, ROC of HB-RTS is enlarged, the specificity is increased, and the sensitivity is decreased. HB-RTS has stronger correlation with ISS than with RTS. The predictive effect of HB-RTS is higher than RTS in predicting mortality of trunk injury patients.
ObjectiveTo understand the current situation and challenges of basic research on respiratory diseases in China.MethodsTo summarize and analyze the application and projects funded in the field of respiratory medicine (Code: H01 and H1615) from National Natural Science Foundation of China (NSFC) during 2010 to 2017.ResultsA total of 2 191 projects of 11 766 applications were funded by NSFC in the field of respiratory medicine and the total subsidy fund reached ￥981 279 000. A total of 1 130 projects of 5 915 applications were funded in the Research Projects, including 1 021 General Program projects, 14 Key Program projects, 16 Major Research Plan projects, 1 Major Research Program project, 2 Program projects of Joint Funds, 30 International (Regional) Cooperation and Exchange Program projects, and 46 Emergency Management Program projects. A total of 1 061 projects of 5 851 applications were funded in the Talent Projects, including 853 Young Scientists Fund projects, 191 projects of Fund for Less Developed Regions, 4 projects of Distinguished Young Scholars, 4 projects of Excellent Young Scientists Fund, and 9 projects of the Research Fund for International Young Scientists. The projects funded were mainly distributed in the field of respiratory inflammation and infection, asthma, chronic obstructive pulmonary disease, pulmonary circulation and pulmonary vascular disease. The top three research directions were asthma (19.0%), acute lung injury and acute respiratory distress syndrome (15.4%), chronic obstructive pulmonary disease (12.7%), pulmonary circulation and pulmonary vascular disease (12.7%) in sequence. Average funding rate of respiratory tumor (application code: H1615) was 17.2%.ConclusionsSince the Department of Health Science of NSFC was established in 2009, with the increasing of NSFC budget, the basic research in the field of Respiratory Medicine has been developed rapidly. With the efforts of scientific researchers and clinical medical workers, research in the field of respiratory medicine will achieve rapid development in China.
Objective To investigate the application of arm medial fascio-cutaneous flap pedicled with cutaneous nerve and nutrient vessel. Methods From February 1999 to December 2004, 18 cases of skin and soft tissue defect in axillary region, elbow and forearm were treated with arm medial fascio-cutaneous flap pedicled with cutaneous nerve and nutrient vessel. Arm medial fascio-cutaneous flap was directly transferred in 3 cases, adversely transferred in 15 cases. The flap area was 4.5 cm×8.5 cm. Results Vein circulation crisis was observed in 3 cases. Of the3 cases, 1 was necrosis and the other 2 by decompressing small vein were saved.The rest 15 cases survived.The period of follow-up was 3 to 30 months. Flap was satisfactory in appearance and function. Conclusion Arm medial fascio-cutaneous flap pedicled withcutaneous nerve and nutrient vessels can be directly or adversely transferred to repair adjacent soft tissue defect.
Objective To introduce the research update of microencapsulation and its application in orthopedics. Methods Recent articlesconcerned were extensively reviewed. Results Drugs and cells modified by genecould be encapsulated in different materials and be implanted in vivo avoiding a host immune system rejection. It act as a continuous source of desired medicine for enhancement of bone healing, the treatment of bone tumor and bone infection, and the regeneration of bone and cartilage. Conclusion Microencapsulation can be used asa carrier for drugs and cells modified gene to treat related disease in orthopedics.
ObjectiveTo explore the application effect of preoperative health education in patients with glaucoma.
MethodsA total of 120 patients with glaucoma who underwent the surgery from February 2013 to December 2014 were randomly divided into control group and observation group, with 60 cases in each. The routine health education was performed on the patients in the control group while the personalized health education (on the basis of adopting the knowledge of the self-designed questionnaire) on the ones in the observation group. The results of Self-rating Anxiety Scale (SAS), Self-rating Depressive Scale (SDS), extent of disease knowledge, and nursing satisfaction were observed.
ResultsAfter health education, the scores of SAS and SDS was 29.9±7.6 and 32.0±7.8, respectively in the observation group, which were significantly lower than those in the control group (34.9±7.9 and 35.9±8.3, P<0.05). Awareness of related knowledge and nursing satisfaction were 53 patients (88.3%) and 57 patients (95.0%) in observation group and 49 patients (81.7%) and 53 patients (88.3%) in the control group, (P>0.05).
ConclusionPreoperative health education can improve the patients psychology and may reduce the occurrence of complications.
ObjectiveTo explore the utility and advantage of same-day surgery mode of Mammotome minimally invasive operation (MMT) in ambulatory surgery center, and summarize the key points of clinical management.MethodsFemale patients who underwent MMT in West China Hospital of Sichuan University between June and December 2019 were included. According to the operation mode, the patients were divided into same-day surgery group and routine group (routine day operation). The perioperative data were analyzed.ResultsA total of 1 297 female patients were included. Among them, 571 cases were in the same-day surgery group and 726 cases were in the routine group. There was no significant difference in baseline data, intra-operative bleeding volume, operation time, or complication rate between the two groups (P>0.05). There were significant differences in the number of masses (χ2=13.384, P<0.001), pathological type (χ2=11.990, P=0.007) and operation method (χ2=89.185, P<0.001). The length of hospital stay in the same-day surgery group was significantly shorter than that in the routine group (Z=–29.746, P<0.001); the cost of biopsy (Z=–8.549, P<0.001), the cost of surgical instruments (Z=–9.564, P<0.001), and the total cost of hospitalization (Z=–10.378, P<0.001) in the same-day surgery group were less than those in the routine group. In addition, the result of generalized estimating equation showed that the postoperative pain scores of patients in the same-day surgery group were lower than those in the routine group (P<0.001).ConclusionsThe same-day surgery mode of MMT is safe and feasible with high time economic benefits, which is worthy promoting in ambulatory surgery center. Cautions should addressed with patients’ safe and high-quality health education.
