Application of case-based learning in training vascular surgery resident doctors / 中华医学教育探索杂志

Objective To explore the application and effect of case-based learning(CBL)in vas-cular surgery clinical teaching. Methods Totally 37 resident doctors were randomly divided into 2 groups respectively: CBL teaching group (n=21)and traditional teaching group (n=16). CBL teaching was con-ducted through the following procedures:selecting typical cases-establishing and applying typical case library-autonomous learning-holding regular seminars. Traditional teaching was conducted through the following procedures: basic theory studying-participating in clinical practice-participating in case discus-sion. Evaluation was conducted based on test socre (written test and clinical operational skill test)and res-idents' feedback of teaching effect. Data were statistically described and independent sample t test was performed. Results Theoretical exam score and clinical skill test score were high in CBL group than in traditional group ((thoretical score:(85.53 ±1.75) vs. (79.94 ±2.29);clinical skill test score:(85.10±1.64)vs.(80.31±1.82)). CBL teaching group had advantages in improving learning efficiency, cultivat-ing clinical thinking,promoting mastery and application of knowledge,broadening knowledge, promoting communication and expression ability and improving study enthusiasm ,et al . Conclusion CBL teaching can effectively improve the teaching quality and obtain higher evaluation. Typical case li-brary should be constantly improved and education of vascular surgical basic theory should be strength-ened to promote CBL.

Observation of layering fibula feet cushion in prevention of deep venous thrombosis after total hip replacement / 中国实用护理杂志

Objective To evaluate the curative effect of layering fibula feet cushion to prevent deep venous thrombosis(DVT) after total hip replacement(THA).Methods 100 patients who underwent THA were divided into two groups at random.The research group was applied layering fibula feet cushion while the control group was applied general feet cushion.VAS,the occurrence rate of DVT,disappearance time of feet swelling and Harris hip function score were used to evaluate the curative effect.Results In according to these four observation indexes,the score of the research group was better than the control group.The effective rate of the research group was 96％,while the control group was 82％.There was a significant difference between the two groups.Conclusions The layering fibula feet cushion can effectively prevent deep venous thrombosis after total hip replacement.It can be generalized and applied in clinical nursing.

System Reading Therapy on Alexia after Stroke / 中国康复理论与实践

@#ObjectiveTo explore the effect of system reading therapy on alexia after stroke.Methods104 stroke patients with alexia were divided into two groups: observation group(51) and control group(53). General speech training were used for the two groups, while the observation group received system reading training at the same time, all for 30 minutes, once a day for 1 month. Chineses Standard Aphasic Examination was applied to assess the reading ability before and 1 month after treatment.ResultsThere are three kinds of alexia in the patients: frontal alexia, alexia with agaphia, and subcortical aphasic alexia. Reading ability improved in the two groups (P<0-01), but the observation group was better than the control group(P<0-05).ConclusionSystem reading therapy is very helpful to improve reading ability of stroke patients with alexia.

Characteristics of Aphasia after Left Ganglion Impairment and Intervention: 6 Case Report / 中国康复理论与实践

@#Objective To explore the speech characteristics and intervention of aphasia after left basal ganglion impairment. Methods Chinese Standard Language Test of Aphasia is used to assess 6 patients with aphasia after left basal ganglion impairment. Schuell's stimulation approach and communication intervention of daily life were used. Results All the patients were difficult for verbal naming and active description. The ability of listening comprehension, speech, and reading improved after intervention. Writing ability improved in 2 patients. Conclusion Aphasia after left basal ganglion impairment appears difficulty of verbal naming and active description. Schuell's stimulation approach combined with communication training of daily life may be helpful to improve their speech.

Diagnosis of Arteriosclerosis Obliterans of Lower Extremity in Early Stage / 中国普外基础与临床杂志

Objective To explore the methods of early diagnosis of arteriosclerosis obliterans of lower extremity (ASOLE).Methods The related literatures on ASOLE detection means adopted clinically were reviewed,and their advantages and disadvantages were compared.Results Asymptomatic ASOLE could be discovered by determination of ankle brachial index (ABI) and toe brachial index (TBI),which was a good index for arterial function assessment of lower extremity.Pulse wave velocity (PWV) was more vulnerable and less sensitive than ABI,and therefore more suitable for screening of a large sample.ASI was an index to assess arterial structure and function,and it had a good correlation with PWV.Flow-mediated dilation (FMD) was a measurement evaluating the function of endothelial cell;Pulse wave measurement was simple,sensitive,and its result was reliable.Color Doppler ultrasonography could localizate the lesion and determine the degree of stenosis at the same time.Multiple-slice CT angiography (MSCTA) was more accurate than color Doppler ultrasonography,but its inherent shortcomings,such as nephrotoxicity of contrast agent,was still need to be resolved.3D-contrast enhancement magnetic resonance angiography (CE-MRA) had little nephrotoxicity,but a combination of other imaging methods was necessary.Microcirculation detections required high consistency of the measurement environment,but they were simple,sensitive and noninvasive,and therefore could be used for screening of ASO.Conclusion Publicity and education of high-risk groups,and reasonable selection of all kinds of detection means,are helpful to improve the early diagnosis of ASOLE.

Surgical treatment of familial adenomatous polyposis:a report of 45 cases / 中国普通外科杂志

Objective To summarize the clinical data of 45 cases of familial adenomatous polyposis(FAP) and the experiences of treatment and diagnosis of FAP. Methods Retrospectively analyzed of the clinical data was made on 45 FAP patients.The choice of operative procedure included total colectomy+ileostomy in 25 cases,subtotal colectomy+rectal polyposis electrocautery in 15,and total colectomy with ileo-anal anastomosis in 5. Results Average age of patients at first diagnosis was 33.5 years. A family history was found in 35 patients. Bleeding, diarrhea, pain are common clinical presentations, and the numbers of polyposis were all more than 100. All patients without malignant change survived for 3-21years;and metastasis of liver was the main cause of death in patients with malignant change. There were age differences between malignant and non malignant group. Conclusions FAP lacks typical clinical presentation, and misdiagnosis is not uncommon. Surgical therapy should be done on an individual basis and according to the actual condition of patients.