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Objective:To explore the application of micro-lecture system based on ASSURE model in clinical practice teaching of dermatology.Methods:Sixty clinical medicine undergraduate intern doctors in Batch 2014 of Anhui Medical University were randomized into 2 groups, with thirty interns in both experimental group and control group. Micro-lecture system based on ASSURE model teaching method was adopted in experimental group, while traditional teaching method was adopted in control group. At the end of practice, theory test scores and medical record writing was used to evaluate the clinical ability of interns in two groups, and questionnaire survey was conducted to evaluate the satisfaction of interns with the teaching method of micro-lecture system based on ASSURE model. SPSS 16.0 was used for t test. Results:①Theory test scores were higher in experimental group than in control group, with statistically significant differences between the two groups ( P<0.05); ②The scores of history of illness, physical examination, treatment plan and the medical record writing were higher in experimental group than in control group ( P<0.05); ③At the end of internship, the questionnaire showed that the interns in the experimental group were more recognized for this new way of teaching. Conclusion:Micro-lecture system based on ASSURE model teaching method has achieved better results in the teaching of dermatology, which is worthy of future research and promotion.
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Objective To analyze the dermoscopic features and patterns of onychomycosis.Methods From February to July in 2017,hospitalized patients from the Department of Endocrine Dermatology of the People's Hospital of Xuancheng City was enrolled and subjected to direct microscopic examination of fungi in nails,and the patients with positive results for fungi were diagnosed with onychomycosis.And then,dermoscopic photographs of infected nails were taken to analyze the dermoscopic characteristics and patterns of onychomycosis.Results A total of 205 patients with 634 infected nails were investigated.The dermoscopic characteristics on the nail plates included marble-like turbid areas (47.3％,300/634),pigmentation (30.9％,196/634),splinter hemorrhages (18.3％,116/634) and onycholysis (13.2％,84/634).The prevalence rates of marble-like turbid areas,pigmentation and onycholysis all significantly differed between distal and lateral subungual onychomycosis (DLSO) group and total dystrophic onychomycosis (TDO) group (X2 =42.09,31.23,18.19,respectively,all P ＜ 0.01).The dermoscopic characteristics at the free edge of the nails included nail thickening (33.1％,210/634) and subungual deposition of keratin and debris (26.5％,168/634).The TDO group showed significantly higher prevalence rates of nail thickening and subungual deposition of keratin and detritus compared with the DLSO group (x2 =44.3,18.52,respectively,both P ＜ 0.01).Periungual skin dryness and desquamation occurred more frequently in the TDO group than in the DLSO group (X2 =16.07,P ＜ 0.01).Of the 634lesional nails,141 (22.2％) showed a short spiked pattern,210 (33.1％) showed a longitudinal striated pattern,202 (31.9％) showed a linear edge pattern,and 193 (30.4％) showed a distal irregular termination pattern.Conclusion The main characteristic dermoscopic manifestations of onychomycosis are marblelike turbid areas,subungual deposition of keratin and debris,periungual skin dryness and desquamation,and characteristic dermoscopic patterns of onychomycosis are short spiked pattern,longitudinal striated pattern,linear edge pattern and distal irregular termination pattern.
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Objective T o explore the casual relationship and the significance of identification am ong the injury, disease and dam age consequence in the disability evaluation of lum bar spondylolysis by the stan-dard for identifying grading of disability caused by w ork-related injuries. Methods T he general data, in-jury m anner, clinical treatm ent and the im aging exam ination of 32 lum bar spondylolysis cases w ere col-lected and retrospectively analyzed. A ccording to the degree of participation in the injury and dam age consequence, the identification and assessm ent of casual relationship w as m ade, and the grading of dis-ability w as assessed. Results For 32 cases, injury had no effect on dam age consequence in 7 cases, slight effect in 5 cases, secondary effect in 13 cases, equivalent effect in 4 cases, and com plete effect in 3 cases. A ccording to the related item s in the standard for identifying grading of disability caused by w ork-related injuries, 3 cases w ere rated level 7, 5 cases w ere level 8, 6 cases w ere level 9, 11 cases w ere level 11 am ong the cases w hich existed causal relationship. Conclusion T he form ation of lum bar spondylolysis is connected to the factors of age, anatom y, occupation and injury m anner etc. T he degree of disability should be accessed com prehensively after the analysis of the casual relationship am ong the injury, disease and dam age consequence.
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Objective To analyze clinical features of and hypertrophy-related factors in patients with hypertrophic port-wine stains (PWS). Methods Patients with PWS were enrolled into this study from Anhui Provincial Hospital and the First Affiliated Hospital of Anhui Medical University between January 2010 and August 2014. Clinical features of hypertrophic PWS were investigated. The factors related to hypertrophy in PWS were analyzed by univariate and multivariate unconditional logistic regression analyses. Results A total of 262 patients with PWS were enrolled, 82 (30 males and 52 females)of whom had hypertrophic PWS with a median age of 32.5 years (range, 18 - 54 years). Among the 82 patients, 66(80.48%)had plaque-like hypertrophic PWS, 9(10.98%)had papular or nodular type, and 7 (8.54%)had mixed type; 56.10% (46/82)were aged ≥ 30 years, 41.46% (34/82)varied from 11 to 30 cm2 in lesional area, and 85.36% (70/82)showed purple lesions. There was a significant difference between patients with hypertrophic PWS and those with flat PWS in the distribution of age, lesional area and color(χ2 = 25.559, 10.580, 90.630, respectively, all P 0.05). Multivariate unconditional logistic regression analysis revealed that an age ≥ 30 years(OR = 2.889, 95%CI: 1.459 - 5.721)and purple lesions(OR = 19.984, 95% CI: 5.704 - 70.023)were factors related to skin hypertrophy in PWS. Conclusion An age ≥ 30 years and purple lesions seem to be hypertrophy-related factors in PWS.
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Objective To analyze the clinical feature and prognostic predictors of disseminated herpes zoster.Methods A retrospective study was carried out on 76 patients with disseminated herpes zoster collected from 2005 to 2012 in the Department of Dermatology,Anhui Provincial Hospital.Statistical analysis and comparisons were done.Results The incidence rate of disseminated herpes zoster was highest in the three age groups:70-79 years,30-39 years,and 60-69 years.Of these patients,59.21％ suffered from complications,and 44.74％ from postherpetic neuralgia.Logistic regression analysis showed that the occurrence of complications was significantly associated with age and impaired cellular immune function,and the incidence of postherpetic neuralgia with age,impaired cellular immune function and presence of underlying diseases.Conclusions There is a high incidence of complications in patients with disseminated herpes zoster,and impaired cellular immune function may be an important factor affecting its prognosis.
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Objective To analyze the clinical features, diagnosis, treatment and prognosis of neurosyphilis. Methods Clinical data on and laboratory findings in 18 cases with neurosyphilis collected in the Affiliated Provincial Hospital, Anhui Medical University from 2006 to 2008 were retrospectively studied.Results Among the 18 patients, 3 sufferred from asymptomatic neurosyphilis, 1 from meningeal syphilis, 7 from meningovascular syphilis, 5 from paralytic dementia, and 2 from intracranial space-occupation. Toluidine red unheated serum reagin test (TRUST) and Treponema pallidum particle agglutination test (TPPA) of sera were positive in all the patients; cerebrospinal fluid (CSF) TRUST was positive in 16 patients, and CSF TPPA in all patients. An increase was observed in CSF leukocyte count in 7 patients and in CSF protein in 13 patients.The findings on cerebral magnetic resonance imaging (MRI) mainly included demyelination, brain atrophy,cerebral infarction, etc. All the patients, except 2 with a TRUST titer of 1:4, experienced a 4-fold decrease in TRUST titer within a 3-month follow up. Clinical symptoms of neurosyphilis improved in all patients except 1 with paralytic dementia. Conclusions The diversity of clinical manifestations usually leads to the misdiagnosis of neurosyphilis, which should be diagnosed based on comprehensive analysis of clinical characteristics as well as laboratory and imaging findings. Early diagnosis and treatment are beneficial to its prognosis.