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Objective:To evaluate the effect of the improved team-based learning (TBL) teaching method in the undergraduate probation course of ophthalmology based on the goal of cultivating excellent doctors.Methods:The undergraduates of clinical medicine were randomly divided into experimental group and control group. The control group ( n=50) was given conventional ophthalmology probation teaching, while the experimental group ( n=50) was given ophthalmology probation teaching of improved TBL teaching method. The theoretical examination performance and skill assessment results of students in the two groups were compared, and the subjective evaluation of the students on the teaching was also compared. SPSS 23.0 was used to conduct t-test and Wilcoxon's rank sum test. Results:The theoretical examination performance of experimental group (29.68±4.52) was better than that of control group (27.84±4.33), with significant differences ( P<0.05); the skill assessment results of experimental group (32.88±5.05) were also better than those of the control group (30.88±6.99), with significant differences ( P<0.05); the subjective evaluation of teaching effect in each item of experimental group was better than that of control group ( P<0.05). Conclusion:The improved TBL teaching method can not only improve students' theoretical knowledge and experimental skills, but also improve students' self-study and teamwork ability, which will provide a feasible educational reform plan for achieving the goal of cultivating excellent doctors.
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BACKGROUND: Previous studies have reported that femoral head finite element models are mostly modeled with single or few samples for specific biomechanical research, but there is little research on model stability. OBJECTIVE: To compare the models of normal femoral head and osteonecrosis of the femoral head with multiple samples, and to analyze the accuracy and stability of the models through the comparison of stress distribution and mechanical parameters, so as to provide mechanical basis for prevention and treatment of collapse of osteonecrosis of the femoral head. METHODS: Totally 20 sides uncollapsed of osteonecrosis of the femoral head one year of non-surgical treatment were selected as the experimental group, and the healthy side of 20 patients with unilateral osteonecrosis of the femoral head were set as the normal group. The CT data of the femoral head were collected to establish the finite element model. The stress distribution of normal femoral head and osteonecrosis of the femoral head, the maximum equivalent stress and the maximum total deformation at the weight-bearing area of the femoral head were observed and compared. This study was approved by the Medical Ethics Committee of Wangjing Hospital of China Academy of Chinese Medical Sciences. Patients signed the informed consent. RESULTS AND CONCLUSION: (1) The finite element models of normal proximal femur, non-necrotic proximal femur and necrotic bone were established. The number of elements and nodes were 502 568±114 196, 692 608±154 678; 449 954±125 824, 623 311±171 401; 19 133±13 167, 27 577±19 131, respectively. (2) When the load was set by simulating one-foot standing position, the cloud image showed that when 2.5 times body weight applied to the weight-bearing area of the femoral head; the surface stress of the weight-bearing area of the normal femoral head was uniform. The stress was uniformly distributed in the femoral head along the stress trabeculae, and the calcar femorale bears the most. The stress concentration area appeared on the surface of the weight-bearing area and the necrotic area of osteonecrosis of the femoral head. The stress was scattered and distributed on the inner and outer sides of the femoral neck and the femoral head of osteonecrosis of the femoral head produced more deformation than the normal femoral head. (3) The maximum total deformation of the weight-bearing area of the osteonecrosis of the femoral head and the normal femoral head was (4.14±1.31) mm and (1.36±0.22) mm and the maximum equivalent stress was (1.94±0.77) MPa and (0.75±0.19) MPa, respectively, and with statistically significance (P < 0.05). Moreover, two groups of data tend to be concentrated and the models are stable. Through the comparison of multi-sample normal femoral head and osteonecrosis of the femoral head, the CT gray-assigned method reflects the actual mechanical properties of osteonecrosis of the femoral head, and has good accuracy and stability.
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OBJECTIVE： To analyze the formulation regularity of Chinese patent medicine for knee osteoarthritis （KOA）， and to provide reference for the clinical standard use of Chinese patent medicine for KOA and the research and development of new drugs. METHODS： Chinese Pharmacopoeia （2015 edition， part Ⅰ），National Drug Reimbursement List （2017 edition）， National Essential Drug List （2017 edition）， Chinese Materia Medica Preparation （1992 version）， Compilation of National Standard for Chinese Patent Medicines （2002 edition）， Handbook of Rational Application of Chinese Patent Medicines in Surgery and Orthopedics （2010 edition） were searched to collect the type and formulation of Chinese patent medicines for “KOA”， “osteoarthritis”， “Bi syndrome”， “promoting blood circulation and removing blood stasis， dispelling wind and removing dampness， tonifying liver and kidney”. Supplementary the type and formulations of Chinese patent medicines for KOA by questionaire survey of clinial experts. The types， properties， meridian tropism， frequency and combination of medicinal materials used in Chinese patent medicine formulations were counted by using TCM inheritance auxiliary platform software V 2.5. The association rules and entropy clustering method were used to analyze the formulation regularity. RESULTS： A total of 190 Chinese patent medicines were collected， involving 289 TCM. With the top 10 used frequency being Angelica sinensis （75 times）， Boswellia carterii （55 times）， Carthamus tinctorius （53 times）， Commiphora myrrha （51 times）， Achyranthes bidentata （49 times）， Notopterygium incisum （47 times）， Angelica pubescens （45 times）， Saposhnikovia divaricata （45 times）， Angelica dahurica （39 times）， Ligusticum chuanxiong （39 times）. Medicinal material were mainly Xinwen in properties field and mainly liver meridian and spleen meridian in meridian entry field. Top 5 frequency of medicinal material combinations were C. myrrha-B. carterii， B. carterii-A. sinensis， A. sinensis-N. incisum， A. bidentata-A. sinensis， L. chuanxiong-A. sinensis. 14 core medicinal material combinations and 7 new developed formulations were concluded. CONCLUSIONS： This study analyzed the formulation regularity of Chinese patent medicines for KOA with the help of TCM inheritance auxiliary platform software V 2.5， which can provide reference for clinical differentiation of symptoms and signs and research and development of related new medicines related to KOA.