ABSTRACT
Objective To explore the effects of problem-based learning (PBL) method on the efficiency of teaching of Chinese medicine dermatology based on medical records. Methods Undergraduate students who were in the same grade were divided into experimental group and control group. The experimental group was taught with the PBL method based on medical records. Teachers selected medical records, combed knowledge points, designed questions and carried out teaching in response to questions. The control group was taught with traditional teaching method. The teaching efficiency of two groups was evaluated by using test scores and questionnaire survey. Results The scores of syndrome differentiation scores, medication scores, and the overall score of experimental group were better than those in the control group. Compared with the control group, learning initiative, ability to involve in the teaching and master knowledge, and ability of logical analysis and communication of experimental group were all improved remarkably. Conclusion PBL method based on medical cases is beneficial for the improvement of the level of diagnosing and treating skin diseases based on syndrome differentiation and ability of solving problem.
ABSTRACT
Objective:To describe long-term results of locking plate used for the treatment of non-osteoporotic fresh three-and four-part proximal humeral fractures with at least 2 years follow-up.Methods:The functional outcomes and the complications of non-osteoporotic three-and four-part fresh proximal humeral fractures treated with locking plate were assessed retrospectively.The active range of motion,the Constant score,the University of California at Los Angeles (UCLA) shoulder score,the visual analogue score (VAS) were employed to evaluate the postoperative shoulder function,and the radiographic images were taken to evaluate the neck-shaft angle of the proximal humeral and postoperative implant-related complications.Results:From January 2007 to October 2014,107 consecutive fresh three-and four-part non-osteoporotic fresh proximal humeral fractures were treated with a locking plate in our department.Among them,67 patients completed at least 2 years follow-up.The average follow-up time was (43.9 ± 23.3) months (range:24-108 months).The mean Constant score was 87.1 ± 11.7 (range:51-100),the mean UCLA score was 30.5 ± 3.9 (range:18-35),the mean VAS score was 1 ±2 (range:0-7).The mean active forward flexion was 159.0° ± 19.3° (range:80°-180°),the mean external rotation was 36.8°± 19.5° (0°-80°) and the mean internal rotation was T11 level (T2-LS level).There were 11 patients who suffered from complications.Screw perforations were observed in 5 (7.5％) patients,avascular necrosis of the humeral head was observed in 9 (13.4％) patients and traumatic osteoarthritis was observed in 5 (7.5 ％) patients.Six patients showed two or more complications.There was no significant difference in outcomes when comparing the patients with three-part fractures (31 patients) with those with four-part fractures (36 patients).The rates of complications and avascular necrosis were significantly higher in the four-part fracture group than in the three-part fracture group.Conclusion:The locking plate is an effective method in treating three-and four-part non-osteoporotic fresh proximal humeral fractures.Strict surgical indication and precise surgical skill are the key points for successful treating non-osteoporotic fresh proximal humeral fractures.There is a higher rate of complications and avascular necrosis of the humeral head in the four-part fractures than in the three-part fractures.