Practice and reflection on educational reform for cultivating the clinical thinking ability of medical students in internal medicine / 中华医学教育探索杂志

Objective:To evaluate the effects of comprehensive reform of clinical education on cultivating the clinical thinking ability of medical students in internal medicine.Methods:A total of 44 clinical interns on medicine rotation were included in this study and divided into experimental group and control group, and a series of measures for clinical teaching reform, which included undergraduate tutorial system, team-based learning (TBL) mode, combination of electronic medical record and handwritten medical record, as well as formative assessment, were applied to fully promote clinical thinking ability of medical students. SPSS 17.0 software was used to compare the scores of final academic tests of rotation and competition of medical record writing between the control and the experiment groups. Self-designed questionnaires on undergraduate tutors and clinical interns were applied to comprehensively evaluate the effects of this education reform.Results:Independent-sample t tests showed there were statistically significant difference ( P<0.01) in the scores of final academic tests of rotation and competition of medical record writing between the two groups, and the mean score of the experiment group was higher than that of the control group. Questionnaire survey showed that tutors and clinical interns both fully affirmed the positive effects of the education reform on cultivating clinical thinking ability of medical students in internal medicine. Conclusion:Application of comprehensive education reform in clinical teaching of internal medicine, which based on introduction of undergraduate tutorial system and TBL mode, could effectively promote the clinical thinking ability of medical students and the teaching quality.

Effects of electroacupuncture on cochlea morphology and expression of aquaporins in guinea pigs with endolymphatic hydrops / 中国针灸

<p><b>OBJECTIVE</b>To observe the effects of electroacupuncture (EA) on cochlea morphology and expression of aquaporin 1 (AQP1) in guinea pigs with endolymphatic hydrops, so as to explore the possible mechanism of EA on endolymphatic hydrops.</p><p><b>METHODS</b>Forty guinea pigs were randomly divided into a blank group, a model group, a medication group and an EA group, 10 guinea pigs in each one. Model of endolymphatic hydrops was established by using intraperitoneal injection of aldosterone. Guinea pigs in the blank group and model group were treated with identical immobilization as EA group but no treatment was given; guinea pigs in the medication group were treated with intragastric administration of hydrochlorothiazide at a dose of 5 mg/kg, once a day for consecutive 10 days; guinea pigs in the EA group were treated with' EA at "Baihui" (GV 20) and "Tinggong"(SI 19), once a day for consecutive 10 days. The serum ionic concentration in each group was tested by turbidimetric method; hematoxylin-eosin staining was used to measure the severity of cochlea hydrops; immunohistochemical method was used to observe the expression of AQP1 in the cochlea.</p><p><b>RESULTS</b>(1) There was no endolymphatic hydrops in the blank group, moderate-severe endolymphatic hydrops in the model group and slight endolymphatic hydrops in the EA group and medication group. (2) The concentration of K+ and Ca2+ in the EA group was higher than that in the model group and medication group (all P<0. 01); the concentration of Na+ was lower than that in the model group (P< 0. 01) but higher than that in the medication group (P<0. 01); the concentration of Cl- was higher than that in the medication group (P<0. 01), but not significantly different from the model group (P>0. 05). (3) The ratio of expression area of AQP1 in the model group was lower than that in the blank group (P<0. 01); the ratio of expression area of AQP1 in the EA group was higher than that in the model group (P<0. 01), and lower than that in the medication group without significant difference (P>0. 05).</p><p><b>CONCLUSION</b>EA could relieve the endolymphatic hydrops in guinea pigs; the mechanism is likely to be related with up-regulating the expression of AQP1 in cochlea and ion concentration might be an important factor involved.</p>

Professor Chen Huade’s Experience on Treatment of Meniere Disease by Acupuncture and Traditional Chinese Medicine / 浙江中医药大学学报

[Objective]To explore the clinical experience of Professor Chen on treating Meniere Disease by acupuncture and Chinese medicine.[Method] By col ecting clinical cases and combining with the record of Professor Chen ’s clinical experience, sorting and analyzing the theory and method of Professor Chen Huade’s clinical treatment on Meniere Disease.[Result] Professor Chen emphasizes acupoints selection treatment on the basis of syndrome differentia-tion, applies body acupuncture, scalp acupuncture and ear acupuncture, moreover focuses on the combination of traditional Chinese medicine in his diagnosis and treatment on Meniere Disease, which is based on the Chinese medicine theory “treating disease from the root”.[Conclusion] Professor Chen has his own insights on treating Meniere’s disease by combining acupuncture with traditional Chinese medicine treatment on Meniere Disease.“This”method has signifi-cant effect in clinic, it worths spreading.