ABSTRACT
Objective To investigate the application of evidence-based medicine combined problem-based learning in clinical teaching of respiratory medicine. Methods 47 students were divided into two groups. EBM-PBL was applied in the experimental group including 27 students and PBL was applied in the control group including 20 students. Teaching effect was evaluated by objective and subjective indicators. Data were analyzed using SPSS 13.0 software and Fisher's exact probability test was also applied. Results The proportion of high level evidences (grade A) that provided by the students in experimental group (51.3％) was significantly higher than that in the control group (30.2％) (P<0.05). About 90％ students in the experi-mental group believed that EBM-PBL could improve their abilities of information acquisition and utiliza-tion, problem analysis and solving as well as multiple discipline literature synthesizing, which was signifi-cantly higher than that in the control group (P<0.05). Conclusion EBM-PBL could cultivate the students' awareness of evidence and the level of clinical decision-making so as to enhance their comprehensive abil-ities, which was superior to mere problem-based learning.
ABSTRACT
In this study,the common critical medical cases were organically combined with SimMan simulation system,which enabled students to deeply understand the diagnosis,treatment of disease and clinical operation as consulting real patients.Also,it could improve their clinical thinking ability,clinical skills and operational level.
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This study compared the efficacy and safety of tiotropium bromide inhalation powder (spiriva) and doxofylline oral tablet (doxofylline) in the treatment of chronic obstructive pulmonary disease (COPD). A multi-center, randomized, double-blind, double-dummy, parallel-controlled study involved 127 eligible stable moderate to severe COPD patients treated with inhaled tiotropium dry powder (18 μg/day) or oral doxofylline tablets (0.2 g/time, 2 times a day) for 12 and 24 weeks. Before and after treatment for 12 weeks and 24 weeks, respectively, pulmonary function, 6-min walking distance and dyspnea index were recorded. The results showed that in both tiotropium group and doxofylline groups, after 12-week treatment, FEV(1), FEV(1)/FVC% and 6-min walk distance were significantly higher than those before the medication, while dyspnea index decreased as compared with that before treatment. After 24-week treatment, a slight improvement in the measures was observed as compared with that of 12-weeks treatment, but the difference was not statistically significant. With both 12-week and 24-week treatment, the effect of tiotropium was slightly better than that of doxofylline tablets, with the difference being statistically insignificant. The major adverse events in the tiotropium group and doxofylline group were observed in 9 cases (9.9%) and 12 cases (12.9%), respectively, and no statistically significant difference was found between them. We are led to conclude that both tiotropium at 18 μg a day and doxofylline tablets at 0.2 g/day (two times a day) are effective and safe for the treatment of COPD.
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Objective: To study the protective effect of Complex EGb(C-EGb) on cerebral ischemic damage. Methods: SD rat model of middle cerebral artery occlusion(MCAO) was established according to the method described by Zea Longa,et al. The neurological symptoms and brain infarction range in rat models were evaluated. Mouse model of cerebral ischemia-reperfusion was set up by ligating bilateral common carotid arteries and loosening them in 30 minutes. Effects of C-Egb on superoxide dismutase (SOD) activity, blood glutathione peroxidase (GSH-Px) level, catalase activity and plasma malonyl dialdehyde (MDA) content were observed. Results: C-EGb markedly improved the neurological symptoms and reduced the range of cerebral infarction in MCAO rats. It also decreased the inhibition of SOD, GSH-Px and CAT activity and reduced the production of MDA in ischemia-reperfusion mice. Conclusion: C-EGb has protective effect on brain tissue from cerebral ischemic damage and its effect is better than that of EGb and that of the mixture of EGb.