Effect of progressive problem-based learning in teaching of neurology / 中华医学教育探索杂志

Objective To evaluate the effect of progressive problem-based learning (PBL) in teach-ing of neurology and study its impact factors. Methods A total of 110 5-year undergraduate students were randomly divided into LBL and progressive PBL groups, with 55 students in each group. Both groups ac-cepted basic knowledge, clinical skills, case analysis and document retrieval teaching. Progressive PBL were given by three steps including introduction phase, transition phase and PBL stage. At the end of the internship, theoretical knowledg,practical skill scores and questionnaires were used to evaluate the effects of different teaching methods. Pearsonχ2 test was used to analyze the effects of gender, urban-rural character, mastery of relevant based knowledge and intra-group contribution on examination results of progressive PBL. Results Theoretical knowledge score of progressive PBL group was significantly lower than LBL group [(78.49 ±3.15) vs. (81.94 ±5.37), t=-4.11, P=0.000], while clinical skill score [(86.34 ±9.16) vs. (80.96±7.85), t=1.63, P=0.003] and clinical analysis score [(82.25±5.17) vs. (70.54±3.85), t=13.47, P= 0.000] of progressive PBL group were significantly higher than LBL group. Teaching satisfaction scales of learning interest ( χ2=7.21, P=0.007), self-learning ability ( χ2=6.70, P=0.010), knowledge use ability ( χ2=7.92, P=0.005), analytical thinking ability (χ2=4.36, P=0.037) and expression ability (χ2=9.17, P=0.003) in progressive PBL group were significantly higher than LBL group. Gender( χ2=0.0109,P=0.917) and urban-rural character (χ2=0.045, P=0.831) showed no significant impact on examination results of progressive PBL. While relevant based knowledge (χ2=6.82, P=0.009) and intra-group contribution (χ2=4.91, P=0.027) showed significant impact on examination results of progressive PBL. Conclusion Progressive PBL can improve the clinical skill and case analysis ability of students. Relevant based knowledge and intra-group contribution have significant impact on the effect of progressive PBL.

Effect of Acupuncture at Point Neiguan on Myocardial Ultramicrostructure in Myocardial Hypertrophy Mice / 上海针灸杂志

Objective To investigate the effect of acupuncture at point Neiguan on mouse myocardial hypertrophy.Methods Thirty-sixty healthy C57BL6 mice were randomized into blank, model and treatment groups, 12 rats each. In the treatment group, an acupuncture needle was inserted into point Neiguan and retained for 15 min, once daily. After nine days of treatment, the ratios of cardiac weight/tibial length were compared between the groups. Left ventricular myocardial tissues were processed by Masson trichrome staining in every group of mice. The differences in myocardial fiber arrangement and collagen fiber distribution between the groups were observed under the ordinary optical microscope in 100 times of field of vision. Sarcomere structure, myofibril arrangement, collagen fibers and mitochondria in injured myocardial tissues were observed by transmission electron microscopy. Results Heart rate increased significantly in the model group and decreased significantly in the acupuncture group compared with the blank group. Cardiac weight and the ratios of cardiac weight/tibial length increased significantly in the model and acupuncture groups compared with the blank group (P<0.01) and decreased significantly in the acupuncture group compared with the model group (P<0.01). In the model group, myocardial tissues had compensatory hypertrophy with incontinuous status, and myocardial transverse striations had severe disorder/disruption, karyopyknosis appeared and cytoplasmic eosinophilic change became obvious in few of the rats. The results were better in the acupuncture group than in the model group. In the model group, part of myofibrils had focal fusion, interstitial collagen fibers proliferated and mitochondria had swelling and compensatory increase. The results were also better in the acupuncture group than in the model group.Conclusions Acupuncture at point Neiguan can reduce the production of collagen fibers and mitochondria, improve the arrangement of sarcomere structure and delay the progression of myocardial hypertrophy.

Observations on the Efficacy of Along-meridian Distal Point Selection in Treating Post-cerebral Infarction Shoulder-hand Syndrome / 上海针灸杂志

ObjectiveTo investigate the efficacy of along-meridian distal point selection in treating post-cerebral infarction shoulder-hand syndrome.MethodSixty patients with post-cerebral infarction shoulder-hand syndrome were randomly allocated to treatment and control groups, 30 cases each. The control group was treated by routine neurological medical treatment, conventional acupuncture for stroke-attack on meridians and rehabilitation training and the treatment group, by along-meridian distal point selection in addition. The therapeutic effects were evaluated in both groups after four courses of treatment. The VAS scores, affected-side hand swelling scores and upper limb FMA scores were compared between the two groups before and after treatment. ResultThe VAS score, affected-side hand swelling score and upper limb FMA score were significantly better in both groups after treatment than before (P<0.01). Post-treatment VAS score, affected-side hand swelling score and upper limb FMA score were significantly better in the treatment group than in the control group; there were statistically significant differences (P<0.01,P<0.05). ConclusionAlong-meridian distal point selection has clinically a better improving effect on the pain, affected-side hand swelling and upper limb function in patients with post-cerebral infarction shoulder-hand syndrome.