ABSTRACT
Objective:To systematically review the teaching effect of problem-based learning (PBL) combined with evidence-based medicine (EBM) teaching mode on the standardized residency training.Methods:CNKI, Wanfang database, VIP database, SinoMed, Embase, PubMed and Web of SCI databases were searched, and the randomized controlled trial (RCT) studies of the application of EBM combined with PBL teaching in standardized residency training were collected. The retrieval time was from the establishment to 1st July, 2018. Two investigators independently extracted data and assessed the quality of the studies. After assessing the risk of bias of included studies, Meta-analysis was performed on RevMan 5.3.Results:In total, 4 studies were included in the review. Narrative assessment was adopted, because outcome indicators of these study were varied and the quality of the literatures could not meet the requirement of Meta-analysis. Our study suggested that the residents who were in PBL combined with EBM teaching mode group got higher scores in the standardized residency training, compared with those in the lecture-based learning (LBL) teaching mode group, especially in case analysis score, total score of examination, improvement of clinical thinking ability, communication and expression ability, organization and cooperation ability, etc.Conclusion:The current evidence suggests that the application of EBM combined with PBL teaching mode has a positive effect on the standardized residency training. Compared with the traditional LBL teaching, EBM can improve students' ability. However, limited by the quantity and quality of included studies, the above conclusions still need to be verified by more studies with larger samples and higher quality.
ABSTRACT
Objective To investigate the value of combined detection of GGT,blood lipid and hs-CRP in patients with coronary heart disease.Methods Totally 134 patients with coronary heart disease and 38 patients without coronary heart disease were selected after coronary angiography.Coronary heart disease patients were divided into mild stenosis group (group A,n =40),Moderate stenosis group (group B,n =38) and severe stenosis group (group C,n =56) according to Gensini score.The age,sex,GGT,blood lipid and hs-CRP levels were detected in all groups,and t-he statistical analysis was performed by using SPSS 22.0 software.Results The level of GGT,TC,TG,LDL and hs-CRP in CHD group were all higher than those in non CHD group (P ＜ 0.05).The level of HDL was lower than that in the non CHD group (P ＜ 0.05).The level of GGT,TC,TG,LDL,hs-CRP in group B and C were higher than group A (P ＜0.05).The level of HDL in group B and C were lower than group A(P ＜0.05).The level of GGT,TC,TG,LDL,hs-CRP in group C were higher than group B (P ＜ 0.05).Logistic regression analysis showed that serum GGT,TG,hs-CRP were independent risk factors for coronary heart disease (P ＜ 0.05),HDL was an independent protective factor for coronary heart disease (P ＜ 0.05).Conclusion The combined detection of GGT,blood lipid and hs-CRP has important value in the diagnosis of coronary heart disease.
ABSTRACT
It is difficult for medical students to understand electrocardiogram theory. The sec-ond clinical medical college of Wuhan University has explored clinical pathophysiology and therapy (CPPT) pattern in electrocardiogram education. Basic medical knowledge and clinic medical knowl-edge are combined with electrocardiogram theory to reinforce students ' comprehension and attract theit interest in order to obtain better teaching effect. Drawing themselves, analyzing electrocardiogram sys-tematically and memorizing theory with figure is aimed at solving forgetful problems. In addition, the problems such as lack of conformable teaching material, professional teaching teams and objective mode of examination are raised, and the solutions are explored under CPPT pattern.
ABSTRACT
Obejective To reform the electrocardiogram teaching mode under clinical pathophisioligy and therapy(CPPT) mode.Methods The junior students of Grade 2010 in Second Clinical Medical College of Wuhan University were selected as subjects.The students were randomly divided into experimental group (44 students) and control group(52 students).Control group was taught by using traditional methods for electrocardiogram(ECG) diagnostics theory,and by using Diagnostics department's own Atlas,while experimental group was taught by reformed teaching methods,and ECG reformed textbook was used in their theoretical lessons,strengthening electrocardiogram and electrophysiology,cardiovascular disease combined.Meanwhile,the practice of teaching was taught by using preview-speaking Figure-Picture stories-Case-Read figure,a way to strengthen the theory-practice-theory of the cycle.The questionnaire was carried out in two groups after ECG teaching.After the end of the course two groups were given packet electrocardiogram atlas test and ECG theoretical knowledge examination and the above evaluation results were statistically analyzed by using SPSS 10.Results The statistically significant differences between experimental group and the control group were in the right ventricular hypertrophy,ventricular fibrillation,WPW syndrome,et al(P＜0.05).The ratio of the experimental group students' liking electrocardiogram course and their recognition of electrocardiogram teaching mode was higher than that of the control group while the ratio of their thinking ECG difficult was lower than that of the control group and the difference was statistically significant difference(P＜0.05).The excellent rate and good rate of the experimental group students' theory knowledge examination results were higher than the control group,two groups of results distribution difference being statistically significant(P=-0.043).Conclusions CPPT teaching model can effectively help students overcome the difficulties in reading electrocardiogram and deepen their understanding of theoretical knowledge and memory.
ABSTRACT
BACKGROUND: Peroxisome proliferation-activated receptor-gamma (PPARγ) is the member of nuclear receptor superfamily, and closely related with the formation of atherosclerosis.OBJECTIVE: To investigate the relationship between PPARγ C161→T gene polymorphism and coronary atherosclerotic heart disease (CAHD).DESIGN: Randomized controlled experiment SETTING: Department of Cardiology, Tonai Hospital of Huazhong University of Science and Technology; Department of Cardiology, Zhongnan Hospital of Wuhan University; Center for Human Genome Research,Huazhong University of Science and Technology; Department of Internal Medicine, Affiliated Hospital of Hubei University of Traditional Chinese Medicine; Institute of Geriatrics, Dongzhimen Hospital, Beijing University of Chinese Medicine PARTICIPANTS: Totally 203 CAHD patients aged (65±11) years, including 129 males and 74 females, were the inpatients and outpatients of Zhongnan Hospital of Wuhan University and Tonai Hospital of Huazhong University of Science and Technology from June 2002 to December 2005.And 156 cases of them were diagnosed by coronary arteriongraphy, among which 43 patients without coronary artery affection or with coronary stricture ＜ 50%, and 113 patients with coronary stricture ＞ 50 %. While 89 healthy physical examinees of Han race and mean (59±9) years old were enrolled as control group, including 56 males and 33 females. There was no blood relationship between controls and patients.METHODS: The experiment was conducted at Tongji Hospital of Huazhong University of Science and Technology from June 2002 to December 2005. PPARγ C161→T gene polymorphism was determined by polymerase chain reaction and restriction endonuclease fragment length polymorphisms. The radio-immunity technique, coronary angiography and clinical routine biochemical index were applied to analyze the genotypic frequency and allele frequency distributions as well as the relation between clinical data, biochemical index and different genotypes. The risk factors of CAHD were estimated in the patients of different genotypes.MAIN OUTCOME MEASURES: The genotypic frequency and allele frequency distributions, the relation between clinical data, biochemical index and different genotypes, along with the blood lipid, blood glucose, fasting insulin and body mass index (BMI).RESULTS: Totally 103 CAHD patients and 89 controls were involved in the result analysis of gene polymorphism and yielded different gene distribution frequencies.① In control group, "T" allele frequency was 0.213 and "C" allele frequency was 0.787, and in CAHD group, "T" allele frequency was 0.192 and "C" allele frequency was 0.808. There was no significant difference in the genotypic frequency and C, T allele frequencies between two groups (P ＞ 0.05).② The CC genotype was dominant in CAHD patients with coronary artery lesions, and showed significant differences from "T"allele carriers (CT+TT) (P ＜ 0.05). The CAHD risk in the "T" allele carries (OR: 0.56, 95% CI: 0.24-0.63) was much lower than that in the CC homozygote (OR: 1.92, 95% CI: 1.09-2.54).③ Apolipoprotein B in patients with CC genotype was obviously higher than that in patients with "T" allele (CT+TT) (P ＜ 0.05), and there was insignificant difference in the insulin resistance index (P ＞ 0.05).CONCLUSION: There is an important correlation between the substitution of PPARγ C161→T and CAHD, and "T" allele carriers demonstrate a lower risk of CAHD.
ABSTRACT
Objective To investigate the relationship of peroxisome proliferator activated receptor gamma ( PPAR?)C161T gene polymorphism with related diseases of metabolic syndrome. To disscuss the mechanism of the elderly diseases from gene level and the relation between the gene polymorphism and lipid metabolism. Methods Three hundred seventy one non-sibship subjects of Han nationality were investigated in this study, including 69 old healthy subjects, 302 elderly cases diagnosed as metabolic syndrome. PPAR? C161T gene polymorphism was determined by polymerase chain reaction and restriction fragment length polymorphism, and radioimmunoassay was used to detect serum insulin. The insulin resistance was obtained from homeostasis model assessment (HOMA), and blood glucose, blood lipoprotein, height, weight and so on were tested. The frequencies of PPAR? C161T genotypes and the allele were compared with the clinical data. Results (1) In the groups of old normal health and metabolic syndrome, "T" allele frequency was 0.217,0.201, and "C" allele frequency was 0.783, 0.798 . There was no significant difference between the groups. (2)The triglyceride in CC genotypes of the metabolic syndrome was significantly higher than that in "T" allele carriers. Conclusions (1) The distributing trend of PPAR ? C161T gene polymorphism of the Han nationality in Wuhan in the elderly normal healthy group was in accord with that in the group of the elderly metabolic syndrome. (2) PPAR ? C161T substitution can influence metabolic syndrome, especially in liporprotain metabolism. "T" allele is associated with lower level of triglyceride.
ABSTRACT
Objective To investigate the effect of fosinopril on transforming growth factor-?1 (TGF-?1) expression in myocardial tissue of streptozotocin(STZ)-induced diatetic rats. Methods A total of 30 SD rats were enrolled in the study, 10 of them were set as normal controls, others were created the model of diabetes by injecting STZ, and then equally divided into fosinopril group and untreated group. Myocardial TGF-ft was observed in all three groups after 5 weeks. Results The expression of TGF-fi, in myocardial tissue was weakly positive in normal group, strongly positive in untreated group and positive in fosinopriol treat group, with absorbance being 0. 009 ? 0. 004,0. 198 ?0. 007 and 0. 104 ? 0. 005,respectively. Conclusion Fosinopril may partly suppress the increased TGF-?1 expression in myocardial tissue of diatetic rats. It may decrease significantly the myocardial injury of diabetic rats.
ABSTRACT
Objective To observe the changes of the levels of transforming growth factor ? 1(TGF ? 1),fibronectin(FN),laminin(LN) and collagen content and myocardium ultrastructure in streptozotocin experimental diabetes mellitus rats.To study the role of TGF ? 1 and extracellar matrix(ECM) in diabetic cardiomyopathy episode.Methods Observing myocardium ultrastructure by electron microscope and assaying TGF ? 1,FN,LN by immunohistochemistric,and observing collagen content by VG staining.Results TGF ? 1,FN,LN were expressed more in STZ inroduced diabetic rats than in normal rats.The difference between two groups was significant ( P