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PBL (Problem-based learning) is a kind of teaching method, which is helpful for guiding students to solve practical and complex problems. The compiling of PBL teaching plans is the key to the implementation of PBL teaching. According to the teaching outline of internal medicine, we set the PBL teaching plan, formulated the teaching goal, collected the clinical real cases, finished the compiling of PBL cases of student version and teacher version, and preceded teaching practice accord-ing to the PBL cases. Improving and constructing the compiling framework of internal medicine PBL teaching plan laid the theoretical foundation for carrying out internal medicine PBL teaching.
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The improvement of diagnostics teaching system,including the establishment of curriculum system and evaluation system,is the base of promoting clinical- medicine teaching.Our study showed that the theoretical knowledge and clinical skill of medical students could be improved by constructing clinical diagnostics curriculum system and improving organization management and assessment system,which could pave the way for the transition from medical students to clinicians.
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Abnormal metabolism in vivo of uric acid leads to many diseases.Recent discovery shows that glucose transporter-like protein-9,which belongs to glucose transporter family not only transports glucose,but also plays an important role in the process of uric acid transport,which is also affected by pH,glucose,estrogen,etc.The variation of glucose transporter-like protein-9 results in metabolic diseases.Therefore,the study of glucose transporterlike protein-9 in uric acid transport and related drug will provide new ideas to control the development of hyperuricemia and related cardiovascular disease.
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The effect of interventional therapy combined with multifactorial intervention on critical limb ischemia in patients with diabetes mellitus was investigated. The patency rate and limb salvage rate were followed up. Interventional therapy is effective in treating diabetic foot with critical limb ischemia. Multifactorial intervention was helpful for reducing amputation.
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Objective To study the target organ damage in patients of hypertension with metabolic disorder. Methods 1033 patients were divided into five groups: hypertension without complications(102 cases), hypertension with dyslipidemia (117 cases), hypertension with abdominal obesity(119 cases), hypertension with type 2 diabetes mellitus(135 cases), hypertension with metabolic syndrome (560 cases). The structure and the function of heart and blood vessel were examined by color Doppler. Urinary microalbuminuria was determined. Results (1)Only 9.9% patients of hypertension were without metabolic disorder, 90.1% hypertensives complicated with the metabolic disorder; (2)Compared with hypertension with dyslipidemia, hypertension with type 2 diabetes mellitus (P90%) complicated with the metabolic disturbance. Hypertension complicated with abdominal obesity accentuate left ventricular hypertrophy. Hypertension with diabetes mellitus and metabolic syndrome accentuated the vascular and renal lesion.
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BACKGROUND: Metabolic disorder of blood lipid can be observed in the non-diabetic first-degree relatives.OBJECTIVE: To explore the relationship between the level of blood lipid and insulin resistance in members of type 2 diabetic pedigrees.DESIGN: A retrospective case control study of the non-diabetic first-degree relatives of type 2 diabetic families.SETTING: The department of endocrinology of a university hospital.PARTICIPANTS: This study was carried out in the Department of Endocrinology of the First Affiliated Hospital of Chongqing Medical College from June to November 1999. A total of 125 non-diabetic first-degree relatives of type 2 diabetic pedigrees in Chongqing were recruited and divided into hyperlipemia group and normal control group according to their blood lipid level.INTERVENTIONS: Body height, body mass and blood pressure of all the subjects were measured. Their cubital venous blood samples were also obtained for determination of the levels of fasting plasma glucose (FPG), fasting insulin(FINS), fasting C-peptide(FCP), triacylglycerol(TG), total cholesterol(TC), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C).homeostasis model assessment insulin resistance(HOMA-IR) between the two groups.RESULTS: The level of FINS was markedly higher in the hyperlipemia group [(12.92 ±5.26) μU/L] than in the control group[(9.15 ±4.66) μU/L]( t = 2. 17, P < 0.05) . HOMA-IR was also significantly higher in the hyperlipemia group [ (2.94 ± 1.25 ) ] than in the control group [ (2.01 ± 0.94) ]( t = 2.70, P < 0.01 ) . In the hyperlipemia group, HOMA-IR was positively correlated with TC, TG and LDL-C ( r = 0. 34, 0. 78, 0.42), with TG most closely correlated( r = 0. 78, P < 0. 01), while HOMA-IR had no significant relation with HDL-C ( P > 0.05).CONCLUSION: There is a close correlation between lipid metabolic disorder and insulin resistance in the high-risk diabetic group.
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Objective To observe the effect of atorvastatin on intraabdominal fat and microalbuminuria (MAU) in patients with metabolic syndrome (MS). Methods Forty-four MS patients were divided into the atorvastatin group and the control group. Blood pressure and blood glucose were controlled in both groups, in addition, atorvastatin was administered to the patients in the atorvastatin group. Blood pressure, blood glucose, body weight, abdominal wall fat, intraabdominal fat and MAU were compared before and after 12 weeks’ treatment. Results Obvious decrease of the intraabdominal fat and MAU was found in the atorvastatin group compared with those before the treatment Intraabdominal fat: non-ACE1/ARB (41.76?3.61) mm vs (33.23?2.47) mm, P
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Using new tape of teaching models in modern medical science education is a trend for medicine development.Investigating medical students’approbation degree and attitudes towards the teaching models,analyzing and resolving the problems about that will provide the valuable reference to reforming the medical education and fostering qualified practitioners.
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To study the necessity and teaching evaluation of clinical medical teaching in dual language,we investigated the students of a five-year medical undergraduate in clinical medicine with a questionnaire.The attitude of medical students on necessity and teaching effect in bilingual teaching was surveyed and analyzed to provide the data and reference to effectively improve the bilingual teaching program.
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Objective To assess myocardial ischemia in metabolic syndrome (MS), and risk factors of coronary heart disease (CHD) in MS, and to evaluate myocardial nuclein perfusion imaging (MPI). Methods 140 in-patients were divided into three groups according to the diseases they suffered from: metabolic syndrome (MS): 82 cases (m/f=54/28), essential hypertension (EH): 38 cases (m/f=15/23), and diabetes mellitus (DM): 20 cases (m/f=10/10). The degree of myocardial ischemia was detected by myocardial perfusion single-photon emission computed tomography (SPECT MPI). Results (1) The percentage of myocardial ischemia in MS group was 81.7%, and 56.8% of the patients in this group suffered from severe ischemia. Both percentages were higher than that in the other two groups (P
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Objective To evaluate the cardiovascular disease (CVD) risk of the patients with metabolic syndrome (MS) by CVD predictive models. Methods The CVD risk of MS patients (n=637) and type 2 diabetes mellitus (T2DM)(n=259) were assessed by Framingham and ischemia CVD (ICVD) predictive models. The technique of myocardial nuclide development (MCND) was used on 121 MS patients to confirm the evaluation. Results The CVD risk of MS patients was significantly higher than that of T2DM. The proportion of CVD risk ≥ 5% in MS group was significantly higher than that in T2DM group. An elevated tendency of the proportion of CVD risk ≥ 10% appeared followed the age increasing in both MS and T2DM groups. The proportion of CVD risk ≥ 5% in male patients was higher than that in females assessed by Framingham predictive model, while an opposite result was given by ICVD predictive model. The MCND findings showed that, the more the increasing of CVD risk evaluated by Framingham predictive model,the severer the myocardial ischemia was. Conclusions The CVD risk of patients with MS is significantly higher than that of T2DM assessed by the both models. Framingham model is more susceptible to predicate CHD in MS patients than ICVD model.
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Objective To investigate the influence of controlling multiple cardiovascular risk factors on early renal impairment in patients with metabolic syndrome. Methods 619 in-patients were categorized, according to the diseases they were suffering from into essential hypertension group (EH, 144 cases, m/f=74/70), type 2 diabetes mellitus group (T2DM, 134 cases, m/f=79/55), and metabolic syndrome group (MS, 341 cases, m/f=167/174). The effects of controlling the blood pressure, blood glucose and plasma lipid on early renal impairment were evaluated. Results 1. There were more than one half of the patients in MS and EH with blood pressure above 140/90 mmHg, more than one half of the patients in MS and DM with HbA1c above 7.0%, and more than one half of the patients in MS with triglyceride≥1.7mmol/L with or without high density lipoprotein
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The expressions of HNF-4? and HNF-1? gene were assayed by RT-PCR in the livers of insulin-resistant rats and type 2 diabetic rats. mRNA levels of HNF-4? and HNF-1? in insulin-resistant rats were lower than those in control rats, and these levels were further decreased in diabetic rats. Changes in expressions of these 2 genes seem to be associated with type 2 diabetes mellitus.
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Objective To ev al uate the genotype distribution of the promoter of leptin gene in Chinese populat ion, and to verify its association with the plasma leptin level and anthropometr ic, metabolic and clinical parameters in type 2 diabetic patients and their non -diabetic first degree relatives. Methods Two hundred and sixty-nine patients with diabetes and 135 non-diabetic first degre e relatives in pedigrees of type 2 diabetes mellitus, and 85 normal controls wer e screened for presence of the polymorphism by PCR-RFLP assay, and body mass in dex (BMI), fasting plasma leptin, insulin, and glucose were measured and HOMA-I R determined. Results (1) In type 2 diabetes gr oup, AA genotype frequency (0.063) and A allele frequency (0.349) were higher th an those in normal controls (0.012 and 0.253, respectively). (2) Diabetic patien ts with AA or AC genotypes showed lower fasting leptin than those with CC genoty pe (P