Exploration of undergraduate practice teaching method for nursing internal medicine based on BOPPPS teaching model / 中华医学教育探索杂志

Objective:To explore the feasibility of applying BOPPPS (B-bridge in, O-objective, P-pre-assessment, P-participatory learning, P-post-assessment, S-summary) course design mode in the teaching of internal medicine practice for nursing undergraduates.Methods:A total of 73 nursing interns of Kunming Medical University were selected as subjects and divided into the experimental group ( n=30) and the control group ( n=43). The experimental group adopted the practice teaching method based on BOPPPS model, while the control group adopted the traditional teaching method. Students' evaluation was collected by questionnaire. The students' comprehensive reasoning ability, holistic nursing skills ability and clinical nursing evaluation ability were evaluated by taking out questions from the question bank. And the results of teachers' evaluation on the participation of case study and problem solving in the process of students' internship were collected. SPSS 20.0 was used for t-test. Results:The students' evaluation of the practice process in the experimental group (86.81±2.85) was significantly better than that in the control group (82.61±3.82) ( P<0.001). The experimental group was significantly better than the control group in comprehensive reasoning of clinical thinking and assessment of holistic nursing ability ( P <0.001). Teachers' evaluation in the experimental group was better than that in the control group ( P <0.05). The overall effect of the experimental group (20.60±1.73) was significantly better than that of the control group (17.84±1.70) ( P <0.001). Conclusion:BOPPPS mode is helpful for teachers to carry out and demonstrate holistic nursing teaching with symptoms as the core according to the overall teaching objectives of nursing internal medicine, optimize the time arrangement and knowledge structure, improve the practice efficiency, and promote the establishment of holistic nursing thinking mode of students.

The Value of Using Ultrasound in Evaluating Neural Stem of the Normal Wrist / 昆明医科大学学报

Objective To evaluate the clinical value of ultrasound in evaluating the wrist nerve stem.Methods The examination of the high-resolution ultrasound about normal median nerve,ulnar nerve,radial nerve in the wrist on 100 normal volunteers,the courser,shape and sonographic appearance of the nerve stem were observed,and the vertical and horizontal diameter and the area of cross-section were measured.Results (1)Ultrasound clearly showed the nerve stem arranged and organization structures around it.(2) Ultrasound entirely measured the vertical and horizontal sections of normal median nerve,ulnar nerve,radial nerve in the wrist,besides it measured various diameters and the cross-section area.By comparing the vertical diameter of MN and RN between left hand and right hand of the same sexuality,the difference had no statistical significance (P＞0.05).By comparing the various diameters of UN between left hand and right hand of females,the difference had no statistical significance (P＞0.05) By comparing the vertical diameter between left hand and right hand of male,the difference had statistical significance (P＜0.05).To compare the vertical diameter of MN,RN and UN between male and females on the same side,the difference had statistical significance (P＜0.05).To compare the CSA of MN,RN and UN between left hand and right hand of the same sexiuality,the diffevence had no statistical significance (P＞0.05);By comparing the CSA of MN,RN and UN between male and females on the same side,the diffevence had statistical significance (P＜0.05).Median nerve cross-sectional area (CSA) and weight correlation was statistically significant (P ＜ 0.05) in a straight line,no statistically significant correlation was found between age and height (P＞ 0.05).(3) High resolution ultrasound clearly showed the neural surrounding adjacent to the organizational structure,and in line with gross anatomy section.Conclusion Ultraound has a clinical evalution value for examing the wrist nerve

The Current Situation and Suggestion of Medical Students' Medical Ethics Education / 中国医学伦理学

Through an introduction to the importance of medical ethics education and the status quo, this paper discusses how to better combine the medical ethics education with medical students′medical practices. It puts for-ward some suggestions from the institutional arrangements, personnel allocation, and publicitymethods. The ulti-mate goal is that the medical students could get more effective, continue and integration medical ethics education in the process of medical practice.

Standardized Management System and Process for Teaching Ward Rounds of Clinical Practice of Medical Students / 昆明医科大学学报

Objective To establish a standardized management system and process for teaching ward rounds of clinical practice,so as to improve the quality of clinical practice. Methods (1) We established the system and process for teaching ward rounds. (2) The students of 2008 grade were divided into two groups. The new system and process for teaching ward rounds was used in 71 students in the experimental group,and the primary teaching ward rounds system was used in 72 students in control group. (3) A survey concerned about students' abilities of grasping theoretical knowledge, clinical thinking, self-study, clinical operation and doctor-patient communication were investigated in both students and their tutors. Result The result showed that the abilities of grasping theoretical knowledge,clinical thinking,self-study,clinical operation and doctor-patient communication in the experimental group were enhanced much more than the control group ( <0.01) . Conclusion The standardized management system and process for teaching ward rounds of clinical practice can improve the students, comprehensive abilities and the quality of clinical practice.

Comparison of two preparation methods of ultrasound microbubbles loaded with paclitaxel / 中国医学影像技术

Objective To compare two effective preparation methods for paclitaxel-loaded lipid microbubbles, and to evaluate the physiochemical properties as for acoustic activated drug delivery. Methods Paclitaxel-loaded lipid microbubbles were prepared with two methods: one was mixed with phospholipids directly (Ⅰ); the other was added in triacetin, then mixed with phospholipids (Ⅱ). Concent ration, size, pH, drug entrapment efficiency, drug-loading amounts of these two kinds of paclitaxel-loaded lipid microbubbles were studied, while drug release with ultrasound and tumor imaging enhanced on rabbit breast tumor were observed. Results There was no significant difference in tumor imaging between two kinds of microbubbles which could be ruptured by low energy ultrasound. Compared with Ⅰ, the mean diameter of Ⅱ decreased significantly ([ 1.07±0.38] μm vs [2.79± 0.41] μm, P<0.01), the surface potencial was higher ([19.10±0.32] mV vs [-5.90±0.21] mV, P<0.01), whereas entrapment efficiency and drug-loading amounts increased markedly ([ 95.00±1.22]% vs [36.10±4.74]%, P<0.01; [5.60±0.11]% vs [0.50±0.04]%, P<0.01). Conclusion The Ⅱ paclitaxel-loaded lipid microbubbles added triacetin have an important clinical value.

Choledochoscopy Combined with Electrohydraulic Lithotripsy for the Treatment of Pancreatolithiasis / 中国微创外科杂志

Objective To evaluate the clinical value of choledochoscopy combined with electrohydraulic lithotripsy (EHL) for the treatment of pancreatolithiasis. Methods From October 2002 to July 2006, choledochoscopy combined with EHL was used in 11 patients with pancreatolithiasis during a dissection of the pancreatic duct combined with pancreato-jejunum Roux-en-Y anastomosis (EHL group). The data of these patients were compared with the data of 12 patients with pancreatolithiasis, who were treated by routine dissection of the pancreatic duct combined with pancreato-jejunum Roux-en-Y anastomosis from January 1995 to September 2002 (Routine group). Results The intraoperative blood loss and the postoperative rate of residual stones in the EHL group were significantly less than those in the routine group [(145.5?82.0) ml vs (406.7?384.9) ml, t=-2.201, P= 0.039; and 0% vs 41.7%, P= 0.037]. The postoperative rate of pain relief in the EHL group was higher than that in the routine group (90.9% vs 58.3%), however the difference was not significant (P=0.155). In the EHL group, 6 patients had diarrhea before the operation, 4 of them achieved relief after the surgery (4/6), which was not significantly more than that in the routine group (5/9, P=1.000). Before the operation, 7 patients in the EHL group and 9 in the routine group had diabetic mellitus; in each group, the disease was relieved in 2 patients after the operation (2/7 vs 2/9, P=0.665). Conclusions Choledochoscopy combined with EHL is effective for the treatment of pancreatolithiasis. The procedure can increase the rate of stone removal, decrease the intraoperative blood loss, and elevate the postoperative rate of pain relief.