RESUMO
Objective To investigate the feasibility and practical value of the integration of humanistic concern into clinical problem-based learning ( PBL ) teaching . Methods A total of 112 undergraduate medical interns in Department of Colorectal Surgery were enrolled and randomly divided into experimental group receiving PBL teaching integrated with humanistic concern and control group receiving PBL teaching alone. Theoretical examination, operation examination, and patient satisfaction survey were performed after practice training to evaluate the teaching effect of the two groups . GraphPad Prism 6 software was used for statistical analysis of data, and the t-test was used for comparison of continuous data between the two groups. Results Compared with the control group, the experimental group had significantly higher scores of medical history collection (22.57±2.63 vs 20.87±3.08, t=3.124, P=0.002) and operation skills (31.42±2.89 vs 29.87±4.72, t=2.107, P=0.037), but there were no significant differences between the two groups in the scores of theoretical examination (90.60±3.19 vs 90.52±3.38, t=0.129, P=0.898) and medical record writing (20.78±2.79 vs 20.65±3.51, t=0.215, P=0.830). Compared with the control group, the experimental group had a significantly higher degree of patient satisfaction with service attitude (3.94±1.07 vs 3.22±1.09, t=3.256, P=0.002), trust (3.85±1.16 vs 3.22±1.05, t=2.759, P=0.007), and communication skills (3.92±1.03 vs 3.16±1.03, t=3.652, P=0.000), but there were no significant differences between the two groups in the scores of operating skills (3.60±1.09 vs 3.67±1.10, t=0.281, P=0.779) and arrangement of medical procedures (2.74 ±1.10 vs 3.02 ±1.02, t=1.312, P=0.193). Conclusion The integration of humanistic concern into PBL teaching of anorectal surgery can improve students' clinical operation ability and degree of patient satisfaction.
RESUMO
Objective To evaluate the clinical value of laparoscopic nephrectomy. Methods Laparoscopic nephrectomy was used in 26 cases (transperitoneal approach in 19 cases and retroperitoneal approach in 6 cases), including 8 cases of radical resection of renal cancer, 7 cases of total resection of kidney and ureter (2 cases of carcinoma of renal pelvis and 5 cases of carcinoma of ureter ), 6 cases of non-functioning or atrophic kidney and 5 cases of living donor nephrectomy. Results All the operations were accomplished successfully. The operative time was 120 min ～ 250 min (mean, 190 min) and the intraoperative blood loss was 50 ml ～ 200 ml (mean, 130 ml). No blood transfusion was needed and no operative complications occurred. Follow-up for a mean of 16 months in 8 cases of renal cancer and 20 months in 7 cases of total resection of kidney and ureter revealed no recurrence or metastasis except for 1 case of local recurrence of ureteral carcinoma. Conclusions The laparoscopic nephrectomy has the advantages of minimal invasion, less blood loss and rapid recovery.
