1.Visualization tool-supported problem-based learning in clinical diagnostic expertise develop-ment
Jun LIU ; Bian WU ; Minhong WANG ; Weimin JIN ; Chungang WANG
Chinese Journal of Medical Education Research 2014;(2):183-186,187
Objective In problem-based learning, students are often found difficult to con-struct medical knowledge systematically and transfer knowledge to solve new problems. In face of this challenge, this study aims to investigate the effect of visualization tool-supported online problem-based learning on medical students' clinical diagnostic expertise development. Methods A controlled study was conducted and 52 medical students were randomly assigned into experimental group (using visual-ization tool-supported online PBL environment for learning) and control group (using online PBL envi-ronment for learning without visualization tool support). Participants were asked to complete the diag-nostic analysis of three kidney problems according to the requirements of the learning environments and to provide feedback of online learning experience afterwards. Paired-sample t test and one-way analysis of vonriance were used to analyze both group's case 1 and case 3 on line learing scores. Results The results revealed that the experimental group had significant improvement in online learning performance [case 1: (1.47 ±0.54), case 3: (2.14 ±0.55), P=0.015], while the control group had no significant improvement [case 1:(1.57±0.67), case 3:(1.66±0.49), P=0.234]. Early performance of online learning and group factor had interative effects (F=7.266, P=0.013). Conclusions The findings suggest that visualization tool-supported online PBL environment can facilitate medical student clinical diagnostic expertise development effectively.
2.Effect of ZL-004 on raising leukocyte count
Haiyan SUN ; Chungang LI ; Lin XIAO ; Guoping WANG ; Quanhai LIU
Acta Pharmaceutica Sinica 2010;45(6):797-800
This study is to investigate the effect of ZL-004 on normal mouse and mice with leukopenia induced by chemotherapeutic agents. 5-Fluorouracil were administered intraperitoneally to mice to develop leucopenia, and the mice were treated with ZL-004. The number of peripheral leukocytes and the percentage of granulocyte in total WBC were examined. The results are that ZL-004 markedly raise peripheral blood leukocytes in the normal mice and the mice model of leukopenia. So, ZL-004 could protect mice against 5-fluorouracil damage and raise peripheral blood leukocyte. Features of bone marrow smears is myeloproliferative hyperactivity in the mice, particularly the matured granulocytic series were observed. The mechanism of ZL-004 is to act on the mouse bone marrow causing proliferation and differentiation.
3.Preliminary study on the size-changing lateral cerebral ventricle in second-third trimester normal pregnancy with gestational age
Xu ZENG ; Zhixi ZHOU ; Guoli DONG ; Lin XU ; Xiaohong WANG ; Chungang ZHAO
Journal of Practical Radiology 2014;(6):983-986
Objective To explore the growing change of sizes of lateral cerebral ventricle in second-third trimester normal fetuses in MRI,to provide the normal reference for clinical monitoring.Methods MRI findings in 98 normal second-third trimester fetuses were retrospectively analyzed.The fetuses were divided into 6 groups according to gestational age (unit:week)including 18-21,22-25,26-29,30-33,34-37 and 38-40 weeks,respectively.The maximum transverse sizes of fetal atrium and occipital horns of lateral ventricle (cm)were measured.The SigmaStat statistical program was used for statistical analysis.Results The length of lateral ventricle atrium horn in 6 groups were 0.35 ± 0.03,0.33 ± 0.05,0.31 ± 0.04,0.30 ± 0.03,0.26 ± 0.05 and 0.25 ± 0.04,respectively,and the ventricle length of occipital horns were 0.91± 0.09,0.84 ± 0.09,0.84 ± 0.1 1,0.81 ± 0.13,0.80 ± 0.1 1 and 0.74 ± 0.13,respectively.The length of lateral ventricle atrium horn and ventricle occipital horns among some differ-ent groups showed significant differences (P <0.05).The length of fetal ventricle atrium and occipital horn were reduced gradually with gestational ages.Conclusion The ventricular length of atrium and occipital horn in second-third trimester normal fetuses reduce gradually with gestational ages.
4.Clinical efficacy of surgery for chronic subdural hematoma assisted by rigid neuroendoscope
Qing ZHU ; Zhongyong WANG ; Tan ZHANG ; Chungang DAI ; Liang XU ; Chao SUN ; Ailin CHEN ; Qing LAN
China Journal of Endoscopy 2017;23(6):52-57
Objective To discuss the clinical efficacy of surgery for chronic subdural hematoma assisted by rigid neuroendoscope and its surgical techniques. Methods Clinical data of 161 patients with chronic subdural hematoma from August 2009 to December 2015 was analyzed retrospectively. 74 of them experienced surgeries assisted by rigid neuroendoscope (endoscope group) and other 87 cases were operated without neuroendoscope (routine group) during the same period. Results Although there were significant difference in operative duration between the two groups, complications, ratio of total removal of hematoma after surgery, postoperative inpatient duration and recurrent rate of hematoma were more advantageous in endoscope group. The operative duration of endoscope group with (112.68 ± 34.86) min was longer than that of routine group with (74.11 ± 28.23) min (t = 7.75, P = 0.000), while the postoperative inpatient duration of endoscope group with (8.23 ± 2.01) d was shorter than that of another group with (10.79 ± 5.02) d (t = -4.12, P = 0.000). There were no surgical associated complications in endoscope group, but 1 patient in routine group experienced intracerebral hematoma of frontal lobe and associated aphemia. Total removal of hematoma was confirmed in endoscope group with 98.65% (73/74), which was higher than that in routine group with 86.21% (75/78) (χ2 = 8.34, P = 0.004). Hematoma recurrence was found in 16 cases of routine group (18.39%), but more superiority in endoscope group with 1.35% (χ2 = 12.29, P = 0.000). Outpatient follow-up was carried out in all patients from 6 to 38 months with an average duration of 30.06 months. In 17 cases with recurrent hematoma during follow-up, 15 of them were cured by a second surgery, and another 2 patients were cured by atorvastatin. Conclusion As a simple, safe and effective technique, the application of rigid neuroendoscope during surgery for chronic subdural hematoma is more advantage than routine surgery. A self-made suction with adjustable soft curved tip is suitable for such procedure.
5.The mechanical characteristics and early-stage clinical effects of double bundle anterior cruciate ligament reconstruction with femoral direct fiber insertion
Xianxiang XIANG ; Chungang ZHANG ; Weiming WANG
Chinese Journal of Orthopaedics 2020;40(7):397-407
Objective:To investigate the finite element analysis and early-stage clinical effects of double bundle anterior cruciate ligament (ACL) reconstruction with femoral direct fiber insertion.Methods:From June 2016 to June 2017, a total of 26 cases of ACL reconstruction were analyzed retrospectively, including 15 males and 11 females, mean age 30.5±4.6 years. All the patients underwent ACL reconstruction by the same operator. The early-stage clinical effects were evaluated by the finite element analysis, pivot shift test, Lachman test, preoperative and postoperative IKDC score, Lyshlom score, KT-2000, 3D-CT and MRI.Results:The finite element analysis confirmed theoretically that the double bundle ACL reconstruction with femoral direct fiber insertion could restore the stability and biomechanics of knee effectively. The results of pivot shift test were negative, and the Lachman test were negative except one first-stage positive after operation. 3D-CT showed that the bone tunnel was located in the direct fiber area. MRI showed clearly the ACL of double bundle after operation. Lysholm score increased from 56.5±3.6 pre-operation to 61.9±3.2 at three months after operation, and up to 88.5±2.0 two years after operation with statistically significant difference ( F=824.72, P<0.001). IKDC score increased from 48.3±2.8 before operation to 58.0±2.0 at three months after operation, and to 92.5±2.6 at two years after operation with statistically significant difference ( F=2 256.66, P<0.001). KT-2000 side-side difference decreased from 5.6±0.7 mm to 1.6±0.5 mm at three months after operation, and to 1.5±0.6 mm at two years after operation with statistically significant difference ( F=389.14, P<0.001). Conclusion:The double bundle ACL reconstruction with femoral direct fiber insertion can effectively restore the stability and the biomechanical environment of knee joint with satisfied early-stage clinical effects.
6.A case of acute myocardial infarction associated with amphetamine abuse.
Sung Ho LEE ; Kyung Eun LEE ; Kwang Je LEE ; Sang Wook KIM ; Tae Ho KIM ; Chee Jeong KIM ; Wang Seong RYU
Korean Journal of Medicine 2007;73(4):428-431
Acute myocardial infarction is a rarely reported complication of amphetamine abuse. We report here on a case of a 39-year-old man who presented with cardiac enzyme patterns, a clinical history and an ECG that were all compatible with acute ST elevation myocardial infarction. This was probably the result from self administration of intravenous amphetamine. The initial coronary angiogram (CAG) showed total occlusion of the distal right coronary artery (RCA) with a large thrombus. Because the RCA was tortuous and removal of thrombus was thought not to be easy, he was treated with thrombolytic therapy and intravenous heparin followed by oral warfarin. The follow-up CAGs at 2 weeks and 10 months later showed almost complete resolution of the coronary abnormalities. In this case, the early coronary angiography was thought to be helpful to determine the relative contribution of thrombus and spasm that were associated with amphetamine abuse.
Adult
;
Amphetamine*
;
Amphetamine-Related Disorders*
;
Coronary Angiography
;
Coronary Vessels
;
Electrocardiography
;
Follow-Up Studies
;
Heparin
;
Humans
;
Myocardial Infarction*
;
Self Administration
;
Spasm
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Thrombolytic Therapy
;
Thrombosis
;
Warfarin
7.Test-retest reliability analysis of MRI criteria in the 2019 Bosniak classification of cystic renal masses
Xu BAI ; Songmei SUN ; Huanhuan KANG ; Lin LI ; Wei XU ; Chungang ZHAO ; Yongnan PIAO ; Ying WANG ; Xiaona WANG ; Meiyan YU ; Meifeng WANG ; Kaiqiang JIA ; Aitao GUO ; Huiyi YE ; Haiyi WANG
Chinese Journal of Radiology 2022;56(10):1121-1128
Objective:To evaluate the test-retest reliability of MRI criteria in the 2019 Bosniak classification of cystic renal masses (CRMs) and to analyze the impact of lesions′ property, size and readers′ experience on the test-retest reliability.Methods:From January 2009 to June 2019, 207 patients with 207 CRMs were included in this retrospective study. All of them underwent renal MRI and surgical-pathologic examination. According to Bosniak classification, version 2019, all CRMs were independently classified twice by eight radiologists with different levels of experience. All radiologists were blinded to the pathology of the lesions. By using intraclass correlation coefficient (ICC), test-retest reliability was evaluated for all CRMs and for subgroups with different pathological properties (benign and malignant) and different sizes (≤40 mm and>40 mm). The test-retest reliability of 4 senior readers (≥10 years of experience) and 4 junior readers (<10 years of experience) were evaluated respectively. The comparison of ICC was performed using Z test. Results:The 207 CRMs included 111 benign lesions (83 benign cysts, 28 benign tumors) and 96 malignant tumors. There were 87 lesions with maximum diameter ≤40 mm and 120 with maximum diameter>40 mm. The test-retest reliability (ICC) of each reader for all lesions was 0.776-0.888, the overall ICC was 0.848 (95%CI 0.821-0.872). The ICCs of senior and junior readers were 0.853 (95%CI 0.824-0.880) and 0.843 (95%CI 0.811-0.871) respectively, without significant difference between the two groups ( Z=0.85, P=0.374). The ICC of all readers was 0.827 for benign lesions and 0.654 for malignant lesions, showing significant difference ( Z=2.80, P=0.005). The ICC was 0.770 for lesions ≤40 mm and 0.876 for lesions>40 mm, which was significantly different ( Z=-2.36, P=0.018). For CRM subgroups with different pathological properties and different sizes, there was no significant difference in test-retest reliability between senior and junior readers (all P>0.05). Conclusion:The test-retest reliability of MRI criteria in the 2019 Bosniak classification of CRMs is excellent and unaffected by readers′ experience. The reliabilities are not consistent among CRMs of different pathological properties and different sizes, but all reached the level of good and above.
8.The change in carotid intima-media thickness in prehypertensive adults.
Sung Jin KIM ; Kap Sung JUNG ; Kwang Ho LEE ; Soo Hee CHOI ; Kyung Eun LEE ; Sung Ho LEE ; Kwang Je LEE ; Sang Wook KIM ; Tae Ho KIM ; Chee Jeong KIM ; Wang Seong RYU
Korean Journal of Medicine 2006;70(2):165-171
BACKGROUND: Prehypertension is a precursor of clinical hypertension and tends to increase in severity over time. Structural vascular changes have not been much investigated in adults with prehypertension. METHODS: We investigated the carotid intima-media thickness (IMT) in prehypertensive adults, pharmacologically untreated, compared with normotensive and hypertensive patients. Mean and maximum carotid IMT were obtained from six far walls of the common carotid, the bifurcation, and the internal carotid artery on both sides of the neck with high-resolution B-mode ultrasonography. RESULTS: Mean IMT was largest in the carotid bifurcation, followed by the common carotid and the internal carotid artery in all groups. Hypertensives had higher mean IMT values at all locations than normotensive controls. In prehypertensive adults, the mean and maximum IMT values were significantly higher than in normotensive controls. In contrast, there was no significant difference in the mean and maximum carotid IMT between prehypertensive adults and patients with stage 1 hypertension. The prevalence of plaques was 15.7% in prehypertensive adults, compared with 4.4% in controls, 22.2% in stage 1 hypertensives, and 29.4% in stage 2 hypertensives. CONCLUSION: Prehypertensive adults had thicker mean carotid IMT than normotensive controls and exhibited similarly abnormal carotid structure as the patients with stage 1 hypertension. These results suggest we need the continuous evaluation for early clinical detection and intervention of prehypertension.
Adult*
;
Carotid Arteries
;
Carotid Artery, Internal
;
Carotid Intima-Media Thickness*
;
Humans
;
Hypertension
;
Neck
;
Prehypertension
;
Prevalence
;
Ultrasonography
9. Practice and evaluation of integrated course in clinical oncology
Chungang WANG ; Zhixiao CHEN ; Jingjue WANG ; Honghua DING ; Qi LI
Chinese Journal of Medical Education Research 2019;18(11):1091-1094
Because clinical oncology course for undergraduates is related to many clinical specialties, traditional teaching of this course is likely to lead to repetition and contradiction of knowledge. Clinical medical college carried out integrated curriculum in clinical oncology for three years during the implementation of teaching reform to overcome the above-mentioned disadvantages. Teaching and research sections related to clinical oncology were horizontally integrated under the guidance of teaching affairs office; On the premise of meeting the requirements of teaching outlines, the clinical oncology in internal medicine, surgery and gynecology was systematically improved in accordance with cognitive laws. Following the previous year, PBL teaching program in clinical oncology still focused on the integration of theoretical course and probation course. After integration, the sub-specialty teacher team was gradually shaped, the teaching quality was significantly improved and the clinical thinking of medical students was enhanced.