Objective:To analyze the application effects of case-based learning (CBL) + Seminar teaching method based on Toulmin model in the education and teaching of clinical medicine innovation class.Methods:A total of 60 students from the clinical medicine innovation class at The Second Affiliated Hospital of Guangzhou Medical University from September 2021 to September 2023 were selected as research objects. These students were divided into control group ( n=30) and research group ( n=30) according to different teaching programs. The traditional teaching method was adopted in the control group, and the CBL + Seminar teaching method based on Toulmin model was adopted in the research group. The two groups were compared in terms of clinical knowledge, clinical skill, and clinical case analysis scores; changes in clinical thinking ability after teaching; and satisfaction with the teaching process. SPSS 22.0 was used for t-test and chi-square test. Results:The research group significantly outperformed the control group in clinical knowledge [(89.59±3.46) points vs. (83.23±3.02) points], clinical skill [(88.87±3.23) points vs. (83.62±3.13) points], and clinical case analysis [(89.73±3.51) points vs. (82.62±3.19) points] ( t=7.58, 6.39, 8.21, P<0.001). The clinical thinking ability after teaching was significantly higher in the research group compared to the control group [(258.49±13.36) points vs. (242.56±13.02) points] ( t=4.67, P<0.001). The overall satisfaction rate of teaching was significantly higher in the research group compared to the control group (100.00% vs. 80.00%, χ2=4.63, P=0.031). Conclusions:The CBL + Seminar teaching method based on Toulmin model can effectively improve student learning performance and clinical thinking ability, demonstrating a promising application value in the education and teaching of clinical medicine innovation class.

Objective:To analyze the application effects of case-based learning (CBL) + Seminar teaching method based on Toulmin model in the education and teaching of clinical medicine innovation class.Methods:A total of 60 students from the clinical medicine innovation class at The Second Affiliated Hospital of Guangzhou Medical University from September 2021 to September 2023 were selected as research objects. These students were divided into control group ( n=30) and research group ( n=30) according to different teaching programs. The traditional teaching method was adopted in the control group, and the CBL + Seminar teaching method based on Toulmin model was adopted in the research group. The two groups were compared in terms of clinical knowledge, clinical skill, and clinical case analysis scores; changes in clinical thinking ability after teaching; and satisfaction with the teaching process. SPSS 22.0 was used for t-test and chi-square test. Results:The research group significantly outperformed the control group in clinical knowledge [(89.59±3.46) points vs. (83.23±3.02) points], clinical skill [(88.87±3.23) points vs. (83.62±3.13) points], and clinical case analysis [(89.73±3.51) points vs. (82.62±3.19) points] ( t=7.58, 6.39, 8.21, P<0.001). The clinical thinking ability after teaching was significantly higher in the research group compared to the control group [(258.49±13.36) points vs. (242.56±13.02) points] ( t=4.67, P<0.001). The overall satisfaction rate of teaching was significantly higher in the research group compared to the control group (100.00% vs. 80.00%, χ2=4.63, P=0.031). Conclusions:The CBL + Seminar teaching method based on Toulmin model can effectively improve student learning performance and clinical thinking ability, demonstrating a promising application value in the education and teaching of clinical medicine innovation class.

Objective This study aims to address the demand for high-quality medical talent cultivation in the new era.It focuses on the low integration of ideological and political education(IPE)with professional education,fragmented and insuffi-cient implementation of curriculum-based IPE,the failure to form a community for IPE,and the inadequacy of the IPE evaluation and supervision system.The goal is to construct an IPE system suitable for medical professionals.Methods Using literature re-search and empirical analysis,this study closely aligns with the actual construction of the IPE system for clinical medicine pro-grams at our institution.Under the competency model framework and guided by the Outcome-Based Education(OBE)philoso-phy,we adopt a student-centered approach.We explore the construction of the IPE system from six key aspects:theoretical rein-forcement,curriculum teaching,daily education,management and service,team building,and evaluation and supervision.Results This study successfully constructs a comprehensive IPE system that integrates ideological and political education,pro-fessional education,and vocational spirit education,addressing the content,process,subjects,and environment involved in pro-fessional talent cultivation.The system achieves a three-in-one integration of online and offline,in-class and extracurricular,and school and hospital settings,providing reform proposals and construction ideas for IPE in medical programs.Conclusion In the context of the new era,guided by the competency model framework and the OBE philosophy,comprehensive measures across six aspects can effectively build and improve the comprehensive IPE system for medical professionals.This is of significant impor-tance for cultivating high-quality medical talent.

Objective:To investigate the clinical features of adenoviral encephalitis (AE), and to provide reference for clinical diagnosis and treatment of adenoviral encephalitis.Methods:From January 2012 to December 2020, 1 185 cerebrospinal fluid (CSF) samples of hospitalized children with suspected central nervous system infection in the Second Affiliated Hospital of Shantou University Medical College were collected for the detection of 22 common respiratory pathogens and common pathogens for encephalitis by polymerase chain reaction. Records of patients with adenovirus positive in CSF were reviewed and relevant clinical manifestations, laboratory tests and imaging examination results were collected for analysis.Results:Among 1 185 CSF samples, 242 samples were positive for viral nucleic acid, with detection rate of 20.4%, including 1.9%(23/1 185) of adenovirus. As for 23 children diagnosed with AE, 18 were male, five were female, with the age of (44.8±35.9) months, ranging from two months and 19 days to 10 years. Of 23 children, 21(91.3%) presented with fever, followed by convulsions (16 cases, 69.6%), headache (four cases, 17.4%), vomiting (11 cases, 47.8%), consciousness change (11 cases, 47.8%) and emotion disturbance (three cases, 13.0%). Among 23 children, eight cases had white blood cell counts (WBC) of (6 to <10)×10 9/L, 10 cases had WBC of (10 to 20)×10 9/L and the white blood cell classification was mainly neutrophils (21 cases, 91.3%), and C reactive protein of 20 cases (87.0%) was in the normal range. Cerebrospinal fluid examination showed that WBC were less than 15×10 6/L in 20 cases (87.0%), and WBC ≥15×10 6/L in three cases, which were up to 500×10 6/L; the protein of 19 cases was in the normal range, the glucose of 15 cases was in the normal range, and the chloride of 19 cases was in the normal range. Among 16 cases with brain magnetic resonance imaging examination, eight cases did not show abnormality, six cases with local meningeal linear enhancement, one case with small intracranial malacia, and one case with extensive intracranial lesions. For 13 cases who received electroencephalogram (EEG) test, seven cases showed normal EEG or marginal state, four cases showed extensive medium and high amplitude slow wave, one case showed spike wave or spike slow wave and one case had both of the above two changes. Among 23 children, 22 cases recovered including one case had secondary epilepsy, and the remaining one case had severe brain dysfunction and was unable to suck when discharged, with an indwelling gastric tube and accompanied by secondary epilepsy. Conclusions:The clinical manifestations and auxiliary examinations of children with AE have no obvious specificity. Most children with AE have a good prognosis, but a small number of them may have serious sequelae.

Objective To evaluate magnetic resonance cholangiopancreatography (MRCP) in identifying Mirizzi syndrome and surgical modality Methods According to MRCP identification open laparotomy was adopted for those 7 case with gallbladder enlargemeng incarcerated stones close to the hilum and long segment obstruction of the common bile duct.Other 16 type Ⅰ Mirizzi syndrome cases without these characteristics underwent LC.Results Among 23 patients in MRCP group 22 cases were successfully operated on based on preoperatively planned surgical procedures.Only one was converted to open surgery because of the variation of gallbladder artery.While in 23 cases without undergoing preoperative MRCP examination,7 out of 12 cases assigned to LC were converted to open cholecystectomy (OC),11cases were done by OC.The Preoperative accurate diagnosis rate was 82.6％ (19/23) in MRCP patients with type Mirizzi Ⅰ syndrome.The success rate of preassigned surgical approach was 95.7％ (22 / 23).While in non-MRCP group,the conversion rate was 58.3％ (7/12),the average length of stay were significantly prolonged.Conclusions Preoperative MRCP examination helps accurately establish the diagrosis of type Ⅰ Mirizzi syndrome,precisely plan appropriate surgical approaches.

Objective: To investigate the innate immune response of influenza virus-infected glial cells,the transcription levels in chemokines in mouse microglia and astrocytes were detected which pre-infected by human H1N1 or avian H5N1 influenza viruses.Methods: The glial cells isolated from neonatal mice cerebral cortex were cultured and further microglia and astrocytes were purified.The primary mouse microglia and astrocytes were infected in vitro by H1N1 or H5N1 influenza viruses in a multiplicity of infection (MOI) 2.Eight hours post infection,the influenza virus nucleoprotein (NP) was detected by immunofluorescence to identify the proportion of infected cells.The cellular RNA were extracted at 6 h and 24 h to detect the transcriptional level of chemokines by semi-quantitative RT-PCR.Results: More than 95% of the microgha and astrocytes which isolated from mice were infected.The transcription levels of CCL-3,CCL-5,CXCL-2,CXCL-9 and CXCL-10 from infected microglia and astrocytes were upregulated.Futhermore,the mRNA level of CXCL-10 increased much more.In addition,avian H5N1 influenza virus could induce more stronger upregulation of those chemokines than human H1N1 did.Conclusion: The mouse microglia and astro cytes which are infected by H1N1 influenza virus or H5N1 influenza virus could induce upregulation of transcription level of chemokines.