ObjectiveTo explore the teaching effects of case-based learning (CBL) as an educational strategy in digestive diseases module teaching. MethodsSixty-three oral and dental medical senior students were randomly divided into two groups during February to June 2012. Among them, 31 students were enrolled in the CBL group accepting CBL teaching method based on certain cases, while the other 32 students were designated into the control group receiving traditional teaching method. Their scores in practice skill examination, analytical ability of medical records, module test scores and behavior observation results were compared. Questionnaire survey was performed for students in the CBL group. ResultsThere were no significant difference in scores of clinical practice skill examination and behavior observation results between the two groups (P>0.05). Students in the CBL group did significantly better in case analysis and module test scores (P<0.05). Questionnaire survey revealed that CBL method could significantly improve the learning interest, cultivate the ability to combine theory and practice, strengthen analytical skills and promote problem-solving abilities. The students were generally satisfied with the CBL teaching method. ConclusionCBL method has an obvious advantage in digestive diseases teaching.
ObjectiveTo study the diagnosis value of anti-SSa (including anti-Ro52 and anti-Ro60). MethodsAntibodies of ENA (including Sm, Ro52, Ro60, SSb, RNP, Scl-70, Jo-1 and Rib-P) from 23145 patients with positive antinuclear antibody (ANA) were retrospected from January 2009 to December 2013. The relationship between anti-Ro52, anti-Ro60 and other test results and the diagnosis or symptomatic information of patients was also analyzed. ResultsThe anti-Ro60 positive rate was 35.19% (8 145/23 145), and the anti-Ro52 was 13.16% (3 046/23 145) in 23145 ANA positive cases (P<0.05). The positive percentage of anti-Ro60 was higher in anti-SSb, anti-RNP, anti-Sm and anti-Rib-P positive cases than anti-Ro52 (P<0.05); the results of anti-Ro52 negative and anti-Ro60 positive (Ro52-Ro60+) had a higher percentage in autoimmune diseases, non-autoimmune disease and symptoms groups than anti-Ro52 positive and anti-Ro60 negative (Ro52+Ro60-) results (P<0.05). ConclusionThe anti-Ro60 has higher positive rate than anti-Ro52, and the sensitivity and prediction value of autoimmune diseases of anti-Ro60 are better than anti-Ro52. But both anti-Ro60 and anti-Ro52 have poor specificity for disease diagnosis.
ObjectiveTo evaluate the teaching effect of Patient based Problem-Based Learning (PPBL) vs. conventional bedside teaching (CBT) instudents of eight years medical program. MethodSix students of Eight years medical program in two grades from volunteer registration were randomized into PPBL group and the other students were recruited into CBT group. After one year study, the test score in module TBL test, written test in final exam and mutual score were evaluated to compare the teaching effect of two groups. ResultsThe baseline of the two groups were matched when comparing their grades in Diagnoses Course. After trainee period, there were no significant differences between two groups of the test score in module TBL test, written test in final exam and mutual score. ConclusionThe PPBL mode is not inferior to conventional bedside teaching. Furthermore, with advantage in developing the competency of communication, cooperation and manage the information, PPBL has its special value and should be popularized.
ObjectiveTo analyze the clinical characteristics and renal outcome of elderly patients with antineutrophil cytoplasmic autoantibody (ANCA) associated vasculitis (AAV) with renal involvement. MethodsWe retrospectively analyzed the clinical data of 147 patients with ANCA relate vasculitis treated between June 2006 and June 2012. Based on the age, the patients were divided into elderly group (65 years or older, n=50) and non-elderly group (younger than 65, n=97). The disease course, clinical characteristics, ANCA serological indexes, renal pathological change and prognosis of patients in the two groups were compared and studied. ResultsIn the elderly group, there were 3 cases of Wegener granulomatosis (WG), 45 of microscopic polyangiitis (MPA), and 2 of pauci-immune crescentic glomerulonephritis (PICGN). The non-elderly group had 8 cases of WG, 82 of MPA, 6 of PICGN, and 1 of allergic angitis granulomatosis. There were 5 cases of positive cANCA and 44 of positive pANCA in the elderly group. The elderly patients had significantly more pulmonary involvement than the younger patients (P=0.030). No significant difference was detected between the two groups in combined pulmonary infection (P=0.281) or combined infectious index C-reactive protein (P=0.326). Elderly patients were less likely to respond to sufficient treatment with pulse intravenous methylprednisolone therapy (P=0.035) and cyclophosphamide (P=0.043), and had worse renal outcome than younger patients (P=0.040). ConclusionElderly patients with AAV have more prevalent pulmonary involvement and have severe complication of pulmonary infection, which affects mortality and morbidity of ANCA-associated systemic vasculitis.