目的:分析汶川8.0级大地震致腹部外伤的患者的心理问题并探索其护理对策。方法:以汶川8.0级大地震致腹部外伤的19名患者为暴露组,普通患者20名和医务人员19名作为对照组。由3名医护人员运用汉密顿抑郁量表进行调查和分析。结果:地震伤员在睡眠质量、精神焦虑、抑郁情绪等3个方面与普通患者及医务人员比较有明显异常。结论:地震致腹部外伤患者的心理影响明显大于普通患者及医务人员,应进行及时有效的心理干预护理,以控制和减缓其心理问题。
Clinical trials are the most reliable means for scientifically rigorous evaluation of the efficacy and safety of drugs, and are the most crucial part receiving the most investment in development and innovation in the pharmaceutical industry. In recent years, the nation has formulated a set of policies and guiding principles to encourage pharmaceutical innovation, promote the independent innovation of China’s pharmaceutical industry and enhance clinical trial capacity. To further improve Chinese researchers’ ability to perform clinical trials, the National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and the National Center for Cardiovascular Diseases invited a multi-disciplinary team of experts from various areas including clinical trial methodology and supervision to work on this consensus. In view of the common concern and puzzles regarding the issues in clinical trials, such as recruitment and retention of participants, outcome selection, quality control, information technology application, and ethics in data security, the expert consensus is based on domestic and international guidelines, the latest advancement of clinical research, and the advice and opinions from national experts. It aims to provide reference information and guidance for clinical trial researchers, and serves as a reference for relevant authorities to formulate clinical trial management policies.
ObjectivesTo systematically review the association between pubertal development progression and emotional and behavioral problems.MethodsVIP, CNKI, CBM, WanFang Data, PubMed, Web of Science and EBSCO databases were electronically searched to collect studies on the relationship between pubertal tempo or trajectory and emotional and behavioral problems from inception to December 31st, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Qualitative methods were then used to analyze the data.ResultsA total of 14 cohort studies were included. The results showed that depression was the most studied emotional problem, and 2 of the 3 studies found a significant association between faster pubertal tempo and more depressive symptoms in juvenile males. However, no association was found in 3 of the 4 studies on juvenile females. The content of behavioral problems of included studies was broad, including internalizing and externalizing problems, substance abuse, attention problem, self-control, first-sexual experience, delinquency, conduct disorder, peer relationship, etc. However, few studies on the same behaviors, and the relationship between behavioral problems was unclear.ConclusionsThe faster pubertal tempo may be associated with depression in juvenile males. The association between pubertal tempo and behavioral problems in males and females remain to be determined by more studies.
目的 促进医学生化检验课程理论与实验的结合，提高学生学习实验兴趣，增强学生临床对话的能力。 方法 通过创建问题情景和病例，在医学检验专业本科班中应用以问题为导向教学法（PBL），结合病例教学方法进行临床生化检验实验教学改革。 结果 问卷调查显示，学生在教学内容掌握、学习的主动性、综合分析能力、创新能力、团队协作等方面均得到明显提高。92.6%的学生认为PBL结合病例教学法优于传统实验教学法。 结论 PBL结合病例教学法值得在生化检验实验教学中加以推广。
Objective To assess the effect of problem-based learning (PBL) versus traditional methods in nursing students. Methods Computer retrieval was conducted to search for controlled studies comparing PBL and traditional methods. The quality of included studies was critically evaluated and data were analyzed by using The Cochrane Collaboration’s RevMan 5.0 software. Results A tota1 of 321 articles were retrieved, but only l1 were included. Metaanalyses showed that there was no significant difference between PBL and traditional methods in the objective knowledge of nursing students (SMD 0.12, 95%CI -0.32 to 0.56, P=0.6gt;0.05); but PBL was superior to traditional methods in the training of critical thinking (WMD 11.52, 95%CI 6.29 to 16.74), conflict resolution skills (WMD 8.09, 95%CI 5.02 to 11.16), clinical problem-solving skills (WMD 0.43, 95%CI 0.22 to 0.64), and communication skills (WMD 1.56, 95%CI 0.17 to 2.95). Although no significant difference was identified in the training of clinical decision-making skills, collaborative skills, and self-directed learning skills, PBL tended to be superior to traditional methods. Conclusion PBL tends are associated with better learning results among nursing students compared with traditional methods. However, most trials included in the review were of low quality, so large-scale randomized controlled trials of higher quality are needed to confirm this.
ObjectiveTo compare the effect of problem-based learning (PBL) and traditional teaching method (lecture-based learning) on clinical practical teaching of orthopedic surgery. MethodsBetween May 2012 and December 2013, 55 orthopedic interns were chosen to be divided into two groups: PBL group (n=29) and traditional lecture group (control group, n=26). Case report and examination on a completion of orthopedic surgery were used to assess the teaching outcomes. ResultsPerformance differences in content of presentation and capability of answers to questions were significant between PBL group and the traditional group in the report test (P<0.05). The test scores of case analysis examination in PBL group were significantly higher than those in the traditional lecture group (P<0.05). There was no significant difference between the two groups in other types of questions (P>0.05). ConclusionThe participants in PBL group have performed significantly better in culturing clinical thinking and comprehensive analysis, competence and in no circumstance did they perform worse than traditional lecture method.
Objective To evaluate the feasibility and significance of problem-based learning (PBL) in orthopedic internship. Methods A total of 315 students in grade 2002 were involved in PBL during their internship in the Department of Orthopedics at the First Affiliated Hospital of China Medical University, Shenyang, China. Teaching effectiveness was evaluated with a questionnaire and an ability examination. The results of PBL teaching during different semesters were compared, and the feasibil ity and significance of PBL were analyzed. Results Students who participated in PBL were in a dominant position and were more active in the learning process. The PBL pattern could improve students’ ability to identify, analyze and solve problems, and also contribute to fostering and enhancing their clinical thinking. This could help them solve the problems that emerged from the theory curriculum.Conclusions The PBL pattern used in the orthopedics internship has advantages and practical significance, which are applicable in modern medical teaching practice.