目的:探索PBL、CBL联合可视化技术在留学生医学影像学实习教学中应用的可行性.方法:将2019年在我科实习的64名本科留学生作为研究对象,并平均随机分为对照组和试验组,对照组32人采用LBL教学模式,试验组32人采用PBL、CBL联合可视化技术的综合教学模式.分析两组留学生考试成绩及对教学方法评价的差异性.结果:试验组理论及阅片考核成绩分别为(88.12±5.98)分、(86.31±5.72)分,均高于对照组(P＜0.01).试验组教学方法在激发学习兴趣、增强学习自主性、提高学习效率、加深知识理解、提升阅片能力、培养临床思维以及学生满意度方面明显优于对照组.结论:基于PBL、CBL联合可视化技术的教学模式,可有效提高留学生医学影像学实习教学质量,值得在临床教学中应用.

目的 回顾性分析CT增强检查对软件测量肺实性结节三维(3 D)体积的影响及增强后体积比在肺实性结节良恶性鉴别诊断价值.方法 选取进行肺部CT平扫和增强检查患者,2次检查间隔<3 d且肺内至少有1个肺实性结节且结节不与大血管及气道相连的病例作为研究对象.CT增强进行2期扫描,分别为延迟30 s、120 s.应用GE AW4.6工作站上高级肺分析(ALA)软件对C T图像进行处理,自动测量结节3 D体积.采用Pearson分析明确两者之间相关性,应用Wilcoxon检验分别进行平扫与延迟30 s、120 s时体积两两比较;采用配对t检验评估不同性质肺实性结节体积比之间差异.结果 64例患者,共88个结节(其中原发性肺癌21个,良性结节31个,转移瘤36个),平扫时肺结节中位体积411.5 mm3(范围11～11781 mm3),增强后30 s中位体积418 mm3(范围15～12302 mm3)、增强后120 s中位体积412 mm3(范围11～12801 mm3).相关分析显示平扫及增强30 s、120 s后结节体积有显著相关性,相关系数均为0.99(P<0.001).平扫及增强后3D体积两两比较的结果显示增强30 s、120 s体积均大于平扫三维体积,且差异有统计学意义,而增强30 s与120 s体积测量结果之间无显著性差异.增强后体积比:原发性肺癌、转移瘤及良性结节在增强后30 s/平扫、120 s/平扫体积比两两比较组间差异无统计学意义;增强120 s/30 s体积比:原发性肺癌与良性结节、转移瘤组间差异有统计学意义,良性结节与转移瘤间差异无统计学意义,原发性肺癌结节体积比随时间延迟呈上升趋势,良性结节及转移瘤体积比随时间延迟呈降低趋势;增强后120 s/30 s体积比鉴别原发性肺癌受试者工作特征(ROC)曲线显示临界值为1.0285,曲线下面积(AUC)为0.715(95％置信区间:0.587～0.843,P=0.003),灵敏度为42.9％,特异性92.5％.结论 CT增强检查对结节的3D体积有明显影响;在随访检查中,建议平扫与平扫比较或者增强检查与增强检查进行比较,二者不能混淆.增强后体积比对肺结节鉴别诊断方面价值:原发性肺癌结节体积比随时间延迟呈上升趋势,良性结节和转移瘤体积比随时间延迟呈降低趋势,增强后120 s vs 30 s体积比可以作为肺实性结节良恶性鉴别诊断参考依据之一.

Background: Premenstrual syndrome (PMS) is a menstrual cycle-related disorder which causes physical and mood changes prior to menstruation and is associated with the functional dysregulation of the brain. Acupuncture is an effective alternative therapy for treating PMS, and sanyinjiao (SP6) is one of the most common acupoints used for improving the symptoms of PMS. However, the mechanism behind acupuncture’s efficacy for relieving PMS symptoms remains unclear. The aim of this study was to identify the brain response patterns induced by acupuncture at acupoint SP6 in patients with PMS. Materials and Methods: Twenty-three females with PMS were enrolled in this study. All patients underwent resting-state fMRI data collection before and after 6 min of electroacupuncture stimulation (EAS) at SP6. A regional homogeneity (ReHo) approach was used to compare patients’ brain responses before and after EAS at SP6 using REST software. The present study was registered at http://www.chictr.org.cn, and the Clinical Trial Registration Number is ChiCTR-OPC-15005918. Results: EAS at SP6 elicited decreased ReHo value at the bilateral precuneus, right inferior frontal cortex (IFC) and left middle frontal cortex (MFC). In contrast, increased ReHo value was found at the bilateral thalamus, bilateral insula, left putamen and right primary somatosensory cortex (S1). Conclusions: Our study provides an underlying neuroimaging evidence that the aberrant neural activity of PMS patients could be regulated by acupuncture at SP6.

Objective To investigate the effect of the problem-based learning (PBL) based on the WeChat platform in Medical Imaging Teaching of Traditional Chinese Medicine. Methods 261 Chinese medicine students were divided into experimental group and control group according to their class. The control group used the traditional teaching method. The experimental group adopted the PBL teaching method based on the WeChat platform. After the class was over, the scores of the two groups of students were compared, and to investigate students' acceptance and satisfaction with PBL pedagogy based on WeChat platform. Results The students' enthusiasm and teaching atmosphere in the experimental group were better than those of the control group, the experimental group could stimulate students' self-study, active teaching atmosphere, and deepen the interaction between teachers and students. The average score of the case analysis in the final examination of the experimental group was higher than that of the control group, but the difference between the two groups was not statistically significant (P=0.054). Conclusion The problem-based learning (PBL) teaching method based on WeChat platform helps to cultivate students' autonomous learning ability, activate teaching atmosphere, improve students' learning enthusiasm, and also enhance communication between teachers and students and enhance teacher-student sentiment.