目的:探索建立标准化病人对(paired-standardized patients,PSPs),弥补临床医学教育中标准化病人的不足。方法:将日常门诊病人与标准化病人组成PSPs,再与真实病人的实验室及影像学资料相结合形成PSPs标准病案(standard case of PSPs)。...目的:探索建立标准化病人对(paired-standardized patients,PSPs),弥补临床医学教育中标准化病人的不足。方法:将日常门诊病人与标准化病人组成PSPs,再与真实病人的实验室及影像学资料相结合形成PSPs标准病案(standard case of PSPs)。采用以问题为中心的教学(problem-based learning,PBL)模式,应用PSPs进行耳鼻咽喉科学临床实习教学。结果:建立了10个PSPs标准病案,通过对PSPs标准病案的学习,使医学生对临床医学产生了浓厚的兴趣,增强了对临床实习的信心。结论:PSPs弥补了标准化病人缺乏变性和生动性的不足,有助于培养医学生的临床技能、临床思维方式、循证医学方法以及自主学习的良好习惯。展开更多
This study investigated the relationship among the severity of hearing impairment,vestibular function and balance function in patients with idiopathic sudden sensorineural hearing loss（ISSNHL）.A total of 35 ISSNHL p...This study investigated the relationship among the severity of hearing impairment,vestibular function and balance function in patients with idiopathic sudden sensorineural hearing loss（ISSNHL）.A total of 35 ISSNHL patients（including 21 patients with vertigo） were enrolled.All of the patients underwent audiometry,sensory organization test（SOT）,caloric test,cervical vestibular-evoked myogenic potential（cV EMP） test and ocular vestibular-evoked myogenic potential（o VEMP） test.Significant relationship was found between vertigo and hearing loss grade（P=0.009）,and between SOT VEST grade and hearing loss grade（P=0.001）.The abnormal rate of o VEMP test was the highest,followed by the abnormal rates of caloric and c VEMP tests,not only in patients with vertigo but also in those without vertigo.The vestibular end organs were more susceptible to damage in patients with vertigo（compared with patients without vertigo）.Significant relationship was found between presence of vertigo and SOT VEST grade（P=0.010）.We demonstrated that vestibular end organs may be impaired not only in patients with vertigo but also in patients without vertigo.The cochlear and vestibular impairment could be more serious in patients with vertigo than in those without vertigo.Vertigo does not necessarily bear a causal relationship with the impairment of the vestibular end organs.SOT VEST grade could be used to reflect the presence of vertigo state in the ISSNHL patients.Apart from audiometry,the function of peripheral vestibular end organs and balance function should be evaluated to comprehensively understand ISSNHL.Better assessment of the condition will help us in clinical diagnosis,treatment and prognosis evaluation of ISSNHL.展开更多
文摘目的:探索建立标准化病人对(paired-standardized patients,PSPs),弥补临床医学教育中标准化病人的不足。方法:将日常门诊病人与标准化病人组成PSPs,再与真实病人的实验室及影像学资料相结合形成PSPs标准病案(standard case of PSPs)。采用以问题为中心的教学(problem-based learning,PBL)模式,应用PSPs进行耳鼻咽喉科学临床实习教学。结果:建立了10个PSPs标准病案,通过对PSPs标准病案的学习,使医学生对临床医学产生了浓厚的兴趣,增强了对临床实习的信心。结论:PSPs弥补了标准化病人缺乏变性和生动性的不足,有助于培养医学生的临床技能、临床思维方式、循证医学方法以及自主学习的良好习惯。
基金supported by grants from the National Twelfth Five-Year Science and Technology Support Program of China(No.2012BAI12B02)the National Eleventh Five-Year Science and Technology Support Program of China(No.2007BAI18B13)
文摘This study investigated the relationship among the severity of hearing impairment,vestibular function and balance function in patients with idiopathic sudden sensorineural hearing loss（ISSNHL）.A total of 35 ISSNHL patients（including 21 patients with vertigo） were enrolled.All of the patients underwent audiometry,sensory organization test（SOT）,caloric test,cervical vestibular-evoked myogenic potential（cV EMP） test and ocular vestibular-evoked myogenic potential（o VEMP） test.Significant relationship was found between vertigo and hearing loss grade（P=0.009）,and between SOT VEST grade and hearing loss grade（P=0.001）.The abnormal rate of o VEMP test was the highest,followed by the abnormal rates of caloric and c VEMP tests,not only in patients with vertigo but also in those without vertigo.The vestibular end organs were more susceptible to damage in patients with vertigo（compared with patients without vertigo）.Significant relationship was found between presence of vertigo and SOT VEST grade（P=0.010）.We demonstrated that vestibular end organs may be impaired not only in patients with vertigo but also in patients without vertigo.The cochlear and vestibular impairment could be more serious in patients with vertigo than in those without vertigo.Vertigo does not necessarily bear a causal relationship with the impairment of the vestibular end organs.SOT VEST grade could be used to reflect the presence of vertigo state in the ISSNHL patients.Apart from audiometry,the function of peripheral vestibular end organs and balance function should be evaluated to comprehensively understand ISSNHL.Better assessment of the condition will help us in clinical diagnosis,treatment and prognosis evaluation of ISSNHL.
