上海中医药大学课程建设项目文档资料.ppt

一、课程建设的既定目标,建设推拿学科系列推拿临床双语查房教学课程。,二、课程建设的内容,1.在以往推拿学科系列双语(英语)教学课程建设（一）、（二）的基础上，继续开展推拿学科系列双语(英语)教学课程（三）推拿临床双语(英语)查房教学课程的建设，使推拿学科系列的双语教学更显系统化和连续性。2从临床实际运用和学生能力培养视角出发，选择推拿临床的常见病腰椎间盘突出症和颈椎病为典型病例进行双语教学，起到以点带面的效果。,二、课程建设的内容,(1)用双语(英语)对腰椎间盘突出症的病史、症状、体征、影像学检查、诊断、鉴别诊断、推拿治疗、调护、国内外研究进展等进行临床查房教学，并着重强调该病临床病史的双语书写；(2)编写腰椎间盘突出症的临床双语查房教学资料片的双语拍摄剧本；(3)依照剧本，拍摄腰椎间盘突出症的临床双语查房教学资料片。,二、课程建设的内容,(4)用双语对颈椎病的病史、症状、体征、影像学检查、诊断、鉴别诊断、推拿治疗、调护、国内外研究进展等进行临床查房教学，并着重强调该病临床病史的双语书写；(5)编写颈椎病的临床双语查房教学资料片的双语拍摄剧本；(6)依照剧本，拍摄颈椎病的临床双语查房教学资料片。,三、课程建设的意义,该课程建设凸现了我校在推拿教学方面的特色和领先其它中医院校的优势。,四、建设中采取的措施,1.前期的准备工作 主要是相关文献的回顾，查阅和分析有关的双语教学文件，着重了解临床双语查房教学课程的性质及重要性、并制定合适的课时数。2.双语剧本编写工作 在前期准备的基础上，参阅了大量的国内相关的书籍和一些国外资料，通过教研室教师反复共同讨论，对腰椎间盘突出症和颈椎病的内容经行了反复推敲，紧扣临床双语查房教学特点，编写推拿双语查房剧本，并反复修改。,四、建设中采取的措施,3拍摄工作 积极与拍摄人员商讨拍摄事宜、准备工作及其拍摄细节等问题；同时组织参拍人员并进行培训工作及英语台词记忆；参与最后定片工作。,五、目前完成情况,(1)已对2003级针灸推拿专业（七年制外向型）及部分其他七年制专业学生完成了用双语(英语)对腰椎间盘突出症的病史、症状、体征、影像学检查、诊断、鉴别诊断、推拿治疗、调护、国内外研究进展等进行临床查房教学工作，并也完成了该病临床病史的英语书写样本；(2)已完成了编写腰椎间盘突出症的临床双语查房教学资料片的双语拍摄剧本；(3)依照剧本，已完成了腰椎间盘突出症的临床双语查房教学资料片的拍摄。,五、目前完成情况,(4)已对2003级针灸推拿专业（七年制外向型）及部分其他七年制专业学生完成了用双语(英语)对颈椎病的病史、症状、体征、影像学检查、诊断、鉴别诊断、推拿治疗、调护、国内外研究进展等进行临床查房教学工作，并也完成了该病临床病史的英语书写样本；(5)已完成了编写颈椎病的临床双语查房教学资料片的双语拍摄剧本,Example of case history,Name:Mr.Peng,Sex:male,Age:45 Chief Complaint(C.C.):Waist pain with numbness in the right limb for a month History of present illness(HPT):The patient has a history of long-term and repeated lumbago for ten years.About one month ago,he sprained his lumbus because of carrying heavythings,after that he was unable to sit up or turn over on bed.Then the stabbing pain is gradually felt radiating to the right limb,and the radiating pain becomes worse when the abdominal pressure is increased during coughing or sneezing.The patient cannot stand and walk for a relatively long time.The stabbing pain in the lumbaus which occurs at a fixed location.He likes to lie on the normal side,and the affected lower limb is often bent.He consulted the doctor in a local clinic and the X-ray showed that the disc problem was between L5 and S1,and he took some pain-killing pills.Then the symptoms has alleveited a little.Now he comes to our hospital for an examination.,Example of case history,Past History:Denied any history of kidney and bladder problems.Examination:Neck flexion test(Lindnerssign)(+),Supine-position-abdomen-straighten-test(+),Straight leg-raising test:left 80,right 30,Bragrads test(+),Patellar reflex:left and right+,Achilles reflex:left+,right+,Hypoesthesia of the dorsum of the right foot and the posterior and lateral parts of the right leg.The lateral curvature of the lumbar vertebral column decreased.Tenderness and percussion pain in the lumbar between L5 and S1 which radiates to the sole through the lower extremity of the right side and marked tenderness in the distributing areas of the sciatic nerve of the right side.The tongue looks dark with ecchymoses on it.The pulse is taut and uneven.,Example of case history,Diagnosis in Traditional Chinese Medicine:Yaotuitong(The stasis of Blood and Qi)Diagnosis in Westen Medicine:Lumbar Disc Hernation Therapeutic Principle:Relaxing muscles and tendons,activating meridians and promoting the flow of Qi and blood.,Example of case history,Tuina treatment1.Manipulations Rolling,pressing,digital-pressing,kneading,and obliquely pulling etc.2.Location of Points Ashi Point,Shenshu(UB 23),Dachangshu(UB 25),Yaoyangguan(Du 3),Zhibian(UB 54),Huantiao(GB.30),Yinmen(UB 37),Weizhong(UB 40),Chengshan(UB 57),Yanglingquan(GB 34)and Jiexi(st 4o).3.Operation1)Rolling the two sides of the lumbar vertebrae,the hip muscles andthe points of Shenshu(UB 23),Yaoyangguan(Du 3),Dachangshu(UB 25),Zhibian(UB 54)and Huantiao(GB 30).2)Palm-kneading and digital pressing to the points of Chengfu(UB 36),Yinmen(UB 37),Weizhong(UB 40),Chengshan(UB 57),Yanglingquan(GB 34),Feiyang(UB 58)and Juegu(GB 39)in the affected limb for 2 or 3 times.3)Pressing-kneading to the Ashi point on the sides of the lumbar vertebrae for 2-3 minutes.4)Obliquely pulling manipulation on lumbar vertebral region.5)Stretching and rotating his knee(s)and hip(s)to help move the lumbar vertebrae 35 times.,Example of case history,4.Course of Treatment:The patient recievcs treatment once every other day,ten times of treatment make one course.The interval between every two courses is 3-5 days.Doctors advice:Keep the lumbar warm.Moderate exercise.Signature,Lumbar Disk HerniationWard round in English,Residents Round(the last night)住院医师查房（前一天晚上）Resident:Good evening,Mary,Im Dr，Zhu in charge of the ward.住院医生：晚上好。玛丽,我是朱医生，主管这间病房。Patient:Hello,Dr.Zhu.病人：晚上好，朱医生。Resident:This is Dr.Shi.Can you take the history now?住院医生：这是史医生。请您现在询问病史吧？Intern:Yes.How do you feel now?实习医生：好的。玛丽，你现在感觉怎么样？Patient:I am fine except for some pain.病人：除了一些地方疼，其它感觉良好。Intern:Oh,how long have you been like this?实习医师：疼痛多长时间了？Patient:About 1 year off and on.病人：大概一年了。疼痛一直是反复性的，时好时坏。Intern:Can you describe the pain?实习医师：你能把疼痛的情况描述一下吗？,CERVICAL SPONDYLOPATHY Ward round in English,Directors Round主任查房Visiting physician:As a rule,the director comes to our ward to make a ward round.Professor Wang,weve received a new case with a one-month history of soreness and numbness in the left upper extremity and decrease of hand strength.There are some troubles in diagnosis and treatment for him.主治医生：作为常规，主任来病房查房。王教授，我们收了一个新病例左上肢酸痛麻木、握力减退一月。在为他诊断和治疗方时遇到了问题。Director:Ok.Well have a look at this new patient.主任医师：让我们去看看病人。Visiting physician:Dr.Shi,Please report the case briefly to the director.主治医生：史医生，请向主任简短报告病例。Intern:OK.This is a 50-year-old male,who was admitted to our hospital in Jun.2nd,2008 because of recurrent attacks of pain in the neck and shoulder for six year,soreness and numbness in the left upper extremity and decrease of hand strength for one month and getting worse for one week.He also has a pain in his left chest.He is a cadre in Beijing University who needs long terms of deskwork.The patient had no obvious trauma history recently and no spinal disease previously.No special for other histories.The blood,urine routine analysis,the ECG and electrolyte analysis are all normal.Upon physical examination,stiffness of the neck muscle and tenderness around spinous process in C5-C7 were evident.The muscle force and tender reflex of left biceps brachii muscle were reduced.Stretching test of brachial plexus nerve and crushing test of intervertebral foramen were positive.Plain X-ray showed decrease of cervical curve,stenosis of intervertebral space of C5-C6 and hyperplasia of vertebral edge.Upon spine MRI films a paramedian left C5-C6 disc herniation and radical compression are depicted.Thats all for this case.,六、存在的问题和采取的措施,由于推拿临床双语(英语)查房教学课程的建设是一项全新的工作，对英语的水平要求较高，这就给我们的工作带来了很大的困难。虽然，项目负责人在此方面有多年的外宾教学经验，但非外语专业人员，而且加之教学任务繁重，时间急促，故缺点和错误难免，希望进一步得到学校外语中心的指导和帮助。,七、经费的使用情况,目前经费已用80%，主要用于调研、日常消耗性材料、文件复印、打印、购置相关专业参考书籍等费用。没有经费购置专用的软件请教相关专家的劳务费用尚欠。,鸣 谢,教务处针灸推拿学院外语教学中心,THANK YOU!,