Objective To assess the effect of problem-based learning (PBL) to improve clinical practice skills for clinical students after graduation. Methods Computer retrieval was conducted to search for controlled studies comparing PBL with non-PBL. The quality of the included studies was critically evaluated and data were analyzed. Results A total of 16 articles were included. The results showed that in integrated capabilities, PBL teaching was superior to traditional teaching methods. Whether in self-evaluation or objective evaluation, in terms of legal and ethical aspects of health care, research and presentation skills and ability to solve problem, PBL teaching was superior to non-PBL-learning methods. But in other aspects, it was yet controversial whether PBL-learning was better than non-PBL-learning. Conclusion Problem-based learning could improve clinical practice skills for clinical students after graduation. However, most trials included are of low quality, so large-scale randomized controlled trials of higher quality are needed to confirm this.
Objective To evaluate the clinical efficacy and safety of triple-antiplatelet treatment based on Cilostazol for restenosis after percutaneous coronary intervention. Methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 3, 2009), PubMed (1966 to 2009), EMbase (1974 to 2009), CNKI (1994 to 2009), CBM (1978 to Feb. 2009), VIP (1989 to Feb. 2009), and CMD Digital Periodicals (1998 to 2009). Two reviewers independently evaluated the quality of the included studies and extracted the data. Meta-analyses were performed using RevMan 5.0 software. Results Five randomized controlled trials (RCTs) involving 2 348 patients were included. The results of meta-analyses showed that triple-antiplatelet treatment based on Cilostazol could increase minimum lumen diameter (MD=0.31, 95%CI 0.11 to 0.51) and decrease restenosis rate (OR=0.49, 95%CI 0.37 to 0.65). In addition, it could decrease death rate (OR=0.52, 95%CI 0.31 to 0.88), but it could not change target-vessel revascularization, stroke rate, palpitation rate, and the rate of major adverse cardiac and cerebral events and major adverse cardiac events. Conclusion Evidence shows that triple-antiplatelet treatment based on Cilostazol could increase minimum lumen diameter and decrease restenosis rate and death rate. Their clinical application is worthy to be advocated.