Objective To explore a new rotation training mode suitable for residency standardized non-professional radiological trainees in radiology department, so as to improve the training quality. Methods The residency standardized non-professional radiological trainees who rotated in the Department of Radiology, West China Hospital, Sichuan University between June 2021 and January 2022 were retrospectively included as the research objects. According to the training mode, they were divided into traditional training mode group and innovative training mode group. The training results of the two groups were compared by taking process assessment, final examination and final score as evaluation indicators. Results Finally, 122 residents were included, including 45 in the traditional training model group and 77 in the innovative training model group. There was no significant difference in gender, major, identity and grade between the two groups (P>0.05). There was no significant difference between the two groups in the first film reading skill examination and their usual homework performance (P>0.05). The score of the second film reading skill examination [15 (14, 16) vs. 12 (11, 13)], the score of the final examination [34 (31, 36) vs. 29 (25, 31)] and the final score [80 (76, 83) vs. 71 (67, 74)] in the innovative training mode group were better than those in the traditional training mode group (P<0.05). Conclusion The innovative training mode of online teaching platform combined with offline teaching can improve the training effect of residency standardized non-professional radiological trainees in radiology department.
摘要:目的: 探討臨床護理安全規范化管理的有效方法和效果。 方法 :成立病房護理安全管理小組;完善護理安全管理制度,培養質量管理意識;改善重點環節工作流程,強化質量監控;構建護理安全文化氛圍。 結果 : 患者滿意度明顯提高,用藥錯誤、管道脫落、壓瘡、投訴等發生率明顯降低(〖WTBX〗P lt;0005)。 結論 : 規范化的護理安全管理提高了護理質量,保障了患者的安全,有效降低了護理風險的發生。Abstract: Objective: To discuss a effective way and effect of standardardized management of clinical nursing safety.Methods :Setted up nursing safety management team; Improved the nursing safety management system and trained awareness of quality management; Improved workflow of key links,and strengthened the quality control; Built a nursing safety culture. Results : Patients satisfaction improved obviously, and the medication errors、 pipe off、pressure sores、the incidence of complaints such as decreased obviously(P lt;0005).Conclusion : Standardized management of nursing safety improved the nursing quality, protected patients safety, and effectively reduced the risk of the occurrence of nursing.
Objective
To review the research progress of the risk factors for slip progression and the pathogenesis of lumbosacral spondylolisthesis, and to discuss the value of Spinal Deformity Study Group (SDSG) classification system for lumbosacral spondylolisthesis.
Methods
Recent articles about the risk factors for slip progression and the pathogenesis of lumbosacral spondylolisthesis were reviewed and comprehensively analyzed with SDSG classification system of lumbosacral
spondylolisthesis.
Results
Pelvic incidence (PI) is the key pathogenic factor of lumbosacral spondylolisthesis. The Meyerding grade of slip, PI, sacro-pelvic balance, and spino-pelvic balance not only are the fundamental risk factors of slip progression, but also are the key factors to determine how to treat and influence the prognosis. Therefore, compared with Wiltse, Marchetti-Bartolozzi, and Mac-Thiong-Labelle classification systems of lumbosacral spondylolisthesis, SDSG classification based on these factors mentioned above, has better homogeneity between the subjects of subgroup, and better reliability, moreover, could better guide operative plan and judge the prognosis.
Conclusion
It is suggested that the SDSG classification system should be the standard classification for lumbosacral spondylolisthesis for the clinical and research work.
The coronavirus disease 2019 (COVID-19) has been evaluated as a pandemic by the World Health Organization (WHO). Although several vaccines with an efficacy of more than 50% have been developed, in terms of treatment, remdesivir remains the antiviral drug approved by the U.S. Food and Drug Administration (FDA) for the treatment of COVID-19, while none of the other treatments has been recommended by FDA due to insufficient clinical data. A number of clinical trials have been registered to study therapeutic drugs or vaccines for COVID-19. To promote the collection, tabulation, analysis of COVID-19 clinical research data, improve the efficiency of clinical research, and facilitate the integration, sharing and secondary analysis of multiple similar research data, CDISC has developed a therapeutic area user guide for COVID-19 and resources for public health researchers. The resources included two documents, one is a SDTM annotated CRF based on ISARIC and WHO core COVID-19 case report form, and the other is SDTM and CDASH mapping spreadsheet. Moreover, CDISC has developed the guidance for ongoing studies disrupted by COVID-19 pandemic and interim ADaM guidance for ongoing studies disrupted by COVID-19 pandemic to help disrupted clinical trials to collect, store, and analyze relevant data. This paper introduced the structure and content of the guide and its related standards, with a view to promoting its application in COVID-19 clinical trials and in ongoing studies disrupted by COVID-19 pandemic.
American College of Cardiology (ACC) issued the updated expert consensus decision pathway on the management of mitral regurgitation in April 2020. The whole process in caring patients with mitral valve regurgitation from patient evaluation to treatment choice was discussed in the consensus. The main change from the 2017 version is the confirmation of the effect of transcatheter mitral valve repair on secondary mitral regurgitation. It standardized the process in this field. In this paper, we aimed to introduce the focus update of this consensus.
Objective To evaluated the application effect of reverse digital modeling combined with three-dimensional (3D)-printed disease models in the standardized training of orthopedic residents focusing on pelvic tumors. Methods From August 2022 to August 2023, 60 orthopedic residents from West China Hospital, Sichuan University were randomly assigned to a trial group (n=30) and a control group (n=30). The trial group received instruction using reverse digital modeling and 3D-printed pelvic tumor models, while the control group underwent traditional teaching methods. Teaching outcomes were evaluated and compared between groups through knowledge tests, practical skill assessments, and satisfaction surveys. Results Before training, there was no statistically significant difference in knowledge tests or practical skill assessments between the two groups (P>0.05). After training, the trial group showed significantly better performance than the control group in knowledge tests (90.5±5.2 vs. 78.4±6.8, P<0.05), skill assessments (92.7±4.9 vs. 81.3±6.2, P<0.05), and satisfaction surveys (9.40±1.10 vs. 7.60±1.20, P<0.05). One month after training, the trial group still showed significantly better performance than the control group in knowledge tests (88.1±6.4 vs. 72.3±7.1, P<0.05) and skill assessments (90.3±5.8 vs. 75.6±6.9, P<0.05). Conclusions Reverse digital modeling combined with 3D printing offers an intuitive and effective teaching approach that improves comprehension of pelvic tumor anatomy and strengthens clinical and technical competencies. This method significantly enhances learning outcomes in standardized residency training and holds promise for broader integration into medical education.
ObjectiveTo compare the short- and long-term efficacy of artery-first approach pancreatico-duodenectomy (AF-PD) and standard approach pancreaticoduodenectomy (S-PD).MethodsThe PubMed, EMbase, The Cochrane Library, Web of Science, CBM, WanFang, and CNKI databases were searched, relevant literatures were included, and relevant data were extracted for meta-analysis.ResultsA total of 30 articles were included, including 2 750 cases underwent pancreaticoduodenectomy. The results of meta-analysis showed that in terms of short-term efficacy when compared with S-PD group, the AF-PD group had less intraoperative blood loss (WMD=–175.87, P<0.001), lower intraoperative blood transfusion rate (OR=0.36, P=0.002), higher R0 resection rate (OR=1.83, P<0.001), lower postoperative pancreatic leakage rate (OR=0.71, P=0.005), and shorter postoperative hospital stay (WMD=–2.69, P=0.007). However, there were no statistically significant differences in the operation time and overall postoperative complication rate between the two groups (P>0.05). In terms of long-term efficacy when compared with S-PD group, the AF-PD group had lower tumor local recurrence rate (OR=0.43, P=0.004) and tumor liver metastasis rate (OR=0.60, P=0.010), but had higher 1-year (OR=1.95, P=0.007), 2-year (OR=2.04, P<0.001), 3-year (OR=2.09, P=0.001), and 5-year (OR=2.06, P=0.003) overall survival rates, and there were no significant differences in the rates of lung metastasis and peritoneal metastasis between the two groups (P>0.05).ConclusionsAF-PD is better than S-PD in some short-term and long-term outcome indicators such as R0 resection rate, pancreatic leakage rate, overall survival rate, and so on. However, due to the limited quality of the included literatures, more high-quality studies are still needed to verify in the future.
In order to improve the management of medical technology and ensure the safety, efficiency, and economy of medical devices, we introduce the current situation and future of clinical medical engineering technology evaluation from eight aspects: evaluation standard, evaluation of technical performance, evaluation of reliability, evaluation of clinical application, evaluation of health economy, evaluation of service system, technology maturity, and human factor engineering. The evaluation of clinical medical engineering technology is still in the initial stage, and it is necessary to speed up the establishment of standardization system and evaluation criterion for all kinds of equipment evaluation.
ObjectiveTo explore the feasibility of introducing student-standardized patients in the teaching reform of medical nursing course.
MethodsWe chose four classes of nursing students from grade 2012 between September and December 2014 as the research subjects.Cluster sampling was used to choose two classes of 84 nursing students randomly as trial group, who received student-standardized patients in their practical learning; while the rest 2 classes of 83 students were chosen as control group, who received traditional teaching method.The course scores and the effect evaluation were compared between the two groups.
ResultsThe basic knowledge test score of the trial group 31.28±4.81 was not significantly different from that of the control group 32.10±2.15(P > 0.05).The case analysis test score of the trial group 54.36±3.45 was significantly higher than that of the control group 43.12±1.37(P < 0.05).The communication ability, health education ability, skill operation ability and professional quality score of nursing students in the trial group were also significantly higher than those in the control group (P < 0.05).
ConclusionIntroducing student-standardized patients in practical teaching of medical nursing can improve the teaching effect and students' comprehensive ability.
In patients with a functionally univentricular heart, the Fontan strategy achieves separation of the systemic and pulmonary circulation and reduction of ventricular volume overload. Contemporary modifications of surgical techniques have significantly improved survival rate. However, the resulting Fontan physiology is associated with high morbidity. Despite large improvements in outcomes of contemporary Fontan patients, a large burden of disease exists in this patient population. In face of the imbalance of medical resources in China and different understanding of Fontan treatment in various regions, there is no consensus on the current status of Fontan strategy, surgical technique and perioperative treatment. By reviewing large amounts of literature, assessing survival rate and risk factors for mortality and complications of the Fontan circulation, knowledge sharing from tens of experts, we achieved a consensus on many aspects of palliation of Fontan. We hope this consensus will help Chinese colleagues further continue their efforts to improve surgical outcomes of the univentricular heart patients.