Improving burn surgery education for medical students in China

IntroductionIn China, although burn treatment develops rapidly, and ranks in the forefront of the world, there is a relative shortage of burn specialists, which limits the development of burn education. In traditional curriculum of surgery education, burn surgery education accounts for few proportions, which results in the indifference to the burn surgery among medical students. To date, few research reported the application of Clinical pathway- Problem based Learning (CP-PBL) in burn surgery education. The objective of the study is to explore the teaching effect of this novel teaching method in burn surgery education.MethodsA pilot study was performed. One hundred and six students were randomly divided into a Lecture based Learning (LBL) only group (control group) and a LBL combined Clinical pathway- Problem based Learning group (observation group). A set of test was designed as evaluation criteria based on questions of burn surgery in National Medical Licensing Examination (NMLE) from 2011 to 2018.ResultsThe students with Clinical pathway- Problem based Learning had better academic performances in profession theory. Type A2 and Type A3/A4 scores in the observation group were higher than those in the control group (p < 0.05). The scores of the observation group were higher than those of control group in the domains of understanding and application (p < 0.05). They also have higher favorable impressions of learning experience.ConclusionsMore active approaches yield more learning and are viewed more favorable, which provides a vital message for the evolution of curriculum in Chinese medical schools.     

临床药师医嘱审核在静脉药物集中配置中的作用

分析医院静脉药物集中配置情况,探讨临床药师通过医嘱审核在静脉药物配置中心（PIVAS）的作用,促进了临床合理用药。方法：针对医院PIVAS为内科病房开展工作,按照随机抽样原则,分别抽取2013年7~12月（A组）及2014年1~6月（B组）的住院用药医嘱中各抽取4000份,进行分析和统计。结果：A组不合格医嘱有377份（占医嘱9.43%）,B组住院用药医嘱中,不合格医嘱有94份（占医嘱2.35%）。结论：通过医嘱审核,临床药师在PIVAS的工作中,将控制不合理用药关口前移,促进了临床合理用药,提高了医院的现代化医疗质量。     

人工智能辅助诊疗技术（手术机器人）临床应用调研报告

目的：通过调研了解人工智能辅助诊疗技术（手术机器人）技术临床应用情况,提出规范手术机器人临床应用及配置管理的建议,推动我国医学新装备新技术的规范应用和科学发展。方法：调研工作采用文献检索、走访机构、问卷调查以及专家咨询的方法。结果：通过对23位实施过机器人手术的临床医师的调查,以及4家配置手术机器人医疗机构的走访,全面了解手术机器人设备配置、使用中的问题,提出加强管理的建议。结论：手术机器人技术有必要引进国内临床使用,并实施技术的引进、吸收、创新;严格执行大型医用设备配置管理制度,制定临床适用范围、定价收费办法。     

下颌角缺损修复钛板构型的拓扑优化研究

目的 为下颌骨缺损修复植入体的构型设计提供优化方法和基本构型。方法 使用基于密度法的拓扑优化算法,针对下颌角缺损的修复体钛板进行拓扑优化计算。结果 通过比较和分析体积分数F和惩罚因子p对优化构型的影响,最终选择F=0.65和p=3.5作为优化的参数组合。用此参数组合对下颌角缺损修复体进行优化计算,认为3孔构型是其基本优化构型。同时发现,对同一构型,磨牙咬合较前牙咬合对植入体应力分布影响更显著。结论 获得了一套适用于下颌骨修复植入体构型优化的参数和方法,得到了优化后的钛板基本构型,可为临床下颌缺损修复体的设计提供借鉴。     

Primary treatment of ocular surface squamous neoplasia with topical interferon alpha-2b: Comparative analysis of outcomes based on original tumor configuration

Purpose:The aim of this study was to evaluate tumor control of OSSN with topical IFNα2b alone based on tumor configuration (flat versus (vs.) dome-shaped).Methods:Retrospective, nonrandomized, interventional cohort study on 64 consecutive tumors in 63 patients with OSSN treated with topical IFNα2b. Topical IFNα2b (1 million international units/cc) was compounded and provided by the Thomas Jefferson University Hospital Pharmacy to be refrigerated and applied 4 times daily until biomicroscopic evidence of tumor resolution was observed.Results:The tumor configuration was flat (n = 15, 23%) or dome-shaped (n = 49, 77%). A comparison (flat vs. dome-shaped) revealed dome-shaped with older mean patient age at presentation (62 vs. 70 years, P = 0.04), greater patient history of smoking (13% vs. 42%, P = 0.04), greater corneal involvement (7% vs. 82%, P < 0.001), larger mean basal diameter (5.5 vs. 12.4 mm, P = 0.001) and mean thickness (1.9 vs. 4.3, P = 0.002), and longer mean duration IFNα2b therapy (3.7 vs. 6.3 months, P = 0.002). There was no difference in mean follow-up time (22.2 vs 23.1 months) or time to complete response (5.0 vs. 6.1 months). There was no difference in achievement of complete tumor control with IFNα2b alone (93% vs. 96%). There were no cases with metastasis or death.Conclusion:Topical IFNα2b alone shows excellent overall tumor control of 95% with no difference in efficacy based on tumor configuration.     

The Effects of Heart Rate Variability Training on Sensorimotor Rhythm: A Pilot Study

Abstract

This article describes the surprising results of a brainmap that was made of Mr. Zhu, a Chi Kung Master. Astonishing results occurred when Master Zhu practiced the art of “losing mind.”     

实验室仪器设备配置明显改善,与标准仍有差距——省级疾控绩效考核应用之六

目的：通过对省级疾病预防控制中心实验室仪器设备配置状况的分析,来检验实验室仪器设备配置类指标的科学性、合理性和可操作性。方法：普查全国省级疾病预防控制中心2009年A类设备配置率、仪器设备正常运行率等相关指标。结果：全国省级疾病预防控制中心A类设备的配置率为78.6%,较2005年提高31.4%,但只有10个省的A类设备配置率完全达标;检验设备正常运行率平均为95.5%,43.7%的省份与95%的标准有一定的差距。结论：我国省级疾控中心的实验室配置状况得到了很大改善,但距标准仍有差距。     

高胆固醇血症红细胞形态扫描电镜观察

目的探讨高胆固醇血症红细胞形态变化及发病机制。方法以扫描电镜观察20例高胆固醇血症（〉6mmol／L）临床亚健康人血红细胞形态。结果所选20例高胆固醇血症（〉6mmol／L）临床亚健康人血红细胞均有不同程度形态变异。结论高胆固醇血症红细胞不仅存在膜组分的变化，同时膜蛋白和膜骨架受损及膜内外环境的劣化可能是导致其形态变异、功能受限的原因所在。     

A “leap in the dark?” Lessons for the United Kingdom from past extensions of bar opening hours

The Licensing Act of 2003 for England and Wales paves the way for 24-hour opening of licensed premises. Senior members of the United Kingdom Government have claimed that the pressure of rigid closing times contributes to the rising problem of binge-drinking and associated harm in the UK. Removing set opening times it is hoped will reduce these problems. These plans have been widely criticised. Moreover, international evidence suggests this may not be the case. Studies from Europe, Iceland, Australia and North America have indicated that extending trading hours may not only fail to reduce alcohol-related problems but might increase them. Evidence exists of licensing liberalisation being followed by rises in alcohol consumption, violent crime, traffic accidents, illicit drug use as well as extra public health and tourism costs.