慕课在医学生假期课前预习中的应用探讨

高校医学生会利用假期时间对将要学习的科目进行预习,力求提前了解或掌握,以利于日后对知识的充分理解。预习对于医学科目学习有一定必要性,然而传统的假期预习模式常存在缺乏引导、效率难以提升等问题。目前,慕课在医学教育领域的应用有所发展。对于医学生,其自主学习的模式、课程设计等契合医学课程的预习需求和假期学习的特点,有助于提升医学生的学习能力和假期预习效果。医学生将慕课作为假期预习资源可有多种学习模式选择。慕课平台的功能拓展和学校教师的辅助可以有效深入慕课在医学生假期预习中的应用,为医学生带来更合理的假期学习安排。     

中西医结合护理干预妊娠晚期合并急性单纯性阑尾炎患者的临床观察

目的:探讨中西医结合护理干预妊娠晚期合并急性单纯性阑尾炎的临床疗效。方法:将2017 年9 月—2018 年12月于我院接受中西医结合保守治疗的31 例妊娠晚期合并急性单纯性阑尾炎患者作为研究对象，按随机数表法随机分为中西医结合护理组(观察组16 例)与常规护理组(对照组15 例)，对照组采取常规护理措施，观察组在对照组的基础上增加中西医结合护理措施，对比两组患者的临床疗效。结果:观察组患者的心理状态变化、新生儿体质状况以及临床疗效等指标等情况均明显优于对照组，且组间对比差异显著有统计学意义(P ＜ 0.05)。结论:中西医结合护理对妊娠晚期合并急性单纯性阑尾炎有较好的临床效果，可减少、甚至避免孕妇因合并急性阑尾炎而造成的打击和创伤。     

临床药师工作评价初探综述

随着我国医疗机构临床药师队伍的不断壮大，其在医疗服务中发挥着越来越重要的作用，对其工作进行绩效考核也是当今医疗领域的重要内容。以现有文献为基础，对国内外临床药师绩效考核体系进行分析，发现现有体系可分为为基于临床药师职责、基于临床药师业务流程、国外临床药师绩效考核体系三个方面；通过结合医疗机构的实际情况对现有绩效考核体系进行分析，发现存在考核指标和标准确定困难、考核难以做到实时性和延续性等问题，并针对这些问题提出清晰职责定位、重视临床药师价值体现等修改说明。     

Heterogeneity in amount of growth factors secreted by platelets in platelet-rich plasma samples from alopecia patients

Platelet α-granules release growth factors (GFs) that promote healing and tissue regeneration. Platelet-rich plasma (PRP) is shown to be beneficial in treating alopecia, and however, clinical response can be inconsistent. Due to several fold enrichment of platelets secreting large quantities of GFs following PRP injections, heterogeneity in amounts of GFs secreted by platelets may contribute to inconsistent clinical responses. Herein, we evaluated factors that could potentially contribute to heterogeneous secretion of GFs by platelets. We measured platelet secretion of transforming growth factor beta1 (TGFβ1), platelet-derived growth factor (PDGF-BB), epidermal growth factor (EGF), vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF2) in aliquots of de-identified PRP samples from female patients undergoing therapy in the hair disease clinic. Although secretion of GFs by platelets was comparable in PRP samples of patients with non-cicatricial and cicatricial alopecia, a Shapiro-Wilk test for normal distribution indicated significant variability across all patient samples. The amount of GF secreted by platelets was comparable when PRP prepared from two FDA-cleared devices with distinct techniques were compared. We provide evidence of platelets secreting heterogeneous amounts of GFs within each sample as high and low secretion of random factors could be simultaneously detected. These results suggest inherent heterogeneity in secretion of GFs by platelets in patient samples that are not influenced by the device used to prepare PRP. Since some GFs could have antagonistic effects on hair growth, a balance between amounts of growth promoting and inhibiting factors may be crucial in determining clinical response to PRP therapy.     

Rethinking PICO in the Machine Learning Era: ML-PICO

Background  Machine learning (ML) has captured the attention of many clinicians who may not have formal training in this area but are otherwise increasingly exposed to ML literature that may be relevant to their clinical specialties. ML papers that follow an outcomes-based research format can be assessed using clinical research appraisal frameworks such as PICO (Population, Intervention, Comparison, Outcome). However, the PICO frameworks strain when applied to ML papers that create new ML models, which are akin to diagnostic tests. There is a need for a new framework to help assess such papers. Objective  We propose a new framework to help clinicians systematically read and evaluate medical ML papers whose aim is to create a new ML model: ML-PICO (Machine Learning, Population, Identification, Crosscheck, Outcomes). We describe how the ML-PICO framework can be applied toward appraising literature describing ML models for health care. Conclusion  The relevance of ML to practitioners of clinical medicine is steadily increasing with a growing body of literature. Therefore, it is increasingly important for clinicians to be familiar with how to assess and best utilize these tools. In this paper we have described a practical framework on how to read ML papers that create a new ML model (or diagnostic test): ML-PICO. We hope that this can be used by clinicians to better evaluate the quality and utility of ML papers.     

工作坊模式在护生压疮护理带教中的应用效果分析

目的探讨工作坊模式在护生压疮护理带教中的应用效果,为临床护理带教提供参考。方法选取2018年7月—2019年6月在医院实习的120名护生作为研究对象,随机分为对照组和观察组,各60名护生。对照组采用传统带教法进行压疮培训,观察组采用工作坊教学模式进行培训。培训结束后比较两组护生压疮知识的掌握程度即理论考核、技能操作成绩,教学效果满意度。结果观察组护生对压疮知识的掌握程度即理论考核成绩、技能操作考核成绩远远高于对照组,两组差异具有统计学意义(P<0.05)。95%的观察组护生对工作坊教学模式的效果表示满意,认为工作坊教学模式能够提高学习的兴趣、主动性和临床实践能力,对临床工作有很大帮助。结论工作坊教学模式应用于压疮护理的临床带教,能让护生亲身体验压疮护理的过程,并参与其中,将理论与实践相结合,更好地活跃课堂气氛,启发护生思考,提高护生对压疮理论和技能的掌握,为临床实际工作中压疮护理质量的提高奠定基础。