浅谈第4版《药事管理学》教材特点及教学方法改革

目的:为促进药事管理学的教学改革提供参考。方法:结合教学实践,总结第4版规划教材《药事管理学》的特点并提出完善续版教材的改进建议和提高《药事管理学》教学质量的教学方法。结果与结论:第4版教材体现了全球医药文化、药事管理交流融合的内容和趋势,增加了不少专业英文术语和图表,较前几版已有较好的改进。但与时事缺少紧密联系,并存在少量编校错误,建议修订时注意修改。建议教师在教学过程中注意运用多媒体教学手段、多引用案例分析,增加学生学习兴趣,提高教学质量。     

药用植物学教材建设探索

围绕高等学校创新人才培养目标,结合四川大学药用植物学精品课程和创新人才培养体系的建设,介绍了全国高等学校"十二五"国家级和卫生部规划教材《药用植物学》(第六版)的建设背景、建设基础和编写思路,指出规划教材的编写特点、结构和内容衔接,并进行配套教材建设,以适应药用植物学教学改革和发展的趋势。     

首部统编教材《医德学概论》的编写和出版前后

我国第一部医学职业道德教材《医德学概论》的出版,离不开在“解放思想实事求是”号召下的课程改革尝试。回顾这部教材的编写和出版前后的工作历程,充分肯定了改革开放在我国生命医学伦理学教材建设及学科发展史上的巨大意义。     

Textbook Outcome as a measure of surgical quality assessment and prognosis in gastric neuroendocrine carcinoma: A large multicenter sample analysis

ObjectiveQuality assurance is crucial for oncological surgical treatment assessment. For rare diseases, single-quality indicators are not enough. We aim to develop a comprehensive and reproducible measurement, called the “Textbook Outcome” (TO), to assess the quality of surgical treatment and prognosis of gastric neuroendocrine carcinoma (G-NEC) patients.MethodsData from patients with primary diagnosed G-NEC included in 24 high-volume Chinese hospitals from October 2005 to September 2018 were analyzed. TO included receiving a curative resection, ≥15 lymph nodes examined, no severe postoperative complications, hospital stay ≤21 d, and no hospital readmission ≤30 d after discharge. Hospital variation in TO was analyzed using a case mix-adjusted funnel plot. Prognostic factors of survival and risk factors for non-Textbook Outcome (non-TO) were analyzed using Cox and logistic models, respectively.ResultsTO was achieved in 56.6% of 860 G-NEC patients. TO patients had better overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) than non-TO patients (P<0.05). Moreover, TO patients accounted for 60.3% of patients without recurrence. Multivariate Cox analysis revealed non-TO as an independent risk factor for OS, DFS, and RFS of G-NEC patients (P<0.05). Increasing TO rates were associated with improved OS for G-NEC patients, but not hospital volume. Multivariate logistic regression revealed that non-lower tumors, open surgery, and >200 mL blood loss were independent risk factors for non-TO patients (P<0.05).ConclusionsTO is strongly associated with multicenter surgical quality and prognosis for G-NEC patients. Factors predicting non-TO are identified, which may help guide strategies to optimize G-NEC outcomes.     

Textbook outcomes of hepatocellular carcinoma patients with sarcopenia: A multicenter analysis

BackgroundThe impact of sarcopenia on textbook outcome (TO) after hepatectomy in hepatocellular carcinoma (HCC) patients remains unclear. This study aimed to investigate the association between sarcopenia and TO, to clarify its long and short-term prognostic value, and to develop a nomogram model based on sarcopenia and TO for survival prediction.MethodsPatients who underwent HCC resection between January 2012 and March 2017 in three large hospitals in Fujian were retrospectively recruited and divided into sarcopenia and non-sarcopenia groups based on skeletal muscle index (SMI) values. TO was defined as no 30-day morality, no 30-day readmission, negative margins, no prolonged hospital stay, and no major complications. Multivariate regression was used to screen for clinical factors associated with TO. Nomograms of overall survival (OS) and recurrence-free survival (RFS) after hepatectomy for HCC were developed.ResultsA total of 1172 patients were included in the study. The TO rates were 28.74% (121/421 patients) in the sarcopenia group and 43.4% (326/751 patients) in the non-sarcopenia group. The results showed that sarcopenia was an independent predictor of TO (p < 0.001), TO was an independent predictor of perioperative treatment-related sarcopenia (PTRS)(p = 0.002), and TO was an independent predictor of OS and RFS (p < 0.001). Nomogram models based on sarcopenia and TO were generated and accurately predicted OS and RFS at 1, 3, and 5 years.ConclusionBoth sarcopenia and TO are independent predictors of OS and RFS after HCC resection. Sarcopenia was an independent predictor of TO. Sarcopenia influenced long-term survival by affecting short-term postoperative outcomes.