In response to the education and teaching reform, West China School of Medicine/West China Hospital, Sichuan University, initiated a general course on clinical engineering technology assessment and evaluation for the undergraduates in 2018. Through the course practice in the past two years, the number of students increased significantly, and we also achieved certain teaching achievements. At the same time, the teaching evaluation among undergraduates was excellent. Nevertheless, there are still certain deficiencies in the content of teaching, teaching methods and faculty. Therefore, this article summarizes the experience and lessons since the start of the course, and proposes corresponding teaching reform measures, providing reference for the establishment or reform of related interdisciplinary courses such as clinical engineering technology assessment and evaluation in the future.
As the reform of medical insurance payment methods is implemented, it is necessary for the medical institutions to further improve cost control and standardize the rational use of medical supplies. Over the years, West China Hospital of Sichuan University has made the assessment of the access of supplies by using the existing external evidence and the internal evidence created through real world data analysis methods. In this thesis, the difficulties faced by the access of medical supplies are deeply analyzed. The supplies access management system of West China Hospital of Sichuan University and its achievements in average waiting time of new supplies, rationality of purchase application, scientificity of demonstration results, support for the implementation of fourth-level surgery, and cost control are taken as examples. From this, a set of new paths can be provided for other hospitals to learn from at the time of carrying out medical supplies access management.
ObjectiveTo present the application of mini-health technology assessment (Mini-HTA) method in configuration management of anti-magnetic anesthesia machine.MethodsFrom February to March 2019, the specialist operation assistant used Mini-HTA method to analyze and evaluate the anti-magnetic anesthesia machine applied by the department from basic situation and four dimensions, including technical dimension, patient dimension, hospital dimension, and economic dimension.ResultsA hospital health technology assessment report was prepared based on the evaluation of the specialist operation assistant, the suggestion of which was adopted by the hospital. As a result, an anti-magnetic anesthesia machine was arranged in the MRI room.ConclusionMini-HTA method can provide decision support for hospital equipment configuration and is conducive to the scientific and rational allocation of resources in hospitals.
ObjectiveTo determine whether there is an imbalance of KLF2/RelA in peripheral blood neutrophils in patients with bronchial asthma, and explore the relationship between KLF2/RelA imbalance and neutrophil apoptosis.MethodsFrom April 2011 to April 2012, a total of 39 patients with acute attack of asthma in Hunan People's Hospital and Third People's Hospital of Changsha were enrolled, with 13 cases in mild asthma group, 17 cases in moderate asthma group, and 9 cases in severe asthma group. Fifteen healthy subjects were recruited as control group. Peripheral blood were collected from all subjects followed by separation of neutrophils. The apoptosis of neutrophils were measured by flow cytometry. The expression of KLF2 and RelA were detected by Western blot. The relationship between the ratio of KLF2/RelA and neutrophil apoptosis rate was analyzed by Pearson correlation test.ResultsNeutrophil apoptosis rates in the mild, moderate and severe asthma groups [(4.45±0.76)%, (2.10±0.25)%, (1.81±0.67)%, repectively] were lower than that in the healthy control group [(5.36±0.57)%, all P<0.01]. The apoptosis rates of neutrophils in the moderate and severe asthma groups were lower than that in the mild asthma group (bothP<0.01), but there was no significant difference between the moderate asthma group and the severe asthma group (P>0.05). The ratios of neutrophil KLF2/RelA in the mild, moderate and severe asthma groups were lower than that in the normal control group (0.667±0.351, 0.384±0.203, 0.536±0.293vs. 4.038±2.011, all P<0.01). There was no significant difference between the groups of mild, moderate and severe asthma (P>0.05). The neutrophil apoptosis rate was positively correlated with the percentage of neutrophil KLF2/RelA (r=0.592 0, P<0.000 1).ConclusionThere is an imbalance of KLF2/RelA in peripheral blood neutrophils in patients with bronchial asthma, and the imbalance of KLF2/RelA may be the mechanism of apoptosis of peripheral blood neutrophils.
Objective To study the current situation of doctor-patient communication education for medical undergraduates, and meanwhile to analyze the students’ satisfactory degree to communication education and its influencing factors, so as to provide sound suggestions to promote the students’ clinical communication abilities. Methods Using simple sampling, 50% of the students who majored in clinical medicine in grade 2006-2009 in West China Medical School of Sichuan University were selected as respondents. The investigation was conducted by face to face talk with a self-designed questionnaire. The data were input using EpiData 3.0 software and the results were analyzed by SPSS 13.0 software. Results A total of 450 questionnaires were distributed, and 404 were validly retrieved (89.78%). Among the respondents, 74.3% of them were satisfied with the current situation of doctor-patient communication education; 75.7% of them begun to know doctor-patient communication education since the stage of learning basic knowledge; 49.8% of them were trained by means of problem-based-learning (PBL); and 65.5% of them were trained with auxiliary standardized patient (SP). “Grade”, “Gender”, “SP used” and “PBL used” were the main factors affecting the satisfactory degree to current doctor-patient communication education (P=0.029, 0.023, 0.012, and 0.029, respectively). Conclusion The medical undergraduates’ satisfactory degree to current doctor-patient communication education is generally high, but it is also affected by various factors. Although doctor-patient communication education has started early, the training system is still problematic and the teaching resources coverage is limited. So in order to make a further systematic, standardized, overall designed education for students’ cognition and communication skills, the medical colleges should open integrated doctor-patient communication curriculum that combines with both PBL and SP auxiliary teaching methods, and covers all the undergraduate learning stage.
目的 通过检测人睾丸生殖细胞肿瘤中的Skp2蛋白质异常表达,探讨相关意义。 方法 应用S-P免疫组织化学法检测睾丸生殖细胞肿瘤，正常睾丸组织和慢性睾丸炎组织中Skp2的表达。 结果 睾丸生殖细胞肿瘤中Skp2阳性表达率为74.5%，正常睾丸组织中Skp2阳性表达率为20.0%，在慢性睾丸炎组织中Skp2阳性表达率为40.0%，在3种不同睾丸组织中表达差异有统计学意义（P＜0.05）；Skp2表达与不同组织学类型的睾丸生殖细胞肿瘤无相关性（P＞0.05）；随着临床分期的增高，睾丸生殖细胞肿瘤中的Skp2表达增多，差异无统计学意义（P＞0.05）。 结论 在人睾丸生殖细胞肿瘤中的Skp2高表达，提示细胞周期的异常调控在睾丸生殖细胞肿瘤的发生、分化中起着重要的作用。
Objective To investigate the effects of Neuritin on the regeneration of the neural axons after acute spinal cord injury (SCI) in rats. Methods The model of acute SCI at T10 was establ ished in 54 adult healthy Wistar rats (half males and half females) weighing 250-300 g by using the improved Allen’s weight-drop method. The rats were randomly dividedinto 3 groups. 100 μL (6 μg) Neuritin and His protein was injected into group A (n=24) and group B (n=24), respectively,through subarachnoid catheter. Six rats from each group were killed 3, 7, 14, and 28 days after injury to receive Basso, Beattie and Bresnahan (BBB) locomotor rating scal ing, HE staining observation, and immunohistochemistry staining observation for neurofilament 200 (NF-200) and growth associated protein 43 (GAP-43). Group C (n=6) served as sham-operated group receiving laminectomy without spinal injury and with an empty catheter in the subarachnoid space and received the above observations 7 days after injury. Results BBB scale: after operation, the scale of groups A and B was increased over time; group A was significantly higher than group B from 14 days (P lt; 0.05); group C was higher than groups A and B at different time points after operation (P lt; 0.05). HE staining: in group C, the injured spinal tissue was normal after operation; from 7 days after operation, group A presented deeper-stained nissl body, less physal iferous cells, and more nerve synapses when compared with group B. NF-200 and GAP-43 immunohistochemistry observation: in group C, there was just l ittle positive expression; while in groups A and B, positive expression of NF-200 and GAP-43 was evident in the spinal cord from 7 days after operation. Mean density integral absorbency (IA) value of NF-200 and GAP-43: group A was higher than group B at each time point (P lt; 0.05) and group C was lower than groups A and B at each time point (P lt; 0.05). Conclusion Local application of exogenous Neuritin can promote the axonal regeneration after acute SCI in rats and the recovery of the locomotion function of hind-limbs in rats.
Compared with traditional medical devices, artificial intelligence medical devices face greater challenges in the process of clinical trials due to their related characteristics of artificial intelligence technology. This paper focused on the challenges and risks in each stage of clinical trials on artificial intelligence medical devices for assisted diagnosis, and put forward corresponding coping strategies, with the aim to provide references for the performance of high-quality clinical trials on artificial intelligence medical devices and shorten the research period in China.
At present, Chinese hospitals widely use a single qualified talent evaluation system. This talent evaluation system has certain limitations. Therefore, based on the long-term demand of research-oriented hospitals for talent team construction, and the limitations of the existing talent evaluation system, this article preliminarily discusses the integrated mode of talent evaluation for research-oriented hospital with integral, qualitative and whole person evaluation based on the Gestalt theory. This model contributes to comprehensively and authentically reflecting the contributions and influences of the evaluated individuals in terms of their professional level, comprehensive abilities, and moral character in research-oriented hospitals. Moreover, it is necessary to fully integrate artificial intelligence and 5G information technology to explore and integrate various evaluation methods into a comprehensive evaluation system for talents in research-oriented hospitals that combines scientific evaluation weights, realizing intelligent, visual, refined, and scientific integrated evaluation.
The pre-market approval and clinical application of innovative medical devices should be based on high-quality evidence, proving their reliability, safety and effectiveness. In 2016, the IDEAL (Idea, Development, Exploration, Assessment and Long-term follow-up) collaboration modified the original IDEAL framework and recommendation to the IDEAL-D methodological framework for the entire life cycle evaluation of innovative medical devices. The framework included five stages, namely the preclinical development stage, idea stage, exploration stage, assessment stage and long-term follow-up stage. This paper aims to interpret the study purpose, content and design at each step of the IDEAL-D framework based on IDEAL framework and recommendation (2019) to provide practical methodological guidance for the design and conduct of clinical research on innovative medical devices.