ABSTRACT
Objective To establish a scientific and rational narrative medical curriculum standards for clinical medicine postgraduates to improve their medical humanistic quality.Methods On the basis of literature review and group discussion,the standards of narrative medical curriculum for postgraduates majoring in clinical medicine were preliminarily constructed,and the Delphi method was used to evaluate and screen the indicators.An expert consultation questionnaire was drawn up for 40 selected experts to finalize the curriculum standards for narrative medicine.The small-scale teaching practice was carried out in postgraduates of the Department of Hepatobiliary Surgery in Southwest Hospital of Chongqing,and the problems in the process of teaching implementation were collected.Results Experts' opinions tended to be consistent after two rounds of consultation.Finally,the study confirmed a theoretical and practical narrative medical curriculum which consisted of introducing narrative medicine theory,reading narrative medicine related books,watching the medical narrative film and television works,and writing the narrative medical records.Through the small-scale teaching practice,we collected a variety of problems,for which,we sorted out and analyzed,and finally put forward the improvement scheme.Conclusion The narrative medical curriculum for clinical medicine postgraduates is reasonable,which can lay the foundation for the promotion of clinical medical postgraduates' medical humanistic quality and doctor-patient communication ability,and accelerate the popularization of narrative medicine idea in our country.
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BACKGROUND:In the clinical orthodontics, ceramic brackets have deficiencies in the aspects of antibacterial and mechanical properties, which easily lead to the emergence of a variety of adverse events and influence the orthodontic effect. OBJECTIVE:To observe the antibacterial and mechanical properties of nano silver hydroxyapatite coating ceramic brackets. METHODS:The nano silver hydroxyapatite coating ceramic brackets were prepared. Scanning electron microscopy was used to observe the coating surface. Coating antibacterial experiment was conducted. Totaly 50 in vitro human maxilary premolars were randomly divided into two groups (n=25 per group): experimental and control groups. Premolars in the experimental group were bonded to nano silver coating hydroxyapatite ceramic brackets, and premolars in the control group were bonded to ordinary ceramic brackets. The shear strength was detected in these two groups.RESULTS AND CONCLUSION: The overall structure of nano silver hydroxyapatite coating was order, uniform and compact. Hydroxyapatite had a porous structure with a micro-nanometer aperture and there were a large number of nano-silver particles uniformly distributed. Quantitative antibacterial experiments showed that nano silver hydroxyapatite coating ceramic brackets had a strong inhibition to Escherichia coli and Staphylococcus albus, with an antibacterial rate of more than 95%. The shear strength in the experimental group was lower than that of the control group (P < 0.05). These results demonstrate that the nano silver hydroxyapatite coating ceramic brackets have good antibacterial and mechanical properties, which meet the requirement of mechanical change in the clinical orthodontics.
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Objective To establish a method for determination of dichloromethane in drinking water by purge and trap gas chro‐matography‐mass spectrometry .Methods Dichloromethane in drinking water was purged and trapped ,then desorbed and detected by using gas chromatography‐mass spectrometry .Quantitive analysis was conducted by using standard curve under selected ion mo‐nitoring (SIM) mode .Results The operation of this method was simple ,and its limit of detection (LOD) was 0 .005 ng/mL .The recovery rate was higher than 97% ,and the relative standard deviation was less than 5% .Conclusion The method may be appro‐priate to measure dichloromethane in drinking water .
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Objective To observe the sedative effect of dexmedetomidine administered at different infusing rates in senile cataract patients with retrobulbar nerve block.Methods Eighty-four senile cataract patients with retrobulbar nerve block were divided into Ⅰ,Ⅱ and Ⅲ group by random systematic sampling method with 28 cases each,the dexmedetomidine infusing rates were 0.2,0.4 and 0.6 μg/(kg·h) accordingly.Ramsay score and mean arterial pressure (MAP),heart rate (HR),respiratory rate (RR),pulse oxygen saturation (SpO2) were recorded before anesthesia (T0),after retrobulbar nerve block (T1),and 1 0,20,30,60min after sedative administration (T2-T5).Results Ramsay scores were higher in three groups at T2-T5 than that at T0 [Ⅰ group:(2.6 ± 0.7),(2.5 ± 0.2),(2.4 ± 0.8),(2.4 ± 0.3) scores vs.(2.0 ± 0.0) scores,Ⅱ group:(3.0 ± 0.7),(3.8 ± 0.7),(4.2 ± 0.2),(4.5 ± 0.2) scores vs.(2.0 ± 0.0) scores,Ⅲ group:(3.8 ±0.6),(4.7 ± 0.4),(5.2 ± 0.8),(5.6 ± 0.6) scores vs.(2.0 ± 0.0) scores],Ⅲ group was higher than Ⅰ group and Ⅱ group,Ⅱ group was higher than Ⅰ groupatT3-T5,difference was statistically significant (P＜0.05).HR was slower in three groups at T3-T5 than that at T0 (P ＜ 0.05),Ⅲ group was slower than Ⅰgroup and Ⅱ group,difference was statistically significant (P＜0.05).There were no significant changes in MAP,RR and SpO2 among groups and the group (P ＞ 0.05).Conclusion Bolus infusion dexmedetomidine 0.5 μ g/kg followed by intravenous infusion at 0.2-0.4 μ g/ (kg· h) is suitable for sedation of senile patients with cataract surgery.