ABSTRACT
From January 23, 2020 to May 29, 2021, there were 17,550 clinical research registrations on the China Clinical Trial Registry Platform. The index of clinical research on COVID-19 showed 840 registrations, accounting for 4.79% (840/17 550) of the total registrations. According to the trend chart of epidemic development, 487 clinical research projects of COVID-19 registered from January 23, 2020 to March 18, 2020 were set as the early stage of epidemic discovery in the region, the following 15 months were divided into stable initial stage, stable later stage and the later stage of the first wave of domestic epidemic every five months. The proportion of COVID-19 research projects registered in each stage was 29.80%, 5.87%, 0.76% and 1.15% of all registered projects respectively. The registration ratios of COVID-19 in each clinical stage was 57.98%, 28.81%, 5.95% and 7.26% respectively. Intervention studies were 61.60% (300/487) in the early stage of the epidemic, and most of them were in biological agent and drug therapy, which were 40.49%, 50.00% and 73.77% respectively in the later stages. Stable initial stage biological agent projects decreased. Then the vaccine research program became a focused research program. Among the 58 registration projects involving vaccines, 25 were clinical trials of vaccines in different stages, with the major research units being biopharmaceutical companies. Of the 487 clinical studies registered in the early stage, 10.23%(50/487) were withdrawn, of which 38 were intervention treatment studies, most notably drug studies (17) and blood biological products (16), but they were still registered in the stable initial stage. It is necessary to reflect on the scientific and ethical nature of early COVID-19 clinical trials or research, including whether the three core values of equal respect, help to alleviate pain and fairness can be achieved. Whether the "ethics review meeting should pay special attention to the scientificity, safety, fairness, subject protection, informed consent documents and informed consent process, avoidance of conflicts of interest, etc. of clinical trials or research" has been implemented. Competent government departments at all levels and all clinical medical research institutions should organize evaluation, and then establish an effective evaluation mechanism when new clinical trials or research projects are registered in the future.
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Objective:To analyze the design and test results of case-introduced papers in Clinical Comprehensive Course graduation test for assistant general practitioners of batch 2015 and 2016, so as to provide references for enhancing the comprehensive abilities of students to analyze clinical problems during training.Method:Brief cases were introduced to part of the questions in the paper. The difficulty coefficient of the paper and the degree of distinction and reliability of the test results of students in the two batches were calculated and analyzed, and the results of their answers to different questions (single choice questions & brief case-introduced questions) were compared. SPSS 15.0 was used to perform chi-square test or t-test. Results:①The test papers for the two batches and the two parts in the papers all conformed to the testing purpose and have achieved the objective of training. The difficulty coefficient of the paper and the distinction and reliability degrees of the results were all reasonable. ②There was a statistically significant difference in the difficulty coefficient of the single choice questions in the papers of the two batches ( P<0.05), but no significant difference in the brief case-introduced questions ( P>0.05). ③There was no statistical difference in the difficulty coefficient of test questions in the two papers ( P>0.05), but a statistically significant difference was found in the difficulty coefficient of brief case-introduced questions ( P<0.05). ④There was a significant difference in the average scores of students in the two batches ( t=8.18, P<0.01) and in the frequency distribution of each fraction frequency in the "single choice question" ( P<0.01), but no difference in the frequency distribution of brief case-introduced questions ( P>0.05). ⑤There was a significant difference in the average scores of single choice questions of students in the two batches ( P<0.01), and no statistically significant difference in the average scores of brief case-introduced questions ( t=1.22, P>0.05). Conclusion:Students of batch 2015 and 2016 accepted the "brief case-introduced questions". These questions requires students with greater abilities, thus can effectively distinct their training outcomes. Generally speaking, introduction of cases in the teaching of assistant general practitioners has made great achievements.
ABSTRACT
By compiling the practice set of "brief problem examples", we continue to advance case-oriented teaching in the "3+2" assistant general practitioner training "clinical comprehensive course". However, we have found that 10.7% of the questions provided by the instructors are still concerned with large-scale equipment, and operation methods etc., suggesting that parts of the teachers' consciousness in general medicine is still urgent to be enhanced. According to the analysis of the graduation test results of the students of Grade 2015, it is obvious that the average scores of the students after the examination reform have not been significantly affected. The questionnaire survey shows that most of the teachers and students think that it is of positive significance to adopt a "brief medical record problem", and 91.5% of the teachers and 81.7% of the students do not affect the examination paper form and do not affect the answers. As for the compiled 1 exercises, 86.6% of the teachers and 67.8% of the students agreed. In view of the supple-mental effect of the form of "brief medical record problem" to case introduction teaching, it is necessary to compile the exercise set suitable for this course and apply it to specific teaching activities.
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Objective Based on the objective test (A type) results of the 2014 comprehensive clinical course graduation test of 3+2 assistant general practitioners training,this article analyzed the differences between different teaching units,so as to provide objective basis for improving the teaching level of each unit.Method We established a database with EXCEL 2000,and put each question's ID and points,and the score of each student into the computer,so we could get the difficulty coefficient,distinction degree and reliability of the test paper,and calculate the difficulty coefficient and difference of each question.Then we analyzed the difficulty coefficient,the difference and the reliability of the 122 students' testing results,and compared the accuracy to the same question of the 6 teaching units.Result The objective test's (A type) difficulty coefficient is 0.77,distinction degree is 0.19,and reliability is 0.99.The highest score of the 122 students is 47 points,and the lowest score is 28 points,the average score is (38.5 ± 3.9) points.In the 50 questions,3 questions' difficulty coefficient is less than 0.4,14 questions' difficulty coefficient is between 0.4-0.7,33 questions' difficulty coefficient is above 0.7,so the difficulty degree of the paper is relatively low.In the 50 questions,23 questions' distinction degree is less than 0.15,17 questions' distinction degree is between 0.15-0.30,10 questions' distinction degree is above 0.30,so the distinction degree of the paper is relatively high.In the 50 questions,20 questions' accuracy appears larger differences between each unit:9 questions' accuracy has decreased significantly among 1-2 units,4 questions' accuracy decreased significantly among 3 units,3 questions' accuracy decreased significantly among 4 units,only 1 unit has high accuracy among 2 questions,and 2 questions' accuracy decreased significantly among all units.These problems are related to the teachers' teaching ability,the difficulty in mastering the key points of the curriculum,the lack of the concept of the general practitioners training.Conclusion The design of the examination paper is basically in line with the study purpose and the objectives of the training course.This examination paper was highly reliable,and suitable for the professional theory and ability test.There are site differences between each unit,which can provide an objective basis for improving the teaching level of different teaching unit,and we will solve the problems in the form of collective preparation next step.
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Objective: To explore the effects of Vitamin K2 (VK2) on theaortic artery calciifcation and oxidative stress injury in experimental rats. Methods: A total of 24 rats were divided into 4 groups:①Control group,②6-week calciifcation group,③12-week calciifcation group and④6-week calciifcation + 6-week VK2 group;n=6 in each group. The arterial calciifcation was induced by warfarin (WFN) treatment. The calcium nodule and deposition in rat’s theaortic artery were detected by Alizarin red staining and o-cresolphthalein complexone method, the reactive oxygen species (ROS) were measured by DHE probe staining and the morphological changes of mitochondria in smooth muscle cells were detected by transmission electron microscopy. Results: Calciifcation nodule formed in both 6-week and 12-week calciifcation groups, the calciifcation deposition and ROS were higher than Control group,P Conclusion: Warfarin induced aortic calciifcation is related to oxidative stress injury which may cause the ultra-micro structural damage in smooth muscle cells; VK2 may reduce the oxidative stress injury and improve the condition of vessel calciifcation in experimental rats.
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The purpose was to helps and inspire clinical research beginners on how to identify research directions and topics that are linked with clinical work.Based on a research project,this paper reviewed how the author started the ideas of the research,selected and set research directions,and established specific goals.
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Objective To investigate the clinic significance of serum carbohydrate antigen ( CA)125 for cirrhosis. Methods 88 patients with type B posthepatitic cirrhosis (male 46,female 24,average age 45?24 years) were divided into three group (A stage35,B stage 28,C stage 25) according to Child-pugh integration. 36 healthy persons as normal controls were studied(male 20,female 16,average age 42?22 years). Serum CA125 was measured by ELISA. We investigated the alteration of serum CA125 with hepatic functional classification. Results The levels of serum CA125 in cirrhosis patients were markedly higher than those in control subjects(P
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Objective To study the Diagnosis and treatment of thyroglossal duct cyst or fistula. Methods The clinical data of 67 patients with thyroglossal duct cyst or fistula treated by surgery were analyzed retrospectively. Results The diagnosis rate preoperatively was 92.5% and the accuracy diagnosis rate by B type ultrasonography was 96.1%; all cases were treated by operation, of them, 14 cases underwent simple cyst resection, 12 with resection of partial periosteum of hyoid and 41 with resection of middle segment of hyoid( Sistrunk's operation ). 54 cases were followed up, recurrence in cases with cyst was 4 of 43 (9.3%) and recurrence in cases with fistula was 2 of 11(18.2%)respectively. Conclusion Ultrasonography shows certain characteristics and clinical value to diagnose and distinguish thyroglossal duct cyst. Postoperative recurrence is due to the selection of operation procedures and control of infection of focus. The Sistrunk's operation properly performed previou to cyst infection should reduce recurrence rate markedly.