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Objective:To explore the effectiveness of PDCA (plan, do, check, action) cycle management method in improving the completion rate of after-department examination in pediatric professional base.Methods:Through the residency management system platform, the completion rate of after-department examination from February 2019 to March 2019 differed greatly. Referring to the PDCA cycle management methods, according to the analysis of fishbone diagram, relevant reasons were obtained and a series of rectification measures were implemented including the formulation of relevant programs from the four aspects such as department, resident, rules and regulations and tools. The rectification courses were taken for 5 months. SPSS 17.0 was used for Chi-square test.Results:April to August 2019 was the main rectification execution stage, during which the monthly completion rate of after-department examination increased, but fluctuated (66.70%-89.70%).Compared with the rectification courses before (in February), the completion rate of after-department examination was significantly increased after rectification (in October) [(96.00%) vs. (42.11%)], with statistical significance ( P < 0.01). Conclusion:PDCA cycle management method can effectively improve the completion rate of after-department examination in pediatric professional base, which should be further widely promoted.
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Objective:To assess the impact of integrated curriculum (vertically integrated curriculum system) and traditional curriculum system on the perceptions of post competency of undergraduate medical students.Methods:Bibliographic retrieval method and expert consultation were used to compile the questionnaire of perceptions on the post competency of undergraduate medical students. The questionnaire was conducted online to survey the undergraduate medical students from Shanghai Jiao Tong University School of Medicine during March to April, 2019. SPSS 20.0 software was applied for data analysis, chi-square test was used to analyze the classroom teaching forms of medical undergraduates who received different curriculum systems, and their cognition of the doctor post competency and cognitive pathways, and finally the top 10 important competencies were compared.Results:A total of 200 questionnaires were distributed and 167 were recovered, with a recovery rate of 83.5%. Workshop learning was more common in the vertically integrated undergraduate curriculum. Compared with Chinese traditional curriculum, the medical students taught by the vertically integrated undergraduate curriculum were much better informed about competency ( P<0.05). The access to knowledge of competency was also statistically different between two groups of students ( P<0.05). Conclusion:The vertically integrated curriculum is more efficient in helping undergraduate medical students to acquire knowledge about competency.
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Currently,the undergraduate teaching of pediatrics in China is still the science-based curriculum,having a big gap with international medical teaching idea and mode.Medical colleges of the University of Ottawa and Shanghai Jiao Tong University co-established the 0ttawa-Shanghai Joint School of Medicine (OSJSM) in October 2014.By enriching the curriculum content (including theory,skill and professionalism),adding "active" teaching,introducing clinical pediatricians to the students-management group,and applying formative evaluation method,the OSJSM started transforming to the competency-based cultivation,improving the teaching quality.
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Objective To compare the efficacy and safety of zoledronic acid and alendronate in the treatment of postmenopausal osteoporosis and to provide a clinical basis for the safe use of zoledronic acid.Methods Two hundred and ten female patients with postmenopausal osteoporosiswomen in Xuanwu Hospital Capital Medical University from January 2013 to January 2014 were selected as research objects,they were randomly divided into zoledronic acid group(105 cases)and alendronate group(105 cases),patients in the zoledronic acid group were given intravenous infusion of zoledronic acid injection 5 mg one time a year,the alendronate group were given alendronate 70 mg one week,both group had been treated for 24 months.The bone mineral density of the lumbar spine and hip was measured by dual energy X-ray absorptiometry before and after treatment,and the VAS score of the pain status was measured.The chest and lumbar spine were examined by X-ray,and the adverse reactions were recorded.Results After treatment,the BMD of the lumbar spine and hip of the zoledronic acid group and alendronate group were(-1.56 ± 0.35)g/ cm2and(-2.21 ± 0.54)g/ cm2, (-1.91±0.32)g/ cm2 and(-2.16 ± 0.26)g/ cm2,which were higher than those before treatment.The differences were statistically significant(t=6.253,3.633,5.834,3.251,P<0.05).But the BMD of the lumbar spine and hip in the zoledronic acid group was significantly higher than that in the alendronate group,the difference was statistically significant(t=4.421,5.262,P<0.05).The VAS scores of the alendronate group and the zoledronic acid group at 12 months,24 months after treatment were(4.02±0.50)points and(3.01±0.44) points,(2.95 ± 0.36)points and(1.82 ± 0.24)points,which were significantly lower than those before the treatment,the differences were statistically significant(P<0.05).The VAS score of zoledronic acid group at 12 months,24 months after treatment were significantly lower than those of the alendronate group,the differences were statistically significant(t=3.513,3.647,P<0.05).The fever incidence of the alendronate group was 2.86%(3/105),lower than that of the zoledronic acid group(30.48%(32/105)),the difference was statistically significant(χ2=32.901,P<0.01).Conclusion Zoledronic acid injection and alendronate are effective in the treatment of PMOP,but zoledronic acid has better effect on increasing bone density,reducing the degree of bone pain,with better compliance.Although it has increased the incidence of adverse reactions,it is well tolerated.
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Objective To explore the value of bedside ultrasound used by ICU doctor in the rapid diagnosis of traumatic abdominal,and to evaluate the advantage of bedside ultrasound in the treatment decision.Methods 60 patients with traumatic abdominal blood in our hospital admitted to the ICU were selected.All patients were checked through bedside ultrasonography by physicians with professional training of ICU,bedside ultrasound and abdominal CT and abdominal flat piece of traumatic hematocelia,and compared the diagnosis of the time of the bedside ultrasound,abdominal CT and abdominal X -ray and ultrasound physician ultrasound examination.Results The difference of abdominal blood detection rate between bedside ultrasonography and abdominal computed tomo-graphy (CT)had no statistical significance (P >0.05);bedside ultrasonography of abdominal blood detection rate was higher than plain film of the abdomen,the difference was statistically significant (χ2 =73.346,P <0.01);bed-side ultrasound received a preliminary diagnosis of time -consuming (4.37 ±2.1)min was significantly lower than that of the examination of ultrasound physicians (13.86 ±5.6)min,abdominal CT (22.13 ±6.9)min and abdominal plain film (28.19 ±7.32)min,the differences were statistically significant (t =3.947,14.607,21.139,26.338,all P <0.01 ).Conclusion By the professional training of ICU physicians for bedside ultrasound traumatic blood abdominal patients can make a more accurate diagnosis,time -shorten,more accord with the requirement of treating critically ill patients in ICU,which has important clinical value for trauma abdominal blood in early rapid diagnosis and treatment.
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Objective To investigate the professional situation and talent drain of pediatric residents,and explore the coping strategies. Methods One hundred and twenty pediatric residents and 6 administrative personnels were selected from three hospitals featured in pediatrics.Questionaires were administered to pediatric residents,and interviews were conducted with administrative personnels. Results Only 28.85% pediatric residents were satisfied with present professional situation.The talent drain of pediatric residents was severe,and the major causes were hard work,low incomes and unfavourable career development prospects. Conclusion A considerate number of pediatric residents are not satisfied with the professional situation,and the talent drain is a common occurrence.Government should attach great importance to pediatric medical education and increase health care investment.Besides,the view of value of pediatric residents should be improved and a harmonious medical environment should be established.
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Shanghai Medical Center for Children, jointly set up by the municipal government and the World Health Foundation of America, possesses advanced intelligence hospital buildings and medical facilities. The authors gave a detailed account of the centers practice in implementing reform with modern ideas of hospital management. Specific ways include: ①improving the overall quality by training all workers and staff of the management contingent; ②strengthening medical quality control via orienting medical service towards the needs of patients; ③conducting widespread international exchanges and cooperation with specialty development serving as the link; ④enriching hospital culture by strengthening the building of a spiritual civilization with special characteristics; ⑤setting up the centers development department so as to raise social charity funds for the advancement of the hospital; ⑥outsourcing logistic service so as to improve operating efficiency.