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Forty two general practice residents who participated in the standardized training in Suzhou Municipal Hospital from April to December 2022 were randomly divided into two groups with 21 in each group. The control group received the traditional teaching method, and the study group received additional training with a special management model for chronic obstructive pulmonary disease. After 3 months of training, the teaching effects were evaluated with the improved Mini Clinical Evaluation Exercise (Mini CEX) in two groups and the teaching satisfaction was also assessed. Compared with the control group, the study group showed significant better performance in outpatient service, including the treatment and rehabilitation planning ( t=3.82, P<0.001), humanistic care ( t=4.83, P<0.001), health education ( t=9.56, P<0.001), communication skills ( t=3.34, P=0.002), and overall performance ( t=3.13, P=0.003). The satisfaction of teaching in study group was also higher than that in the control group ( Z=-2.02, P=0.044). The study shows that incorporating the "specialized management of chronic obstructive pulmonary disease" model into the general practice standardized residency training can significantly improve the teaching effects.
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Objective:To survey the post competency of general practitioners who completed residency training in Suzhou Municipal Hospital.Methods:A questionnaire survey on post competency of general practitioners was conducted from January to March 2022. General practitioners who completed standardized residential training in Suzhou Municipal Hospital from 2009 to 2021 were randomly selected for the survey. The self-designed questionnaire included the basic information and post competency in terms of clinical, public health, research and teaching abilities as well as medical ethics and humanism. A self-evaluation was also performed and the abilities were graded (A 86-100, B 70-85, C 55-69, D 0-54), and grade A was classified as excellent.Results:A total of 163 questionnaires were distributed and 157 valid ones were collected with a recovery rate of 96.3%. Among 157 respondents 62 (39.5%) were males. The participants mainly worked in urban community health service institutions (78 (49.7%)), and most of them worked as general practice (119 (75.8%)). For the self-assessment of clinical skills, the proportion of respondents with excellent abilities in history taking, basic drug use, diagnosis and treatment of common diseases, and chronic disease management was 58.8% (70/119), 57.1% (68/119), 54.6% (65/119) and 54.6% (65/119), respectively. The proportion of respondents with excellent abilities in evidence-based clinical decision making, physical examination, tests interpretation, referral services, family medical services, rehabilitation services, first aid, and psychological counseling and treatment was 43.7% (70/119), 42.9% (52/119), 38.7% (46/119), 37.8% (45/119), 33.6% (40/119), 22.7% (27/119), 21.0% (25/119), and 16.8% (20/119), respectively. For the self-assessment of basic public health service ability, the proportion of respondents with excellent abilities in health education, disease prevention and control, health management, health care for key and special groups, handling public health emergencies, management of infectious diseases, epidemiology-based community diagnosis and community health leadership was 38.7% (46/119), 33.6% (40/119), 33.6% (40/119), 26.1% (31/119), 25.2% (30/119), 2.7% (27/119), 22.7% (27/119), and 21.0% (25/119), respectively. For humanistic literacy, the proportion of respondents with excellent abilities in privacy protection, sense of responsibility for patients, understanding patients′ needs, effective communication and cooperation with patients was 82.4% (98/119), 73.9% (88/119), 61.3% (73/119), 55.5% (66/119) and 2.1% (62/119), respectively. For research and teaching, the proportion of respondents with excellence abilities in continuous learning and innovation, training and teaching and literature retrieval was 47.9% (57/119), 10.9% (13/119), 10.1% (12/119), respectively. In addition 56.3% (67/119) of respondents were interested in scientific research, 23.5% (28/119) had published articles as the first author or correspondence author, and only 6.7% (8/119) had scientific research projects in the last 5 years.Conclusion:The post competency of general practitioners who received standardized residency training in our hospital varies in different aspects, their abilities in basic public health service, scientific research and teaching are relatively low, which need to be strengthened.
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Objective To evaluate the clinical value of combined treatment for spontaneous intraventricular hemorrhage. Methods 26 patients with spontaneous intraventricular hemorrhage were conducted on the whole turn of low lateral drainage of bilateral urokinase infusion therapy, supplemented by lumbar puncture cerebrospinal fluid replacement. Results The total effective rate was 84.62% ,mortality rate was 15. 38%. Conclusion Bilateral lateral drainage of alternating low urokinase infusion,supplemented by lumbar puncture cerebrospinal fluid replacement was effective in treatment of spontaneous intraventricular hemorrhage. It could reduce mortality in patients with intraventricular hemorrhage and increase the patients' prognosis.
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Objective To investigate the positive end-expiratory pressure (PEEP) ventilation in the treatment of neurogenic pulmonary edema. Method 64 patients with neurogenic pulmonary edema were treated with the timely use of positive end-expiratory pressure(PEEP) ventilation. Then the curative effect was observed. Result The symptoms of hypoxia, pulmonary edema were had a rapid improvement in ventilation with PEEP. the improvementof heart rate, respiratory rate, oxygen saturation, partial pressure of oxygen, carbon dioxide partial pressure had significant difference compared with that before treatment(P ＜ 0.01). Conclusion Neurogenic pulmonary edema patients treated with PEEP therapy had goved clinical effect.
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The technology of water-jet is an advanced technology of cold cutting which is widely used in industry, espe-cially in the cutting of metal, glass, ceramics and paper. Its character and classification are introduced, especially basic prineiple, development and application. The technology of water-jet will paly an important role in medicine.