ABSTRACT
Forty trainees who underwent position-transition training for general practitioner in the Affiliated Huai′an First People′s Hospital of Nanjing Medical University from August 2021 to July 2022 were randomly divided into the control group and the trial group with 20 in each group. The traditional teaching methods were applied in control group and the problem-based learning/case-based learning (PBL/CBL) combined scenario simulation teaching method were applied in trial group. The effect of the two teaching methods was evaluated by the examination results and the teaching satisfaction was assessed by the questionnaire survey. The exam scores of general practice thinking, comprehensiveness of inquiry content, integrity of preliminary diagnosis, comprehensiveness of preliminary treatment, ability to deal with critical and severe cases, ability of chronic disease management and concept of holistic care in trial group were significantly higher than those in control group( t=-15.79,-15.74,-16.67,-13.66,-18.57,-18.55,-19.74,all P<0.05). The satisfaction of trainees in the trial group was also significantly higher than that in the control group in terms of teaching methods, stimulating learning interest; and improvement of independent learning ability, general practice clinical thinking, doctor-patient communication ability, teamwork ability and community problem-solving ability( χ2=12.10,10.03,12.22,10.03,8.18,10.03,8.18,all P<0.05). The study shows that PBL/CBL combined scenario simulation teaching method can improve the learning effect and satisfaction of the trainees in position-transition training for general practitioner.
ABSTRACT
Objective To evaluate the association between preoperative serum thyroglobulin concentration and aggressive behavior of papillary thyroid cancer(PTC).Methods A total of 334 PTC patients diagnosed by surgical pathology treated in our hospital from Jan.2013 to Dec.2017 were retrospectively reviewed.Patients were divided into two groups according to Tg levels and clinicopathological characteristics between the two groups were compared.Binary logistic regression analysis was conducted to evaluate the factors influencing extrathyroidal extension and lymph node metastasis of PTC.Results High level of preoperative serum Tg was signifcantly associated with old age,multifocality,larger maximum tumor size,more frequent extrathyroidal extension,lymph node metastasis,and advanced T and TNM stage(P＜0.05).Maximum tumor diameter ＞2 cm(P=0.031) and preoperative serum Tg level ＞17.21 ng/ml(P=0.028) were independent risk factors for extrathyroidal extension.Maximum tumor diameter ＞2 cm(P=0.007) and preoperative serum Tg levels ＞25.40 ng/ml (P=0.016) were independent risk factors for lymph node metastasis,whereas female was a significant protective predictive factor(P＜0.001).Conclusion Preoperative serum Tg levels may serve as an independent risk marker for extrathyroidal extension and lymph node metastasis of PTC,and partly contributes to predict aggressive behavior of PTC.
ABSTRACT
[Summary] The relationship between the state of cognition and hypertension in 155 type 2 diabetic patients was studied.The results showed that significant difference in the state of cognition was found in patients with or without hypertension,so as to those with poorly or well controlled hypertension (P＜0.05).Systolic blood pressure,pulse pressure,mean arterial blood pressure,and duration of hypertension were negatively correlated with multiple cognitive domains,suggesting that proper control of blood pressure may have a protective effect on cognitive function in type 2 diabetic patients.
ABSTRACT
BACKGROUND:Human memory is significantly correlated with recognition. When recognition begins to decrease, a decrease in memory appears first. How about the memory of rural population?OBJECTIVE:To investigate the picture memory related factors of the rural households who are over 50 years old.SETTING:Department of Geriatrics,Huaian First Hospital,Nanjing Medical University;Department of Neurology, Huashan Hospital,Fudan University.PARTICIPANTS:Totally 50 rural inpatients at the Department of Geriatrics,Huaian First Hospital Nanjing Medical University,who would be recovered and out of charge,were selected from March 2003 to February2004. Meanwhile, 11 relatives of the patients and 55 healthy elderly people from Dingji Town,Huaiyin District, were also included.All the participants were over 50 years old.METHODS:Employing questionnaire,mini-mental state examination,auditory-verbal learning test (AVLT), pictorial learning test and many nonmemory tests were performed. According to the levels of education,participants were divided into illiterate group,primary school group,junior middle school group and higher than junior middle school group.The correlation of picture memory ability with sex,age,educational level and simple intelligence test was compared. And the interactions among variables of picture memory were also investigated.MAIN OUTCOME MEASURES:The relationships between the variablesof picture memory and age, sex, educational level and simple intelligence of rural households in Huaian city were calculated. And the interactions among these variables were all investigated.RESULTS:Practically, 103 participants entered the statistical analysis proage,sex,educational level and simple intelligence:Except for recurring figures, all the other variables of picture memory had positive correlations with simple intelligence and educational level (r=0.197-0.533, P ＜ 0.05-0.01).Among them, immediate memory showed the closest correlation with simple intelligence (r=0.533).Delayed recall memory of pictures, recurring figures,and serial memory 4 (the number of recalled pictures in the last 4 pictures in delayed recall test) had negative correlation with age (r=-0.194 to -0.324,P ＜ 0.05-0.01),among them, serial memory of 4 pictures had the closest correlation with age (r=-0.324),while, all the other variables were not related to age. All the variables of picture memory were not linked to sex. Recurring pictures was not linked to educational level 1 (period of education:0-11 years),2 (education level: illiterate, primary school, junior middle interactions among these variables:Recurring figures was not linked to serial memory 2 (the number of recalled pictures in the last 4 pictures in immediate memory test),serial memory 1 (the number of recalled pictures in the first4 pictures in immediate memory test) was not related to serial memory 2 and serial memory 4.Except for these cases, variables of picture memory had significant correlations with each other (r =0.206-0.855 ,P ＜ 0.05-0.01),and delayed recall memory of pictures had the closest relationship with conceptual memory 2 (r=0.855).CONCLUSION:Picture memory capacity of middle aged and elderly rural households is not linked to sex, while it is correlated with age,educational level and intelligence.