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There are still some shortcomings in the training of preventive medicine undergraduates in China, such as outdated education mode, disjointed theory/practice, and lack of multi-dimensional integration. This paper proposes an attempt to reform the cultivation mode of preventive medicine undergraduates by combining student research training programs. However, many problems have been exposed during the implementation of the reform, and it has not achieved satisfactory results, especially in emergency management and solving practical problems. In order to cultivate practical preventive medicine talents in line with the needs of the times, the training mode based on student research training projects still needs considerable efforts in many aspects, including project approval, project guidance, project evaluation and so on.
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Objective:This study aims to explore the key points of the operation mode and construction of psychiatric research ward, provide possible reference for the construction of research ward.Methods:In this study, the construction of research ward in a psychiatric hospital was considered and explored through literature review, drawing on the operation mode of other research wards, combined with the characteristics of psychiatric clinical research.Results:This Study put forward the construction orientation and operation management mode of the psychiatric research ward, and analyzed the advantages of existing platform and key points for future development.Conclusions:The construction of psychiatric research ward should be based on clinical needs and hospital practice. Strategies including tailored fine management, optimize platform supporting, efficient organizing and management system, talent team and appropriate incentive mechanism should be implemented to strengthen the construction.
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Objective:To investigate the clinial phenotype and genetic characteristics of a child with cerebral dysgenesis, neuropathy, ichthyosis, and palmoplantar keratoderma (CEDNIK) syndrome and to improve the clinicians′ understanding of this disease.Methods:Clinical data of the child with CEDNIK syndrome diagnosed in Department of Endocrinology, Genetics and Metabolism, Xi′an Children′s Hospital in June 2020 were collected. Whole exome sequencing was carried out to identify the potential variants of SNAP29 gene. Suspected variants were verified by Sanger sequencing of family numbers. The literature about the cases of CEDNIK syndrome were reviewed.Results:The proband is a boy, who was aged 1 year and 4 months, had the manifestations of psychomotor retardation, microcephaly, feeding difficulties, severe malnutrition, recurrent respiratory tract infection, binocular esotropia, sensorineural deafness, cutaneous ichthyosis and keratosis, left cryptorchidism. Brain magnetic resonance imaging indicated congenital dysplasia. Whole exome sequencing identified a homozygous variant of c.383dupT (p.E129Rfs *5) in the SNAP29 gene of the proband, and the heterozygous variation was observed at the same locus in his parents, which conformed to the autosomal recessive inheritance. This mutataion was determined as a pathogenic mutation according to the guidelines of American College of Medical Genetics and Genomics. Literature retrieval showed currently a total of 29 cases of CEDNIK syndrome were reported, containing 8 types of SNAP29 gene mutation. However, there was no Chinese case reported. And the c.383dupT (p.E129Rfs *5) mutation found in this study was a novel one which had not been reported yet. Conclusion:The phenotype of the proband is generally consistent with the CEDNIK syndrome and the novel c.383dupT (p.E129Rfs *5) mutation of SNAP29 gene is the genetic cause.
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Objective:To explore the effect of situational simulation interactive training on rehabilitation compliance and motor function of stroke patients with hemiplegia.Methods:A total of 140 hemiplegic patients with stroke from July 2017 to October 2019 in Beijing Rehabilitation Hospital Affiliated to Capital Medical University were selected and divided into control group and observation group, 70 cases in each group. Routine treatment and rehabilitation nursing were used in the control group, and situational simulation interactive training were used in the observation group on the basis of the control group. Both groups were followed up for 6 months. Fugl-Meyer Assessment (FMA), World Health Organization Quality of Life Scale Brief (WHOQOL-BREF), Fugl-Meyer Assessment (FMA), self-made rehabilitation training compliance questionnaire and self-made nursing satisfaction questionnaire were used to evaluate the quality of life, motor ability, cognitive ability before intervention and after follow-up, rehabilitation compliance and nursing satisfaction after follow-up of the two groups.Results:There was no significant difference in FMA, WHOQOL-BREF and MMSE scores between the two groups before intervention ( P>0.05). After follow-up, the scores of FMA, WHOQOL-BREF and MMSE in the observation group were 62.57±6.52, 80.65±9.25, 25.30±3.24, significantly higher than 52.68±7.23, 66.68±8.34, 20.36±3.12 in the control group, the difference was statistically significant ( t value was 8.499, 9.385,9.189, P<0.05). After follow-up, the total compliance rate and satisfaction rate of the observation group were 92.86% (65/70) and 94.29% (66/70), respectively, while those of the control group were 78.57% (55/70) and 80.00% (56/70), respectively, the difference between the two groups was statistically significant (Fisher's exact test, P<0.05). Conclusions:The situation simulation rehabilitation training can effectively improve the motor function, rehabilitation compliance and nursing satisfaction of stroke patients with hemiplegia.
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Objective:To analyze the characteristics of the platform management of scientific research reagents and consumables, and provide references for the procurement management construction of scientific research reagent consumables in hospitals.Methods:According to the combination of literature review and daily management practice in the hospital, to sum up the main modes of reagents and consumables platform management and analyzing their characteristics.Results:Nowadays, the platform management modes of reagents and consumables procurement can be summarized as self-construction and self-management mode and e-mall management mode. Take into consideration of the practice at hospital, a new mode named resource database sharing mode is proposed and discussed in this article to specify key points for future management.Conclusions:Scientific research reagents and consumables procurement platform management is a future trend, hospitals should develop tailored management model based on their internal management demands.
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Objective To explore the imaging features of brucellar spondylitis (BS).Methods The imaging data of 49 cases who were diagnosed as brucellar spondylitis by a positive standard tube agglutination titer test (≥1:100) and (or) the isolation of brucella species from blood or other tissue at our institution between September 2012 and October 2016 were retrospectively reviewed.X-ray,CT scan and MRI examination was performed in 49,28 and 42 cases,respectively,of which 19 cases underwent both CT scan and MRI examination.The imaging manifestations of the spine were analyzed.The x2 test or Fisher's exact test were applied to compare the imaging manifestations of the patients who underwent both CT scan and MRI examination.Results Of the 49 patients,34 patients (69.4％) had involvement of the lumbar vertebra.Forty-five patients (91.8％) had contiguous involvement at adjacent 2 vertebral bodies.There were 10 cases (20.4％) with bony spur or bone bridge,3 cases (6.1％) with spondylolisthesis and 3 cases (6.1％)with slightly kyphosis deformity.There were 8 cases (28.6％) showing bone destruction of more than half of the vertebral body and 6 cases (21.4％) with sequestra on CT.There were 14 cases (33.3％) with psoas abscesses,of which 2 (4.8％) had migrating abscess.Epidural abscesses with dural sac compression were found in 17 cases (40.5％) and 3 cases (7.1％) showed nerve roots compression.There were statistically significant differences in the detection of vertebral bone destruction,bone marrow edema,hyperosteogeny,intervertebral disc changes,abscess formation and sequestrum between CT and MRI (P＜0.05).Conclusion BS has characteristic imaging features.The presence of bone destruction,sequestrum,and migrating abscess should warrant the possibility of BS.
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Objective Summarize main problems identified in the budget execution of medical research projects,analyze main causes for proposing improvement countermeasures in daily practice.Methods Based on the auditing work of scientific research expenditure,administrative policies,as well as existed studies,this study conducted analysis and discussions from the perspective of research administrators.Results In this study,budget execution problems are classified into four categories.During recent years,updates and changes in the policy of research funding played important role in solving or relieving some problems in budget execution.However,some factors related to the problems still existed,thus,we put forward some suggestions on the management of scientific research funds from four aspects:multi-department collaboration,promoting the construction of scientific research funds management platform,budget execution training and implementing the financial assistant system.Conclusions The management of scientific research funds is a cooperative activity involving the administrative department of research projects,undertaking units,research groups etc.The unit which undertakes scientific research should coordinate many other departments to strengthen the supervision and management,improve the efficiency of the use of scientific research funds.
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Objective To observe the value of CT spectral imaging in assessment of synovial hemosiderin deposition (SHD) in the knee joint in patients with hemophilic arthropathy (HA).Methods Twenty-five HA patients (40 assessable knees) underwent CT spectral imaging and MR scanning.According to the MRI international prophylaxis study group (IPSG) score of SHD,the knees were divided into mild group and severe group.CT value,iron (water) concentration (FeC),water (iron) concentration (WC),effective atomic number (Eff-Z) and average spectral curve slope (aSCS) of SHD area were measured and calculated,respectively.Meanwhile,the adjacent semi-membrane muscles in the same slice were taken as controls.The spectral parameters of CT were compared with One-Way ANOVA,and ROC curves were plotted to obtain the spectral parameters and the optical diagnostic threshold of SHD.Results CT value,FeC,and aSCS of SHD area were statistically significant among three groups (F=148.08,307.88,7.80,364.62 and 261.50,P＜0.01),and the differences of parameters between any two groups except WC were statistically significant (all P＜0.05).The area under ROC curve of SHD evaluated with aSCS was the largest,and the thresholds for the diagnosis of severe and mild SHD of aSCS was 1.84 and 0.42,respectively.Conclusion Multiple parameter analysis of CT spectral imaging is of great value for assessment of the severity of SHD in the knee joint in HA patients,therefore having important clinical significance.
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Objective To evaluate the effect on threshold of triggered angiographic acquisition by different iodine flow rate on renal artery CTA using Smart Prep tracking technique.Methods A total of 420 patients were randomly divided into A-D group with iodine flow rate of 0.90 gI/s,1.11 gI/s,1.20 gI/s,1.48 gI/s on average respectively.And each group were divided 7 subgroups with threshold 140-＜150 HU,150-＜ 160 HU,160-＜ 170 HU,170 ＜180 HU,180 ＜190 HU,190-＜200 HU,200-210 HU respectively.The quality of the images were graded from 1 5 by 2 radiologists.The best image quality subgroups were achieved,and the scores were compared among the best image quality subgroups.Results Image quality of renal CTA in each group were best performed with a threshold of 170-＜ 190 HU,160-＜ 190 HU,170-＜ 180 HU,160-＜ 180 HU respectively.When the threshold were 170-＜180 HU,image quality were good with all iodine flow rate groups.There was no significant difference among the scores of the best image quality subgroups (all P＞0.05).Conclusion Different iodine flow rate with appropriate threshold can acquire better image quality of renal CTA.
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Objective To prospectively determine the feasibility of high-resolution in vivo MR imaging in the evaluation of esophageal carcinoma invasion at 3.0 T.Methods One hundred and eighteen patients with esophageal carcinoma,proven by the gastroscopic biopsy,were prospectively studied using 3.0 T MR.The esophageal specimens were sectioned transversely to keep consistent in the orientation with the MR images,the histopathological stage was made and the thickness of the tumor on the largest diameter of the slice were measured.The MR images were reviewed in the transverse plane.According to the seventh American joint committee on cancer,the MR stage was made and the tumor's thickness was measured.The MR images and the histopathological slices were matched.The staging diagnostic efficacy of the MR imaging was evaluated with the histopathological results as the standard reference,Kappa test was used to compare the stage of MR imaging with that at the histopathological analysis.Bland-Altman scatterplots were used to compare the thickness of tumor measured on the MR images with that at the histopathological measurement.Results Ninety seven cases(82.2％,97/118) of MR stage were accurately made,including 7 T1a,15 T1b,18 T2,25 T3 and 32 T4a cases,furthermore,14 cases were over staged and 7 cased were underestimated.The MR stage was highly consistent with the histopathological stage (Kappa=0.772).The sensitivity for the staging of high-resolution MR imaging at 3.0 T was 58.3％(7/12) to 100.0％(32/32),the specificity was 95.3％ (82/86) to 98.1％ (104/106),and the accuracy was 91.5％ (108/118) to 96.6％ (114/118),respectively.Bland-Altman scatterplots demonstrated that the discrepancy of the mean thickness between the value obtained by three radiologists respectively and the histopathological analysis were 2.0,2.6 and 2.1 mm,which demonstrated a good consistency.Conclusion High-resolution MR images obtained at 3.0 T can be used to evaluate the depth of carcinoma invasion and provide excellent diagnostic accuracy for preoperative staging.
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Objective To investigate the feasibility of reducing spine metal artifacts with metal artifacts reduction technique (WARP) at 3.0 T MRI.Methods This study included 15 cervical and 14 lumbar spine cases.The image quality of WARP sequences and conventional sequences were compared (5 score evaluation scale) as well as the signal to noise ratio (SNR) and contrast noise ratio (CNR) of the image artifacts.The scanning time was recorded.Paired-t test and Mann-Whitney test were used respectively to compare the SNR and CNR,and qualitative scoring between the two sequences.P＜0.05 was considered to indicate a significant difference.Results The image distortion and blur of the WARP sequences were obviously reduced as compared to the conventional sequences.The SNR and CNR of artifacts of the WARP sequences were lower than that of the conventional sequences (All P＜0.05).The image quality scores of WARP sequences in cervical and lumbar spines[4(3 to 5) and 4(3 to 5)] were higher than that of conventional sequences[3(2 to 4),3(2 to 4)](P＜0.05).The scanning time of cervical spines in WARP sequence(14 min 9 s) was increased by 64 s (8.2％),and the time of lumbar spines (13 min 41 s) decreased by 9 s (1.1％).Conclusion The WARP sequences at 3.0 T could effectively reduce the artifacts of metallic prosthesis in cervical and lumbar spine without prolonging the scanning time at 3.0 T MRI.
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Background and purpose: Ovarian lymphoma (OL) is usually misdiagnosed as ovarian cancer with bulk lymph node invasion (OC-BLN), and vice versa. Therefore, to distinguish these two types of disease, we compared their clinical characteristics in this study. Methods: This study retrospectively reviewed 14 OL and 14 OC-BLN patients from Fudan University Shanghai Cancer Center and Shanghai Eighth People's Hospital. The clinical char-acteristics, image and laboratory examination data were compared. Results: There was no significant difference in age, symptom, fever, weight loss and volume of ascitic fluid between the two groups. Comparing with OC-BLN, OL patients have larger tumor in ovaries [(13.04±5.94) cm vs (7.78±6.38) cm, P=0.033], and higher percentage of solid ovarian tumor (85.71% vs 28.5%, P=0.006). Lactate dehydrogenase(LDH)/CA125 was higher in OL (7.66±8.03) than OC-BLN (0.31±0.27, P=0.009). Using LDH/CA125 to diagnose OL, area under the curve (AUC) was 0.952. When the threshold value was set at 1, the sensitivity and specificity was 91.7% and 100%, respectively. Conclusion: OL and OC-BLN are easily to be misdiagnosed. OL has larger and more solid tumor than OC-BLN. LDH/CA125 can help to distinguish these two diseases and guide clinical decision making.
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Bibliometrical method was used in this article to analyze the publications in a hospital from 2004 to 2013.Results show that the number of publications increased during 8 years,and the quality has been improved consistently.However,the rate of clinician participation in research and the present of core authors were still on the lower side.Besides,the age structure of core authors is steady and lack of growth.Based on this analysis,we summarized the past experience and explored the strategies of research management.
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Objective To explore the quality of life and its related factors among left‐behind children in Shandong and Si‐chuan provinces .Methods The cluster sampling method was used to select the study participants and thus each 3 rural primary schools were randomly chosen as the study sites in Shandong and Sichuan provinces .t‐test ,χ2 test and rank sum test were employed to perform univariate analysis ,and multivariate analysis was conducted using multiple linear regression .Results In this study ,there were totally 1804 participants with 778 left‐behind ones .There was statistical difference between left‐behind children and average children in each aspects of quality of life and the total score(P<0 .05) .Multiple linear regression analysis showed that the multiple influencing factors of the quality of life among left‐behind children in Shandong and Sichuan provinces were age ,the guardian、left‐behind time、parents′care and study result .Conclusion The quality of life among left‐behind children in Shandong and Sichuan provinces was not high and was affected by many factors .In order to improve the quality of life of left‐behind children ,the guardians should pay more attention to care and communicate with their children in the future education and management of left‐behind chil‐dren ,especially the elder ,long time left behind or poor grades ones .
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ObjectiveTo investigate the early diagnosis and treatment of pleuropulmonary blastoma in children. Meth-ods The progress of pleuropulmonary blastoma from type 1 to type 3 was retrospectively analyzed.Results The male infant had no obvious abnormality in chest X-ray at 18 days. At one year old, X-ray iflm of the chest showed cystic lesions near hilum of the left lung (about 5 cm × 4 cm × 4 cm). The congenital cystic adenomatoid malformation was considered and an operation resection was suggested. However, it had been rejected by his parents. At 3 years and 2 months old, chest X-ray and CT showed left lung had a solid cystic lesion, the volume was signiifcantly enlarged, the back side was solid and the upper part had a large gas cavity. Two months later, the patient had asthmatic suffocation. The chest CT showed the tumor was completely solid. Pleuropulmonary blastoma type 3 was considered. The patient received the conventional chemotherapy after operation excision, and was followed up for 1 year. No recurrence was observed after the treatment.Conclusions Type 1 pleuropulmonary blastoma and congenital cystic adenomatoid malformation are hard to be differentially diagnosed. Early diagnosis and treatment of type 1 pleuropulmo-nary blastoma can improve the prognosis.