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Objective To design and conduct objective structured clinical examination (OSCE) in professional postgraduates in obstetrics and gynecology, and to investigate the improvement measures for the teaching of professional postgraduates in obstetrics and gynecology by analyzing the performance of postgraduates in OSCE. Methods In October 2017, OSCE was performed for postgraduates in obstetrics and gynecology in the classes of 2016 and 2017 to evaluate their clinical ability. This OSCE consisted of the following four aspects: inquiry of standardized patients, basic practical skills in obstetrics and gynecology, utilization and interpretation of auxiliary examinations, and case analysis. The postgraduates were scored according to the following six items: doctor-patient communication skills, completeness of inquiry, basic practical skills in obstetrics and gynecology, utilization of auxiliary examinations, competence of clinical thinking, and mastery of medical knowledge. SPSS 18.0 was used for statistical analysis, and the t-test was used for comparison between groups . Results A total of 27 postgraduates participated in this OSCE . Among the six scoring items, completeness of inquiry had the lowest score (78 ±6), and utilization of auxiliary examinations had the highest score (85±3). Among the 27 postgraduates, 7 (25.9％) lacked doctor-patient communication skills, 6 (22.2％) showed serious problems in basic practical skills in obstetrics and gynecology, and 6 (22.2％) lacked the scientific thinking of clinical diagnosis. Conclusion In the training of professional postgraduate students in obstetrics and gynecology, doctor-patient communication skills and clinical thinking should be emphasized, and basic clinical skill training should be strengthened.
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Objective To analyze the demands of Chongqing municipal medical and health institutions at grass-roots level for the graduates of clinical medicine,pharmacy and medical laboratory science and biotechnology.Methods The Chongqing medical and health institutions at grass-roots level served as the objects and their professionals and administrators were randomly performed the talents demands investigation by adopting the questionnaire investigation as the principal thing assisted by the interview on the spot or informal discussion.Results In the aspect of talents demands,the demands for internist,general practitioner and clinical examination staff were greater,which reached to 36.54％,30.77％and 78.10％respectively;in the aspect of professional knowledge demands,the demands for clinical diagnosis,general practice,clinical medication,clinical laboratory and blood test were greater.Con clusion The school talents cultivation does not understand the true requirements of medical and health institutions at grass-roots level and is inconsistent with the practical demands.
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Objective To investigate and analyze clinical obstetrics and gynecology clinicians' mastery of basic skills, and then find the way to help clinicians master basic clinical skills. Methods A self-designed questionnaire survey was conducted among 310 clinicians working in 1-3 grade hospital from Chongqing, Sichuan, Guizhou, Yunnan provinces anonymously by spot field investigation and letter-investigations from February 1, 2015 and to March 31, 2015. The data were analyzed by descriptive analysis, using SPSS 19.0 software package for rank sum test analysis. Result Among 310 valid questionnaires, 31.6% (98) clinicians considered having inadequate clinical skills, 26% (81) average and 42.3%(131) expert. All the basic skills obtained had a relationship with the number of operations, working years and professional title. Most of the basic clinical skills were from working in hospitals 85% (270), journal 82% (254), academic conference 58% (174); 94.2% (293) willing to participate in training classes like clinical teaching and training in moulds. Conclusion The gynecology and obstet-rics basic clinical skills have a great relationship with basic skills training. Providing opportunities for the basic clinical skill trainings, academic conferences, in-service education and establishing regional medical source sharing platform can enhance their clinical skills.
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OBJECTIVE@#To verify the relationship between THI and VAS scores in patients with sudden hearing loss and tinnitus in a prospective study.@*METHOD@#Forty-four patients classified their tinnitus according to VAS and THI before and after treatment, and both scores were compared through the Pearson's correlation coefficient test and Nonparametric tests.@*RESULT@#There was a correlation between VAS and THI scores in patients with sudden hearing loss and tinnitus. Tinnitus assessment scores were significantly reduced after treatment. Decreasing of THI and VAS scores were not depended on frequency and loudness of tinnitus and severity of deafness, but therapeutic effect of sudden sensorineural hearing loss.@*CONCLUSION@#THI and VAS scores are useful for assessment of tinnitus in patients with sudden hearing loss and tinnitus.
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Humans , Audiometry , Deafness , Hearing Loss, Sensorineural , Hearing Loss, Sudden , Prospective Studies , TinnitusABSTRACT
The relationship between subclinical hypothyroidism (SCH) and the components of metabolic syndrome (MS) was explored.A total of 2 252 subjects aged 20 to 79 years from medical examination were identified.The prevalence of SCH was 4.88％.The rate of 7.30％ in female was markedly higher than 2.17％ in male(P＜0.01).The highest SCH prevalence in adults was in the ≥70 years old group.The prevalence of SCH in female was increased with age(P＜0.01).Compared with the euthyroid group,body mass index,triglyceride,and low density lipoprotein-cholesterol were significantly elevated (P＜0.05),while high density lipoprotein-cholesterol was significantly decreased in SCH group(P＜0.05).The incidences of hypertension,dyslipidosis,and MS in SCH group were significantly higher than those in euthyroid group(P＜0.05 or P＜0.01) ; Serum TSH in the MS group was higher than that in the Non-MS group[(2.43 ± 1.55 vs 2.21 ± 1.48) mU/L,P＜0.01].The incidence of SCH in MS group was significantly higher than that in the Non-MS group (7.69％ vs 4.25％,P＜0.05).The prevalence of SCH in women was increased with age.Multiple factors of dysbolism were clustered in subjects with SCH.There is a correlation between SCH and MS.
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Objective To evaluate the performance of the hypersensitive C-reactive protein(hs-CRP) rapid quantitative chemilu-minescent detection kit .Methods According to National Committee for Clinical Laboratory Standards (NCCLS) EP10-A2 docu-ment ,hs-CRP rapid quantitative chemiluminescent detection kit was employed to measure the CRP at low ,medium and high con-centration levels of quality control serum .Bias ,total imprecision and their slope rates ,intercepts ,carryover ,non-linearity and drift were calculated ,and its clinical acceptability was evaluated .Results Bias and total imprecision of hs-CRP rapid quantitative chemi-luminescent detection kit were within the allowable ranges ,the average values of slope rates ,intercepts ,carryover ,non-linearity and drift were 1 .005 7 ,0 .537 8 ,0 .789 6% ,0 .019 2 ,0 .036 0 ,respectively ,the differences showed no statistically significance ( P>0 .05) .Conclusion hs-CRP rapid quantitative chemiluminescent detection kit has good accuracy and precision ,stable perform-ance ,and consistent with the clinical testing requirements .
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BACKGROUND:Previous experiments have prepared shape memory polymer based on D,L-poly(lactic acid). According to domestic technical requirements for biological y evaluating biomaterials and medical equipments, tissue-engineered grafts must be subjected to preclinical experiment for biosecurity and cytocompatibility evaluation. OBJECTIVE:To observe the biosecurity of the shape memory polymer based on D,L-poly(lactic acid). METHODS:(1) Bacterial endotoxin test:polymer extract, endotoxin working standard solution and checking standard water were added into limulus reagent, respectively. (2) Sensitization test:Polymer extract+Freund’s complete adjuvant+physiological saline and Freund’s complete adjuvant+physiological saline were injected into the scapula of Kunming mice. After induction by intradermal injection, local induction and excitation, stimulate skin erythema and edema degree were observed in animals. (3) Acute toxicity test:Kunming mice received intraperitoneal injection of 100%, 50%, 25%polymer leaching solution and physiological saline, respectively. (4) 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay for cel proliferation:The direct method was that human umbilical cord vascular endothelial cel s were inoculated onto the polymer film, lactic acid and glass, respectively;the indirect method was that human umbilical cord vascular endothelial cel s were inoculated into the polymer leaching solution, acrylamide solution and 1640 culture solution. RESULTS AND CONCLUSION:This shape memory polymer based on D,L-poly(lactic acid) is free of bacterial contamination in compliance with the biosecurity standards, and it has no al ergenic and toxicity but has good cytocompatibility.
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10.3969/j.issn.2095-4344.2013.25.017
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ObjectiveTo investigate serum lipopolysaccharide (LPS) level in people with different glucose tolerances and to explore the relationship between LPS and insulin resistance/β-cell secretory function.Methods Sixty-seven subjects were recruited,including 23 with newly diagnosed type 2 diabetes ( T2DM),21 impaired glucose tolerance ( IGT),and 23 normal glucose tolerance (NGT).Serum LPS was assayed by limulus amebocyte lysate test ;expression of LPS toll-like receptor 4 (TLR4) on surface of plasma monocytes was measured by flow cytometric assays,and the changes of LPS levels by 0.5 hours and 2 hours after a high-fat diet were detected.Insulin resistance was evaluated by homeostasis model assessment for insulin resistance (HOMA-IR); β-cell secretory function was evaluated by homeostasis model assessment for β3 cell function ( HOMA-β )/HOMA-IR,increment in insulin in the first 30 minutes/increment in glucose in the first 30 minutes ( AIns30/ΔG30)/HOMA-IR,AUCIns120min/HOMA-IR.Results2 h LPS levels after a high-fat diet were significantly higher than fasting LPS levels [ NGT:0.96(0.33,0.99)vs 0.62 (0.22,0.64),IGT:1.08(0.53,1.22)vs 0.71 (0.39,0.82),T2DM:1.23 (0.62,1.43)vs 0.86( 0.45,0.94 ),EU/ml,all P＜0.01 ].Fasting,0.5 h,and 2 h LPS levels and fasting TLR4 levels of T2 DM group and IGT group were respectively higher than those of NGT group [ fasting LPS:0.86( 0.45,0.94 ),0.71 ( 0.39,0.82 ) vs 0.62(0.22,0.64),EU/ml;0.5 h LPS:1.10(0.55,1.18),0.84(0.50,1.07) vs 0.73(0.31,0.76),EU/ml;2 h LPS:1.23(0.62,1.43),1.08(0.53,1.22)vs 0.96(0.33,0.99),EU/ml; fasting TLR4:36.96( 17.22,55.19),30.34 ( 15.00,45.18 )vs 15.66 (6.09,9.76),MIF/105 cells,all P＜0.01 ].Fasting LPS,AUCLPS 120 min,and fasting TLR4 were positively correlated with insulin resistance index and negatively correlated with β-cell secretory function index ( P＜0.05 ).Multiple linear regression analysis showed that fasting LPS was an independent correlative factor of HOMA-IR and 0.5 h LPS was an independent correlative factor of (AIns30/AG30)/HOMA-IR and AUCIns Ins120min/HOMA-IR.ConclusionPeople with different glucose tolerances show differed LPS levels and its receptor TLR4 levcls,both of which are correlated with insulin resistance and β-cell secretory function,suggesting that LPS is associated with the pathogenesis of abnormal glucose regulation.
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ObjectiveTo evaluate the clinical features of hyperuricemia (HUA) and relationship between serum uric acid (SUA) and metabolic syndrome (MS) in adults.MethodsData were gathered from medical examination among adults age ≥ 20 years,and totally 18 862 subjects were analyzed in this study.ResultsThe prevalence of HUA was 14.8％ (2788/18 862).The rate was 18.4％( 1926/10 445) in men,10.2％ (862/8417) in women.The prevalence of HUA was increased with age,there was significant difference among different age (P =0.000),the rate in men was higher than that in women (P ＜ 0.01 or ＜0.05 ).Compared with normal SUA Patients,the levels of body mass index(BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),total cholesterol (TC),triacylglycerol (TG) and lowdensity lipid cholesterol(LDL-C) were markedly elevated (P ＜0.01 or ＜0.05),and the level of highdensity lipid cholesterol (HDL-C) was markedly decreased in HUA patients (P ＜0.05).Stepwise regression analysis showed that BMI,SBP,DBP,fasting plasma glucose (FPG),TG,HDL-C were the independent correlation factor of SUA.The incidence of hypertension,over weight/obesity,dyslipidosis,hyperglycosemia and MS in HUA patients [24.1％ (672/2788),36.2％ (1009/2788),31.2％ (870/2788),18.0％ (502/2788),20.8％(580/2788) ] was significantly higher than that in normal SUA patients [ 18.2％ (2925/16 074),26.4％(4244/16 074),22.0％(3536/16 074),15.00(2411/16 074),17.0％(2733/16 074),P＜ 0.01 ].The level of SUA in patients with MS [ (342.3 ± 64.2 ) μ mol/L ] was higher than that of those without MS[ (319.3 ± 67.1 )μ mol/L,P =0.000].ConclusionsThe prevalence of HUA is increased with age.Multiple factors of dysbolism are clustered in subjects with HUA.There is correlation between SUA and MS.
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Objective To investigate the association between obesity and benign prostate hyperplasia (BPH).Methods A total of 253 men (>40 year old) with no obesity related diseases were selected.Medical history,height,body weight,waist circumference (WC),body fat ratio,blood pressure,fasting blood glucose,blood lipid and prostate ultrasound were evaluated.The participants were then assigned to the normal group (body mass index 18.5 to 23.9 kg/m2),overweight group (24.0 to 27.9 kg/m2) and obesity group (≥28 kg/m2).The subjects were also divided into the normal group (WC25%).Prostate volume was analyzed in each group.Results The prostate volume was significantly different between the normal body mass index group and overweight or obesity groups,normal WC group and abdominal obesity group,and normal body fat ratio group and excessive body fat ratio group.The prostate volume was increased in individuals with higher body mass index,WC and body fat ratio.Of those with body mass index≥24 kg/m2 and normal WC or body fat ratio,the incidence of BPH was not significantly increased.Conclusion Obesity may be a risk factor for BPH; individuals with increased WC and body fat ratio may have a higher risk of BPH.
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Objective To investigate the effects of weight-loss intervention on metabolic indicators in over-weight or obesity adults.MethodsA total of 116 over-weight or obese adults entered into this study from March 2008 to December 2009.The participants were divided into three groups by age.Each group received 6 months'weight-loss intervention.Body mass index(BMI),body fat rate,blood pressure,fasting blood glucose(FBG),oral glucose tolerance test(OGTY)2 h blood glucose,serum triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol (LDL-C)were measured before and after the intervention.The data were analyzed using t test.Results After the intervention,BMI,FBG,TG,and LDL-C were significantly decreased while HDL Was significantly increased in each group(P＜0.05).Body fat rate,systolic blood pressure,diastolic blood pressure and OGTT 2 h blood glucose were significantly reduced in the young and middle-aged groups(P＜0.05),however,there Was not significant difference in the older-age group.ConclusionsWeight-loss intervention may be effective in improving physical and metabolic indicators in adults with over-weight and obesity and reducing the risk of obesity-related diseases.