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The concept of people first has important inspirations for the value rational return of medical humanities education in the new era. It is consistent with the educational value, curriculum attribute, and practical attribute of medical humanistic education, and puts forward new requirements for the value rational return of medical humanities education in terms of educational supply content, practical curriculum setting, educational development form, and educational effect evaluation. Medical colleges and universities should further adhere to the medical humanities education concept centered on people’s health, optimize the practice curriculum of medical humanistic education, innovate the practice platform of medical humanistic education, and construct a value evaluation mechanism of medical humanistic education, so as to promote the value rational return of medical humanities education under the concept of people first.
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The ethical governance of science and technology has put forward higher ethical requirements for researchers. As important personnel in medical research and front-line workers in contact with patients, clinical health workers should regulate their ethical behavior during the research process and provide informed consent to patients participating in study to protect their rights and interests. At present, patients’ rights and interests are still violated due to insufficient ethical awareness of researchers in the process of clinical research. Ethical governance of science and technology is not only a standard for researchers’ behavior and protection of patients’ rights and interests, but also a new test for scientific research management and ethical review departments, as well as an important measure to enhance the trust between doctors and patients and build harmonious doctor-patient relationship.
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Objective To compare the dosimetric difference of target and organs-at-risk between intensity-modulated radiotherapy (dIMRT) and volumetric modulated arc therapy (VMAT) for bilateral breast cancer, so as to discuss the clinical feasibility of radiotherapy for bilateral breast cancer. Methods The clinical data of 18 patients receiving radical or modified radical mastectomy for confirmed bilateral breast cancer were enrolled in this study. dIMRT plans and VMAT plans were designed for each patient, and discuss the dosimetric data of two radiotherapy plans. Results Both the two plans satisfied the prescription. In terms of the homogeneity index, VMAT plans (0.09 ± 0.02) were superior to dIMRT plans (0.11 ± 0.01, P < 0.05). In terms of the conformity index,VMAT plans (0.82 ± 0.52) were superior to dIMRT plans (0.71 ± 0.51, P < 0.05). Furthermore, VMAT plans (0.98 ± 0.06) were superior to dIMRT plans (1.24 ± 0.08, P < 0.05) in the dose gradient index. The V10、V20、V30 and Dmean of lungs in VMAT plans (39.07 ± 4.92，22.19 ± 4.36，12.81 ± 4.71，1309.03 ± 135.55) were higher than those in dIMRT plans (30.34 ± 4.26，17.56 ± 4.31，6.77 ± 3.93，1201.39 ± 166.77, P < 0.05).Meanwhile, the V5 of lungs in VMAT plans (63.36 ± 9.02) was higher than that in dIMRT plans (58.01 ± 7.17, P > 0.05). However, the V5、V30 and Dmean of heart in VMAT plans (51.98 ± 3.60，3.78 ± 1.76，885.89 ± 59.84) were lower than those in dIMRT plans (77.16 ± 12.11，5.22 ± 2.85，1036.96 ± 151.46, P < 0.05). The Dmax of spinal cord in VMAT plans (2150.42 ± 136.19) was significantly lower than that in dIMRT plans (3008.23 ± 304.15, P < 0.05). Monitor units in VMAT plans（792.61 ± 62.53）was significantly lower than that in dIMRT plans (3225.33 ± 498.66, P < 0.05). Conclusion Although VMAT has many advantages: achieves better homogeneity index and conformity index of target areas, reduces the irradiation dose of organs-at-risk, especially, the irradiation dose of heart and spinal cord is significantly reduced, however, it increases the irradiation dose of lungs. To reduce the recurrence of grade ≥ 2 radiation pneumonia, dIMRT should be better considered in the application of radiotherapy for bilateral breast cancer.
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Objective The purpose of this study is to provide a reference for the selection of clinical radiotherapy plan by comparing the difference of dosimetry between coplanar dynamic intensity modulation dIMRT and coplanar VMAT plan in hippocampal protective whole brain radiotherapy (WBRT). Methods 10 patients were selected whose hippocampal were protected by WBRT, dIMRT and VMAT plans were designed for each patient, the differences of target dose, organ-endangering dose and machine hop count were compared between the two groups. Results The two technical plans PTV V30 Gy, D98% and D2% all meet the standard of RTOG 0933, which is better than the dIMRT group for the PTV HI VMAT group (P = 0.004). The hippocampal dose of dIMRT group was better than that of VMAT group, but it did not meet the standard of RGOT 0933. The average Dmax of hippocampus in dIMRT group and VMAT group was 18.44 Gy and 19.30 Gy, respectively (P = 0.004). The average value of hippocampal Dmin was 10.03 Gy and 10.77 Gy, respectively (P = 0.013), and the mean value of hippocampal Dmean was 14.20 Gy and 15.12 Gy, respectively (P = 0.002). The doses of lens, eyeball and optic nerve all met the standard of RTOG0933, and the dose of dIMRT group was significantly better than that of VMAT group (P = 0.000). The treatment time in VMAT group was significantly lower than that in dIMRT group. The treatment time in VMAT group was significantly lower than that in dIMRT group. Conclusion Varian dIMRT has more advantages in controlling hippocampal dose and protecting lens than VMAT, but PTV HI and treatment efficiency are higher in VMAT group.
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Objective:To establish a risk prediction model of acute myocardial infarction(AMI)in elderly patients with hyperuricemia(HUA).Methods:A total of 148 elderly patients with HUA in Shanghai Fourth People's Hospital Affiliated to Tongji University for prospective study from March 2020 to March 2021 were divided into AMI group and non-AMI group according to whether they were complicated with AMI.The baseline data of patients were recorded at admission and compared between the two groups.Multivariate Logistic regression analysis was used to examine the risk factors for AMI in elderly patients with HUA.And AMI risk prediction model was established.The ROC curves were plotted.Using the ROC curve, the prediction efficiency of AMI risk prediction model was evaluated.Results:Among 148 elderly patients with HUA, 22 cases(14.86%)had AMI.The proportion of smoking history in AMI group was higher than non-group( χ2=6.192, P=0.013). The diastolic blood pressure, systolic blood pressure, fasting blood glucose(FPG), low density lipoprotein cholesterol(LDL-C), serum uric acid(SUA)and homocysteine(Hcy)were statistically significantly higher in AMI group than in non-AMI group( U=1.973, 2.652, 2.016, 1.364, 2.151, 2.973, 5.972, P=0.049, 0.008, 0.044, 0.032, 0.003, <0.001). The multiple Logistic regression analysis showed that smoking history, high DBP, high SBP, high FPG, high LDL-C, high SUA and high Hcy were risk factors for AMI in elderly HUA patients( OR=3.120, 1.072, 1.887, 2.358, 3.365, 1.031, 3.773, P=0.016, 0.001, <0.001, 0.008, 0.028, 0.001, <0.001). By substituting the risk factor index and the regression coefficient into the Logistic regression equation formula, the obtained final fitting equation was: AMI=1.138×smoking history(no=0, yes=1)+ 0.070×DBP+ 0.635×SBP+ 0.858×FPG+ 1.213×low density lipoprotein+ 0.030×SUA+ 1.328×Hcy.The ROC curve was drawn and showed that the AUC of forecast value of AMI risk prediction model in predicting the risk of AMI in elderly HUA patients was 0.847, >0.80, which had certain predictive value.Hosmer-Leme show goodness of fit test χ2=5.743, P=0.676, P>0.05, the model had good correction ability and satisfactory fitting. Conclusions:AMI in elderly hyperuricemia patients are affected by multiple risk factors.The AMI risk prediction model is established via combining with multiple risk factors.The model has certain efficiency in predicting the occurrence of AMI in elderly patients with hyperuricemia.
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This paper, on top of its introduction of the concept of medical ethics counseling, analyzed the necessity of establishing a medical ethics consultation system in China.By reviewing the development of the medical ethics counseling system in other countries, the authors, in view of China′s medical practice, put forward specific recommendations on establishing a medical ethics counseling system in China.Issues on the construction of organ donation ethics counseling system in China were also discussed in focus.
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Medical students' medical ethics education is an important mission of medical college moral education.The current medical ethics cultivation is facing the profound reform of humanistic medical education,the gradual exploration and improvement of medical ethics education system,the development and application of online information platform,the establishment and development of china medical self-media alliance and other opportunities.Meanwhile,it is facing the differences in the motivations of students to study medicine,the diversified values,the sharp decline of professional teams,the deterioration of occupational environment and other challenges.In order to actively deal with opportunities and challenges,medical colleges and universities should establish the longitudinal three-dimensional medical ethics cultivation mode,form the horizontal collaborative pattern of medical ethics education,perfect the dynamic and long-term medical ethics cultivation safeguard mechanism,and improve the evaluation system that combined qualitative and quantitative.
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Objective:To understand present situation and explore effectiveness of medical ethics quality train-ing on the Preeminent Medical Talents .Method: Questionnaires were used for investigating "Preeminent class"students of 2013~2016 level Fourth Order in order to grasp present situation of medical ethics quality and compare and analyse the stituation longitudinally .Result:The effectiveness of medical ethics quality training of senior grades"preeminent class" students is higher than junior grades "preeminent class" students , but the overall effec-tiveness is not very obvious .Conclusion:Attention should be paid on the top -level design with the the purpose of improving medical ethics quality training effectiveness on the Preeminent Medical Talents and its systematicness should be strengthened .We should not only regard the effectiveness more dialectically and emphasize its long -term effect and procedural ,but also strengthen its practical .
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The excellent medical talents education is a path of elite medical education .At present , the cultiva-tion of medical ethics quality of excellent medical talents is facing with the unidirectional medical ethics cognition education ,lacking humanistic care in the cultivation of medical ethics emotion , the utilitarian tendency of the culti-vation of medical ethics will and the formalization of the medical ethics practice .Therefore , medical colleges can improve medical ethics quality of excellent medical talents with reforming the traditional curriculum system , enric-hing the campus cultural activities and formulating scientific personnel training mode .
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Compared with the evaluation method of the integration of formative evaluation and summation evalu-ation, development evaluation is based on the development of medical students ' medical ethics quality , takes the role of medical ethics in the cultivation of preeminent medical talents as clear goal , adjusts the enthusiasm of the teachers and students as the evaluation subjects by teacher evaluation , self -evaluation and mutual evaluation , comprehensively evaluates medical student ' s medical ethics awareness , medical ethics emotion and practice .It pays attention to the stage development and overall development of preeminent medical talents and meets the practi -cal situation of pilot class of the education training plan of outstanding doctors , the cultivation regularity of medical ethics quality and the development law of preeminent medical talents , thus to be necessary and feasible .
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The present medical ethics quality training of excellent medical talents should always follow the edu -cation concept that profound moral tenet is the basis of medical science and the key of education is to shape one ' s mind , and focus on practice .The correct cognition of practical education is the precondition of medical ethics qual-ity training of excellent medical talents;the practice activities of classroom teaching are the basis of medical ethics quality training of excellent medical talents;the campus cultural practice activities are the guarantee of medical eth-ics quality training of excellent medical talents;the clinical practice is the key point of medical ethics quality train-ing of excellent medical talents;the social practical activities are the deepening of medical ethics quality training of excellent medical talents .
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Foreign medical professional spirit cultivation has made much successful experience in cultivating concept , cultivating mode , evaluation method , and so on .It provided important enlightenment for the medical eth-ics quality training of excellent medical talents in our country .Drawing lessons from the beneficial practice , we can do further attempts in the aspects of medical ethics quality training of excellent medical talents in our country .For example , we can enhance the humanity of the medical ethics quality training curriculums , explore the diversity of medical ethics quality training methods , adhere to the comprehensiveness of the medical ethics quality assessment , and strengthen the professionalism of medical ethics quality training organizations .
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Objective:To understand present situation and explore effectiveness of medical ethics quality train-ing on the Preeminent Medical Talents .Method: Questionnaires were used for investigating "Preeminent class"students of 2013~2016 level Fourth Order in order to grasp present situation of medical ethics quality and compare and analyse the stituation longitudinally .Result:The effectiveness of medical ethics quality training of senior grades"preeminent class" students is higher than junior grades "preeminent class" students , but the overall effec-tiveness is not very obvious .Conclusion:Attention should be paid on the top -level design with the the purpose of improving medical ethics quality training effectiveness on the Preeminent Medical Talents and its systematicness should be strengthened .We should not only regard the effectiveness more dialectically and emphasize its long -term effect and procedural ,but also strengthen its practical .
ABSTRACT
The excellent medical talents education is a path of elite medical education .At present , the cultiva-tion of medical ethics quality of excellent medical talents is facing with the unidirectional medical ethics cognition education ,lacking humanistic care in the cultivation of medical ethics emotion , the utilitarian tendency of the culti-vation of medical ethics will and the formalization of the medical ethics practice .Therefore , medical colleges can improve medical ethics quality of excellent medical talents with reforming the traditional curriculum system , enric-hing the campus cultural activities and formulating scientific personnel training mode .
ABSTRACT
Compared with the evaluation method of the integration of formative evaluation and summation evalu-ation, development evaluation is based on the development of medical students ' medical ethics quality , takes the role of medical ethics in the cultivation of preeminent medical talents as clear goal , adjusts the enthusiasm of the teachers and students as the evaluation subjects by teacher evaluation , self -evaluation and mutual evaluation , comprehensively evaluates medical student ' s medical ethics awareness , medical ethics emotion and practice .It pays attention to the stage development and overall development of preeminent medical talents and meets the practi -cal situation of pilot class of the education training plan of outstanding doctors , the cultivation regularity of medical ethics quality and the development law of preeminent medical talents , thus to be necessary and feasible .
ABSTRACT
The present medical ethics quality training of excellent medical talents should always follow the edu -cation concept that profound moral tenet is the basis of medical science and the key of education is to shape one ' s mind , and focus on practice .The correct cognition of practical education is the precondition of medical ethics qual-ity training of excellent medical talents;the practice activities of classroom teaching are the basis of medical ethics quality training of excellent medical talents;the campus cultural practice activities are the guarantee of medical eth-ics quality training of excellent medical talents;the clinical practice is the key point of medical ethics quality train-ing of excellent medical talents;the social practical activities are the deepening of medical ethics quality training of excellent medical talents .
ABSTRACT
Foreign medical professional spirit cultivation has made much successful experience in cultivating concept , cultivating mode , evaluation method , and so on .It provided important enlightenment for the medical eth-ics quality training of excellent medical talents in our country .Drawing lessons from the beneficial practice , we can do further attempts in the aspects of medical ethics quality training of excellent medical talents in our country .For example , we can enhance the humanity of the medical ethics quality training curriculums , explore the diversity of medical ethics quality training methods , adhere to the comprehensiveness of the medical ethics quality assessment , and strengthen the professionalism of medical ethics quality training organizations .
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Objective Androgen receptor ( AR) is extensively expressed in breast cancer and influences the proliferation of the malignant cells.Our study aimed to investigate the effect of AR on estrogen receptor (ER)-positive breast cancer. Methods ER-positive MCF-7 breast cells were exposed to various concentrations of agonist dihydrotestosterone ( DHT) or antagonist bicalutamide or left untreated .Then the proliferation and apoptosis of the cells were determined by MTT assay , cell counting , and flow cytometry , and the expressions of the proteins related to cell cycle regulation were detected by Western blot . Results The relative gray value of AR was significantly increased in the DHT group (1.055 ±0.020) but decreased in the bicalutamide group (0.705 ±0.010) as com-pared with the blank control (0.795 ±0.020) (both P<0.05).Flow cytometry showed that the early apoptosis rate of the breast cancer cells was markedly higher in the DHT group ([51.20 ±0.312]%) but lower in the bicalutamide group ([2.410 ±0.367]%) than in the blank control ([3.540 ±0.375]%) (both P<0 .01). In comparison with the control group , the expressions of the p53, p73 and p21 proteins in the MCF-7 cells were remarkably up-regulated in the DHT group but down-regulated in the bicalutamide group ( both P<0.05). Conclusion AR inhibits the proliferation of ER-posi-tive breast cancer cells , which suggests that it may be a potential ther-apeutic target for ER-positive breast cancer .
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Medical ethics courses play a main channel role in the cultivation of applicable medical profession-als, who have both virtue and professional competence. To adapt to clinical medical education comprehensive re-form on the need for educating and training outstanding doctor and strengthen medical students′professional ethics and ethical practice ability, we must further optimize the medical ethics teaching reform:optimizing medical ethics education philosophy that to enhance the students′ability of ethical practice as the goal;optimizing implementation of the interactive case teaching that to strengthen the students′ethical thinking and decision-making skills as the basis;optimizing the channels and methods of research that to strengthen the students′ability of scientific research ethics as the promotion;optimizing evaluation method of medical ethics that to strengthen the formative assessment methods as the sudden breaking.
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Medical students′ professional spirit cultivation is an important content as well as a basic require-ment of the Preeminent Doctor Education and Training Plan. Currently, there are several problems in medical tal-ents′professional spirit cultivation, such as the unstandardized curriculum, the lack of subjective experience, and the ignorance of the unity of education stages, student differences and coherence. This study intends to explore thedouble teacher method, in which both clinical teaching doctors and medical ethics teachers engage in the medi-cal students′professional spirit cultivation. Its purpose is to build a bridge between medical ethics education in uni-versities and the clinical practice, and further to integrate them through doctors′ and teachers′ joint participation, which will significantly enhance medical students′practice ability of medical moral.