Discussion on the evaluation of radiation protection of “four-in-one” dental X-ray equipment / 中国辐射卫生

Objective To evaluate the radiation protection of “four-in-one” dental X-ray equipment and to investigate the safety interlock of the equipment by measuring the scattered radiation at the position of the patient during operation. Methods A cone-beam CT dental phantom was used to simulate the patient’s head. The intra-oral and extra-oral components of the “four-in-one” X-ray equipment were installed in a 5 m2 room. The scattered radiation at patient position was measured using a γ/X-ray survey meter, and the effects of intra-oral and extra-oral components were compared. Results For a 5 m2 room, when CBCT was exposed under typical conditions, the dose at the patient's position was 10.70 uSv/h when there was an intra-oral component and 10.60 uSv/h when there was no intraoral component. The intra-oral part did not affect the radiation dose at the patient's position. When the intra-oral component was exposed, the dose rate at the patient's position was 4.05-6.85 uSv/h, and the extra-oral part did not affect the scattered dose of the patient examined with intra-oral components. Conclusion The evaluation of radiation protection of new equipment must comprehensively consider radiation safety and equipment operation safety. The results of this study provide suggestions for clinical radiation protection supervision and evaluation of “four-in-one” dental X-ray equipment.

Reform of clinical medical talents cultivation model based on post competency: a case study of Guangxi Medical University / 中华医学教育探索杂志

Through the reform and practice of the "four-in-one" cultivation model of clinical medical talents, the training mode of applied high-quality medical and health talents with different orientations is established, and the curriculum teaching system suitable for the development of modern medical education is constructed to promote the reform of education and teaching. It solves the problems of single medical talents training mode, fragmentation of curriculum system, single teaching and training in teaching, and insufficient support for talent training. This reform established a set of curriculum system, teaching methods and evaluation methods to strengthen the cultivation of medical students' post competency, and achieved the goal of improving the quality of clinical medical personnel training in local medical colleges.

Implementing the special action plan to comprehensively strengthen and improve students mental health work / 中国学校卫生

Abstract@#In recent years, mental health issues have gradually expanded from adults and professional groups to the primary and secondary school students, and are showing a trend of younger age. The article analyzes the "Special Action Plan for Comprehensively Strengthening and Improving the Mental Health Work of Students in the New Era (2023-2025)" jointly issued by 17 departments including the Ministry of Education. It explores the current situation, overall concept, key tasks, and other aspects to further improve the "four in one" student mental health work system of health education, monitoring and warning, consulting services, intervention disposal, and improve students mental health literacy.

Application of clinical value assessment of treatment protocols in guideline development: taking the WFAS Clinical Practice Guideline of Acupuncture and Moxibustion for Migraine as an example / 中国针灸

To enhance the clinical applicability of guidelines and provide more effective guidance for clinical practice, a clinical value assessment was conducted during the development of the World Federation of Acupuncture-Moxibustion Societies (WFAS) Clinical Practice Guideline of Acupuncture and Moxibustion for Migraine, which involved the evaluation of 59 acupuncture and moxibustion treatment protocols from randomized controlled trials (RCTs). This article introduced the methodology, content and results of the clinical value assessment of RCT-based acupuncture and moxibustion treatment protocols, which involved the integration of historical and contemporary medical evidence and expert consensus. It served as a methodological reference for the future development of acupuncture and moxibustion clinical practice guidelines.

Environment control and healthy education are the most important methods for prevention and treatment of allergic rhinitis / 中华预防医学杂志

The almost all guidelines of allergic rhinitis (AR) diagnosis and treatment in the world agree the strategy of "combination of prevention and treatment, four in one". There are more descriptions about anti-allergic medications and allergen immunotherapy (AIT), but less contents of environmental control and health education. It is necessary to emphasize again that clinicians must attach great importance to environmental control and strengthen health education in order to realize the three-level prevention of AR and reduce its harm.

Exploration and Practice of the "One Combination, Two Highlights, Three Combinations, Four in One" Innovative Talents Training Mode in Forensic Medicine / 法医学杂志

Talent is one of the basic and strategic supports for building a modern socialist country in all aspects. Since the 1980s, the establishment of forensic medicine major and the cultivation of innovative talents in forensic medicine have become hot topics in higher education in forensic medicine. Over the past 43 years, the forensic medicine team of Shanxi Medical University has adhered to the joint education of public security and colleges, and made collaborative innovation, forming a training mode of "One Combination, Two Highlights, Three Combinations, Four in One" for innovative talents in forensic medicine. It has carried out "5+3/X" integrated reform, and formed a relatively complete talent training innovation mode and management system in teaching, scientific research, identification, major, discipline, team, platform and cultural construction. It has made a historic contribution to China's higher forensic education, accumulated valuable experience for the construction of first-class major and first-class discipline of forensic medicine, and provided strong support for the construction of the national new forensic talent training system. The popularization of this training mode is conducive to the rapid and sustainable development of forensic science, and provides more excellent forensic talents for national building, regional social development and the discipline construction of forensic science.

Construction and prospect of healthy enterprises in the new era / 中华劳动卫生职业病杂志

The construction of health enterprises practice the concept of big health. It is an important solution to protect the overall health of occupational groups in the new era, which is of great significance to promoting a healthy city and helping to build a healthy China. This paper clarifies the connotation of healthy enterprises in the new era, discusses the key points of healthy enterprise construction around the "four in one" construction content, "PDCA" construction procedures, and evaluation methods of healthy enterprises. It focuses on the progress of healthy enterprise construction, analyzes the problems faced by the construction of health enterprises in China, and puts forward suggestions to improve the construction efficiency, with a view to providing ideas for further promoting the construction of health enterprises in China.

Mechanism of Zhigancao Tang Against Coronary Heart Disease： An Exploration Based on Thought of "Four in One" / 中国实验方剂学杂志

"Four in one" is a research idea of identifying the classic prescriptions from the following four dimensions： "nature， location， tendency， and syndrome". The multi-dimensional analysis of the mechanism of classic prescription Zhigancao Tang in treating coronary heart disease helps to understand the syndrome differentiation and treatment thoughts of ZHANG Zhong-jing. The coronary heart disease results from deficiency. The efficacy of Zhigancao Tang in treating coronary heart disease can be elucidated from the "nature，location，tendency， and syndrome". In terms of nature， Zhigancao Tang is pungent and sweet in flavor and warm in property， with the sweet responsible for tonifying deficiency， the pungent for dispersing Yang， resolving Yin， and eliminating surplus pathogen， and the warm for moving Yangqi， nourishing blood， and promoting blood circulation. In terms of location， Zhigancao Tang mainly acts on vessels for restoring the normal circulation of blood in the vessels and improving coronary artery stenosis and the resulting ischemia and anoxia. In terms of tendency， Zhigancao Tang tends to affect the upper and inner parts of the body to tonify deficiency in Zangfu organs， promote fluid production， nourish nutrient blood， and dissipate cold simultaneously， thus alleviating chest impediment. In terms of syndrome， Zhigancao Tang is applicable to fluid exhaustion with blood dryness and Yin-yang-qi-blood deficiency syndrome， manifested as regularly or irregularly intermittent pulse and severe palpitation. Zhigancao Tang has been widely used for the treatment of over 70 diseases classified into 10 systems， especially the cardiovascular diseases， in traditional Chinese medicine （TCM） and western medicine. As the “one” of “four in one”， Zhigancao Tang is composed of multiple Chinese herbs and its therapeutic effect is superior to the sum of its parts. It ameliorates the coronary heart disease by resisting inflammation， protecting against ischemia-reperfusion injury， adjusting the ion channels of myocardial cells， and participating in atrial remodeling and hematopoiesis. Its mechanism and clinical efficacy in the treatment of coronary heart disease have been verified by clinical and experimental studies. The utilization of the thought of "four in one" to analyze classical prescriptions enables the combination of prescriptions with syndromes， which is of great significance to the clinical application and modern development of classical prescriptions.

Establishment and practice of the innovative science and technology evaluation and service system of Fuwai Hospital / 中华医学科研管理杂志

Objective:By demonstrating the performance, experience and practical value of the original " science and technology evaluation" of Fuwai Hospital, it is expected to build the brand of " Fuwai innovative service for science and technology evaluation" and provide a wider social service.Methods:The four-in-one " science and technology evaluation and service system" , which is composed of " standardized local data-base" , " Fuwai Spider Net Map and Spider Track Map evaluation method" , " hierarchy three-level index system" , and " intellectual science and technology evaluation and service system" , is established for efficient evaluation of science and technology.Results:The " science and technology evaluation and service system" has run with benefit in Fuwai Hospital for years.With the multi-factor evaluating feature, it solves the drawbacks of traditional evaluating system, thus improving accuracy of evaluation and helping implementation of national policies.If the system is extended to other hospitals, it would advocate the feature and strength of Fuwai science and technology evaluation system as well as provide pluralistic reference and advice for decision-making departments.Conclusions:Science and technology evaluation is such a systemic work, with all issues of different levels along the whole evaluating process to be considered.Drawbacks exist in the traditional method which depends on a single final score.By the practice of Fuwai Hospital, the innovative " four in one" evaluation system has been validated to be more scientific.

Knowledge of blood donation among adults in north-central Nigeria

Background: About half of the population in Nigeria is medically fit for blood donation but only four in one thousand are voluntary donors. The low level of blood donation has been attributed to poor knowledge, misconceptions, myths, bias, poverty, fear, malnutrition among the population. Therefore, this study assessed the knowledge of blood donation among adults in two selected North Central States of Nigeria.Methods: It was a descriptive cross-sectional study. A total of 3104 respondents comprising of adults between 18 and 60 years were involved in the study. A multistage sampling technique was used and the research tool was interviewer-administered questionnaire. The data generated were entered into the computer and subjected to appropriate statistical analysis using EPI INFO computer software package (version 3.5.3). Pearson Chi Square (χ2) was used to test statistical significance and p-value was set at < 0.05.Results: Majority of the respondents 2565 (82.5%) knew that blood donation save lives. More than three-quarters, 2468 (79.5%), knew where to go for voluntary blood donation. About one-third, (37.1%), demonstrated good knowledge of voluntary blood donation. Older respondents (>60 years) had poor knowledge of blood transfusion compared with younger age groups (p<0.001). Respondents' occupation and educational status were significantly associated with knowledge of blood transfusion (p<0.001)Conclusion: Periodic awareness programme on voluntary blood donation in rural and urban areas across Nigeria is needed. In addition, sensitization of the informal sector on the significance of non-remunerated voluntary blood donation should be given priority

Knowledge of blood donation among adults in north-central Nigeria

Background: About half of the population in Nigeria is medically fit for blood donation but only four in one thousand are voluntary donors. The low level of blood donation has been attributed to poor knowledge, misconceptions, myths, bias, poverty, fear, malnutrition among the population. Therefore, this study assessed the knowledge of blood donation among adults in two selected North Central States of Nigeria. Methods: It was a descriptive cross-sectional study. A total of 3104 respondents comprising of adults between 18 and 60 years were involved in the study. A multistage sampling technique was used and the research tool was interviewer-administered questionnaire. The data generated were entered into the computer and subjected to appropriate statistical analysis using EPI INFO computer software package (version 3.5.3). Pearson Chi Square (χ2) was used to test statistical significance and p-value was set at < 0.05. Results: Majority of the respondents 2565 (82.5%) knew that blood donation save lives. More than three-quarters, 2468 (79.5%), knew where to go for voluntary blood donation. About one-third, (37.1%), demonstrated good knowledge of voluntary blood donation. Older respondents (>60 years) had poor knowledge of blood transfusion compared with younger age groups (p<0.001). Respondents' occupation and educational status were significantly associated with knowledge of blood transfusion (p<0.001). Conclusion: Periodic awareness programme on voluntary blood donation in rural and urban areas across Nigeria is needed. In addition, sensitization of the informal sector on the significance of non-remunerated voluntary blood donation should be given priority

Application of Four in One model for diabetes management in hospital consortium / 中华全科医师杂志

In 2017,the Diabetes Management Center was founded in Shandong Third Provincial Hospital.On the basis of the center,a network was established which integrated the tertiary hospital,district hospitals,community health service institutions and family of patients forming the"Four in One"model of diabetes management.This article introduces the background,application,and preliminary accomplishments in individualized and standardized diabetic management of this internet plus model.The challenges and suggestions for future development of the "Four in One" model are also discussed.

IMPLICACIONES DE LOS HÁBITOS TÓXICOS EN EL CÁNCER / Cancer toxic habit risks

Encabezado de página Carta Remisoria Consentimiento informado para reporte de casos Documento garantías y cesión de derechos a favor de la Academia Nacional de Medicina Formato de evaluación Revista Medicina Ver términos de licencia Open Journal Systems Ayuda de la revista USUARIO/A Nombre de usuario/a Contraseña No cerrar sesión Iniciar sesión NOTIFICACIONES Ver Suscribirse IDIOMA CONTENIDO DE LA REVISTA Buscar Buscar Examinar Por número Por autor/a Por título TAMAÑO DE FUENTE Make font size smallerMake font size defaultMake font size larger INFORMACIÓN Para los lectores/as Para los autores/as Para los bibliotecarios/as HERRAMIENTAS DEL ARTÍCULO Imprimir este artículo Metadatos de indexación Cómo citar un elemento Referencias de búsqueda Política de revisión Enviar este artículo por correo electrónico (Inicie sesión) Enviar un correo electrónico al autor/a (Inicie sesión) INICIO ACERCA DE INICIAR SESIÓN REGISTRARSE BUSCAR ACTUAL ARCHIVOS AVISOS ENVIAR-ARTICULOS DIRECTIVOS ANM PAGINA WEB ANM Inicio > Vol. 39, núm. 1 (2017) > Chavarro-Carvajal IMPLICACIONES DE LOS HÁBITOS TÓXICOS EN EL CÁNCER Diego Andrés Chavarro-Carvajal, Elkin García-Cifuentes, Mauricio Acosta RESUMEN Los hábitos nocivos pueden provocar daños a corto o largo plazo. Se clasifican en: hábitos de riesgo y hábitos tóxicos. Esta revisión se enfoca en analizar los hábitos tóxicos y cómo se relacionan con la aparición de procesos neoplásicos. En la literatura, se ha descrito ampliamente la relación que existe entre diferentes agentes químicos o físicos que se asocian con la génesis de neoplasia, enfatizando en el consumo de tabaco, el alcohol (etanol) y el café. El tabaco se produce a partir de las hojas de la Nicotiana tabacum. Su principal forma de consumo es a través de la combustión y aún hoy, 53 años después de que el Comité Asesor del Director General de Sanidad publicara su informe en 1964 advirtiendo de sus efectos nocivos, persiste su aparición como la principal causa de mortalidad prevenible por cáncer. Por otra parte, el alcohol constituye la principal droga consumida en nuestra sociedad. Actualmente, se encuentran todo tipo de bebidas con diferentes concentraciones de alcohol. Se define como consumo moderado la ingesta de una bebida por día para mujeres y dos tragos por día para los hombres; mientras que se concibe como exceso el consumo mayor a tres bebidas cualquier día o siete bebidas por semana en mujeres y más de cuatro bebidas al día o catorce bebidas a la semana en hombres. Adicionalmente, la cafeína se encuentra principalmente en el café, es una sustancia ampliamente consumida y culturalmente aceptada. Los estudios sobre el papel que desempeñan sus componentes han sido controversiales y se plantean diversos retos en su investigación.

Noxious habits can be harmful in the short and long term. They are classified into risk habits and toxic habits. We focus this review paper on toxic habits and its relation to the onset of neoplastic processes. The relationship between chemical and physical agents and the genesis of neoplasia has been widely described through literature, making emphasis on tobacco, alcohol (ethanol) and coffee. Tobacco is made out of the leaves of the Nicotiana tabacum. It is mainly consumed by the inhalation of its base after combustion, and even now a days 53 years after the Advisory Committee Director General of Health, published its 1964 report, where they warned the community about the tobacco harmful effects, it still remains the main cause of preventable cancer mortality. In addition, alcohol (ethanol) is the most consumed drug in our society; currently all kind of beverages with different concentration of alcohol levels are available. Moderate consumption is defined as no more than one drink per day for females, and two drinks for males, whereas excessive consumption is defined as more than three drinks in one day or more than 7 per week for females, and more than four in one day or more than 14 drinks for males. Furthermore, caffeine is mainly found in coffee, it is a widely consumed and culturally accepted substance. The investigations concerning the role of its components have been controversial, dealing with a variety of challenges during the research.

"Application study of""Four in One""informational teaching model in Medical Nursing teaching" / 中国实用护理杂志

Objective To construct Four in One informational teaching model based on cloud platforms, simulation training, nursing micro-lectures and multidimensional evaluation investigate, and to explore the effect of theFour in Oneinformational teaching model applied in Medical Nursing teaching. Methods Two classes students of 2014 were selected by randomized sampling and were divided into experiment group and control group, the experiment group operated the Four in One informational teaching mod, the control group operated regular teaching. After the experiment,using the medical nursing theory test, the skill test, the questionnaire survey to evaluate the teaching effectiveness. Results The theoretical examination score, skill examination score and overall results of experiment group were (78.81±6.44), (82.01±5.22), (80.41±6.32) points, while (71.12±8.12), (76.74±6.3), (75.57±5.51) points of control group, and the difference was statistically significant (t=5.47, 4.86, 3.22, P<0.01 or 0.05). The students' interested in the informational teaching model of the experimental group reached 78.72%(37/47) and learning satisfaction reached 91.48% (43/47). Conclusions The Four in One informational teaching model applied in Medical Nursing teaching can improve the study effect .

"Four-in-One" Management Mode of Chronic Disease Based on Big Data / 医学信息学杂志

The paper analyzes the current situation of chronic disease and the disadvantages of traditional chronic disease management mode in China,puts forward the building of the comprehensive "four-in-one" (inhabitant-community-hospital-disease prevention and control center) chronic disease management mode based on big data,discusses the connotation,building idea and research content,and provides reference for the research of chronic disease management.

"Effectiveness of ""Four in one"" nutritional management mode in treatment of type 1 diabetes mellitus in children" / 中华健康管理学杂志

Objective To evaluate the effectiveness offour in onenutrition management mode in the treatment of type 1 diabetes mellitus (T1DM) in children. Methods Ninety children diagnosed with T1DM in Tianjin Children's Hospital were selected during March 2011 to June 2013. Segmented balanced random method was used to generate a random number timer, and the children were divided into intervention group and control group (n=45) by random letters. The patients in the intervention group were treated withFour in one nutrition management. Those in the control group were treated with traditional nutrition education method. Observation period was one year. The change of food choices of the parents was assessed before and after the intervention. Nutritional treatment compliance of children,fasting plasma glucose (FPG),2 hours postpransial glucose (2 hPG),and hemoglobin A1c (HbA1c) levels and complications, and so on were also evaluated. Results One year after intervention, the percentages of parents who chose low glycemic index food (41/45), vegetables and fruits consumed every day (40/45), often ate soy products(41/45), did not drunk carbonated drinks (43/45) of treatment group were significantly higher than those of control group (24/45, 20/45, 19/45, 26/45, P all<0.001);diet treatment compliance of children in treatment group was significantly better than that of the control group (P=0.000 2);FPG, 2 hPG, HbA1c of two groups of children decreased significantly than before. FPG[(8.11 ± 2.82) mmol/L], 2 hPG [(12.82 ± 1.05) mmol/L], HbA1c [(6.10±0.93)%] of treatment group were significantly lower than those of the control group [(11.71± 2.75) mmol/L, (13.77±1.49) mmol/L, (9.02±0.93)%;t=6.13, 1.66, 14.89;P<0.001 for all comparisons]. After treatment, 14 cases of treatment group had acute ketoacidosis and hypoglycemia , while 39 cases of control group had these complications (P=0.000 00). Readmission occurred in 11 cases of treatment group and 33 of the control group (P=0.000 00). Conclusions Four in onenutrition management mode was effective in the management of children with T1DM.

Exploration on Life Significance Education in Medical Students from Vision of New Media / 中国医学伦理学

In the perspective of new media , has carried on the review to the current situation of medical students′life consciousness , and puts forward the nationwide medical students life education of subjectivity , and open features , explore “four in one” mode of medical students′life education , namely:the use of new media inte-gration of curriculum resources , consolidate the first classroom; using new media to expand audience , strengthen education;using new media foil emotional rendering , rich campus culture;using new media development hot spec-ulative , vowed to cultural practice .

Câncer de mama hereditário: rastreamento de mutações nos genes BRCA1 e BRCA2 e busca de novos genes de susceptibilidade / Hereditary breast cancer: screening for mutations in the BRCA1 and BRCA2 genes and search for new susceptibility genes

O Câncer de Mama Hereditário (HBC) é uma doença autossômica dominante caracterizada, principalmente, por mutações germinativas nos genes BRCA1 e BRCA2 que conferem alto risco em desenvolver câncer de mama e ovário. A identificação da causa genética responsável pelo aumento de risco em mulheres com critérios clínicos para HBC é extremamente importante para o manejo das mesmas. Dessa forma, o objetivo do presente estudo foi avaliar mutações pontuais germinativas e alterações no número de cópias (CNV) nos genes BRCA1 e BRCA2 em 128 famílias brasileiras, as quais preencheram os seguintes critérios para HBC: 108 para Câncer de Mama e Ovário Hereditário (HBOC), 20 para Câncer de Mama e Colón Hereditário (HBCC), sendo que 32 preencheram critérios clínicos para ambos. Amostras de DNA de sangue periférico foram utilizadas para avaliar a presença de mutações germinativas através do sequenciamento completo dos genes BRCA1 e BRCA2 nas sequências codificadoras e limites éxon-íntron e também verificar as mutações pontuais nos genes TP53 (R337H) e CHEK2 (1100delC). Os pacientes não portadores de mutações nos genes BRCA1/2 foram selecionados para análise de MLPA (multiplex ligation-dependent probe amplification) para avaliar as CNVs nestes genes. A prevalência de mutações patogênicas neste estudo foi de 25% (32/128), incluindo 21 no BRCA1 (2 splice site, 2 missense, 9 frameshift, 6 nonsense e 2 CNVs), 7 no BRCA2 (3 frameshift e 4 nonsense), 3 no TP53 (3 missense) e uma no gene CHEK2 (1100delC). Sete (25% - 7/28) das mutações patogênicas identificadas nos genes BRCA1 e BRCA2 foram descritas pela primeira vez neste estudo, cinco no gene BRCA1, incluindo uma nova mutação no sítio de splice no BRCA1, cuja patogenicidade foi confirmada através da análise do transcrito; e duas no gene BRCA2...

Hereditary Breast Cancer (HBC) is an autosomal dominant disease mainly characterized by germline mutations in BRCA1 and BRCA2 genes that confer high risk for developing breast and ovarian cancer. The identification of high-risk women carrying mutations responsible for the disease is extremely important for their management. Thus, the aim of this study was to evaluate germline mutations and copy number variations (CNVs), in BRCA1 and BRCA2 in 128 Brazilian families, who met the following criteria for HBC: 108 for Hereditary Breast and Ovarian Cancer (HBOC) and 20 for Hereditary Breast and Colon Cancer (HBCC). Thirty two patients met clinical criteria for both syndromes. DNA samples from peripheral blood were used to assess the presence of germline mutations by capillary sequencing of the entire coding sequence of BRCA1 and BRCA2 genes, exon - intron boundaries, as well as TP53 (R337H) and CHEK2 (1100delC) variants. Patients who did not carry mutations in the BRCA1/2 genes were selected for MLPA analysis (multiplex ligation-dependent probe amplification) to assess CNVs in these genes. The prevalence of pathogenic mutations in this study were 25 % (32 /128) , including 21 in BRCA1 (2 splice site, 2 missense, 9 frameshift, 6 nonsense and 2 CNVs), 7 BRCA2 (3 nonsense and 4 frameshift ), 3 in TP53 (3 missense) and one in CHEK2 gene. Seven (25 % - 7/28) out of 28 pathogenic mutations in BRCA1 and BRCA2 genes were first described in this study, of which five were in the BRCA1, including a novel splice site mutation, whose pathogenicity was confirmed by transcript analysis and two in the BRCA2 gene. Among the VUS carriers 18 different were found variants, where two of them were described for the first time. The analysis of the three algorithms for protein prediction of VUS ( Polyphen, SIFT and AlignGVGD) showed that seven variants have been classified as probably pathogenic in at least one of them (four in one algorithm , two in two algorithms and one...

Application of four-in-one teaching mode in clinical probation teaching in the department of obstetrics and gynecology / 中华医学教育探索杂志

Objective To compare the effect of four-in-one teaching method and traditional teaching method in clinical clerkship teaching in the department of obstetrics and gynecology. Methods Totally 70 clinical probationer were enrolled(35 from 2007 grade were taken as control group and 35 from 2008 grade were taken as experiment group ). Four-in-one teaching method and traditional teaching method were respectively in experiment group and control group. Examination score and clinical skill re-sults were analyzed by t test and satisfaction degree was analyzed byX2 test. P<0.05 signifies statistical sig-nificances . Results Examination score of experiment group and control group were 86 . 9 ± 7 . 7 and 76.5 ±8.7 respectively with statistically significant differences(P=0.000). Clinical skill score of experi-ment group and control group were 87.6±6.9 and 75.9±7.5 respectively with statistically significant dif-ferences(P=0.000). Each questionnaire index was significantly higher in experiment group than in con-trol group with statistically significant differences(P=0.000). Conclusions Four-in-one teaching method can make students understand theoretical knowledge and master obstetrics and gynecology basic clinical skills,enhance interests in learning,build up self-confidence and establish preliminary clinical thinking ability and innovation ability which will lay a solid foundation for future clinical and research practice.

Evaluation of Associated Carpal Bone Fractures in Distal Radial Fractures

BACKGROUND: The purpose of this study was to investigate the frequency and distribution of associated carpal bone fractures (CBFs) in distal radial fractures (DRFs). METHODS: Three hundred and thirteen patients who underwent surgical treatment for DRFs between March 2007 and January 2010 were reviewed retrospectively. In this study, 223 patients who had preoperative computed tomography (CT) were included. We investigated the frequency and distribution of associated CBFs on CT scans. The relationship between the frequency of associated CBFs and patient factors such as age, gender, body mass index, and the mechanism of injury was assessed. RESULTS: CBFs were complicated in 46 of 223 DRFs (20.9%). The distribution of CBFs was 23 cases in the triquetrum, 16 in the lunate, 12 in the scaphoid, five in the hamate, and four in the pisiform. Among the 46 cases, a fracture of one carpal bone occurred in 36 cases, two in seven cases, three in two cases, and four in one case. In 10 of the 46 cases, associated CBFs occurred in more than two carpal bones. No significant differences were observed for age, sex, body mass index, or the mechanism of injury between patients with DRFs and CBFs and those without CBFs. CONCLUSIONS: Because CBFs that mainly occur in the proximal carpal row are complicated in DRFs at a relatively high frequency, assessment of carpal bones using CT scans is beneficial.