Development and application of drug-induced liver injury surveillance and assessment system / 中国药房

OBJECTIVE To establish the drug-induced liver injury （DILI） surveillance and assessment system （DILI-SAS）， and to improve the diagnostic efficiency of clinical DILI. METHODS The DILI-SAS was constructed by using natural language processing technology to mine and utilize all inpatient medical record data， and combined with Roussel Uclaf causality assessment method （RUCAM）. The medical records of 19 445 hospitalized patients from August 2022 to January 2023 were detected to verify the performance of the system and manually analyze the basic data of patients with DILI and the distribution of the first suspected drugs. RESULTS The overall accuracy rate of the DILI-SAS system was 91.95%， and the recall rate was 93.20%. Seventy-five DILI cases were detected， and the DILI incidence rate was 385.70/100 000 people. The efficiency of DILI monitoring by human- computer coupling was increased by about 60 times of manual monitoring； males （61.33%） and patients over 60 years old （56.00%） were the most common in the 75 cases of DILI. The clinical type of liver injury was hepatocyte injury （69.33%）， the incubation period was mainly 5-90 days after treatment （62.67%）， and the RUCAM score between 3 and 5 was the most common （66.67%）； pharmacological distribution of the first suspected drugs was mainly dihydropyridines， HMG CoA reductase inhibitors， proton pump inhibitors， etc. The specific drugs were atorvastatin， omeprazole， ceftriaxone， metronidazole and other drugs. CONCLUSIONS The establishment of DILI-SAS can improve the evaluation efficiency on the basis of ensuring the accuracy degree， and provide a solution for the early identification， diagnosis and evaluation of clinical DILI.

Advances in research on vascular assessment of lower extremity chronic total occlusion for interventional therapy / 西安交通大学学报(医学版)

Lower extremity chronic total occlusion (CTO) is the most severe manifestation of peripheral artery disease (PAD), with high amputation and mortality rates. As a minimal invasive reconstruction therapy, endovascular therapy (EVT) plays an important role in limb salvage for CTO in current clinical practice. The complexity of CTO lesions leads to a high risk for complications and a low success rate of EVT. Therefore, establishing a grading or scoring system to predict the success rate of revascularization strategy will be helpful in developing appropriate treatment strategies and assessing benefits and risks. This paper summarizes the most popular CTO scoring systems, such as PACSS grading, PARC grading, TAC grading, CTOP classification, Infrapop-CTO scoring, and J-BTK CTO scoring. PACSS grading and PARC grading are suitable for evaluating the severity of vascular calcification including iliofemoral segment, femoral-popliteal segment, and below-the-knee artery segment. TAC grading is suitable for grading calcification below the knee lesions; with low intervention success rate in a high calcification grading. CTOP classification was developed by analyzing the effect of morphological characteristics of proximal and distal fibrous caps of lower extremity CTO lesions on the outcome of EVT. The success rate of antegrade intervention is lower in type IV. The Infrapop-CTO score and J-BTK CTO score can predict successful anterograde crossing of infrapopliteal CTO lesions, with low intervention success rate in high score. Both scoring systems use three variables, namely, shape of proximal stump, calcification, and occlusion length.

Optimization of quality assessment system of clinical blood transfusion records / 中国输血杂志

【Objective】 To determine the value of quality assessment system in supervising standard clinical blood use and improving the quality of clinical blood transfusion medical records. 【Methods】 The clinical blood transfusion records of Children′s Hospital, Zhejiang University School of Medical every quarter from January 2019 to December 2022 were selected and extracted for evaluation by 5% to 10% for the current season. These blood transfusion medical records were scored and graded A(≥90 points)/B(80-89 points)/C(<80 points)according to the Evaluation Table of Clinical Science Rational Use of Blood in Children′s Hospital of Zhejiang University, and the annual A rate was statistically analyzed. After summarizing the deduction points, a rectification plan was submitted to the medical department and publicized on the hospital network. 【Results】 A total of 1 975 blood transfusion medical records were analyzed from January 2019 to December 2022, including 343 in 2019 (17.37%), 517 in 2020 (26.18%), 556 in 2021 (28.15%) and 559 in 2022 (28.30%), with Grade A rates at 67.06%, 92.07%, 93.17% and 91.06%, respectively. According to Pearson Chi-square test, the Grade A rates of blood transfusion records in 2020, 2021 and 2022 were significantly higher than those in 2019 (P<0.000 1). In the assessment, the main reasons for deduction of points were missed pre-transfusion immunization tests and missed blood transfusion course records. From 2019 to 2022, the missed rates of pre-transfusion immunization tests were 22.68%, 6.47%, 1.26% and 2.49%, and the missed rates of blood transfusion course records were 32.21%, 10.59%, 5.57% and 6.61%, respectively. 【Conclusion】 The regular and reasonable assessment and publicity system of blood transfusion medical records is conducive to improving the quality of blood transfusion medical records, promoting rational blood use and ensuring the safety of blood use for children.

Influence of tomoxetine hydrochloride on the cognitive processing of children with attention deficit hyperactivity disorder / 中华行为医学与脑科学杂志

Objective:To explore the influence of tomoxetine hydrochloride on the cognitive processing of children with attention deficit hyperactivity disorder (ADHD).Methods:From January 2018 to July 2021, 62 ADHD children who were treated with tomoxetine hydrochloride for the first time for(8±4) weeks were selected as the ADHD group.And 62 healthy children matched with age and sex were selected as the healthy control group.Pre-test and post-test by the Das-Naglieri: Cognitive Assessment System(DN: CAS) were performed to evaluate the cognitive function of all individuals.The differences of cognitive processing in pre-treatment and post-treatment of ADHD group were compared with those in healthy control group.The difference between before and after treatment of ADHD group was also compared.SPSS 26.0 statistical software was adopted for statistical analysis.The scores of ADHD group pre-treatment and post-treatment were compared by paired sample t-test, and the scores of ADHD group pre-treatment and post-treatment were compared with those of healthy control group by independent sample t-test. Results:Compared with healthy control group, there were lower of planning score((18.77±5.92) vs (28.56±5.55)), attention score((22.24±5.93) vs (29.56±6.16)), simultaneous processing ((34.21±7.75) vs (37.61±6.29)), successive processing((30.37±7.12) vs (33.74±5.43)), and the total scores((105.60±21.29) vs (134.84±22.87)) in ADHD group before treatment, and there were significant differences( t=9.49, 6.74, 2.68, 2.96, 7.36, all P<0.05). Compared with healthy control group, there were lower of planning score ((22.13±5.99)s), attention score((25.26±7.11) with significant difference( t=6.20, 3.60, both P<0.05) in ADHD group after treatment.And there was no significant difference in the simultaneous processing test and the successive processing test after treatment compared with the healthy control group(both P>0.05). In ADHD group, the scores of planning, simultaneous processing, attention, successive processing and the total score were significantly higher after treatment than those before treatment and there were significant differences( t=-6.03, -4.13, -4.77, -5.48, -8.59, all P<0.05). (2) Compared with the healthy control group, there were lower of matching number score and other 8 sub-test scales in DN: CAS test in ADHD group before treatment, and the differences were statistically significant (all P<0.05). Meanwhile, there were still lower of matching number score and other 4 sub-test scales in DN: CAS test in ADHD group after treatment, and the differences were statistically significant (all P<0.05). The matching number score and other 10 sub-test scales in DN: CAS test in ADHD group after treatment were all higher than those of before treatment(all P<0.05). Conclusion:The planning, attention, simultaneous processing, successive processing and total cognitive function of ADHD children were significantly improved after treatment with tomoxetine hydrochloride, special for simultaneous processing and successive processing.

Comparison of domestic and international elderly care needs assessment system and the implication / 上海预防医学

The construction of elderly care needs assessment system is conducive to realize the reasonable matching between care services and needs of the elderly， and to promote the effective allocation of pension resources. It is the basis and premise of the development of long-term care insurance system. Questions such as "Who is responsible for the assessment？ Who can apply for the assessment？ What is the assess tool？ How to pay the assessment fee？" are the core issues that need to be addressed in the construction of the evaluation system. This study compared the current situation of the elderly care needs assessment systems in China， the Netherlands， Germany， Japan and the United States from four aspects： assessment subject， assessment object， assessment cost source， and assessment tools’ dimensions. It has been a trend to entrust a third party for the evaluation work in pilot cities in China. Compared with foreign countries， domestic appraisers’ discipline and professional background are simpler. In foreign countries， the evaluation objects of elderly care needs are more extensive； the legal and financial support system of needs evaluation is more mature； and the evaluation dimensions are more objective and comprehensive. Based on this study， we suggest China to establish a national unified elderly care needs assessment system， cultivate professional assessment teams， expand the coverage of care needs assessment objects， improve the standards of assessment objects and assessment dimensions， and improve the law and financial support regulations related to needs assessment.

Exploration on the assessment system of teaching practice for postgraduate students of pharmacology / 中华医学教育探索杂志

Teaching practice is an important link in the process of postgraduate training. This paper analyzes the current situation and existing problems of postgraduate teaching practice, and discusses the influence of new teaching practice mode on postgraduate training. Aiming at the problems existing in the teaching practice of postgraduate students, this paper carries out the reform from five aspects: subject course learning, teaching preparation, theoretical teaching, experimental teaching participation and teaching management participation, and evaluates the implementation effect of the reform. Through the reform of postgraduate teaching practice, the teaching ability and social competitiveness of postgraduate students have been effectively improved. The new teaching practice mode provides new ideas and methods for the cultivation of postgraduate students' teaching ability.

Clinical evaluation on idiopathic pulmonary fibrosis / 中南大学学报(医学版)

Idiopathic pulmonary fibrosis (IPF) is a chronic fatal pulmonary disease characterized by complex illness condition. There is no effective treatment at present except lung transplantation. The comprehensive evaluation is helpful for the management of patients with IPF in hierarchical stages. Therefore, it is very important to evaluate IPF by various independent factors. At present, the commonly used methods for clinical evaluation on IPF include assessment of health-related quality of life, assessment of physiological function, assessment of imaging, assessment of laboratory examination, and multi-dimensional assessment system. However, there are different advantages and disadvantages on diverse evaluation methods for the evaluation of IPF.

Advances in risk assessment systems from non-clinical to clinical arrhythmia stages / 中国临床药理学与治疗学

The withdrawal of drugs from the market due to serious adverse reactions arising from the risk of cardiac arrhythmia has been a major concern for regulatory authorities in recent years. In 2005, the International Council for the Harmonisation of Registration of Medicinal Products for Human Use (ICH) issued preclinical S7B and clinical E14 guidelines for the evaluation of arrhythmia risk. The former includes in vitro hERG experiments and in vivo animal-based QT studies, while the latter is the TQT study (thorough QT study, TQT study). The high cost and conservative results of TQT studies have led to the introduction of new alternative methods, and the E14 guidelines were revised in 2015 and introduced concentration-QT analysis (C-QTc), based on the PK/PD (pharmacokinetics/pharmacodynamics) concept, by making full use of high-quality double-negative data from the non-clinical phase (double-negative, low risk of hERG tests at high clinical exposure, and low risk of QTc prolongation in vivo QTc study) makes it possible to substitute TQT studies based on specific situations. This article reviews the history of the development of E14 and its latest developments, analyses the specific situations in which C-QT can replace TQT studies through case studies, introduces the preclinical-clinical arrhythmia risk stage assessment system and compares the drug assessment process and decision making under different versions of E14 guidelines, with a view to providing a reference for the arrhythmia risk assessment system in China.

Comparative Evaluation of ICDAS, WHO and Histological Examination in Detection of Occlusal Carious Lesions / Avaliação comparativa de ICDAS, OMS e Exame histológico na detecção de lesões cariosas oclusais

A detecção de lesões cariosas oclusais através de sistemas de pontuação visual está em contínua validação com a profundidade histológica do processo de desminerização da cárie. Objetivo: O presente estudo teve como objetivo comparar o Sistema Internacional de Detecção e Avaliação de Cáries (ICDAS), o Sistema da Organização Mundial da Saúde (OMS) e o exame histológico na detecção de lesões cariosas oclusais. Material e Métodos: 20 pré-molares foram avaliados por exame visual ICDAS, OMS e exame histológico usando estereomicroscópio (SM) para a detecção de cárie oclusal. As superfícies oclusais foram avaliadas por dois examinadores, e todos os dentes foram avaliados visualmente e histologicamente. Resultados: Para cada um dos três sistemas, foi realizada uma análise do coeficiente de correlação interclasses, sendo que a diferença entre os três sistemas de detecção de cárie oclusal foi mínimo. O exame visual através da OMS registrou o maior coeficiente de intercorrelação seguido pelo sistema ICDAS, em seguida, o exame histológico, respectivamente. Conclusão: OMS e ICDAS demonstraram reprodutibilidade e precisão diagnóstica quando comparado com o exame histológico para detecção de cáries oclusais (AU)

Detection of occlusal carious lesions with visual scoring systems is in a continuous validation with the histological depth of carious demineralization. Objective: The present study aimed to compare the International Caries Detection and Assessment System (ICDAS), the World Health Organization (WHO) system and histological examination in detecting occlusal carious lesions. Material and Methods: 20 premolars were evaluated by visual examination using ICDAS, WHO and histological examination using stereomicroscope (SM) for occlusal caries detection. Occlusal surfaces were evaluated by two examiners then all teeth were visually and histologically assessed. Results: For each of three systems the inter class correlation coefficient was examined, the differences between the three systems of occlusal caries detection were minimal. The visual examination through WHO recorded the higher intercorrelation coefficient followed by ICDAS system then histological examination respectively. Conclusion: WHO and ICDAS have demonstrated reproducibility and diagnostic accuracy when compared with histological examination for detecting occlusal caries. (AU)

Toma de decisiones para el tratamiento de caries oclusales en el sistema de salud público brasileño / Decision-making for the treatment of occlusal caries in the Brazilian public health system

ABSTRACT Introduction: Caries diagnosis errors have become a public health problem. Objective: Verify the consistency in terms of decision-making between Brazilian dentists from the country's public health system and the International Caries Detection and Assessment System (ICDAS), and evaluate the influence of professional experience on the management of the decay. Methods: There are 80 dentists in the public health service of Recife city, Brazil. All dentists were invited to participate in this cross-sectional study. Forty dentists agreed to answer questions about their decision-making in relation to the treatment of occlusal caries in low, moderate and high-risk caries situations. The time of clinical experience, the use of methods for the assessment of caries risk and the lesion activity were also inquired about. The T-test was applied with a significance level of 5 por ciento to compare the correlation between the International Caries Detection and Assessment System scores regarding the mean age of participants. Results: The disagreement between the dentists and the criteria used by the International Caries Detection and Assessment System for decision-making were mainly related to the sound surfaces or lesions restricted to the tooth enamel. It was thus verified that lack of consistency for the low-risk condition reached a score of 3 (32 percent), while moderate (95 percent) and high-risk (85 percent) conditions lay at a classification code of 0. The time of professional experience was not considered to have interfered with decision-making on any scale, regardless of the risk condition of the patient (p> 0.05). Conclusions: A divergence in terms of decision-making between dentists of the public health system and the International Caries Detection and Assessment System could be observed, specifically regarding sound surfaces or surfaces with lesions restricted to the tooth enamel. Furthermore, professional experience was seen as not influencing the management of caries(AU)

RESUMEN Introducción: Los errores de diagnóstico de caries se han convertido en un problema de salud pública. Objetivo: Verificar la concordancia de la toma de decisiones entre los dentistas brasileños del sistema de salud pública del país y el Sistema Internacional de Detección y Evaluación de Caries (ICDAS), así como evaluar la influencia de la experiencia profesional en el manejo de la caries. Métodos: De los 80 dentistas que existen en servicio público de salud en la ciudad de Recife, Brasil, todos fueron invitados a participar en este estudio transversal. Cuarenta dentistas acordaron responder sobre su toma de decisión en relación con el tratamiento de la caries oclusal en situaciones de caries de bajo, moderado y alto riesgo. El tiempo de experiencia clínica, el uso de métodos para la evaluación del riesgo de caries y la actividad de la lesión también fueron cuestionados. La prueba T, para un nivel de significancia del 5 por ciento, fue aplicada para comparar la correlación entre los escores del Sistema Internacional de Detección y Evaluación de Caries en relación con el promedio de edad de los participantes. Resultados: El desacuerdo entre los dentistas y los criterios utilizados por el ICDAS para la toma de decisiones se concentró en los códigos de clasificación que representan superficies sanas o lesiones restringidas al esmalte de los dientes. Se verificó así que la falta de consistencia para la condición de bajo riesgo se concentró en la puntuación de 3 (32 por ciento), mientras que las condiciones moderada (95 por ciento) y de alto riesgo (85 por ciento) se concentraron en los códigos de clasificación de 0. El factor tiempo de experiencia profesional no interfirió en la prevalencia de concordancia de la toma de decisión para cualquier escore, independientemente de la condición de riesgo del paciente (p> 0,05). Conclusiones: Se pudo observar una divergencia en cuanto a la toma de decisiones entre los dentistas del sistema de salud pública y el Sistema Internacional de Detección y Evaluación de Caries, específicamente con respecto a superficies sanas o superficies con lesiones restringidas al esmalte de los dientes. Además, la experiencia profesional no influyó en el manejo de la caries(AU)

Construction of dynamic assessment system for practice base of professional master's degree in clinical medicine / 中华医学教育探索杂志

Objective@#To construct the dynamic assessment system for practice base of professional master's degree in clinical medicine.@*Methods@#The teaching managers, clinical experts, postgraduate tutors and postgraduates of seven tertiary general hospitals with standardized training qualifications for residents in Hunan province were selected. Using the literature review and site investigation, we drafted the framework and score-factor of the dynamic assessment indicator system and adopted the percentage system to construct the assessment system.@*Results@#We interviewed and discussed with 28 teaching managers, 21 clinical experts, 35 graduate tutors and 112 graduate students; the response rate of all interviewees was 100%. The dynamic assessment system was composed of 4 first-level indicators and 20 second-level indicators; the score-factor of the primary indicator was 25%, and the score-factor of the secondary indicator was 5%.@*Conclusion@#The established dynamic assessment system has reasonable indicators and strong operability, and can provide useful reference.

Application of multimodal epilepsy assessment system in focal cortical dysplasia-related epilepsy / 第二军医大学学报

Objective: To propose a multimodal epilepsy assessment system to guide the surgical treatment of patients with focal cortical dysplasia (FCD)-related epilepsy, and to explore its significance in improving the prognosis of patients with FCD-related epilepsy. Methods: Twenty-two epilepsy patients with FCD confirmed by postoperative pathology, who underwent surgical treatment at Second Hospital of Lanzhou University from Oct. 2016 to Nov. 2018, were enrolled. All patients were evaluated by multimodal epilepsy assessment system during the perioperative period. The assessment techniques included onset symptom assessment, structural imaging, long-term scalp video electroencephalogram monitoring, positron emission tomography-computed tomography, image fusion analysis, and magnetic resonance imaging (MRI). Engel efficacy grading system was used to assess the prognosis. Engel I grade was defined as good control for epilepsy and Engel II to IV as poor control. Fisher exact test was used to explore the influences of gender, age, pathological type, MRI examination, lesion location, duration of disease, and electroencephalogram-clinical characteristic-anatomical localization consistency on the prognosis of patients. Results: Twenty-two patients (13 males and 9 females) underwent surgical resection of the lesions, and were followed up for 4 to 28 months. There were 18 cases of Engel I grade, 2 cases of Engel II grade, 1 case of Engel III grade, and 1 case of Engel IV grade, with the good control rate being 81.8% (18/22). Fisher exact test analysis showed that disease duration and electroencephalogram-clinical characteristic-anatomical localization consistency were independent factors of efficacy of FCD-related epilepsy (P = 0.045 and 0.005). While age, lesion location, gender, pathological type and MRI findings had no significant effect on prognosis (all P < 0.05). Conclusion: The multimodal epilepsy assessment system can more accurately locate epileptogenic foci of patients with FCD-related epilepsy, providing a theoretical basis for epilepsy surgery. It is a comprehensive and accurate assessment method for epileptogenic foci.

Study of a screening system for mild cognitive impairment based on machine learning model / 上海交通大学学报（医学版）

Objective:To evaluate the reliability and validity of a computerized cognitive assessment system designed for screening mild cognitive impairment (MCI), and compare the screening accuracy among constructed different machine learning classification models. Methods:A group of random stratified samples of over 55 years old residents in the communities, nursing homes and memory-clinics from Shanghai and Henan were selected to assess their cognitive status using Montreal Cognitive Assessment (MoCA) by well-trained investigators. The reliability and validity were assessed by intrinsic consistency analysis and factor analysis, respectively. Taking the results of MoCA as standards, four machine learning classification algorithms, i.e., naïve Bayesian classification model, random forest classifier, Logistic regression classifier, and K-nearest neighbor classifier, were compared in accuracy and area under curve (AUC). Results:A total of 359 participants were included, the median age of whom was 63 years old. And 82.80% of them were secondary school graduates or below. According to the results of MoCA, 147 of them might be MCI. The Cronbach's α and KMO of this system were 0.84 and 0.78, respectively; Bartlett's sphericity test was significant (P<0.05); thirteen common factors could explain 75.10% of the system. The best classification model was naïve Bayesian classification model, and its accuracy and AUC were 88.05% and 0.941, respectively. Conclusion:The new designed computerized cognitive assessment system has been proved to be reliable and valid. The naïve Bayesian classification model has good classification accuracy.

Development of a mobile assessment system for combat-injury treatment training / 医学研究生学报

There are many problems in field training of mobile medical service units, such as lack of training ground, backward training methods, simple training methods and weak comprehensive treatment ability. The purpose of this study is to explore the research and development idea and application effect of mobile combat-injury treatment training assessment system, which consists of handheld mobile terminals, 3 function modules for training mode, training evaluation and inquiry, and 5 basic modules for comprehensive appraisal of training performance, recording and analysis of training results, facilitation of personalized training programs, multi-view summary of training performances and intelligent stratified management of trainees, respectively. This mobile assessment system makes the training equipment more portable, training means more convenient, training activities derestrict to time, place or weather and, as a result, the whole combat-injury treatment training more efficient.

Feasibility of Multi-dimensional Visual Hand Function Rehabilitation Quantitative Assessment System in Assessing Hand Function for Stroke Patients / 中国康复理论与实践

@#Objective To investigate the feasibility of Multi-dimensional Visual Hand Function Rehabilitation Quantitative Assessment System in the assessment of hand function for stroke patients. Methods From November, 2017 to July, 2018, 17 stroke inpatients were assessed with Fugl-Meyer Assessment-upper extremities (FMA-UE) and the Multi-dimensional Assessment System. Results The results of Multi-dimensional Assessment System positively correlated with the score of FMA-UE (r = 0.609, P = 0.010). Conclusion The Multi-dimensional Visual Hand Function Rehabilitation Quantitative Assessment System can be used to assess the hand function for stroke patients quantitatively.

A cognitive survey of the standardized training of residents in Chongqing / 中华医学教育探索杂志

Objective To investigate the cognition and attitude of check-up system in Standardized Residents Training Program in Chongqing, so as to provide further suggestions to improve teachers' qualifi-cation and examination management system. Methods From September 2016 to December, a questionnaire survey was conducted among 265 teachers and 59 teachers in Chongqing, which includes basic information of teachers and their cognition, satisfaction and suggestion of residents training examination management system. SPSS 21.0 was used to describe the survey results and the Spearman rank correlation analysis was conducted. Results 265 valid questionnaires were recovered, and the effective recovery rate was 100％. The survey showed that the teachers' cognition of resident training examination management system is good. Only 21 people (8％) completely had no knowledge of the management system of resident related assessment. A total of 90.6％ of the clinical mentors considered that a check-up system of clinical mentors on training should be implemented strictly during the period of clinical mentors on training. Only 167 (63％) of the hos-pitals had developed detailed assessment system for resident physicians. Conclusion Most of the teachers in Chongqing have a higher awareness of living and training management system, and it is universally recog-nized for strict process assessment. However, in terms of the standardized training examination system for residency, it needs improvement. It is suggested that the examination system should be perfected, the ex-amination management be strengthened, and the teachers' team be standardized.

The establishment and evaluation of the application of assessment system in the ability of physician-patient communication of pediatric residents / 中华医学教育探索杂志

Objective To explore the assessment system of humanistic communication in the grad-uation examination of pediatric residents. Methods A humanistic communication assessment program and an evaluation form were designed and put into practice in the graduation examination of pediatric residents in 2016 and 2017 in Beijing Children's Hospital affiliated to Capital Medical University and the scores were collected and analyzed to compare the differences in pediatric residents who have undergone system-atic physician-patient communication scene training and who didn't. With this analysis, the assessment system was further improved. Results Of all the 5 dimensions, communication content, nonverbal skills, and communication effects and the comparison of their respective scores were statistically significant. The scores of the residents who have undergone systematic physician-patient communication scene training are much better than those who didn't. Conclusion This assessment system focuses on the investigation of ability. From the design of examination questions and assessment scenes, to the evaluation of students per- formances, only when candidates have mastered the skills of communication can they do well in examina-tions and achieve good results.

Attitudes of nurses to the use of intelligent admission assessment system / 现代临床护理

Objective To investigate the nurses'acceptance for the intelligent admission assessment system. Method The user acceptance questionnaire of intelligent admission assessment system was developed to look into the attitude of 135 nurses. Results The self-designed questionnaire on user acceptance of intelligent admission assessment system was of good reliability and validity. The scores on intention and use behavior of nurses in ICU were lower than those in other departments (P＜0.05).The level of acceptance among the nurses having been worked for 21 to 31 years was higher than those for 1 to 10 years. There were no significant differences in age, education, professional title and position. Conclusions The intelligent admission assessment system is so easy to use that it is well-accepted among the nurses. However, the nurses in different departments and with length of nursing service differ in acceptability. They need more attention during the clinical application and training process.

Exploration of the clinical research implementation quality assessment system in top three hospitals / 中华医学科研管理杂志

Objective To set up the measurable Clinical Research Implementation Quality As sessment System in Top Three Hospitals.Methods The literature analysis,brain storm and Delphin Method were adopted to establish the evaluation indicators and related index weight,the assessment procedures and method were used in real clinic research for verification.Results An Assessment System,which was made up by five primary indexes,including research progress,ethical review,informed consent,case study and budget,as well as ten secondary indexes were established.Conclusions The Assessment System plays an important role in the evaluation of clinical research and appropriate for the process management of research implementation.

Establishment of perioperative risk assessment system for type A aortic dissection / 中华胸心血管外科杂志

Objective To explore the independent risk factors of the prolonged time of retention ICU after type A aortic dissection operation,to establish a corresponding perioperative risk assessment system.Methods A total of 509 consecutive patients with type A aortic dissection were enrolled in the study from September 2011 to May 2016,among which,418 patients received emergency operation.The prolonged retention time of ICU was considered as endpoint event.A perioperative assessment system was established through the analysis of related risk factors of the most common complications after type A aortic dissection operation.The possible risk factors of prolonged retention time of ICU were introduced into a single factor analysis.The meaningful variables in the single factor analysis were introduced into logistic regression analysis.The independent risk factors which were obtained from logistic regression analysis were used to establish risk prediction modeL,and the ROC curve and Hosmer-Lemeshow goodness of fit test were used to evaluate the model.Results The perioperative mortality rate was 8.64％,the prolonged retention time of ICU was 5.06 days,and 98 cases exceeded 7 days.The results of logistic regression analysis showed that age,the history of stroke,obesity,emergency operation,cardiopulmonary bypass time,deep hypothermic circulatory arrest time,renal inadequacy,massive transfusion,hypoxemia,and pulmonary infection were the independent risk factors for prolonged retention time of ICU.Accordingly,a mathematical model was established.The area under ROC cure for prediction model(AUC) =0.761,Hosmer-Lemeshow goodness of fit test P =0.512.Conclusion The logistic model estabhshed in this study can successfully predict ICU retention time after type A aortic dissection operation,and the efficacy was predicted satisfactorily.