6. Perspectives on Researcher Development / 医学教育

In the new Model Core Curriculum, the objective stated is to "understand the importance of medical research for the advancement of medicine and medical care, and support innovation in medicine through involvement in academic and research activities, developing one's scientific thinking skills." Importantly, scientific background and researcher training education, such as laboratory assignments, are clearly positioned in the Model Core Curriculum and are available to all students. The curriculum consists of five components : Developing a research mindset, Understanding established theories, Conducting Research, Publishing Research, and Research Ethics. In addition, laboratory experience and practical training in basic medicine were also added to the description. Further policy and financial support for researchers will be necessary to increase the number of basic medical researchers in the future.

A survey on the scientific research competitiveness of newly-established medical universities — taking four medical colleges in Shanghai, Shaanxi, Zhejiang and Fujian of China as examples / 中华医学教育探索杂志

Objective:To provide reference for the construction and development of medical colleges and universities by comparing the scientific research competitiveness of four newly-established medical universities in Shanghai, Shaanxi, Zhejiang and Fujian of China.Methods:Four young state-owned medical universities, founded successively from 2015 in Shanghai, Shaanxi, Zhejiang and Fujian provinces, were selected as the research samples. Both CNKI and WoS databases were used to conduct comparative bibliometric analysis of high-quality literature published in core Chinese and foreign journals during 2016 to 2020 from such perspectives as number of papers, discipline distribution, source titles and funding, etc.Results:All four universities have displayed an increasing trend of publishing literature in core Chinese and foreign journals, but there are relatively fewer literature published in top international journals. The university from Shaanxi leads the other three with most indexes, and the two universities from Shanghai and Zhejiang stand close, while the one from Fujian lags behind, indicating a gap of scientific research competitiveness among the four.Conclusion:The reasons for the existing gap are potentially related to different college foundation and history, orientation and objectives, as well as the strength of scientific research team. Newly-built medical universities should keep deepening the comprehensive reform of medical education and strengthening comprehensive power of scientific research competitiveness.

Experiencia de aplicación de modelos de seguimiento de cumplimiento del perfil de egreso en el plan de estudios en las carreras de la Facultad de Medicina de la Universidad Finis Terrae / Experience of applying models for monitoring compliance with the graduation profile in the study plan in the careers of the Faculty of Medicine of the Finis Terrae University

El Perfil de egreso constituye un modelo teórico y la imagen del profesional que la institución de educación superior aspira formar. Es un conjunto de atributos que son certificados y le permiten a una persona ser reconocida y aceptada por la sociedad como profesional. La emergencia de estándares de calidad, utilizados por las agencias de acreditación de carreras universitarias, hoy exigen la necesidad de evaluar y rendir cuentas acerca del logro de las competencias establecidas y declaradas en el perfil de egreso, sin embargo, hay escasa evidencia concreta que demuestre modelos operativos de cómo abordar ese proceso de evaluación en distintos programas. Dada la relevancia del Perfil de Egreso de una carrera de pregrado y considerando que constituye el eje fundamental para el desarrollo curricular de los programas educativos, para realizar el proceso de autoevaluación y la posterior acreditación de las carreras, diseñamos e implementamos un modelo de seguimiento del cumplimiento del perfil de egreso en el plan de estudios de las carreras de la Facultad de Medicina de la Universidad Finis Terrae.

The Graduate Profile constitutes the theoretical model and the professional image that higher education aspires to form. It is a set of certified attributes and allows a person to be recognized and accepted by society as a professional. The emergence of quality standards, used by university careers' accreditation agencies, demands the need to evaluate and be accountable for achieving the competencies established and declared in the Graduate Profile. However, the is limited concrete evidence to demonstrate operational models of how to approach this evaluation process in different programs. Given the relevance of the Graduate Profile of an undergraduate career and considering that it constitutes the fundamental axis for the curricular development of educational programs, to carry out the self-evaluation process and the subsequent accreditation of the degrees, we design and implement a model for monitoring the compliance with the graduation profile in the study plan of the Faculty of Medicine of Universidad Finis Terrae.

Established Genital and Extragenital Lichen Sclerosus:A Clinicopathological Analysis / 中国医学科学院学报

Objective To investigate the clinicopathological characteristics of established genital and extragenital lichen sclerosus(LS)and compare the differences between them. Method The clinicopathological data of 55 patients with established genital and extragenital LS diagnosed by pathological examination in the Department of Dermatology of Beijing Hospital were retrospectively analyzed. Results The 55 patients included 11 males and 44 females.Among them,38,15,and 2 patients had genital lesions,extragenital lesions,and both genital and extragenital lesions,respectively.Extragenital LS mainly involved the back(14.55%)and extremities(7.27%).Among the patients,28.30% were asymptomatic,and 73.58% and 24.53% felt itchy and painful,respectively.The asymptomatic patients had a higher proportion in extragenital cases(

Relevance of Established Risk Factors for Carcinoma Breast in Indian Women.

Breast cancer is the most common cancer in women of India and across the globe. More than 2.1 million women were diagnosed to have breast cancer in 2018 worldwide. An incremental trend in incidence and mortality has been observed in South-Asian, low to middle income, developing countries. Age adjusted incidence in India is 25.8 per 100,000 women in India. The established risk factors for causation of carcinoma breast have been deduced primarily from Western studies and their applicability to Indian women remains varied. We wanted to evaluate the relevance of the established risk factors for carcinoma breast in patients presenting to our institute. METHODSThis case-control study included 65 patients with histologically confirmed diagnosis of carcinoma breast in the test group and 65 healthy women in the control group. All enrolled women were made to fill a questionnaire to assess for presence or absence of established risk factors in them. Results were obtained by calculating percentage of women with these risk factors in both arms. RESULTSAmong the established factors for carcinoma breast, 18.4% patients in the test group were obese compared to 12.3% women in the control group. This difference was found to be statistically significant with a p value of <0.02. However, there was no significant relevance between the two compared groups with respect to other risk factors studied. CONCLUSIONSWhile the established risk factors for carcinoma breast have been found to be relevant in multiple national and international studies, their applicability to specific populations such as those catered to by our institution varied. Out of all the established risk factors for carcinoma breast in the western population, the present study suggested significance only for obesity, with a BMI of ≥30 Kg/m2

Participación instituyente y política local mediante procesos y metodologías participativas: la construcción ciudadana del observatorio de la participación en Cuenca, Ecuador / Instituting Participation and Local Politics through Participatory Processes and Methodologies. Citizen Construction of the Participation Observatory in Cuenca, Ecuador

Resumen En este artículo se retoma la relación de la participación instituida y la participación instituyente en un proceso participativo en la Ciudad de CuencaEcuador provincia de Azuay, entre los años 2017 y 2018. A par tir de una investigación acción basada en un estudio de caso exploratorio, empleando técnicas participativas y cualitativas se encontraron como resultados que, (i) las metodologías participativas potencian la participación instituyente, (ii) la participación instituyente favorece la adaptación y mejora de los sistemas de participación de los gobiernos locales - participación instituida - y, finalmente (iii) el proceso participativo genera propuestas de prácticas democráticas directas, concretas e inclusivas.

Abstract This article retakes the relationship of the instituted participation and the instituting participation in a participatory process in the city of Cuenca-Ecuador province of Azuay, between the years 2017 and 2018. From an action research based on an exploratory case study, by using participatory and qualitative techniques were found as results that, (i) parti cipatory methodologies enhance instituting participation, (ii) instituting participation promotes the adaptation and improvement of the systems of participation of local governments - an instituted participation, - and finally (iii), the participatory process generates proposals for direct, con crete and inclusive democratic practices.

Acerca de los mecanismos de desconstrucción del orden social instituyente durante el momento adolescente / Sobre os mecanismos de desconstrução da ordem social instituída durante a adolescência / Regarding the mechanisms that deconstruct established social order during adolescence / À propos des mécanismes de déconstruction de l'ordre social institué au moment de l'adolescence

Los estudios desarrollados sobre la cuestión del súperyo en el momento adolescente, reconocen la posibilidad y la necesidad de distanciamiento del sujeto frente a esta figura, dejando no obstante abiertas las preguntas por los mecanismos de esta operación. En este artículo, se propone una lectura de esta problemática, mediante el análisis del vínculo entre el trabajo de posicionamiento adolescente frente al orden social instituyente y el trabajo de la sublimación en el sujeto. Con este propósito se propondrá comprender las posibilidades del sujeto de posicionarse éticamente frente a lo real, a partir de la construcción de un espacio subjetivo de transición, traducción y narración.

Os estudos desenvolvidos sobre a questão do supereu na adolescência reconhecem a possibilidade e a necessidade de distanciamento do indivíduo frente a esta aparência, deixando, ainda assim, abertas as perguntas sobre os mecanismos desta operação. Neste artigo, é proposta uma leitura dessa problemática, mediante a análise do vínculo entre o trabalho do posicionamento adolescente em relação à ordem social instituída e o trabalho da sublimação no indivíduo. Com esse propósito, a proposta será compreender as possibilidades de a pessoa posicionar-se eticamente frente à realidade, a partir da construção de um espaço subjetivo de transição, interpretação e narração.

Studies about the superego in adolescence acknowledge the possibility and need to distance individuals from this appearance; nevertheless, they leave certain questions unanswered regarding the mechanisms inherent to this behavior. This paper proposes a review of this issue through analysis of the bond between the process of teenage positioning regarding established social order and the process of sublimation in individuals. To this end, we suggest understanding individuals' ability to position themselves ethically facing reality, based on the establishment of a subjective place of transition, interpretation and narration.

Les études menées autour de la question du surmoi lors de l'adolescence reconnaissent la possibilité et le besoin d'établir une distance entre le sujet et ce concept, laissant néanmoins ouvertes les questions relatives aux mécanismes régissant cette manœuvre. Cet article propose une lecture de cette problématique par l'analyse du lien entre le travail de positionnement de l'adolescent face à l'ordre social instituant et le travail de la sublimation chez le sujet. C'est dans ce but que notre propos vise à comprendre les possibilités du sujet de se positionner de manière éthique face au réel à partir de la construction d'un espace subjectif de transition, de traduction et de narration.

Die Studien, die sich mit dem Über-Ich in der Adoleszenz befassen, bestätigen die Möglichkeit und Notwendigkeit der Distanzierung des Individuums vom Über-Ich, lassen jedoch Fragen zu den Mechanismen dieses Vorgangs offen. Dieser Artikel beschreibt einen Ansatz zu diesem Problem, wobei der Zusammenhang zwischen der Positionierung des Jugendlichen innerhalb der bestehenden gesellschaftlichen Ordnung und der Sublimierung des Subjekts analysiert wird. Dieser Ansatz ermöglicht es uns, die allfälligen ethischen Stellungnahmen des Individuums zur Realität zu verstehen, wobei zu diesem Zweck ein subjektiver Raum für den Übergang, die Auslegung und die Narration geschaffen wird.

Severe Cognitive Dysfunction and Occupational Extremely Low Frequency Magnetic Field Exposure among Elderly Mexican Americans.

Aims: This report is the first study of the possible relationship between extremely low frequency (50-60 Hz, ELF) magnetic field (MF) exposure and severe cognitive dysfunction. Earlier studies investigated the relationships between MF occupational exposure and Alzheimer’s disease (AD) or dementia. These studies had mixed results, depending upon whether the diagnosis of AD or dementia was performed by experts and upon the methodology used to classify MF exposure. Study Design: Population-based case-control. Place and Duration of Study: Neurology and Preventive Medicine, Keck School of Medicine, University of Southern California, 2 years. Methodology: The study population consisted of 3050 Mexican Americans, aged 65+, enrolled in Phase 1 of the Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE) study. Mini-Mental State Exam (MMSE) results, primary occupational history, and other data were collected. Severe cognitive dysfunction was defined as an MMSE score below 10. The MF exposure methodology developed and used in earlier studies was used. Results: Univariate odds ratios (OR) were 3.4 (P< .03; 95% CI: 1.3-8.9) for high and 1.7 (P=.27; 95% CI: 0.7-4.1) for medium or high (M/H) MF occupations. In multivariate main effects models, the results were similar. When interaction terms were allowed in the models, the interactions between M/H or high occupational MF exposure and smoking history or age group were statistically significant, depending upon whether two (65-74, 75+) or three (65-74, 75-84, 85+) age groups were considered, respectively. When the analyses were limited to subjects aged 75+, the interactions between M/H or high MF occupations and a positive smoking history were statistically significant. Conclusion: The results of this study indicate that working in an occupation with high or M/H MF exposure may increase the risk of severe cognitive dysfunction. Smoking and older age may increase the deleterious effect of MF exposure.

Marketing approaches and regulation analysis for Chinese materia medica products in European Union / 中草药

As European Union (EU) is one of the largest herbal markets in the world, EU registration is an important way for the internationalization of Chinese materia medica products. According to the current EU legislation, Chinese materia medica products can access to the EU market in the form of food supplements, drugs, cosmetics, and medical devices. This article discusses the main EU marketing approaches related regulations such as application of food supplements, well-established use (WEU), and traditional use (TU) of medicine. The purpose is to clarify the feasible way of EU registration for Chinese materia medica products and to provide reference for the Chinese enterprises which are aspiring to open up the EU market.

Leibniz e a teologia natural dos chineses / Leibniz and the natural theology of the Ch

O início da interpretação filosófica do pensamento chinês, com Leibniz, ocorre no epicentro de uma complexa disputa metafísico-religiosa entre os missionários católicos, na primeira metade do século XVII, denominada "querela dos rituais", que teve como polos duas concepções distintas referentes aos métodos de catequização a serem empregados no processo de conversão dos chineses ao cristianismo. Neste contexto, Leibniz posiciona-se a favor de uma das partes e, ao justificar sua postura, relaciona elementos do pensamento chinês com aspectos de sua filosofia. A teoria da harmonia preestabelecida é o ponto de partida de sua interpretação do pensamento chinês. Leibniz refuta a acusação de materialismo no pensamento chinês, ao observar que os conceitos de substância originária, para os chineses, e o de matéria, na perspectiva escolástica, eram duas coisas completamente distintas. A oposição de Leibniz ao pensamento escolástico e cartesiano mostra-se em sua forma mais clara na abordagem do problema da comunicação das substâncias ao refutar o dualismo com sua teoria da harmonia preestabelecida e sua concepção do universo como uma unidade orgânica, e esses dois aspectos são os elementos principais que ligam Leibniz ao pensamento chinês.

The beginning of the philosophical interpretation of Chinese thought, with Leibniz, takes place at the epicenter of a complex metaphysical-religious dispute among Catholic missionaries in the first half of the seventeenth century called "quarrel of the rituals", which was stirred by two distinct catechization concepts used to convert the Chinese to Christianity. In this context, Leibniz stands in favor of one party and to justify his stance, he associates elements of Chinese thought to aspects of his philosophy. The theory of pre-established harmony is the starting point of his interpretation of Chinese thought. Leibniz refutes the accusation of materialism in Chinese thought, observing that the Chinese concept of original substance and the concept of matter according to the scholastic perspective are completely different. Leibniz's opposition to the scholastic and Cartesian thought becomes most clear when he addresses the problem of communication of substances refuting dualism by means of his theory of pre-established harmony and his conception of the universe as an organic unity. Those two aspects are the main elements that associate Leibniz to Chinese thought.

Feasibility of establishing Shanghai Academy of Medical Sciences / 中华医学科研管理杂志

The idea of establishing Shanghai Academy of Medical Sciences was brought forward　in the background of great external changes.It was to meet the demand for resolving all kinds of　conflicts about researches arised from the long time operation of Medical Institutes in Shanghai.This　article mainly discusses about the necessity and plans for establishing Shanghai Academy of Medical　Sciences.

Free transfer of abductor hallucis combined with anastomosis of blood vessels and nerves for established facial paralysis: Assessment of long term effectiveness / 第二军医大学学报

Objective: To evaluate the long-term effectiveness of free transfer of Abductor hallucis muscle plus anastomosis of blood vessels and nerves for dynamic reanimation of the established facial paralysis. Methods: Twenty-eight patients who received the above-mentioned treatment during March 1999 to November 2006 were followed up. The follow-up period was 1 to 16 years, with a median period of 4 years. The facial pictures of frontal view were analyzed before and after operation. T-FGS and facial nerve function index (FNFI) were used to evaluate the facial nerve function before and after operation. Meanwhile, the survival of the graft, the width of the face, the scar, and the function of the foot were analyzed and compared. Results: All patients obtained satisfactory symmetric faces in static state and voluntary contraction of the transferred muscles. Twenty-two patients obtained ideal smiling faces. The T-FGS score increased by (27±7.2) points and the score of FNFI increased by (57± 10.7)% after transplantation (P<0.05). Furthermore, the scars on the face were well concealed and there was no functional impairment in the donor loots. Conclusion: Free transfer of abductor hallucis muscle plus anastomosis of blood vessels and nerves has satisfactory long term outcome in dynamic reanimation of established facial paralysis, without functional impairment to the donor foot and is worth of popularizing.

Comparing the Effects of Carvedilol Enantiomers on Regression of Established Cardiac Hypertrophy Induced by Pressure Overload / 한국실험동물학회지

Pressure overload diseases such as valvular stenosis and systemic hypertension morphologically manifest in patients as cardiac concentric hypertrophy. Preventing cardiac remodeling due to increased pressure overload is important to reduce the morbidity and mortality. A recent clinical study has shown that carvedilol has beneficial effects on the survival rate of patients with heart failure. This may be due to the actions of carvedilol such as beta-adrenoceptor blockade and the alpha1-adrenergic receptor blockade effects. Therefore, we investigated whether carvedilol can reverse preexisting cardiac hypertrophy and we compared the effects of racemic carvedilol and the carvedilol enantiomers. Cardiac hypertrophy was induced in rats by suprarenal transverse abdominal aortic constriction (AC). Fifteen weeks after AC surgery, concentric hypertrophy was identified in the AC group by performing echocardiography. Low dose S- and SR-carvedilol (2 mg/kg/day), which were orally administered for three weeks, caused significant regression of the cardiac hypertrophy, and this most significantly occurred in the rats that received S-carvedilol. However, R-carvedilol did not reduce cardiac hypertrophy. Regression of cardiac hypertrophy by carvedilol was confirmed on the echocardiograms and electrocardiograms. These results suggest that carvedilol could reverse the development of leftventricular concentric hypertrophy that is induced by pressure overload. S-carvedilol is proposed to be superior to SR-and R-carvedilol as a beneficial treatment for cardiac hypertrophy.

The Attempt to Develop a "Model Program" on the Basis of the Objectives Established by the Ministry of Health, Labour and Welfare in the New Postgraduate Clinical Training System / 医学教育

Clinical training programs play an extremely important role in the new postgraduate clinical training system introduced in 2004 because facilities for clinical training now include various health-related institutions in addition to the university hospitals and special hospitals for clinical training used in the previous system. Although educational goals have been established by the Ministry of Health, Labour and Welfare, trainees may have difficulty achieving these goals, even under the guidance of staff at the various facilities. There are differences in the function and quality of health-related institutions in the community. For the practical and convenient application of educational goals, we have attempted develop a “model program” to supplement the objectives indicated by the learning goals with more specific objectives. These supplementary objectives can be modified by individual institutions. We hope that this “model program” contributes to the development of objectives for each institution and helps improve the quality of the postgraduate training system in Japan.

The Analysis of Primary Origin in Spinal Metastasis Occurring as the Initial Manifestation of Malignancy

OBJECTIVE: The objective of this study is to delineate clinical features and specific diagnostic and therapeutic implications of spinal metastasis occurring as the initial manifestation of malignancy(SM-IMM)-a less common event than spinal metastasis in the setting of previously established malignancy(SM-PEM). METHODS: The authors reviewed retrospectively the clinical records of 19 patients in SM-IMM group at Korean Cancer Center Hospital between January 1, 2000 and December 31, 2001 and analyzed symptom duration, primary origin, treatment modality and survival time. Then 287 cases of SM-PEM group were searched for primary origin. RESULTS: Thyroid cancer(36.8%), metastasis of unknown origin(31%), liver cancer(10.5%) and stomach cancer (10.5%) were found as primary tumor in SM-IMM group. But in SM-PEM group lung cancer was most frequent primary tumor(22%), breast cancer(17%), stomach cancer(7.3%) and liver cancer (7.3%) followed. Primary pathology was confirmed with spinal decompressive surgery(7 cases), biopsy of spinal lesion(5 cases), and biopsy of other sites except spine(7 cases). Patients in SM-IMM group showed short symptom duration and multi-segmental involvement at diagnosis. And post-treatment survival time was short except thyroid cancer in spite of aggressive treatment(mean survival time, 2.7 months). CONCLUSION: SM-IMM group showed different profile from SM-PEM group on primary origin. And in the diagnosis of primary origin in SM-IMM group, important clues were provided with history taking, physical examination and PET.

Establishment and Analysis of Prescription Database of Chinese Patent Medicines Associated with Rheum-atic Diseases / 中国药房

OBJECTIVE:To utilize computer to give better service to clinical practice METHODS:About 4 000 prescriptions of Chinese patent medicines,derived from phamacon criteria:the Chinese traditional patent medicine volume 1～20 published by Ministry Health P R China,were logged into computer and corresponding database was established by using Microsoft Access database By searching the

Free transfer of abductor hallucis combined with anastomosis of blood vessels and nerves for established facial paralysis:assessment of long term effectiveness / 第二军医大学学报

Objective:To evaluate the long-term effectiveness of free transfer of Abductor hallucis muscle plus anastomosis of blood vessels and nerves for dynamic reanimation of the established facial paralysis.Methods: Twenty-eight patients who received the above-mentioned treatment during March 1999 to November 2006 were followed up.The follow-up period was 1 to 16 years,with a median period of 4 years.The facial pictures of frontal view were analyzed before and after operation.T-FGS and facial nerve function index(FNFI) were used to evaluate the facial nerve function before and after operation.Meanwhile,the survival of the graft,the width of the face,the scar,and the function of the foot were analyzed and compared.Results: All patients obtained satisfactory symmetric faces in static state and voluntary contraction of the transferred muscles.Twenty-two patients obtained ideal smiling faces.The T-FGS score increased by(27?7.2) points and the score of FNFI increased by(57?10.7)% after transplantation(P

Changes and Trends in the Newly Established Clinics in Korea / 예방의학회지

After medical insurance came into effect in Korea, health care system has undergone tremendous changes. Changing patterns of newly established clinics is one of them. To investigate changes and trends, a total of 10,184 clinics which were newly established from 1981 to 1990 were analysed. Data were obtained from the file of contracting medical facilities of the Federation of Medical Insurance Societies. The proportion of newly establishied clinics has increased gradually, so that they amount to 13% of the total medical facilities in Korea. Meanwhile, the number of newly established medium-size hospitals and general hospitals have decreased. The number of newly established clinics per 100, 000 populations has increased in the all areas, but the rate of increase has decreased in the cities except in 6 major cities in 1990. The rate of increase in newly established clinics surpasses that of population increase. This study has identified the trend of young physicians' early driving into their solo medical practice than before. This indicates chance of the medical specialty training nowadays toughen due to the limited openings in residency programs. However, the sex ratio of physicians at newly established clinics has not changed. The decreasing tendency to open medical practice without beds and the increasing size of clinics are found in this study(The size has been measured in terms of medical manpower, of beds, and of medical equipment in this study). Two thirds of general practitioners have opened their clinics without beds, although such trend has been less in the case of specialists. All three indicators show increasing size, especially in the case of rural clinics. However, among them, the number of medical equipments has increased most significantly from 8.9 items in 1981 to 12.9 in 1990.

Treatment of the Established Compartment Syndrome in the Forearm / 대한정형외과학회잡지

The treatment of the established compartment syndrome in the forearm varies along the degree of the severity. We reviewed 17 cases of the established compartment syndrome in the forearm treated at Seoul National University Hospital from February 1979 to July 1985. Follow-up was performed more than one year in 14 cases. And the mean follow-up period was 30 months. Out of 17 cases operated on, mild involvement were found in 5 cases. Moderate and severe involvements were observed in 6 and 6 cases respectively. Tenolysis-tendon lengthening was done for 7 cases and proximal release (muscle-sliding operation) was performed in 8 cases. In two cases, living muscle and skin were transfered using microsurgical technique. In mildly to moderately affected, functional improvements can be obtained in most cases. The proximal release was superior to the tenolysis-tendon lengthening in this category of involvement. However, in severely involved group, the functional gain after the operation is slight in spite of the time consuming, difficult surgery including free muscle transfer. The neurological problems could be gradually improved without treatment in almost all cases.