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Objective:To explore the effect of early clinical clerkship training in the early exposure to clinical practice of eight-year program medical students.Methods:Experimental control method was used in this study. A total of 120 eight-year program medical students in the third year of Batch 2014 to 2016 from the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were selected as the research objects. The students of each grade were randomly selected by computer and divided into experimental group and control group, with 20 students in each group. Before early clinical exposure, the experimental group received 16 class hours of early clinical clerkship training, while the control group did not receive early clinical clerkship training. After the early clinical exposure, the clinical diagnosis and treatment ability of the two groups of students was compared. SPSS 24.0 software was used for t test. Results:The scores of medical history inquiry of experimental group and control group were [(17.45±1.96) points and (15.95±1.93) points; (18.30±1.03) points and (16.75±1.86) points; (17.95±1.36) points and (16.40±1.60) points, respectively]. The physical examination scores were [(17.75±1.65) points and (16.05±1.64) points; (17.85±1.18) points and (16.80±1.47) points; (18.25±1.16) points and (16.85±1.63) points, respectively]. The clinical judgment scores were [(18.15±1.42) points and (16.35±2.41) points; (18.20±1.24) points and (16.65±1.53) points; (18.35±1.35) points and (16.25±1.83) points, respectively]. Diagnosis and treatment scheme scores were [(17.15±1.57) points and (14.55±2.56) points; (17.30±1.42) points and (15.90±1.48) points; (17.80±1.06) points and (16.35±1.87) points, respectively]. The scores of communication skills were [(17.95±1.15) points and (17.00±1.19) points; (18.55±0.83) points and (17.45±1.50) points; (18.45±1.00) points and (17.45±1.23) points, respectively], with statistically significant differences (all P<0.05). Conclusion:The application of early clinical clerkship training in the early exposure to clinical practice of eight-year program medical students can improve the quality of students' clerkship.
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Hepatitis B virus infection and hepatitis C virus infection often progress to end-stage liver diseases such as liver cirrhosis, liver failure, and hepatocellular carcinoma, which endanger the life of patients. Recent studies have shown that gut microbiota are closely associated with chronic viral liver diseases. This article reviews the association of gut microbiota with chronic hepatitis B (CHB), chronic hepatitis C (CHC), and their related liver diseases and the research advances in therapies targeting gut microbiota against CHB and its related liver diseases, in order to provide more ideas for the clinical treatment of CHB, CHC, and their related liver diseases.
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Objective To discuss the clinical value of different methods in detecting helicobacter pylori (HP) infection.Methods 268 patients with digestive diseases were randomly selected by the method of generating random number through the computer,and detected by bacterial culture,rapid urease test (RUT) intrusion and silver staining,etc,invasive detection method,and using 13C-breath test(13C-UBT) and Helicobacter Pylon stool antigen detection,etc,non-invasive detection method,respectively.The positive detection rate and sensitivity,specificity,accuracy,positive predictive value and negative predictive value the difference was evaluated among the different methods.Results By comparing these methods of detecting HP infection,the specificity and accuracy of heavy silver staining method were 100.00％ and 97.01％,which were significantly higher than that of RUT and 13C-UBT(x2 =6.36,7.01,5.21,5.14,all P ＜ 0.05),Heavy silver staining method to detect positive predictive value was 100.00％,which were significantly higher than the 13C-UBT,negative predictive value was 89.19％,which were significantly higher than that of RUT method (x2 =6.04,6.34,all P ＜ 0.05),HP stool antigen test sensitivity,specificity,accuracy,positive predictive value were above 90.00％.Conclusion Sensitivity,specificity,accuracy rate,positive predictive value and negative predictive value of Heavy silver staining method and HP stool antigen test are high on detecting HP infection.
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A mouse model for acute hepatitis B virus (HBV) infection was established by using the hydrodynamical injection of mouse tail vein, in which the immunocompetent BALB/c mice were hydrodynamically injected with a competent replication plasmid pAAV-HBV1.2 having 1.2 fold over-length of HBV DNA. On day 1, 2, 4, 6 and 8 after injection, the levels of HBsAg, HBeAg and HBV DNA in blood serum were detected by using ELISA and fluorogenic quantitative PCR assay (FQ-PCR). And on day 8. HBsAg and HBeAg in liver tissue were assayed by immunohistochemical staining. It was found that HBsAg in blood serum could be detected on day 1 after infection in 14 of 16 mice (85.7%) injected with pAVV-HBV1.2 by using ELISA assay and the peak levels of HBsAg and HBeAg were attained during the first day after injection and then it dropped down gradually up to day 8 following injection. The titer of HBV DNA in blood serum attained its peak on day 2 and maintained a high level later on. On day 8 after injection, its titer was 1.9×10~4 copies/mL. The percentage of HBcAg-positive hepatocytes and HBsAg-positive hepatocytes in liver tissues were 5% and 2% respectively. Thus, by using the hydrodynamic injection with the competent replication plasmid, a mouse model for acute HBV infection is successively developed.
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Cost accounting is an important measure in hospital economic management.This article approaches the problems and their causes in cost accounting in army hospitals in terms of the correlation between income and cost,the normality of asset management,the accuracy of internal service cost,the advancedness of cost accounting techniques and so on.It also proposes a some corresponding countermeasures based on our work experience.