Investigation and analysis of the training needs of scientific research ethics among medical graduate students in the context of science and technology ethics governance / 中国医学伦理学

ObjectiveTo investigate the training needs of knowledge of scientific research ethics and ethical review among medical graduate students in Shandong Province， and provide targeted suggestions for carrying out education and training on scientific research ethics for medical graduate students. MethodsA random sampling method was used to conduct a questionnaire survey among 807 medical graduate students from 7 medical colleges and universities in Shandong Province. The data were statistically described and analyzed， and Pearson’s chi-squared test and binary logistic regression were used to analyze the influencing factors. ResultsThere were 94.1% of medical graduate students believed that they “need” to receive training on knowledge of scientific research ethics. Their training needs were ranked as ethical principles of science and technology （75.5%）， the content of ethical review （68.5%）， ethical review process （68.3%）， ethical issues that may be involved in frontier fields （63.6%）， ethics committee system （58.1%）， applied ethical regulation for medical scientific research （55.8%）， and interpretation of relevant ethical documents （42.4%）. The training forms and methods were， in order， online knowledge lectures （67.4%）， academic conferences organized by relevant ethical review organizations （60.3%）， the teaching methods in traditional classrooms （48.8%）， learning by tutors or research groups （48.5%）， conducted by the unit during the internship and work period （26.4%）， and other forms （2.6%）. The results of the regression analysis showed that medical graduate students with experience in project application and ethics course learning have a higher willingness for training needs in scientific research ethics （P<0.05）. ConclusionThe education and training on scientific research ethics among medical graduate students still need improvement， and graduate students have an urgent need for training on scientific research ethics. Schools and hospitals should overall plan and set up a perfect science and technology ethics curriculum system， strengthen the practical training of medical research ethical review， and diversify the ways of scientific research ethics training for medical graduate students， to accelerate the improvement of research ethics literacy of them.

The Conjunction Logic of Collaborative Education between Medical Humanities Courses and Ideological and Political Courses / 中国医学伦理学

It is a new requirement of the new era that medical humanities courses and ideological and political courses should go together with each other. There is an inherent logic in the collaborative education of the two courses, which has the consistency of ideas, the commonality of goals, the intersection of contents and the mutual learning of methods. In practice, it is necessary to combine education with talent, theory with practice, indoctrination with penetration, online with offline, so as to improve the effectiveness of collaborative education between medical humanities courses and ideological and political courses.

Research on the Role of Ethical Governance of Science and Technology in Constructing a Harmonious Doctor-patient Relationship / 中国医学伦理学

The ethical governance of science and technology has put forward higher ethical requirements for researchers. As important personnel in medical research and front-line workers in contact with patients, clinical health workers should regulate their ethical behavior during the research process and provide informed consent to patients participating in study to protect their rights and interests. At present, patients’ rights and interests are still violated due to insufficient ethical awareness of researchers in the process of clinical research. Ethical governance of science and technology is not only a standard for researchers’ behavior and protection of patients’ rights and interests, but also a new test for scientific research management and ethical review departments, as well as an important measure to enhance the trust between doctors and patients and build harmonious doctor-patient relationship.

Value Rational Return of Medical Humanities Education under the Concept of People First / 中国医学伦理学

The concept of people first has important inspirations for the value rational return of medical humanities education in the new era. It is consistent with the educational value, curriculum attribute, and practical attribute of medical humanistic education, and puts forward new requirements for the value rational return of medical humanities education in terms of educational supply content, practical curriculum setting, educational development form, and educational effect evaluation. Medical colleges and universities should further adhere to the medical humanities education concept centered on people’s health, optimize the practice curriculum of medical humanistic education, innovate the practice platform of medical humanistic education, and construct a value evaluation mechanism of medical humanistic education, so as to promote the value rational return of medical humanities education under the concept of people first.

The Conjunction Logic of Collaborative Education between Medical Humanities Courses and Ideological and Political Courses / 中国医学伦理学

It is a new requirement of the new era that medical humanities courses and ideological and political courses should go together with each other. There is an inherent logic in the collaborative education of the two courses, which has the consistency of ideas, the commonality of goals, the intersection of contents and the mutual learning of methods. In practice, it is necessary to combine education with talent, theory with practice, indoctrination with penetration, online with offline, so as to improve the effectiveness of collaborative education between medical humanities courses and ideological and political courses.

Establishment of risk prediction model for acute myocardial infarction in elderly patients with hyperuricemia / 中华老年医学杂志

Objective:To establish a risk prediction model of acute myocardial infarction(AMI)in elderly patients with hyperuricemia(HUA).Methods:A total of 148 elderly patients with HUA in Shanghai Fourth People's Hospital Affiliated to Tongji University for prospective study from March 2020 to March 2021 were divided into AMI group and non-AMI group according to whether they were complicated with AMI.The baseline data of patients were recorded at admission and compared between the two groups.Multivariate Logistic regression analysis was used to examine the risk factors for AMI in elderly patients with HUA.And AMI risk prediction model was established.The ROC curves were plotted.Using the ROC curve, the prediction efficiency of AMI risk prediction model was evaluated.Results:Among 148 elderly patients with HUA, 22 cases(14.86%)had AMI.The proportion of smoking history in AMI group was higher than non-group( χ2=6.192, P=0.013). The diastolic blood pressure, systolic blood pressure, fasting blood glucose(FPG), low density lipoprotein cholesterol(LDL-C), serum uric acid(SUA)and homocysteine(Hcy)were statistically significantly higher in AMI group than in non-AMI group( U=1.973, 2.652, 2.016, 1.364, 2.151, 2.973, 5.972, P=0.049, 0.008, 0.044, 0.032, 0.003, <0.001). The multiple Logistic regression analysis showed that smoking history, high DBP, high SBP, high FPG, high LDL-C, high SUA and high Hcy were risk factors for AMI in elderly HUA patients( OR=3.120, 1.072, 1.887, 2.358, 3.365, 1.031, 3.773, P=0.016, 0.001, <0.001, 0.008, 0.028, 0.001, <0.001). By substituting the risk factor index and the regression coefficient into the Logistic regression equation formula, the obtained final fitting equation was: AMI=1.138×smoking history(no=0, yes=1)+ 0.070×DBP+ 0.635×SBP+ 0.858×FPG+ 1.213×low density lipoprotein+ 0.030×SUA+ 1.328×Hcy.The ROC curve was drawn and showed that the AUC of forecast value of AMI risk prediction model in predicting the risk of AMI in elderly HUA patients was 0.847, >0.80, which had certain predictive value.Hosmer-Leme show goodness of fit test χ2=5.743, P=0.676, P>0.05, the model had good correction ability and satisfactory fitting. Conclusions:AMI in elderly hyperuricemia patients are affected by multiple risk factors.The AMI risk prediction model is established via combining with multiple risk factors.The model has certain efficiency in predicting the occurrence of AMI in elderly patients with hyperuricemia.

Dosimetric study of hippocampal protective whole brain radiotherapy based on Varian accelerator / 中国辐射卫生

Objective The purpose of this study is to provide a reference for the selection of clinical radiotherapy plan by comparing the difference of dosimetry between coplanar dynamic intensity modulation dIMRT and coplanar VMAT plan in hippocampal protective whole brain radiotherapy (WBRT). Methods 10 patients were selected whose hippocampal were protected by WBRT, dIMRT and VMAT plans were designed for each patient, the differences of target dose, organ-endangering dose and machine hop count were compared between the two groups. Results The two technical plans PTV V30 Gy, D98% and D2% all meet the standard of RTOG 0933, which is better than the dIMRT group for the PTV HI VMAT group (P = 0.004). The hippocampal dose of dIMRT group was better than that of VMAT group, but it did not meet the standard of RGOT 0933. The average Dmax of hippocampus in dIMRT group and VMAT group was 18.44 Gy and 19.30 Gy, respectively (P = 0.004). The average value of hippocampal Dmin was 10.03 Gy and 10.77 Gy, respectively (P = 0.013), and the mean value of hippocampal Dmean was 14.20 Gy and 15.12 Gy, respectively (P = 0.002). The doses of lens, eyeball and optic nerve all met the standard of RTOG0933, and the dose of dIMRT group was significantly better than that of VMAT group (P = 0.000). The treatment time in VMAT group was significantly lower than that in dIMRT group. The treatment time in VMAT group was significantly lower than that in dIMRT group. Conclusion Varian dIMRT has more advantages in controlling hippocampal dose and protecting lens than VMAT, but PTV HI and treatment efficiency are higher in VMAT group.

Dosimetric comparison between dIMRT and VMAT for bilateral breast cancer / 中国辐射卫生

Objective To compare the dosimetric difference of target and organs-at-risk between intensity-modulated radiotherapy (dIMRT) and volumetric modulated arc therapy (VMAT) for bilateral breast cancer, so as to discuss the clinical feasibility of radiotherapy for bilateral breast cancer. Methods The clinical data of 18 patients receiving radical or modified radical mastectomy for confirmed bilateral breast cancer were enrolled in this study. dIMRT plans and VMAT plans were designed for each patient, and discuss the dosimetric data of two radiotherapy plans. Results Both the two plans satisfied the prescription. In terms of the homogeneity index, VMAT plans (0.09 ± 0.02) were superior to dIMRT plans (0.11 ± 0.01, P < 0.05). In terms of the conformity index,VMAT plans (0.82 ± 0.52) were superior to dIMRT plans (0.71 ± 0.51, P < 0.05). Furthermore, VMAT plans (0.98 ± 0.06) were superior to dIMRT plans (1.24 ± 0.08, P < 0.05) in the dose gradient index. The V10、V20、V30 and Dmean of lungs in VMAT plans (39.07 ± 4.92，22.19 ± 4.36，12.81 ± 4.71，1309.03 ± 135.55) were higher than those in dIMRT plans (30.34 ± 4.26，17.56 ± 4.31，6.77 ± 3.93，1201.39 ± 166.77, P < 0.05).Meanwhile, the V5 of lungs in VMAT plans (63.36 ± 9.02) was higher than that in dIMRT plans (58.01 ± 7.17, P > 0.05). However, the V5、V30 and Dmean of heart in VMAT plans (51.98 ± 3.60，3.78 ± 1.76，885.89 ± 59.84) were lower than those in dIMRT plans (77.16 ± 12.11，5.22 ± 2.85，1036.96 ± 151.46, P < 0.05). The Dmax of spinal cord in VMAT plans (2150.42 ± 136.19) was significantly lower than that in dIMRT plans (3008.23 ± 304.15, P < 0.05). Monitor units in VMAT plans（792.61 ± 62.53）was significantly lower than that in dIMRT plans (3225.33 ± 498.66, P < 0.05). Conclusion Although VMAT has many advantages: achieves better homogeneity index and conformity index of target areas, reduces the irradiation dose of organs-at-risk, especially, the irradiation dose of heart and spinal cord is significantly reduced, however, it increases the irradiation dose of lungs. To reduce the recurrence of grade ≥ 2 radiation pneumonia, dIMRT should be better considered in the application of radiotherapy for bilateral breast cancer.

Enlightenment and Reference of Foreign Medical Professional Spirit Cultivation to the Medical Ethics Quality Training of Excellent Medical Talents in China / 中国医学伦理学

Foreign medical professional spirit cultivation has made much successful experience in cultivating concept , cultivating mode , evaluation method , and so on .It provided important enlightenment for the medical eth-ics quality training of excellent medical talents in our country .Drawing lessons from the beneficial practice , we can do further attempts in the aspects of medical ethics quality training of excellent medical talents in our country .For example , we can enhance the humanity of the medical ethics quality training curriculums , explore the diversity of medical ethics quality training methods , adhere to the comprehensiveness of the medical ethics quality assessment , and strengthen the professionalism of medical ethics quality training organizations .

Focus Points of Medical Ethics Quality Training of Excellent Medical Talents / 中国医学伦理学

The present medical ethics quality training of excellent medical talents should always follow the edu -cation concept that profound moral tenet is the basis of medical science and the key of education is to shape one ' s mind , and focus on practice .The correct cognition of practical education is the precondition of medical ethics qual-ity training of excellent medical talents;the practice activities of classroom teaching are the basis of medical ethics quality training of excellent medical talents;the campus cultural practice activities are the guarantee of medical eth-ics quality training of excellent medical talents;the clinical practice is the key point of medical ethics quality train-ing of excellent medical talents;the social practical activities are the deepening of medical ethics quality training of excellent medical talents .

Necessity and Feasibility of Developmental Evaluation in Cultivating Medical Ethics of Preeminent Medical Talents / 中国医学伦理学

Compared with the evaluation method of the integration of formative evaluation and summation evalu-ation, development evaluation is based on the development of medical students ' medical ethics quality , takes the role of medical ethics in the cultivation of preeminent medical talents as clear goal , adjusts the enthusiasm of the teachers and students as the evaluation subjects by teacher evaluation , self -evaluation and mutual evaluation , comprehensively evaluates medical student ' s medical ethics awareness , medical ethics emotion and practice .It pays attention to the stage development and overall development of preeminent medical talents and meets the practi -cal situation of pilot class of the education training plan of outstanding doctors , the cultivation regularity of medical ethics quality and the development law of preeminent medical talents , thus to be necessary and feasible .

Analysis and Countermeasures on the Dilemma of Cultivation of Medical Ethics Quality for Excellent Medical Talents / 中国医学伦理学

The excellent medical talents education is a path of elite medical education .At present , the cultiva-tion of medical ethics quality of excellent medical talents is facing with the unidirectional medical ethics cognition education ,lacking humanistic care in the cultivation of medical ethics emotion , the utilitarian tendency of the culti-vation of medical ethics will and the formalization of the medical ethics practice .Therefore , medical colleges can improve medical ethics quality of excellent medical talents with reforming the traditional curriculum system , enric-hing the campus cultural activities and formulating scientific personnel training mode .

Present Situation Investigation and Comparative Analysis on Medical Ethics Quality Training Effectiveness of the Preeminent Medical Talents / 中国医学伦理学

Objective:To understand present situation and explore effectiveness of medical ethics quality train-ing on the Preeminent Medical Talents .Method: Questionnaires were used for investigating "Preeminent class"students of 2013~2016 level Fourth Order in order to grasp present situation of medical ethics quality and compare and analyse the stituation longitudinally .Result:The effectiveness of medical ethics quality training of senior grades"preeminent class" students is higher than junior grades "preeminent class" students , but the overall effec-tiveness is not very obvious .Conclusion:Attention should be paid on the top -level design with the the purpose of improving medical ethics quality training effectiveness on the Preeminent Medical Talents and its systematicness should be strengthened .We should not only regard the effectiveness more dialectically and emphasize its long -term effect and procedural ,but also strengthen its practical .

Enlightenment and Reference of Foreign Medical Professional Spirit Cultivation to the Medical Ethics Quality Training of Excellent Medical Talents in China / 中国医学伦理学

Foreign medical professional spirit cultivation has made much successful experience in cultivating concept , cultivating mode , evaluation method , and so on .It provided important enlightenment for the medical eth-ics quality training of excellent medical talents in our country .Drawing lessons from the beneficial practice , we can do further attempts in the aspects of medical ethics quality training of excellent medical talents in our country .For example , we can enhance the humanity of the medical ethics quality training curriculums , explore the diversity of medical ethics quality training methods , adhere to the comprehensiveness of the medical ethics quality assessment , and strengthen the professionalism of medical ethics quality training organizations .

Focus Points of Medical Ethics Quality Training of Excellent Medical Talents / 中国医学伦理学

The present medical ethics quality training of excellent medical talents should always follow the edu -cation concept that profound moral tenet is the basis of medical science and the key of education is to shape one ' s mind , and focus on practice .The correct cognition of practical education is the precondition of medical ethics qual-ity training of excellent medical talents;the practice activities of classroom teaching are the basis of medical ethics quality training of excellent medical talents;the campus cultural practice activities are the guarantee of medical eth-ics quality training of excellent medical talents;the clinical practice is the key point of medical ethics quality train-ing of excellent medical talents;the social practical activities are the deepening of medical ethics quality training of excellent medical talents .

Necessity and Feasibility of Developmental Evaluation in Cultivating Medical Ethics of Preeminent Medical Talents / 中国医学伦理学

Compared with the evaluation method of the integration of formative evaluation and summation evalu-ation, development evaluation is based on the development of medical students ' medical ethics quality , takes the role of medical ethics in the cultivation of preeminent medical talents as clear goal , adjusts the enthusiasm of the teachers and students as the evaluation subjects by teacher evaluation , self -evaluation and mutual evaluation , comprehensively evaluates medical student ' s medical ethics awareness , medical ethics emotion and practice .It pays attention to the stage development and overall development of preeminent medical talents and meets the practi -cal situation of pilot class of the education training plan of outstanding doctors , the cultivation regularity of medical ethics quality and the development law of preeminent medical talents , thus to be necessary and feasible .

Analysis and Countermeasures on the Dilemma of Cultivation of Medical Ethics Quality for Excellent Medical Talents / 中国医学伦理学

The excellent medical talents education is a path of elite medical education .At present , the cultiva-tion of medical ethics quality of excellent medical talents is facing with the unidirectional medical ethics cognition education ,lacking humanistic care in the cultivation of medical ethics emotion , the utilitarian tendency of the culti-vation of medical ethics will and the formalization of the medical ethics practice .Therefore , medical colleges can improve medical ethics quality of excellent medical talents with reforming the traditional curriculum system , enric-hing the campus cultural activities and formulating scientific personnel training mode .

Present Situation Investigation and Comparative Analysis on Medical Ethics Quality Training Effectiveness of the Preeminent Medical Talents / 中国医学伦理学

Objective:To understand present situation and explore effectiveness of medical ethics quality train-ing on the Preeminent Medical Talents .Method: Questionnaires were used for investigating "Preeminent class"students of 2013~2016 level Fourth Order in order to grasp present situation of medical ethics quality and compare and analyse the stituation longitudinally .Result:The effectiveness of medical ethics quality training of senior grades"preeminent class" students is higher than junior grades "preeminent class" students , but the overall effec-tiveness is not very obvious .Conclusion:Attention should be paid on the top -level design with the the purpose of improving medical ethics quality training effectiveness on the Preeminent Medical Talents and its systematicness should be strengthened .We should not only regard the effectiveness more dialectically and emphasize its long -term effect and procedural ,but also strengthen its practical .

Construction of medical ethics counseling system in China / 中华医院管理杂志

This paper, on top of its introduction of the concept of medical ethics counseling, analyzed the necessity of establishing a medical ethics consultation system in China.By reviewing the development of the medical ethics counseling system in other countries, the authors, in view of China′s medical practice, put forward specific recommendations on establishing a medical ethics counseling system in China.Issues on the construction of organ donation ethics counseling system in China were also discussed in focus.

Opportunities and Challenges Facing by Current Medical Ethics Cultivation in Medical Colleges and Universities / 中国医学伦理学

Medical students' medical ethics education is an important mission of medical college moral education.The current medical ethics cultivation is facing the profound reform of humanistic medical education,the gradual exploration and improvement of medical ethics education system,the development and application of online information platform,the establishment and development of china medical self-media alliance and other opportunities.Meanwhile,it is facing the differences in the motivations of students to study medicine,the diversified values,the sharp decline of professional teams,the deterioration of occupational environment and other challenges.In order to actively deal with opportunities and challenges,medical colleges and universities should establish the longitudinal three-dimensional medical ethics cultivation mode,form the horizontal collaborative pattern of medical ethics education,perfect the dynamic and long-term medical ethics cultivation safeguard mechanism,and improve the evaluation system that combined qualitative and quantitative.