Comparison and reflection on training methods of Chinese and American pathologists: taking Duke University as an example / 中华医学教育探索杂志

Taking the Department of Pathology of Duke University as an example, this paper compares and analyzes the training mode of pathology residents in China and the United States. It is found that the organization and management system and supervision and assessment system of residency training in China have been improved, but it is still necessary to strengthen the in-depth implementation of humanistic education and training subjects for residents. Pathologist training should be based on "elite education" as the guiding ideology, to cultivate high-quality, high-level outstanding clinical pathology personnel as the specific goal, to build a solid foundation of clinical medicine.

Comparison of occupational exposure limits of hexavalent chromium compounds in China and foreign workplaces / 中国职业医学

@#Objective To compare and analyze the occupational exposure limit（OEL）of hexavalent chromium compounds in China and foreign countries. Methods The OEL and background information of hexavalent chromium compounds released by nine official and unofficial organizations in seven countries/regions were collected and sorted. The classification，limit levels， formulation principles and compound characteristics labeling of OEL were compared. Results The OEL values published by nine organizations ranged from 0.000 02 to 0.050 00 mg/m3 . Among them，the limits of seven organizations（including China） did not clearly distinguish the soluble types of hexavalent chromium compounds；the limits of eight organizations（including China）were calculated in terms of chromium；seven organizations（including China）have only developed OEL for long-term exposure. The OEL of hexavalent chromium in China was 0.050 00 mg/m3 which is relatively loose. Its carcinogenicity label was consistent with international standards，its sensitization label was consistent with some countries，and its percutaneous absorption label had not been included in the characteristic labeling of limit values. Conclusion It is suggested that the OEL of hexavalent chromium in China should be revised timely，and the systemic adverse effects caused by percutaneous absorption of hexavalent chromium compounds should be focused on. At the same time，it is recommended to systematically adjust the management concepts and principles of all carcinogens.

A comparative study of different methods of estimating glomerular filtration rate in a subset of Filipinos with normal renal function

@#Kidney function is commonly quantified using the glomerular filtration rate (GFR). However, the gold standard of measuring GFR, inulin clearance, is not practical for daily clinical use. This study compares different methods of GFR estimation based on serum creatinine, plasma levels of 99mTc-diethylenetriaminepentaacetic acid (DTPA), and camera acquisition of 99mTc-DTPA uptake. Seventy-five Filipino adults between ages 20 and 35 presumed to have normal kidneys were recruited. Each subject underwent gamma camera scintigraphy using the Gates and Inoue protocols after receiving a dose of 99mTc-DTPA. Blood samples were subsequently extracted at 1 hour and 3 hours after tracer injection, and GFRs were calculated based on single- and double-plasma sampling methods (SPSM and DPSM, respectively). Serum creatinine was also measured to derive GFR using the CKD-EPI, MDRD, and CockroftGault equations. Each method was correlated with a reference standard (DPSM) based on accuracy, linear regression, bias, and precision. SPSM tends to overestimate GFR unlike the other methods evaluated, but otherwise shows the most favorable diagnostic performance among the six methods when correlated with DPSM. The Inoue method appears modestly better than the routinely utilized Gates protocol, though both methods exhibit lack of precision. The CKD-EPI formula shows similar, if not slightly superior, diagnostic properties to the MDRD and Cockroft-Gault equations, thus confirming its validity for use in this Filipino population subset. Further studies are needed, particularly involving SPSM and CKD-EPI, to determine the applicability of our findings in Filipinos with varying degrees of kidney function. It is hoped that modifications to these methods can be made that are tailor-fit to derive more accurate and population-specific GFR values.

Comparison study on sampling methods of Oncomelania hupensis snail sur-vey in marshland schistosomiasis epidemic areas in China / 中国血吸虫病防治杂志

Objective To optimize and simplify the survey method of Oncomelania hupensis snail in marshland endemic re?gion of schistosomiasis and increase the precision,efficiency and economy of the snail survey. Methods A quadrate experimen?tal field was selected as the subject of 50 m×50 m size in Chayegang marshland near Henghu farm in the Poyang Lake region and a whole?covered method was adopted to survey the snails. The simple random sampling,systematic sampling and stratified ran?dom sampling methods were applied to calculate the minimum sample size,relative sampling error and absolute sampling error. Results The minimum sample sizes of the simple random sampling,systematic sampling and stratified random sampling meth?ods were 300,300 and 225,respectively. The relative sampling errors of three methods were all less than 15%. The absolute sampling errors were 0.221 7,0.302 4 and 0.047 8,respectively. Conclusion The spatial stratified sampling with altitude as the stratum variable is an efficient approach of lower cost and higher precision for the snail survey.

A comparison study of the big five personality characteristics in patients with first-episode, treatment-naive major depressive disorder / 中国神经精神疾病杂志

Objective To explore the big five personality characteristics of the first-episode, treatment-naive major depressive disorder. Method Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI) was used to assess the personality. A comparison was conducted between 112 first-episode, treatment-naive major depressive disorder (MDD) patients and 99 sex-, age- and education level-matched healthy controls (HC). The Hamilton depression scale (HAMD) was used to evaluate patients’symptom. Result Compared with HC, the neuroticism score in MDD group was significantly higher, while the extraversion, openness, agreeableness and conscientiousness were significantly lower. Lo?gistic regression analysis showed that MDD was significantly associated with higher neuroticism (OR=1.106, 95%CI:1.029~1.189, P=0.006) and lower extraversion (OR=0.809, 95%CI: 0.733~0.893, P<0.001) and agreeableness (OR=0.870, 95%CI:0.794~0.953, P=0.003). Linear regression showed that the HAMD score was significantly associated with higher neuroticism (B=0.121, P=0.003). The onset age of MDD was significantly associated with conscientiousness (B=0.015, P=0.001). Conclusion This study confirms that the personality of MDD is different from HC. Higher neuroticism is an important personality facets in treatment-naive patients with first-episode MDD. The low conscientiousness might associate with early age of depression onset.

<b>Difference Between Moxa Floss Made in Japan and in </b><b>China</b> / 日本東洋医学雑誌

<p>Direct moxibustion has been a common used moxibustion method in Japan, has required moxa floss of high-quality, and has promoted the development of a moxa floss manufacturing method unique to Japan. At the same time in China, because indirect moxibustion and the stick moxibustion method has been commonplace, low moxa floss of a purified standard has been produced with a simple manufacturing method. However well-refined moxa has become available in China recently, and it is now more similar to that in Japan.<br>In this study, we investigated the difference between highly-refined moxa made in Japan and China based on reports from Japanese clinicians on the usability of moxa in firsthand practice. We performed a questionnaire survey with the country of manufacture blinded in 265 moxibustion clinicians. The number of valid responses was 164 (61.9%).<br>To the question asking what the difference between the two types of moxa was, 54.9% of clinicians responded there was “a little difference,” and more than half responded with “better usability” and “favorability” for the Japanese moxa. Of 119 clinicians who performed moxibustion, 85 (71.4%) selected “comfort” for the Japanese moxa.<br>We therefore conclude that Japanese clinicians recognize moxa refined with the Japanese manufacturing method as more suitable for direct moxibustion treatment.</p>

Diagnostic Performance of Diffusion-weighted Imaging for Hepatic Neuroendocrine Tumor: Comparison with Combined Diffusion-weighted Imaging and Contrast-enhanced Magnetic Resonance Imaging

BACKGROUND/AIMS: To investigate the diagnostic performance of diffusion-weighted imaging (DWI) for hepatic neuroendocrine tumors (NET) compared with combined DWI and contrast-enhanced magnetic resonance imaging (MRI). METHODS: Fifteen patients with hepatic NET (n=128) underwent enhanced MRI and DWI with multiple-b values. We analyzed three different sets: Precontrast set; DWI set (added DWI); combined set (added enhanced image). Two reviewers rated possibility of NET using a 5-point scale for each image set. Their diagnostic performance was compared using Jackknife alternative free-response ROC (JAFROC). RESULTS: Diagnostic performance was better on the combined set (figure of merit [FOM]=0.852, 0.761) than the precontrast set (FOM=0.427, 0.572, P〈0.05) and the DWI set (FOM=0.682, 0.620, P〈0.05). However, DWI improved performance compared with precontrast set without statistical difference. In small NETs (〈1 cm), all sets showed low sensitivity (10.7-65.9%) with high specificity (95.4-100%). Interobserver agreement was moderate in all image sets (k=0.521 to 0.589). CONCLUSIONS: Combined DWI and enhanced MRI were more useful for detecting NET. Although statistically insignficant, there was a trend in improved diagnostic performance with DWI.

Method comparison studies in medicine

Most of important variables measured in medicine are in numerical forms or continuous in nature. New instruments and tests are constantly being developed for the purpose of measuring various variables, with the aim of providing cheaper, non-invasive, more convenient and safe methods. When a new method of measurement or instrument is invented, the quality of the instrument has to be assessed. Agreement and reliability are both important parameters in determining the quality of an instrument. This article will discuss some issues related to methods comparison study in medicine for the benefit of medical professional and researcher. METHOD: This is a narrative review and this article review the most common statistical methods used to assess agreement and reliability of medical instruments that measure the same continuous outcome. The two methods discussed in detail were the Bland-Altman Limits of Agreement, and Intra-class Correlation Coefficient (ICC). This article also discussed some issues related to method comparison studies including the application of inappropriate statistical methods, multiple statistical methods, and the strengths and weaknesses of each method. The importance of appropriate statistical method in the analysis of agreement and reliability in medicine is also highlighted in this article. CONCLUSION: There is no single perfect method to assess agreement and reliability; however researchers should be aware of the inappropriate methods that they should avoid when analysing data in method comparison studies. Inappropriate analysis will lead to invalid conclusions and thus validated instrument might not be accurate or reliable. Consequently this will affect the quality of care given to a patient.

Theory of mind in patients with bipolar disorder / 中华行为医学与脑科学杂志

Objective To explore whether patients with bipolar disorder are deficit in their theory of Mind (ToM) and the factors influencing the ToM.Methods Three groups (27 with bipolar disorder,27 with schizophrenia,and 26 in health control) were tested.All subjects' ToM was assessed by Faux pas Questions and IQ by WAISR.The symptoms of groups of patients were measured by Positive and Negative Symptom Scale (PANSS).Results Three groups' scores of Faux pas Questions(ToM scores) displayed significance(One-Way ANOVA:F(2,77) =13.686,P =0.000) ; Post-hoc test (Games-Howell) showed that ToM scores (13.81 ± 5.66) of bipolar disorder group were lower than those of the control group (17.04 ± 3.79) and higher than the schizophrenia group (9.44 ±6.13).The difference was significant (P =0.048,0.024).Independent sample t test showed that ToM scores of gender in bipolar disorder group were not significant (male:13.20 ± 6.07,femal:14.58 ± 5.26,t =-0.623,P =0.539).There was no correlation between ToM scores of patients with bipolar disorder and their age,years of education,age of onset,duration of illness,scores of negative,positive and general psychiatric rating scale of PANSS,and IQ (＞ 70).Linear regression by stepwise regression was used on each specific symptom of the PANSS,and according to the outcome,related factor was selected as independent variables,the ToM scores as the dependent variable.The regression equation was ToM scores =21.79-1.53 G12-3.16 N6 ;R2adjust was 0.46.Conclusion Patients with bipolar disorder as a whole compared to the control have deficit in their ToM,and the deficit is less than that of patients with schizophrenia.G12 and N6 of the PANSS are the influencing factors,which explain 46％of the variation sources.

Prediction of Chinese Translational Research Organizations——Illuminations of Research Organization Comparison between American and China / 中华医学科研管理杂志

translational research highly depends on Translational research organizations.America is the leading country in science and technology. It is very important to learn from America successful experience in order to develop perfect translational research organization.This paper analyzed the needs of changing the current research organization,and provided some suggestions for Chinese translational research organization based on understanding the differences between America and Chinese present research organization.

Comparison of student performance after lecture-based learning and case-based/problembased learning in vascular surgery teaching / 中华医学教育探索杂志

Case based learning/problem-based learning ( CBL/PBL ) is a new teaching method based on traditional medical education methods.In order to conquer the deficiency of traditional education methods in autonomous study motivation and ability of knowledge integration, CBL/PBL has been introduced into vascular surgery teaching procedure since 2006.The quality and effort of CBL/PBL compared with lecture-based learning ( LBL ) were evaluated and scored. The outcome of this teaching innovation shows CBL can arouse students' desire in autonomous study and enhance their ability in clinical analysis.But, its superiority is difficult to develop in the current medical education system.

Comparison study of family functioning of adolescents with anxiety disorders / 中华行为医学与脑科学杂志

Objective To explore family functioning and related factors in anxiety disorder(AD)adoles cents.Methods 84 adolescent patients with AD and 124 controls without mental disorder matched by gender,age,and residential township were assessed with Family Adaptability and Cohesion Scale(FACES-Ⅱ),Family Assessment Device.Chinese version(FAD-CV)and demographic questionnaires.Results There were statistical differences between case and control groups in family economic conditions(P<0.05).There was lower family cohesion in AD group(64.82±9.63)than that in the control group(69.72±8.91);the scores of communication,emotional involvement and behavioral control were higher in AD group((2.34±0.45),(2.52±0.44),(2.46±0.32))than that in controls((2.12±0.34),(2.36±0.42),(2.24±0.24)),all P<0.05.Logistic regression analysis showed that better family economic condition(OR=0.784;95%CI:1.459-3.396)and higher cohesion of family(OR=0.969;95%CI:0.942～0.998)were protective factors for AD,while over-strict behavioral control (OR=2.181;95%CI:0.993～2.441)was a risk factor for AD.Conclusion There are different family functioning characters between AD and controls,and the intimacy relationship and suitable behavior control in family may improve the mental health of adolescents.

Case comparison study of the compliance influencing factors for colorectal cancer screening among residents in urban communities / 中华医院管理杂志

Objective To identify the compliance and influencing factors of colorectal cancer screening among urban communities. Methods People in urban communities are categorized as the case group, comparison group A and comparison group B, according to whether they receive questionnaire survey, FOBT test, intestine mirror, and different follow-up results in this screening test Results No significant differences (P>0.05) are found among people from different groups. In the survey for screening related knowledge, understanding of such knowledge is significantly higher than the comparison group(P>0.01), and the knowledge of comparison group A is higher than that of comparison group B. Conclusion The higher their knowledge in screening, the higher their compliance for screening.

Comparative Study of Lumbar Magnetic Resonance Imaging and Myelography in Young Soldiers with Herniated Lumbar Disc

OBJECTIVE: This study was undertaken to compare the diagnostic performances of magnetic resonance imaging (MRI), MR myelography (MRM) and myelography in young soldiers with a herniated lumbar disc (HLD). METHODS: Sixty-five male soldiers with HLD comprised the study cohort. A visual analogue scale for low back pain (VAS-LBP), VAS for leg radiating pain (VAS-LP), and Oswestry disability index (ODI) were applied. Lumbar MR, MRM, and myelographic findings were checked and evaluated by four independent radiologists, respectively. Each radiologist was asked to score (1 to 5) the degree of disc protrusion and nerve root compression using modified grading systems devised by the North American Spine Society and Pfirrmann and the physical examination rules for conscription in the Republic of Korea. Correlated coefficients between clinical and radiological factors were calculated. Interpretational reproducibility between MRI and myelography by four bases were calculated and compared. RESULTS: Mean patient age was 20.5 +/- 1.1. Mean VAS-LBP and VAS-LP were 6.7 +/- 1.6 and 7.4 +/- 1.7, respectively. Mean ODI was 48.0 +/- 16.2%. Mean MRI, MRM, and myelography scores were 3.3 +/- 0.9, 3.5 +/- 1.0, and 3.9 +/- 1.1, respectively. All scores of diagnostic performances were significantly correlated (p < 0.05). However, none of these scores reflected the severity of patients' symptoms. There was no statistical difference of interpretational reproducibility between MRI and myelography. CONCLUSION: Although MRI and myelography are based on different principles, they produce similar interpretational reproducibility in young soldiers with a HLD. However, these modalities do not reflect the severity of symptoms.

The Comparison with Health Promoting Life Styles of People between Demonstrating and Non-Demonstrating Health Promotion Services in Rural Community / 農村醫學 地域保健

OBJECTIVES: This study was to compare with health promoting Life styles of people between demonstrating and non-demonstrating health promotion services in rural community. METHODS: Objects of the study were 13,000 people by stratified sampling in rural community of H and J Gun in Korea. Data were collected from 1st December to 30th, 2005, using structured questionnaire. Research tool of this study were modified Korea BRFSS, Park's stress questionnaire and Nutritional evaluation tool suggested by ministry of health & welfare in Korea. RESULTS: People received demonstrating health promotion services were significantly more good health promoting life styles in related drinking, exercise and stress than that of non-demonstrating health promotion services. CONCLUSIONS: There were significantly higher health promoting Life styles of people received demonstrating health promotion services than that of non-demonstrating. Government supporting health promotion services was more effective than that of local government finance.

Enlightenment for Postgraduate Education in Our Military Medical Universities in China Derived from America and Japan / 中华医学教育探索杂志

We analyzed the characteristics of postgraduate education in military universities in America and Japan,including idea of education development and system of administration,and drew on the useful experiences in this regard for military universities in China.The topic is practically significant for current reformation and development of postgraduate education in military universities in China.

Comparison of the Medical Scientific Thoughts and the Medical Moral Thoughts / 中国医学伦理学

In the thesis we elucidate the connotation,correlative concept of medical scientific thoughts and the medical moral thoughts,emphasize the direction and method of the two thoughts.Through comparison,we find that the two thoughts have great differences in the direction,motive and manifestation while they have in common in the origin,foundation and destination.

Comparison Study Between Rush Nailing and Ender Nailing in the Treatment of Fracture of the Tibial Shft / 대한정형외과학회잡지

Fracture of the tibial shaft is one of the most common fracture of the long bones and, due to its frequency and easy accessibility to traumatic insults, it is frequently complicated with malunion, delayed union and nonunion, and osteomyelitis. Recently, closed flexible intramedullary nailing of the fracture of the long bones has gained popularity. And its application to the tibial shaft fracture is reported to meet the object of fracture treatment by providing maintenance of reduction and by allowing early mobilization of the injured leg. There are other advantages such as stimulation of forming external callus by allowing some motion at fracture site, adequate fixation without exposure of the fracture site. Authors carried out retrospective study of the 56 tibial shaft fractures in 54 patients which were fixed with Rush nails (31 tibial fracture in 30 patients) or Ender nails (25 tibial fractures in 24patients). The results were analyzed to compare the effectiveness of these two methods. The results were as follows: 1. Tibial fracture treated with rush nailing united clinically at 15.7 weeks and united radiologically at 21.8 week on an average postoperatively. 2. There was a tendency of earlier healing of fracture of tibial shaft treated with Ender nailing:clinical union and radiological union were obtained at 12.8 weeks and 18.8 weeks on an average, respectively. 3. Ender nailing has advantage such fracture fragment during insertion. 4. Additional insertion of Ender nail as ease of nailing, low incidence of displacement of undisplaced provided greater stability at the fracture and it was attributable to earlier healing of tibial fracture treated with Ender nailing. 5. Rush and Ender nailings failed to maintain reduction of the fracture of proximal tibia shaft. As the advantages of Ender nailing surpass those of Rush nailing, authors have preference of Ender nailing in the treatment of the tibial shaft fracture.