Defects and Amendment Suggestions of Human Organ Transplantation Ordinance / 中国医学伦理学

This paper put forward suggestions on the Human Organ Transplantation Ordinance, including: clarify the priority of the protection of the rights and interests of organ owner in Article 1; conditionally increase the range of relatives who can donate cadaver organs; clarify whether relatives can donate cadaver organs of people without full civil capacity and strictly regulate them; allow matured juveniles to donate living organs under strict restrictions; distinguish between donor and organ owner in legal expression.

Validación de un instrumento para evaluar el nivel de conocimiento en la aplicación de fórceps obstétrico / Validation of an instrument to assess the level of knowledge about the application of obstetric forceps

Resumen OBJETIVO: Diseñar y validar un instrumento para evaluar el nivel de conocimiento en la aplicación del fórceps Salinas en médicos residentes de Ginecología y Obstetricia. MATERIALES Y MÉTODOS: Estudio descriptivo, transversal, tipo validación de un instrumento. El primer constructo se desarrolló con base en el marco teórico; el cuestionario fue objeto de análisis por parte de un grupo de expertos que se basaron en la metodología Delphi. Se obtuvo un constructo de 20 preguntas y se emprendió un estudio para evaluar la pertinencia del instrumento. La confiabilidad se evaluó con el coeficiente de Kuder-Richardson, prueba Kaiser-Meyer-Olkin y de esfericidad de Bartlett. Los datos se procesaron en el programa SPSS versión 21. RESULTADOS: El instrumento se aplicó a 66 médicos residentes con media de edad de 28.5 ± 0.7 años. El coeficiente de Kuder-Richardson fue 0.608. Las pruebas de Kaiser-Meyer-Olkin y Bartlett mostraron que se trató de un instrumento multidimensional. CONCLUSIONES: Se obtuvo un instrumento válido, confiable y multidimensional para determinar el nivel de conocimientos en relación con la aplicación del fórceps Salinas en médicos residentes de Ginecología y Obstetricia.

Abstract OBJECTIVE: To design and validate an instrument to assess the level of knowledge of Salinas forceps application in Gynecology and Obstetrics residents. MATERIALS AND METHODS: Descriptive, cross-sectional, validation-type study of an instrument. The first construct was developed based on the theoretical framework; the questionnaire was analyzed by a group of experts based on the Delphi methodology. A construct of 20 questions was obtained and a study was undertaken to assess the relevance of the instrument. Reliability was evaluated with the Kuder-Richardson coefficient, Kaiser-Meyer-Olkin test and Bartlett's sphericity test. The data were processed in SPSS version 21. RESULTS: The instrument was applied to 66 resident physicians with a mean age of 28.5 ± 0.7 years. The Kuder-Richardson coefficient was 0.608. The Kaiser-Meyer-Olkin and Bartlett tests showed that it was a multidimensional instrument. CONCLUSIONS: A valid, reliable and multidimensional instrument was obtained to determine the level of knowledge in relation to the application of Salinas forceps in Gynecology and Obstetrics residents.

A Comparison between Objective Structured Practical Examination and Traditional Practical Examination as an Assessment Tool in Biochemistry

Introduction: The competency based medical curriculum implemented in 2019 stresses on assessment systems aligned to the teaching-learning process. Assessment drives the learning process, so assessment tools have to be objective, uniform, valid and reliable. Traditional practical examination is more subjective and prone to examiner bias and is suspect to its validity and reliability. OSPE has been advocated as a tool to be used in CBME as it possesses the requisite criteria of an ideal assessment tool. However OSPE is not widely used in our st country. Methods: In this study the performance of 1 MBBS students in traditional practical examination & OSPE was compared & perception of students towards it evaluated. 150 first MBBS students of 2020-21 batch were included. Assessment by traditional and OSPE was conducted on “Blood sugar Estimation”. OSPE was conducted with 2 observer & 3 response stations. Mean was calculated and analysed for statistical significance using MS Excel. A well-structured questionnaire was administered to the same students and a feedback was obtained about the process of OSPE. Results: There was statistically significant difference between the mean scores of traditional format and OSPE (P <0.001). Analysis of students' feedback showed that more students found OSPE better in terms of scoring, passing and catering to psychomotor domain evaluation. Anumber of students felt that OSPE was more useful and comfortable than the conventional pattern of examination. Most students did not find OSPE intimidating and opined that it should be kept as assessment method in internal and university examination. Interpretation & Conclusion: Our study observed OSPE scores to be better than traditional format. OSPE eliminated examiner bias by integration of cognitive, psychomotor and affective domains. Therefore we conclude that OSPE though time and labour intensive, should be introduced and adopted as an assessment tool.

Exploration and Practice of Closed-loop Management of Drug Valid Date in the Intelligent Outpatient Pharmacy / 中国药房

OBJECTIVE：To explore the closed-loop management mode of drug valid date in the intelligent outpatient pharmacy，and to provide reference to improve the management level of drug valid date and ensure the safety of drug use in patients. METHODS ：The model and practice of closed-loop management of drug valid date in the intelligent outpatient pharmacy were summzired from the aspects of dispensing system ， logistics system ， temperature and humidity monitoring system ， management of drugs to be about to expired ，internal quality control and performance evaluation. The patients ’satisfaction degree of the indicators were compared between the new and old hospital districts. RESULTS ：The intelligent drug dispensing system ， logistics and information flow system ，temperature and humidity monitoring system were established in the new district of our hospital，and management system of drugs to be about to expire ，internal quality control and performance evaluation system were established. The workflow of drug validity management was optimized ，the pharmacy working environment was improved ，and the pharmaceutical service quality and pharmacy management level were improved. The results of satisfaction survey of outpatients in new and old distrcts showed that the indicators of patients ’satisfaction（service attitude ，work quality ，drug consultation ，waiting time）in new distrct were improved to different extents ，compared with old district. The satisfaction of special storage tips and waiting time in new district were all significantly higher than old district ，with statistical significance （P＜0.05）. CONCLUSIONS ： The design and management concept of intelligent outpatient pharmacy in our hospital has been significantly improved ，the drug valid date management is more scientific and reasonable than before ，and the patient satisfaction is improved.

Developing a Bank of Faculty-authored, Valid and Reliable Objective Questions for Institutional Use: Sharing the Experience

@#Introduction: With the increasing number of institutions implementing competency-based education which demands to provide feedback to students at regular intervals, there is an increase in the frequency of assessments. For this purpose, the written examinations using multiple choice questions (MCQs) are the most feasible form of assessment. However, constructing MCQs is an arduous task and significantly adds to the work-load of the academic staff members. To ease this burden, the institutions may consider to develop banks of valid and reliable MCQs. Methods: Based and built on our experience and literature review, the steps – relating to the process of constructing valid and reliable questions and development of question banks (QBs) – are the actions needed to develop new QBs or improve on the existing ones. Results: We have described ten practical steps for developing and banking of MCQs. The first five steps relate to the development of quality items and the remaining steps relate to the development of QBs, their maintenance, growth and safety and security. We have also established the criteria for selection and the frequency of reuse of questions. Conclusion: Using QBs will alleviate some of the burden of constructing novel quality questions needed for frequent assessments of students using 21st century teaching/learning approaches. The use of banked questions with known psychometric properties would allow the authorities to take charge and control of items’ quality and overall examination standards.

Comparative Study on the Valid Decision Mode of the Living Will / 中国医学伦理学

In the discussion on the establishment of the system of living will in China, the major controversy is whether the living will made by patients in medical treatment is valid. Different countries and regions have different decision-making modes for the validity of living will, which are mainly divided into patient-independent decision-making mode, physician based decision-making mode and family-based decision-making mode. On the basis of drawing lessons from international experience and combining with national conditions, this paper made a comparative analysis of the decision-making modes of the validity of living will. It is believed that the legislation of the decision-making of living will, which suits China's national conditions, should give priority to appointing agents from family members, consolidate the validity of living will through pre-consultation procedure, and confirming their rationality and legitimacy through legal custody and periodic review. In terms of legislative steps, it is suggested that non-legislative forms can be promoted first, and then incorporated it into legislation when conditions are ripe.

A literature review of the Ophiuroidea (Echinodermata) from the Pacific coast of Mexico / Revisión de literatura de Ophiuroidea (Echinodermata) de las costas del Pacífico de México

Abstract Despite the important effort of knowing the Ophiuroidea diversity in the Mexican Pacific, some mistakes in the taxonomic nomenclature have pervaded through time. In order to clarify the latter, a checklist based on literature review of brittle stars from the Mexican Pacific is provided. We reviewed a total of 105 references that in total summarized 125 species of brittle stars from the Mexican Pacific (112) and the Gulf of California (97), belonging to two orders, 16 families and 50 genera. These records are higher than those reported on previous studies carried out in the area. México is the country with the highest number of brittle stars reported in the Tropical Eastern Pacific; this may be due to its exceptional oceanographic conditions, location and coastline extension. However, a total of 27 species reported in the literature were considered doubtful due to their general distributions and were not included in the checklist. Of the reported species, 35 have their type locality in the Mexican Pacific, corroborating the importance of the country in the Tropical Eastern Pacific in terms of Echinodermata diversity. Rev. Biol. Trop. 63 (Suppl. 2): 37-47. Epub 2015 June 01.

Resumen A pesar del importante esfuerzo en el conocimiento de la diversidad de ofiuroideos del Pacífico mexicano, algunos errores en la nomenclatura taxonómica han perseverado a través del tiempo. Con el objetivo de clarificar lo anterior, se provee una lista de especies de ofiuroideos del Pacífico Mexicano, basada en la revisión de literatura. Se revisó un total de 105 referencias que en total suman 125 especies pertenecientes a dos órdenes, 16 familias y 50 géneros de ofiuros del Pacífico Mexicano (112) y el Golfo de California (97). Estos reportes son mayores que otros estudios llevados a cabo en el área. México es el país con el mayor número de ofiuros reportados en el Pacífico Oriental Tropical; esto puede deberse a su excepcional condición oceanográfica, ubicación y extensión de línea de costa. Un total de 27 de las especies reportadas en la literatura fueron consideradas dudosas de acuerdo distribución geográfica por lo que no fueron incluidas en la lista. 35 especies poseen su localidad tipo en el Pacífico Mexicano, corroborando la importancia de México en el Pacífico Oriental Tropical en términos de diversidad de equinodermos.

Study on the application of low temperature plasma sterilizer for endoscopic disinfection and cost, period of validity / 中国医学装备

Objective: To Study on the application of low temperature plasma sterilizer for endoscopic disinfection and cost, period of validity. Methods: Used duodenum mirrors were collected in December 2012-December 2013 in our department, respectively by low temperature plasma sterilizer with conventional disinfection sterilizer. To compare two methods of sterilization effect and cost, the period of validity. Results: Low temperature plasma sterilizer every time sterilization costs RMB (78.21+7.57), significantly higher than the conventional sterilizer (44.82 5.26) yuan (t=7.71, P<0.05);Low temperature plasma sterilizer sterilization is 5 to 7 months, longer than conventional sterilizer 9-28 d (t=12.50, P<0.05). Conclusion: Low-temperature plasma sterilization method has strong sterilization, temperature, rapid and long shelf life and other advantages, worthy of promotion and application.

Valoración de endotoxinas bacterianas en el inyectable ácido zoledrónico mediante la prueba de lisado del amebocito de Limulus / Assessment of bacterial endotoxins in Zoledronic acid injectable drug by using Limulus amebocyte lysate test

Objetivo: valorar las endotoxinas bacterianas por la técnica del lisado del amebocito de Limulus para el producto inyectable ácido zoledrónico, por el método de gelificación. Métodos: el ensayo se realizó mediante dos pruebas: 1) confirmación de la sensibilidad del lisado etiquetado, para lo cual se preparó una curva estándar con diluciones seriadas dobles de endotoxina por cuadruplicado; y 2) el ensayo del producto de inhibición, en el que se prepararon diluciones seriadas dobles de endotoxina con agua apirogénica y con las muestras de los lotes a ensayar sin sobrepasar la máxima dilución válida. Se determinó el punto final y se calculó la media geométrica. Se definió la dilución de trabajo, la cual se validó por cuadruplicado en tres lotes consecutivos. Resultados: la sensibilidad del lisado resultó 0,03125 UE/mL. La máxima dilución válida fue de 112 UE/mL y la dilución de trabajo 1/100. La cantidad de endotoxinas bacterianas presentes en tres lotes del producto inyectable no sobrepasó el límite establecido, por lo que cumplió con las especificaciones de calidad establecidas para el ensayo. Conclusión: la estandarización de las condiciones del método por gelificación, hace que este resulte eficaz, confiable, rápido y de fácil ejecución, por lo que puede emplearse como ensayo de rutina en el control de la calidad del inyectable analizado

Objective: To asses the presence of bacterial endotoxins in Zoledronic Acid injectable drug by using the Limulus amebocyte lysate test, particularly by the gelling procedure. Methods: The assay was performed in two tests: the first was the confirmation of labeled lysate sensitivity by preparing a standard curve with serial double dilutions of endotoxins four times, and the second was the inhibition product test in which serial double dilutions of endotoxins were prepared with apyrogenic water and with samples from the batches to be tested, without exceeding the maximum valid dilution. The end point was determined and the geometric mean was calculated. Working dilution was defined and then validated four times in three consecutive batches. Results: The lysate sensitivity was 0.03125 EU/mL). The maximum valid dilution and the working dilution were 112 EU/mL and 1/100 EU/mL) respectively. The amount of bacterial endotoxins present in three batches of the injectable drug did not exceed the set limit, so it complied with the quality specifications for this test. Conclusions: The standardization of the gelling method conditions makes it possible to state that this method is effective, reliable, quick and easy-to-perform, so it can be used as a regular test in the quality control of the analyzed parenteral drug

Assessment of Changes in Computerized Neurobehavioral Performance across Multiple Test Sessions / 대한산업의학회지

OBJECTIVE: A cross-sectional study was performed to assess changes in computerized neurobehavioral performance across multiple test sessions for developing a valid performance level and reducing test time. METHODS: The study was conducted on 118 male car painters exposed to low-dose, mixed organic solvents. The study controls were 113 unexposed reference workers matched for age and educational year from different sections of the same factory. Each worker completed a medical and occupational exam and questionnaire. Three tests of the Swedish Performance Evaluation System (5 minutes of Simple Reaction Time, 9 sessions of Symbol Digit, and 4 sessions of Finger Tapping Speed) were administered to each group. RESULTS: The mean age, mean duration of employment, and mean years of education were 33 years, 6.7 years, and 12 years in both groups, respectively. The mean reaction times of the Simple Reaction Time increased with the lapse of time. The known group difference between the exposed and control groups was larger for the first minute than for the successive 3 minutes. Both groups showed improved performance across the first to the seventh sessions on Symbol Digit. Following the seventh session, the performance levels of Symbol Digit had worsened. The t statistic of the two groups was the largest when the two mean reaction times were calculated from the sessions of the fifth to the seventh. In the dominant and non-dominant hands, the number of taps increased and decreased, respectively, across the sessions on Finger Tapping Speed. The known group difference was the largest when comparing the performances from the first to the second sessions. CONCLUSIONS: For valid interpretation and timesaving in computerized neurobehavioral tests, the following is recommended: one practice and one test session for Simple Reaction Time, four practice and three test sessions for Symbol Digit, and one practice and two test sessions for Finger Tapping Speed.

Vacuum Packaging Technique for Storing Sterilized Packs:An Applied Study / 中华医院感染学杂志

OBJECTIVE To explore the effect of vacuum packaging technique for storing sterilized packs in order to extend the period of valid storing.METHODS From 420 sterilized packages 210 were randomly taken as a test group,and the other 210 packages as the control group.According to aseptic techniques the packages of test group were vacuumized and the control group was packed as by outine protocol.Two groups were simultaneously stored in aseptic closet,and then regularly taken out 30 samples from two groups respectively for microbial(culturing).RESULTS Bacterial growth was seen in the control group at first month.But none of the specimens in test group showed any microbial growth until the eighth month.There was a statistically significant difference((P