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Objective:To investigate the effect of curriculum on the awareness and attitude on the rural-oriented medical education among medical students.Methods:The grade 2019 and 2020 medical students of rural-oriented program in Hebei Medical University were enrolled. Two different curricula were adopted in the first year, for students of grade 2020 more courses in general medicine, humanities and social sciences were added, and not for those of grade 2019. A questionnaire survey was conducted at the end of their first academic year. The questionnaire contained the basic information of students, opinions and satisfaction with curriculum design, understanding of policies about rural-oriented medical education, and the sense of career identity; each item in the questionnaire was scored by 5-point Likert scale.Results:A total of 173 questionnaires were distributed and 161 valid questionnaires were recovered, with a recovery rate of 93.1%; there were 55 responders (15 males and 40 females) from grade 2019, and 106 from grade 2020 (52 males and 54 females). The main reasons for choosing rural-oriented program were job security (60.0% (33/55) in 2019 and 58.5% (62/106) in 2020), the main way to know the relevant policies of the program was through the internet (54.5% (30/55) in 2019 and 66.0% (70/106) in 2020); 34.5% (19/55) of grade 2019 students were willing to continue working in rural areas after contracted period of service, while the percentage was 47.2% (50/106) for grade 2020. Students in grade 2020 had a higher satisfaction scores on the content and quality of teaching courses, as well as teaching satisfaction compared to those in grade 2019( t=2.34 and 3.00, P<0.05). The awareness of relevant policies before enrollment and policies related to contract violations among grade 2020 students was higher than that of grade 2019( t=2.70 and 5.08, P<0.05); the scores of all questions about general practice answered by students in grade 2020 were higher than those in grade 2019( t=3.96, 3.37, 3.55, 2.85, 3.84, 5.26 and 5.10,all P<0.05). There were no statistically significant differences in the scores of cognitive, emotional, behavioral, and adaptive aspects of career identity between students of two grades( t=0.70, 0.78, 0.74 and 1.37,all P>0.05). Conclusions:The reformed curriculum has positive effect on the satisfaction and awareness of rural-oriented medical education program and relevant policies among medical students in the program; however, it has less effect on the sense of career identity and willingness to continue to work in rural areas after the contracted period of serve.
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Objective:To investigate the status quo and training needs of general practitioner (GP) job-transfer training program in Hebei Province.Methods:An online survey with self-designed questionnaire was conducted on May 2019 through WeChat among 165 trainees in the General Practice Training Center of Hebei Province. A total of 165 questionnaires were distributed and 149 were valid with an effective rate of 90.3%. The contents of the questionnaire included the basic information of the trainees, the evaluation of the current training, and the needs of the GPs′ job-transfer training.Results:Among 149 participants, there were 131 (87.9%)from the secondary hospitals or above, 146(98.0%)with bachelor′s degree or above, and 128 (85.9%)with intermediate or above professional titles. The survey showed that 72.0%(67/93)thought the main reasons affecting participation in the training were busy work load and insufficient personnel, the main problems of training were too short training duration(45.2%, 42/93), the not focused training contents(38.7%, 36/93) and lack of practice(37.6%, 35/93). In the 149 trainees, 136(91.3%) thought that the most important contents should be standardized diagnosis and treatment of common diseases; 104(69.8%), 118(79.2%), 115(77.2%) and 98(65.8%) considered that the knowledge of prevention and health-protection, first aid, latest progress and chronic disease management were needed for training; 110(73.8%)and 80(53.7%)thought the mastery of clinical practice and basic theory were needed. And 57.7% (86/149)of the trainees believed that research training was needed, and there was significant difference in the demand for research training among participants from different work units and with different professional titles (χ 2=15.371,10.625,all P<0.05). The accepted training methods were case study(53.7%, 81/149) and practical work(37.6%, 56/149). For training duration, 43.6% (65/149) thought it should not exceed 6 months and 56.4% (84/149) preferred more than 1 year; there was a significant difference in demanded training duration among trainees from different work units, with different education background and professional titles (χ 2=16.225,6.243,25.966, all P<0.05). Conclusion:We need a multi-channel and multi-level training model to establish a better job-transfer training system for general practitioners, in order to meet different training needs and to improve the effectiveness of the training.
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The organ system-based teaching model integrates the morphology and function of various organ and system of human body, breaks the boundaries of disciplines, and avoids the duplication and disjunction between disciplines. With this model general practitioners can effectively and efficiently learn basic knowledge and clinical skills in the training. This article introduces the organ system-based teaching model and its application in general practice job-transfer training in China.
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Objective To survey the current status and training requirement of rural doctors in Hebei province.Methods A questionnaire survey was conducted among1 200 rural doctors selected from 11 cities of Hebei province by stratified sampling from October to December 2017.The self-designed questionnaire included general condition,job satisfaction,impact of medical reform policies,training needs of rural doctors.Results A total of 1 200 questionnaires were distributed and 1 170 valid ones were retrieved with a recovery rate of 97.5％.Among the 1 170 responders,there were 726 males(62.1％) and 444 females (37.9％);748 (63.9％) were aged more than 40 years;612 (52.3％) hold secondary school degree;826 (70.6％) had been working in the village for more than 10 years,and the overall job satisfaction rate was 30.8％ (360/1 170).Among all responders,73.8％ (864/1 170) worked in the standardized village clinics,and 72.0％ (842/1 170) were contracted with local residents as family doctors;52.8％ (618/1 170) responders believed that the reform policy improved the health care for villagers.In all responders,98％ (1 147/1 170)thought they needed training,93.6％ (1 095/1 170) had received training.The training contents they most needed werethe management of common diseases (904,77.3％),followed by medical humanities(650,55.6％)and first aid knowledge (492,42.1％).The influencing factors for training were lack of time,no energy (656,54.3％),lack of appropriate training forms (510,43.6％),economic reasons (476,40.3％) and so on.Conclusion The working status of rural doctors need to befurther improvedand the training need to be strengthened to increase their job satisfaction.
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Objective To investigate the influence of WeChat + family centered health intervention on the self-efficacy of elderly hypertensive patients in General clinic. Methods A total of 102 elderly hypertensive patients aged≥60 years in General clinic from February 2017 to July 2017 were enrolled.They were divided into experimental group and control group with the table of random number, with 51 cases in each group. The experimental group used the WeChat+ family centered health intervention model,while the control group adopted the traditional health education model.The changes of blood pressure and self-efficacy were evaluated before intervention, 3 months and 6 months after intervention respectively. Results There were no statistic significant difference in blood pressure and self-efficacy total score between the two groups before intervention(P>0.05). At 3 months after intervention,the blood pressure(systolic pressure/diastolic pressure)of the patients were(144.20±4.60), (80.00±5.00)mmHg(1 mmHg=0.133 kPa)in the experimental group,those of which were(154.20±7.16), (87.00±3.81)mmHg in the control group,the differences were statistically significant (t=-2.628,-2.490,P<0.05).At 6 months after intervention,the blood pressure(systolic pressure/diastolic pressure)of the patients were(141.60±6.43),(76.00±4.85)mmHg in the experimental group,those of which were(151.60± 5.94),(85.40±4.56)mmHg in the control group,the differences were statistically significant (t=-2.555,-3.158,P<0.05).There were differences in systolic and diastolic pressure in patients with different groups at different time,and the differences were statistically significant(F=18.668,18.174,P<0.01).The total score of self-efficacy at 3 months and 6 months after intervention was(30.14±0.43),(32.56±0.23)points in the experimental group and (28.14 ± 0.15), (29.40 ± 0.19) points in the control group, the difference was statistically significant(t=9.736, 23.819, P<0.05). The differences in the total score of patients′self-efficacy in different groups at different time had statistically significance (F=2 631.551, P<0.01). Conclusions The WeChat+family centered health intervention model can significantly improve the self-efficacy of the elderly patients with high blood pressure in the General clinic.
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Danshen (Salvia miltiorrhiza Bunge) hairy roots were obtained by infecting Danshen leaves with Agrobacterium rhizogenes 9402. Besides rosmarinic acid (RA) and salvianolic acid B (SAB), the hairy root could also produce salvianolic acid K (SAK), salvianolic acid L, ethyl salvianolic acid B (ESAB), methyl salvianolic acid B (MSAB), and a compound with a molecular weight of 538 (compound 538) identified by using LC-MS. Effects of methyl jasmonate (MeJA) and yeast elicitor (YE) on the accumulation of these compounds had been investigated. MeJA increased the accumulation of SAB, RA, SAK, and compound 538 from 4.21%, 2.48%, 0.29%, and 0.01% of dry weight to 7.11%, 3.38%, 0.68%, and 0.04%, respectively. YE stimulated the biosynthesis of RA from 2.83% to 5.71%, but depressed the synthesis of SAB, SAK and compound 538. It was indicated in all the results that these Danshen hairy roots could be used as alternative resources to produce salvianolic acids. Analysis of the content variation of these compounds after elicitation suggested that SAK and compound 538 might be the intermediates in the biosynthesis from RA to SAB in Danshen hairy roots.
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OBJECTIVE:To analysis outcomes of patients with knee osteoarthritis treated by mini-incision knee replacement accompanied by early rehabilitation. METHODS:Outcomes of 28 knee osteoarthritis patients (46 knees) who were treated by joint replacement from 2005 June to August were retrospectively analyzed. Sixteen patients were served as experimental group,including 4 males and 12 females,aged 59-77 (65.3?5.3) years,and the course of disease was 10-15 (13.4?4.3) years. These patients were received mini-incision knee replacement,accompanied by specified early rehabilitation procedure. Early rehabilitation procedure comprised psychological treatment,training before knee replacement,muscle strength training after knee replacement,and correction of poor gait,joint position sense training and exercise for coordination after knee replacement,early quadriceps femoral muscle active extension knee exercises especially emphasized. Another 12 patients were served as control group,including 5 males and 7 females,aged 60-75 (67.5?4.7) years,with course of disease 8-18 (12.8?4.9) years,they were received normal knee replacement. Pain severity,joint motion ranges and functional situations were evaluated. RESULTS:Twenty-eight patients stayed in hospital for (13.2?2.7) days (ranging from 10 days to 16 days). All the patients were followed up 9 to 12 months. There were no significantly differences in pain severity,joint motion ranges and functional scores on admission between two groups. Pain,joint motion and joint functions were improved greatly after knee replacement. The joint motion ranges and functional scores were higher on discharge and the last follow-up in the experimental group than that of the control group. CONCLUSION:The program that consists of Mini-incision knee replacement,which protected quadricep muscle intactness and diminished surgical injury,accompanied by psychological treatment,preoperational preparation,postoperational training,correction of gait,training in articular position sensation and all the body coordination,can improve the outcomes of the knee osteoarthritis patients with knee replacement.