The construction of clinical skills training and assessment system based on whole process and staged type / 中华医学教育探索杂志

To meet the requirements of training objectives for medical students , The national Experimental Teaching Demonstration Center for Clinical Skill (Xi'an Jiaotong University) has established three training platforms for "basic clinical skills", "clinical specialist skills" and "clinical comprehensive skills", and constructed a "whole-process and staged" clinical skills training and assessment system lasting from entering clinical study to graduation, in which clinical courses as the carrier, the clinical skill center as the main training base and containing clinical novitiate, internships and pre-graduation stage. This system integrates clinical skills training and evaluation into the whole process of clinical medicine teaching. More than two years of practice shows that the system has effectively improved the clinical practice ability of medical students, and the quality of medical education, and helped the school achieve the expected teaching objectives.

Real-time Shear Wave Elastography Combined with Gray-scale Ultrasound in Evaluating Perineal Body Muscle Tension / 中国医学影像学杂志

Purpose To observe the changes of perineal body morphology and modulus of primiparas with real-time shear wave elastography (SWE) combined with gray-scale ultrasound and to explore the influence of delivery on perineal body tension. Materials and Methods One hundred and sixty primiparas after 42 to 56 days of delivery in the Department of Gynecology and Obstetrics of the First Affiliated Hospital of Nanchang University from December 2016 to August 2017 were enrolled and divided into cesarean section group (n=80) and vaginal delivery group (n=80). Meanwhile, 100 healthy married nulliparous women during the same period were selected as nulliparous group. Perineal body depth, height and Young's modulus were measured by using gray-scale sonography and SWE at resting state and retraction status. Values of each ultrasonic parameter were analyzed. Results Difference of perineal body depth and height contraction amplitude was of statistical significance among subjects in the three groups (P<0.05). The mean Young's modulus of perineal body during resting state and retraction status in nulliparous group was higher than those in the cesarean section group and vaginal delivery group, while that in cesarean section group was higher than that in vaginal delivery group. The differences were statistically significant (P<0.05). Conclusion Different delivery modes have different effects on female perineal body muscle, among which vaginal delivery is of more obvious damage to perineal body.