Analysis of demand utilization and satisfaction of residents in a district of Guangzhou City for community health services / 中华医学教育探索杂志

Objective:To understand the utilization situation of community health service institutions, the awareness of basic public health items and the degree of satisfaction of residents in Guangzhou City, so as to provide direction and reference for improving the quality of community health service in Guangzhou City.Methods:In December 2020, 1 050 residents in a district of Guangzhou City were selected by multi-stage random sampling method to fill out the questionnaire. Single factor analysis was used for Pearson chi-square test, and binary logistic regression analysis was used for multiple-factor analysis.Results:A total of 1 092 questionnaires were sent out and 1 050 were valid, with an effective rate of 96.2%. The average times of seeing a doctor or receiving other health services in community health service center in the past year were (4.60±4.10). The total awareness rate of basic public health services was 91.6%(962/1 050), and the total awareness rate of free public health services was 89.5% (940/1 050). The total scores of residents' satisfaction with community health service institutions were (4.61±0.75) points, among which the basic medical service scored the highest, and the institution facilities, system and basic information scored the lowest. Single factor analysis showed that 10 factors, such as type of medical insurance, preferred medical institution, walking time to community center and medical service time, were the influencing factors of residents' overall satisfaction. Multiple-factor analysis found that institutions and facilities, systems and basic conditions, basic medical services, medical expenses, the type of first-visited hospital were the four influencing factors of residents' overall satisfaction ( OR=21.294, 109.013, 18.203 and 20.989, respectively). Conclusion:The residents have a good utilization of community health services, and they have good awareness of public health service projects, but the residents' satisfaction with community health services still needs to be improved, especially in the aspects of facilities, equipment and service efficiency of medical staff.

Chinese registry of rheumatoid arthritis: IV. Correlation and consistency of rheumatoid arthritis disease activity indices in China / 中华医学杂志(英文版)

BACKGROUND@#Disease activity indices (DAIs) including disease activity score 28 (DAS28), simplified disease activity index (SDAI), and clinical disease activity index (CDAI) have been widely used in clinical practice and research studies of rheumatoid arthritis (RA). The objective of our study was to evaluate the correlation and concordance among different DAIs in Chinese patients with RA.@*METHODS@#A cross-sectional study, including patients enrolled in the Chinese registry of rheumatoid arthritis from November 2016 to August 2018, was conducted. The correlations were evaluated using Spearman correlation coefficient and concordance with Bland-Altman plots, quadratic weighted kappa, and discordance rates in the crosstab. For other indices, the optimal cutoff points corresponding to SDAI remission were explored through receiver operating characteristic curve analysis.@*RESULTS@#A total of 30,501 patients were included, of whom 80.46% were women. Most individuals were with moderate disease activity or high disease activity. High correlations among DAS28-erythrocyte sedimentation rate (ESR) and DAS28-C-reactive protein (CRP), SDAI and CDAI were observed. Similarly, the weighted kappa value among the indices was high. In Bland-Altman plots, a positive difference between DAS28-ESR and DAS28-CRP was observed, with an absolute difference of >1.2 in 3079 (10.09%) patients. In crosstab, approximately 30% of the patients were classified into different groups. Concordance values between SDAI remission and the optimal cutoff points of DAS28-ESR, DAS28-CRP, and CDAI were 3.06, 2.37, and 3.20, respectively.@*CONCLUSIONS@#Although DAIs had high correlations and weighted kappa values, the discordance between DAIs was significant in Chinese patients with RA. The four DAIs are not interchangeable.

Exploration and practice of micro-video teaching of / 中国针灸

In this paper, the micro-video teaching mode was explored in the course construction of . The micro-video teaching contents include the academic thought, experience in diagnosis and treatment, characteristic technology and clinical manipulation of famous acupuncture experts in the Henan University of CM. Each micro-video film is designed within 15-18 min, including three sections of knowledge, i.e. basic theory, technological application and clinical manipulation. Each section is designed within 5-6 min. The construction of the teaching course of is the innovation of practice mode of TCM and the new approach to the inheritance of the experience of experts. The construction of micro-video teaching course propels the reform of teaching mode, improves the learning initiative of students and clinical manipulative ability so as to improve the teaching effect and quality.

Treatment satisfaction with rheumatoid arthritis in patients with different disease severity and financial burden: A subgroup analysis of a nationwide survey in China / 中华医学杂志(英文版)

BACKGROUND@#Despite the recent advances in treatments for rheumatoid arthritis (RA), there are still unmet needs in disease outcomes. This study aimed to analyze the satisfaction with drug therapies for RA according to the levels of disease severity (patient-assessed) and proportions of treatment cost to household income.@*METHODS@#This was a subgroup study of a cross-sectional study in patients with RA and their physicians. The patients were subdivided into different subgroups based on their self-assessed severity of RA and on the proportions of treatment cost to household income (50%). The Treatment Satisfaction Questionnaire for Medication version II was used to assess patients' treatment satisfaction.@*RESULTS@#When considering all medications, effectiveness, convenience, and global satisfaction scores were lower in the severe and moderate RA subgroups than those in the mild and extremely mild RA subgroups (all P 50% subgroup (all P 50% subgroups (F = 12.646, P = 0.005). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup (F = 8.794, P = 0.032).@*CONCLUSION@#Higher disease severity and higher financial burden were associated with lower patient satisfaction.

Tea consumption and risk of Parkinson’s disease: A meta-analysis

@#The results of studies on the association between tea consumption and Parkinson’s disease (PD) have been inconsistent. Therefore, the aim of this study was to perform an updated meta-analysis to better resolve any association between tea consumption and PD. We searched PubMed, Embase, and the Cochrane Library– from their commencement to November 2016 – for qualified studies that evaluated the associations between tea drinking and risk of PD. A total of nine case–control studies and three prospective cohort studies were included. The meta-analysis showed that tea consumption was associated with a reduced risk of developing PD(OR, 0.82; 95% CI, 0.69–0.98) when case–control studies and prospective cohort trials were considered together. Subgroup analysis on the category of tea consumption and risk of PD showed that black tea was not associated with PD (OR: 0.89; 95% CI, 0.64–1.24; I2 =0.0%), but other kinds of tea was associated with a reduced risk of developing PD (OR: 0.67; 95% CI, 0.48–0.95; I2 =0.0%). Subgroup analysis on the dose of tea consumption and PD risk showed that drinking more than one cup of tea daily was associated with a reduced risk of developing PD in case–control studies (OR: 0.38; 95% CI, 0.22–0.66; I2 =0.0%). No indication of publication bias was found. In conclusion, the current evidence showed that tea consumption was associated with a reduced risk of developing PD. The results of our subgroup analysis suggested that people who drinking more than one cup of non-black tea daily might have a reduced risk of developing PD

Study on the short-term effect of practice skill training for general practitioners / 中华医学教育探索杂志

Objective To understand the short-term effect of practice skill training for general practitioners in Guangdong province and to provide scientific basis for improving the training strategy. Methods According to the training outline (Outline of job-transfer training for general practitioner in primary health institutions (trial))of the Ministry of Health,job-transfer training was provided for a total of 451 primary care doctors in economically undeveloped cities for one year. All trainees were investigated before and after training by questionnaire,which were designed by ourselves and included practical skill level and satisfaction degree.SPSS 13.0 software was used to do statistical analysis and data were processed by description analysis,t test,ANOVA and correlation analysis. Results Average self-evaluation scores of practical skills were 136.37 ±21.74 and 169.39 ±17.12 before and after training with significant differences (t=29.028,P=0.000). Scores of all types of practical skills after training were significantly higher than those before training (P<0.000 1). Total satisfaction rate was 91.6%and students were not well satis-fied with training environment and training guarantee. Fac-tors influencing the effect of training included educational background,professional title,doctors' de-sire of training,whether taking part in the general practitioner training or not. The effect of practical training was positively correlated with total satisfaction (r=0.162,P=0.037). Conclusions Remark-able results of practice skill training have been achieved. In the future,more chances for practice should be provided for trainees and contents of skill training should be designed according to the need of community health service,and more attention should be paid to the training project management.

Discussion on WANG Guo-rui's acupuncture academy thought / 中国针灸

Through study on Bianque Shenying Zhenjiu Yulong Jing (Bianque's Classic of Effective Acupuncture Prescriptions), acupuncture experiences and ideology of WANG Guo-rui, an acupuncture physician of the Yuan Dynasty (1271-1368), is discussed in this article. Inherited and carried forward DOU's acupuncture theory, WANG Guo-rui encouraged to use experiential points and to expand extra points. Penetrating needling method was created, and the application of acupoints according to needling opportunities and seasonal factors were enriched by him. Great importance was also attached on treatment according to differentiation of syndromes, which including the simultaneous acupuncture and moxibustion, simultaneous reinforcing and reducing, reducing after reinforcing, reinforcing after reducing, predomination of reducing and predomination of reinforcing. The flexible treating methods are still extensively adopted in clinic nowadays. WANG Guo-rui is a master of clinical acupuncture who made great contribution to the development of acupuncture and moxibustion.

Investigation on employment of non medicine majors in medical universities and colleges and its countermeasures / 中华医学教育探索杂志

Objective To investigate employment of non medicine majors in medical universities and colleges and to provide recommendations.Methods Investigation on employment intention of 2010 grade non medicine majors in medical universities and colleges in Guangzhou was conducted.SPSS 13.0 was used to establish database and results were expressed as constituent ratio.Results Most non medicine majors wanted to find a job rather than taking postgraduate entrance exams and civil service test.Realizing their own values was the main purposes of employment.Preferred employment areas were mainly concentrated in large city(71.08％)and urban city(18.67％).Students expect a monthly salary between 3001 and 4000.Conclusions Employment intentions of non-medical students in medical universities and colleges are rational enough and career planning education should be strengthened.

Implementation of web-based PBL teaching mode in medical education and case studies / 中华医学教育探索杂志

Due to the subjective and objective constraints of universities in China,PBL Teaching Mode failed to gain its popularity in China's medical education.In its teaching reform,Guangzhou Medical University put forward a new teaching model--Web-based PBL Teaching Mode(hereinafter referred to as WPBL).by integrating the classical concept of PBL education with the real situation of the university and carried it out among students in bilingual classes of Clinical Medicine.The resuIts showed that by effectively overcoming the difficulties during the implementation of classical PBL teaching,Web-based PBL Teaching Mode not only succeeded in achieving the teaching objectives,but also improved the learning efficiency and utilization of teaching resources greatly by means of network technology.

Evaluation method about the learning effect of web-based PBL with key factors simulation / 中华医学教育探索杂志

Objective This paper aims to use components as the key factors to explore the feasibility of evaluation method about the learning effect of Web-based PBL.Methods We distributed a questionnaire to 101 students of clinical class of 2007 and 2008 grade in Guangzhou Medical University,and electronically distributed after 2 weeks.Cranach's α coefficient WaS used to evaluate intrinsic consistency reliability of the questionnaire.We applied principal axis factoring to extract components and to explain components which were orthogonally rotated by varimax.Multi-factor regression model Was simulated with key factors and the model's performance of fitting WaS tested.Results Multi-factor regression mode(WPBLSUM)=0.545 Collective collaboration capabilities+0.202 Self-learning and quest skills+0.137 linical reasoning and problem-solving capabilities+0.116 memorizing and understanding of medical knowledge.The coefficient of determination R2Was 0.998 and the corrected coefficient of determination R2Was 0.998.indicating that the model's fit results are obvious.Conclusion This paper demonstrates that using components as the key factors to simulate and assessing the Web-based PBL learning effect is feasible,which assesses the Web-based PBL learning effect well from four different aspects.

Clinical observation on the treatment of childhood refractory idiopathic thrombocytopenic purpura with Dihuang Zhixue Capsule / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the clinical effect of Dihuang Zhixue Capsule (DZC, a Chinese preparation for cooling blood and dispelling toxic substances) in the treatment of childhood refractory idiopathic thrombocytopenic purpura (RITP), with cyclosporin A (CsA) used as the control.</p><p><b>METHODS</b>Forty-one children of RITP were randomized into the treated group and the control group. The 21 patients in the treated group were orally given 2 to 3 DZC capsules each time, thrice a day and the 20 in the control group were given 3 mg/kg CsA per day, with 3 months as one therapeutic course. The therapeutic efficacy, platelet count and adverse reaction in the two groups were compared at the end of the course.</p><p><b>RESULTS</b>(1) In the treated group, 1 (4.8%) patient was evaluated as cured, 3 (14.3%) as markedly effective, 5 (23.8%) as effective, 5 (23.8%) as improved, 7 (33.3%) as ineffective, with the total effective rate being 66.7%; while in the control group, the corresponding numbers were 0, 2 (10.0%), 2 (10.0%), 3 (15.0%), 13 (65.0%) and 35.0%, respectively, showing statistical significance in difference between the total effective rates of the two groups (xi(2)=4.11, P=0.0426). (2) As compared with the baseline, the platelet count increased in both groups after 2 months' treatment (P<0.05). After 3 months' treatment, the platelet count was higher in the treated group than in the control group (P<0.05). (3) The improvement of hemorrhage in the treated group after 8 weeks' treatment was better than that in the control group (P<0.05). (4) No apparent adverse reaction was observed in the treated group, while in the control group, hirsutism was shown in 15 cases; gingival hyperplasia in 10; digestive reaction in 5, liver function impairment in 5, hypertension in 2 and renal impairment in 2.</p><p><b>CONCLUSION</b>The therapeutic efficacy of DZC is better than that of CsA, and DZC shows good compliance but brings no obvious adverse reaction.</p>

Suppression of Mdr1 gene using RNA interference in cultured rat astrocytes induced by coriaria lactone / 中华神经科杂志

Objective To reverse P-glycoprotein-mediated muhiple drug resistance using RNA interference(RNAi)in cultured rat astrocytes.Methods Astroeytes overexpressing P-glyeoprotein induced by coriaria lactone were transfected with the short-hairpin RNA expression vector-p-SIREN shuttle designed to target Mdrl mRNA.The mRNA level of Mdrl gene was evaluated by real-time PCR;the P-glycoprotein was examined by immunocytochemistry and image analysis,meanwhile the rhodamine efflux was assessed by flow cytometry.Results The astrocyte model overexpressing P-glycoprotein were established and successfully transfected with the short-hairpin RNA expression vector-p-SIREN shuttle.The mRNA level of Mdrl gene was knocked down by 67.70%(P