The practice of the cultivation strategy of incremental training of modern clinical thinking ability to cultivate clinical post competency of "5 + 3" integration students / 中华医学教育探索杂志

At present, some "5+3" integration students have different levels of understanding and application problems in various stages, such as role transformation, professional knowledge and technology, communication ability and humanistic care ability, clinical thinking and evidence-based medicine concepts, clinical research thinking, learning and work attitude. This research will permeate and run through the training of "5+3" integrated students' diagnostic and therapeutic operation ability through the training of modern clinical thinking oriented by post competency, and integrate humanistic care, evidence-based medicine, learning attitude, working attitude, and attitude towards patients in the whole process to gradually complete the comprehensive training goal of clinical thinking oriented by post competency + diagnostic and therapeutic operation ability.

Construction of training objectives and assessment system of cardio-oncology for doctors at different levels / 中华医学教育探索杂志

Cardio-oncology has developed into a new subspecialty of modern cardiology, and the clinical mentors usually need to guide students to focus on this frontier field. However, there are many deficiencies in the field of cardio-oncology training in China, and there is a lack of perfect teaching and training objectives and evaluation system. In order to adapt to the goal and orientation of talent training in cardio-oncology, the First Affiliated Hospital of Dalian Medical University adopts a multi-disciplinary teaching mode. Corresponding teaching contents and training objectives are set according to the trainees at different levels of training, and various teaching methods and assessment forms are cooperated to explore and establish the training and assessment system of cardio-oncology for doctors at different levels. The system is put into practice, and the teaching effect is outstanding which has been widely recognized by teachers and students.

Insulin resistance in elderly patients with liver cirrhosis and diabetes mellitus / 中华老年医学杂志

Objective To investigate the relationship between insulin resistance and hepatic function in elderly liver cirrhosis (LC)patients with diabetes (LC-DM)and to provide evidence for clinical treatment.Methods Thirty cases of elderly LC,30 cases of elderly LC-DM,30 younger patients (＜60 years)with LC-DM and 30 healthy subjects were enrolled.Levels of fasting plasma glucose(FPG)and fasting plasma insulin(FINS)were examined to evaluate the homeostasis model for assessment of insulin resistance (HOMA-IR),which was used for comparison between the groups.Moreover,the relationship between HOMA-IR and the Child Pugh classification was also analyzed.Results Patients in the elderly LC group were associated with significantly higher levels of FINS (9.58±3.62 vs.6.03±1.99 mU/L,P＜0.05)and HOMA-IR(2.47±0.88 vs.2.12±0.99,P＜0.05),compared with the control group.Meanwhile,levels of FPG,FINS and HOMA-IR in the elderly LC-DM group were (5.83 ± 1.40) mmol/L,(15.63 ± 6.37) mU/L and 6.33 ± 2.59,respectively,significantly higher than those[(5.03±0.83)mmol/L,(9.58±3.62)mU/L,2.47±0.88]in the elderly LC group and those[(5.31±0.58)mmol/L,(6.03±1.99)mU/L,2.12±0.99]in the control group (all P＜0.05).However,levels of FPG,FINS and HOMA IR were similar between the elderly LC-DM group and the younger LC-DM group(P＞0.05).In the elderly LC-DM group,more patients(66.7 ％) had Child-Pugh C liver function compared with the elderly LC group(36.7 ％)and the younger LC-DM group(40.0％)(both P＜0.05).Of those in the LC and LC-DM groups,levels of HOMA IR were 7.39±2.25 in patients with Child-Pugh C,which were significantly higher than those in patients with Child Pugh B function(4.90± 1.76) and with Child Pugh A liver function(2.69± 1.02)(both P＜0.05).Conclusions Hyperinsulinemia and insulin resistance are more pronounced in elderly LC DM than in elderly LC,with poor liver function and prognosis.

Exploration on the coaching of hematology clinical practice for undergraduate students of clinical medicine / 中华医学教育探索杂志

[Abatract] In order to improve the result of clinical practice for undergraduate students of clinical medicine, combined with the professional characteristics of hematology and teaching syllabus, Hematology Department in the First Affiliated Hospital of Dalian Medical University developed practi-cal teaching content and tried using a variety of teaching methods and teaching means such as multi-media aided teaching, case teaching and simulation teaching method and so on. Besides, multiple station examination was established; teaching feedback and supervision were strengthened. The prac-tice proved that the reform measures were conducive to the cultivation of medical students' practical skills and clinical thinking, which helped to speed up the transformation from the students to the role of doctors.