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Objective:To evaluate the application effect of mini-clinical exercise assessment (Mini-CEX) in clinical teaching of pediatrics of Chinese medicine, further optimize Mini-CEX scale with characteristics of pediatrics of Chinese medicine, and improve teachers' understanding of its connotation.Methods:A total of 50 pediatric clinical practice undergraduates were randomly divided into Mini-CEX group and control group, 25 in each group, with a total of 4 weeks of practice. The application effect of Mini-CEX was evaluated by clinical comprehensive ability assessment, and the students' evaluation on the introduction of Mini-CEX in clinical teaching was understood through questionnaire survey on the recognition, advantages and existing problems of various contents of Mini-CEX. SPSS 17.0 was used for t test and chi-square test. Results:Total scores and sub-item scores of clinical comprehensive ability examination in Mini-CEX group were higher than those in control group ( P < 0.05), and the satisfaction with teaching in Mini-CEX group was significantly higher than that in control group ( P < 0.05). Through the questionnaire, it was found that the students had a high degree of recognition for the items in the improved Mini-CEX scale, and thought it was more suitable for the internship study and effect evaluation of pediatrics of Chinese medicine, especially in the aspects of clinical communication skills and humanistic care. Conclusion:Mini-CEX has many advantages, such as improving the clinical comprehensive ability of undergraduates, teaching effect, flexible teaching methods, objective evaluation methods and focusing on the cultivation of doctor-patient communication skills, which is worthy of clinical promotion.
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Objective To study the effect of AIDS intervention programs among college students, and to provide fundamental support for the formulating of AIDS prevention strategies. Methods A cluster sampling methods was used to conduct a longitudinal follow-up survey among 2 000 freshmen from four colleges in Yantai in 2016, The knowledge, attitudes and behaviors related to AIDS were analyzed by generalized estimating equation analysis method. We also conducted in-depth personal interviews among university leaders. Results The awareness rate of AIDS among young students in Yantai was 70.4%, 85.9%, and 95.8%, respectively. The generalized estimating equation showed that the total awareness rate of AIDS knowledge increased year by year (Z=-23.42, P<0.001). The occurrence of different types of sexual behaviors maintained at a low level, and no obvious trend changes were observed. Multivariate Logistic regression showed that a high occurrence of sexual behaviors among young college students was found related to male, poor knowledge of AIDS prevention, having not received public services related to AIDS prevention, and having not participated in public services related to AIDS prevention (all P<0.05). Interview results showed that, three of the four colleges have included AIDS health education into their teaching plans, and the AIDS epidemic notification system has been fully implemented. Conclusions The awareness rate of AIDS knowledge among college freshmen in Yantai is relatively low. Implementing comprehensive intervention measures and establishing a multi-sectoral cooperation mechanism are the most effective measures to improve the knowledge of AIDS prevention, and promote safe sexual behaviors among young college students.
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Objective@#To evaluate the intervention effects of response to heatwave in communities of four cities, China.@*Methods@#Baseline survey on heatwave and climate change related knowledge, attitude and practice (KAP) was conducted in the pilot communities in Harbin, Nanjing, Shenzhen and Chongqing, using face-to-face questionnaire interview in November, 2011 to November, 2013. Finally, 1 604 residents were interviewed. Intervention measures were implemented in summers of 2013 and 2014, including delivering early warning information of heatwave health risk and launching health education and promotion. The second survey was conducted in same communities using the same questionnaire and sampling method as baseline survey in November, 2014, and 1 640 residents were interviewed. The Chi-square test was used to compare the demographic characteristics and KAP of community residents between before and after intervention, and the factors that affected the intervention effect were selected by logistic multiple stepwise regression model.@*Results@#The age of the residents interviewed before and after intervention was (46.4 ± 15.5) years and (45.0 ± 15.9) years, respectively. Overall, the residents' awareness rates of heatwave before and after intervention were 70.5% (1 131/1 604) and 82.9% (1 359/1 640) (χ2=69.40, P<0.001). The rate of residents who had wished to receive early warning information increased 6.3% (χ2=41.11, P<0.001), which reached 94.6% (1 551/1 604) after intervention from 88.3% (1 416/1 604) in baseline survey. Both heatwave health risk early warning and health education had big impacts to residents. There were 92.7% (1 105 residents) among the 1 192 residents who had received the early warning information arrange work and rest time according to the early warning information and 93.0% (1 231 residents) among the 1 323 residents who knew about health education activities being conducted in community thought that the community health education activities had made active role in protecting health from heatwaves. After a series of intervention, male had a effect on attitude about hot wave than female in Nanjing and Chongqing, OR (95%CI) were 1.48(1.02-2.16) and 1.45 (1.18-2.05) , respectively; compared with subjects below primary school education, people with college degree or above had higer KAP in all cities (ORs range from 1.18 to 2.05), P<0.05; regular physical exercise (ORs range from 1.39 to 2.70) also had profound impacts on KAP in all cities (P<0.05).@*Conclusion@#s Early warning and health education were effective measures to enhance residents' response capacity to climate change.
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At present,most of the scholars of traditional Chinese medicine (TCM) considered that climacteric syndrome was caused by yin-deficiency,as the therapy of nourishing yin and clearing heat was the most common treatment,neglecting the pathologic role of yang-deficiency in climacteric syndrome.This paper redefined the pathogensis of climacteric syndrome and its syndromes based on differentiation in Gynecology of Traditional Chinese Medicine of various versions and in accordance with previous syndrome epidemiological results over it.The emerge of hot flushes and sweating,forgetful and hyposexuality was prevalent.The inaccurate description of hot flash and sweating in climacteric syndrome was rectified.The therapeutic effects of nourishing yin therapy on vasomotion were discussed based on the understanding of etiology,pathology and treatment of climacteric syndrome in ancient Chinese medical books.The phytoestrogens action of warming kidney-yang drugs was summarized from the aspect of modern pharmacology for exploring the significance of the role of yang-deficiency in climacteric syndrome.The treatment against yang-deficiency would be an innovative clinical pathway of climacteric syndrome.
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This study was aimed to investigate the requirement of our hospital nurses in the effect evaluation of fifteen traditional Chinese medicine (TCM) nursing programs,and to make it as the basis for making feasible evaluation tables of TCM nursing programs.The investigation survey was given among 78 nurses from the internal medicine ward,surgical ward and the department of orthopedics in our hospital.The questionnaire was graded according to the Likert 5 scoring method,including 3 themes and 11 items.The SPSS 17.0 package was used for statistical processing.The results showed that 93％ nurses participated in the training of effect evaluation table of unified TCM nursing program in the hospital or department,but the overall attitude was negative in terms of the operability and objectivity on the effect evaluation of the program.Requirements of guidelines for effectiveness evaluation of TCM nursing program showed that most nurses agreed that the new TCM nursing program needed to increase quantifiable indicators and to increase its objectivity and reproducibility.It was concluded that nurses generally considered that the evaluation system of nursing program of TCM had no quantitative indicators,but with strong subjective.In the clinical practice,it is in urgent need of an objective TCM nursing program with quantitative indicators and strong operability.
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OBJECTIVE: To improve the control rate of cancer pain and the satisfaction of community patients with cancer pain. METHODS: A multidisciplinary team was built, which included community public health workers, clinical pharmacists, community physicians and tracking pharmacists. Pharmaceutical care was provided to patients with cancer pain in the community, and the effects of pharmaceutical care were evaluated. RESULTS: The clinical pharmacists provided 52 times of pharmaceutical care to 17 patients, 224 cases of medication problems were discovered, and 337 pieces of medication suggestions were made. After receiving pharmaceutical care, the scores of the most severe pain, the mild pain and the average pain in the past 24 h decreased from(9.12 ± 1.34), (5.53 ± 1.46) and (7.24 ± 1.99) to (4.71 ± 1.36), (1.18 ± 0.95) and (2.41 ± 1.18) (P < 0.01), respectively. The percentage of good medication compliance increased from 0% to 64.7% (P < 0.01). The influence of pharmaceutical care on patients included"helping understand the drugs", "taking medicine on time", "reducing adverse drug reaction", "establishing correct concept of medication" and"reducing medical costs", which got scores of (4.35 ± 0.49), (4.53 ± 0.51), (4.00 ± 0.61), (4.29 ± 0.59), and (3. 76 ± 0.66), respectively. For"convenience of pharmaceutical care", "pharmacist ability", "pharmacists' attitude", "symptom improvement" and"improvement of the quality of life", the patients gave scores of (4.06 ± 0.66), (4.24 ± 0.44), (4.20 ± 0.40), (4.41 ± 0.71) and (4.29 ± 0.47), respectively. CONCLUSION: The problems in the drug treatment in community patients with cancer pain are numerous and complex. Pharmaceutical care can reduce the problems, improve the control rate of cancer pain, and increase the community patients' satisfaction on the management of cancer pain. The patients give positive evaluation to the pharmaceutical care.
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Objective To investigate the criteria for assessing the clinical therapeutic effect of chronic urticaria in China.Methods The application of criteria for assessing the clinical therapeutic effect of chronic urticaria in China and their applicable scope were analyzed by frequency analysis and K-means clustering analysis, respectively.Results The criteria for assessing symptoms and therapeutic effect were different in the 857 papers included in this study. SSRI was used in 549 (64.17) out of the 857 papers included in this study.K-means clustering analysis showed that the applicable scope of SSRI with curative rate ( 100%≥SSRI>90%) , improvement rate ( 90%≥SSR20%) , and no response rate (20%≥SSR≥0%) as its criteria was wider than that of frequency analysis.Conclusion The criteria for the clinical assessment of chronic urticaria and its drug treatment effect should be unified and standardized.
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Objective To evaluate the clinical effect of cluster nursing measures and conventional nursing measures to prevent the ventilator associated pneumonia.Methods The domestic related literatures were searched using computer,and the results underwent comprehensive analysis according to RevMan 5.2 in the Cochrane collaboration.The quantitative comparison of two different nursing measures in reducing the incidence of ventilator associated pneumonia was conducted.Results A total of 23 articles which contained 6 146 patients met the inclusion standard.Due to heterogeneity between the included studies,the random effects model analysis was adopted to merge the RR combined (Total)=0.46,95％ CI(0.38,0.56),showed that cluster of nursing measures to significantly reduce the incidence of ventilator associated pneumonia.Conclusions The effect of cluster nursing measures for ventilator associated pneumonia prevention is superior to the conventional nursing measures,which should vigorously be advocated in clinic.
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This study was aimed to review of the selection and use of the therapeutic effect assessment indexes of randomized controlled trials ( RCTs ) on traditional Chinese medicine ( TCM ) syndrome differentiation and treatment of chronic obstructive pulmonary disease ( COPD ) based on clinical efficacy . Published studies were searched in the CBM , CNKI , VIP , Wanfang database , Cochrane Library , PubMed and Embase to identity all RCTS on TCM treatment of COPD . Two researchers selected studies and extracted data independently using a designed extraction form . The Cochrane collaboration software RevMan 5 . 1 was used for meta-analysis . The re-sults showed that a total of 40 RCTs were included . Meta-analyses showed that TCM syndrome differentiation and treatment of COPD can improve the pulmonary function and life quality , improve the clinical effect and TCM syndrome effect , reduce the number of acute exacerbation of COPD and improve clinical symptoms . Some therapeutic effect assessment indexes , such as pulmonary function , life quality , clinical comprehensive effect , the number of acute exacerbation of COPD, clinical symptoms and signs, syndrome effect and the integral of syndrome were used more frequent . Other indexes such as 6-min walk distance , BODE Index and health eco-nomic evaluation were used less frequently . It was concluded that TCM syndrome differentiation and treatment of COPD had certain therapeutic efficacy. A large number of strictly-designed, multicenter, high-quality RCTs are required because of the low quality of the included studies. The selection of therapeutic effect assessment indexes is still not standardized . The therapeutic effect assessment indexes should be selected based on differ-ent purposes of clinical studies with the clinical characteristics of TCM .
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ObjectiveTo cultivate high-qualified talents with innovation and comprehensive clinical skills under the guidance of Chinese standard of undergraduate medical education.Methods Courses of clinical thinking and misdiagnosis,medical record writing,communication between patients and doctors were provided.Objective structured clinical examination (OSCE) with standard patients (SP) was employed.Results Satisfactory scores were obtained among relevant tests,the passing rates of specialist qualification examination and practicing doctors clinical skills test were increased from 44.61％ and 59.18％ to 66.66％ and 95.45％.ConclusionThe implementation of correlative courses and OSCE can comprehensively promote the medical students' clinical competency and pave the way for their future work and practicing doctors' qualification exam.
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Objective To explore the application effect of the model of clinical nursing path management in clinical nursing. Methods A comparative study was conducted of the clinical nursing paths respectively with regard to patients who had received thyroid adenoma resection and with regard to patients who had received hysteromyomectomy. Results In the experimental group involving clinical nursing path management, the average length of stay was shortened, pre operation days were reduced, and the average hospitalization expenses were lowered while the satisfaction rate of patients with thyroid adenoma rose by 2.18%, reaching 98.96% and that of patients with hysteromyoma rose by 2.87%, reaching 99.55%. At the same time, clinical nursing path management also enhanced the job satisfaction of nurses. Conclusion It is viable to adopt the model of clinical nursing path management in clinical nursing in China.