Analysis of the results of the nationwide interlaboratory comparison of gross α and gross β radioactivity measurement / 中国辐射卫生

Objective To summarize and improve the related technical issues by analyzing the nationwide interlaboratory comparison of gross α and gross β radioactivity measurement over the years. Methods According to the requirements of interlaboratory comparison and the national standards, the gross α and gross β radioactivity in water were measured, and the results were analyzed to identify the influencing factors. Results From 2018 to 2022, our laboratory participated in five nationwide interlaboratory comparisons of gross α and gross β radioactivity measurement. The Z-test values for gross α and gross β measurement ranged from −0.24 to 1.8 and −1.4 to 0.35, respectively. The relative deviations ranged from −4% to 32% and −18% to 6%, respectively. All comparisons were within the acceptable ranges. Conclusion The analysis of comparisons showed that the results were within the acceptable ranges. The relative deviations between the measurement and the reference values have decreased over the years. The summary and improvement of related technologies have improved the measurement accuracy.

Comparison of Sociodemographic and Radiographic Features in Distal Radio Fracture Treatment: Hand Surgeons versus Non-specialists / Comparação de características sociodemográficas e radiográficas no tratamento de fratura de rádio distal: Cirurgiões de mão versus não especialistas

Abstract Objective: This study evaluated sociodemographic and radiographic features of patients with distal radial fractures treated at a trauma hospital in southern Brazil, comparing those treated by hand surgery specialists (group 1) and non-specialists (group 2). Methods: This study consists of a retrospective cohort of 200 patients treated in 2020. After reviewing medical records and radiographs, the following parameters were analyzed: age, gender, trauma mechanism, laterality, associated comorbidities and fractures, fracture classification (AO), radial height, radial inclination, and volar inclination. Comparison of the two groups used the Student t-test, chi-square test, or Fisher exact test. Results: Most subjects were women (54%), sustained low-energy traumas (58%), and were left-handed (53%). Group 1 had a lower mean age (50.2 years); most of their subjects sustained high-energy trauma (54%) and had type C fractures (73%); type A fractures prevailed in group 2 (72%). Radiographs showed a significant difference regarding the mean radial inclination (21.5° in group 1 and 16.5° in group 2 [p < 0.001] in women, and 21.3° in group 1 and 17° in group 2 [p < 0.001] in men) and volar inclination (10.1° and 12.8° in groups 1 and 2, respectively [p < 0.001]). In addition, the absolute number of cases with reestablished anatomical parameters per the three evaluated variables was also significantly different; all parameters were better in group 1. Conclusion: Hand surgeons treated the most severe fractures and had the best radiographic outcomes.

Resumo Objetivo: Avaliar as características sociodemográficas e radiográficas dos pacientes com fratura de rádio distal tratados em um hospital de trauma no sul do Brasil, comparando os casos tratados pelos especialistas em cirurgia da mão (grupo 1) com aqueles tratados por não especialistas (grupo 2). Métodos: Coorte retrospectiva realizada com 200 pacientes, no ano de 2020. Por meio da revisão de prontuários e radiografias, analisaram-se: idade, sexo, mecanismo de trauma, lateralidade, presença de comorbidades e fraturas associadas, classificação da fratura (AO), altura radial, inclinação radial e, inclinação volar. Comparou-se os dois grupos por meio do teste t de Student, qui-quadrado ou exato de Fisher. Resultados: A maioria era de pacientes do sexo feminino (54%), traumas de baixa energia (58%) e lateralidade esquerda (53%). O grupo 1 apresentou média de idade menor (50,2 anos), traumas de alta energia (54%), e fraturas tipo C (73%), enquanto no grupo 2 fraturas tipo A prevaleceram (72%). As radiografias apresentaram diferença significativa quanto à média de valores de inclinação radial (21,5° no grupo 1 e 16,5° no grupo 2 [p < 0,001] nas mulheres e, 21,3° no grupo 1 e 17° no grupo 2 [p < 0,001] nos homens) e inclinação volar (10,1° e 12,8° no grupo 1 e 2, respectivamente [p < 0,001]), bem como no número absoluto de casos que reestabeleceram os parâmetros anatômicos nas três variáveis avaliadas, sendo todos melhores no grupo 1. Conclusão: Os cirurgiões de mão trataram as fraturas mais graves e apresentaram os melhores resultados radiográficos.

Use of Extracorporeal Membrane Oxygenation in Adult Patients During Cardiac Arrest

Abstract Background Integrated extracorporeal membrane oxygenation (ECMO) in the treatment of cardiopulmonary resuscitation (CPR) is described as extracorporeal cardiopulmonary resuscitation (ECPR). It is used to ensure recovery of cardiac output when it is not possible to obtain sustained return of spontaneous circulation (ROSC) through conventional CPR methods. The comparison between ECPR and conventional CPR is a dilemma that has been frequently discussed. Objective To identify in the literature the use of ECMO in adult patients during cardiac arrest (CA) in and pre- and in-hospital settings. Method This is an integrative review using the following guiding question: What is the evidence in the literature on the use of ECMO in adult patients with cardiorespiratory arrest in the pre- and in-hospital setting? It consists of primary studies, published in full and available in Portuguese, English, and Spanish. Results The search identified 559 publications in the literature, of which 13 were articles read in full, after applying the inclusion criteria. Of these, 3 were disregarded due to unavailability in the complete format; 7 did not respond to the guiding question, and 3 studies were included. The studies were analyzed according to the 2020 version of the PRISMA Model. Conclusion ECPR is a practice adopted when CPR is refractory to conventional life support and concomitantly with this management. There are no significant differences in the rate of favorable neurological outcomes when comparing the pre- and in-hospital scenarios. In short, the development of institutional protocols with selection and exclusion criteria for ECPR is considered relevant.

Determinantes do cumprimento das despesas com pessoal e do resultado primário nos estados brasileiros: uma análise de 2017 a 2022 / Determinantes del cumplimiento de los gastos de personal y el resultado primario en los estados brasileños, un análisis de 2017 a 2022 / Determinants of compliance with personnel expenses and primary result in Brazilian States: an analysis from 2017 to 2022

Resumo O artigo científico avalia os determinantes da gestão fiscal representada pelo cumprimento dos limites da Lei de Responsabilidade Fiscal (LRF) e o cumprimento da meta do resultado primário. Para atender aos objetivos propostos, fez-se uma abordagem econométrica, na qual se utilizou a variável binária para cumprimento da meta de despesa total com pessoal e do resultado primário por parte das unidades federativas brasileiras. Para a análise dos fatores determinantes, usaram-se dados sociais e contábeis, características do gestor e uma análise de regressão múltipla para dados em painel, examinando o período de 2017 a 2022. No modelo para a despesa total com pessoal, as transferências da União para os estados e a receita tributária favorecem o não cumprimento dos limites da LRF. Por outro lado, para a meta do resultado primário, as transferências, os restos a pagar, a capacidade de pagamento, a escolaridade e a idade do gestor favorecem o cumprimento da meta.

Resumen Este artículo científico evalúa los determinantes de la gestión fiscal representados por el cumplimiento de los límites de la Ley de Responsabilidad Fiscal (LRF) y el cumplimiento de la meta de resultado primario. Para alcanzar los objetivos propuestos, se adoptó un enfoque econométrico, utilizando la variable binaria para el cumplimiento de la meta de gasto total en personal y la variable binaria para el cumplimiento de la meta de resultado primario por las unidades federales brasileñas. Además, se utilizaron datos sociales y contables y características de los gestores para analizar los factores determinantes, así como un análisis de regresión múltiple para datos de panel, examinando el período de 2017 a 2022. En el modelo para el gasto total de personal, las transferencias del gobierno federal a los estados y los ingresos fiscales favorecen el incumplimiento de los límites de la LRF. Por otro lado, para la meta de resultado primario, las transferencias, las deudas impagadas, la capacidad de pago, el nivel educativo y la edad del gestor favorecen el cumplimiento de la meta.

Abstract This scientific article evaluates the determinants of fiscal management represented by compliance with the thresholds of the Fiscal Responsibility Law and the primary result target. The study adopted an econometric approach, using binary variables regarding the Brazilian states' compliance with the total personnel expenditure target and the primary result target. Social and accounting data and the manager's characteristics were used to analyze the determining factors. In addition, a multiple regression analysis for panel data was conducted, examining the period from 2017 to 2022. In the model for total personnel expenditure, transfers from the federal government to the states and tax revenue favor non-compliance with the thresholds of the Fiscal Responsibility Law. On the other hand, for the primary result target, transfers, accounts payable, payment capacity, and the managers' education level and age favor compliance with the target.

Analysis on patent development at 13 general hospitals in Beijing / 中华医院管理杂志

Objective:To analyze the patent development status of 13 general hospitals in Beijing, for reference in promoting the management and translation of intellectual property rights of public hospitals.Methods:13 tertiary general hospitals in Beijing as one of the top 100 hospitals in China in terms of science and technology evaluaton metrics in 2020 were selected as the research subjects. The patent application and authorization information of 13 hospitals was retrieved from the IncoPat technology innovation intelligence platform, during the period from January 1, 2012 to December 31, 2021. The patent application and authorization status, international patent classification distribution, inventor information, patent validity, and registration of patent transfer were analyzed.Results:The numbers of patent applications and authorizations from 13 hospitals increased from 123 and 13 in 2012 to 2 053 and 2 368 in 2021, respectively. From 2012 to 2021, 13 hospital applied for 10 050 patents and authorized 6 896 patents, including 906 authorized invention patents, 5 863 utility model patents, and 127 appearance design patents. Valid patents amounted to 5 925, accounting for 85.92%, and valid authorized invention patents amounted to 796, accounting for 13.43%. 110 of these patents were transferred or licensed, accounting for 1.60% of the authorized patents.Conclusions:Aapplied and authorizated patents were rising year by year, but the ratios of invention patents and patient translation remained at a low level. The author suggestted that hospitals should highlight the value orientation of patents, strengthen-industry-academia-research cooperation, establish a professional management team and standardized management system for intellectual property, cultivate high-value patents, conduct pre patent application evaluation and screening, and improve patent conversion and technological innovation capabilities.

Research on the role of the cognitive conflict theory combined with knowledge internalization teaching strategy in improving the core competence of nursing interns in the department of internal medicine / 中华医学教育探索杂志

Objective:To explore the role of the cognitive conflict theory combined with knowledge internalization teaching strategy in improving the core competence of nursing interns in the department of internal medicine.Methods:A total of 100 nursing interns in our department were randomly selected and divided into control group (provided with traditional teaching) and study group (provided with the cognitive conflict theory combined with knowledge internalization teaching strategy) according to the teaching methods. After one month of teaching, two groups were compared for the comprehensive competence, learning engagement, and assessment results. The t-test, chi-square test, or rank sum test was performed using SPSS 26.0. Results:The teaching quality score and degree of satisfaction with teaching in the study group were significantly higher than those in the control group [(18.38±0.71) vs. (17.95±0.84), P<0.05]; the comprehensive competence, core competence score, and learning engagement subitem scores in the study group were significantly higher than those in the control group ( P<0.05); the theory score and skill score in the study group were significantly higher than those in the control group ( P<0.05). Conclusion:The cognitive conflict theory combined with knowledge internalization teaching strategy can effectively improve the quality of nursing teaching, effectively enhance the learning engagement of nursing interns, help improve the comprehensive competence and core competence of nursing interns, enable them to better acquire clinical nursing knowledge, and improve their satisfaction with clinical teaching.

Influence of Corneal Staining in Rabbits on the Evaluation of Eye Irritation Test Results / 实验动物与比较医学

Objective To observe the influence of the staining phenomenon after fluorescein sodium staining on eye irritation in normal rabbits.MethodsIn the experimental rabbit eye irritation test conducted with sodium chloride eye drops, Siwei Zhenceng Bingpeng eye drops, sodium hyaluronate eye drops, sodium cromoglycate eye drops, and compound aspartate eye drops (4 in each group, half male and half female), the left eyes of rabbits were administered normal saline (self-negative control) and the right eyes were administered the experimental medicine; the eyes were stained with 1% sodium fluorescein, and eye irritation was observed and scored using slit lamp microscope for 31 days. Morphological changes of corneal epithelial staining were recorded and the incidence of staining was calculated. After the observation, the eyeballs and Hasselblad glands were examined histopathologically, and the staining rate of the left eye was compared with that of the right eye which was administered the corresponding medicine.ResultsNeither eye had any irritation symptoms; the scores were 0, and the total incidences of corneal staining were 3% (left) and 1% (right), respectively. There was no significant difference between the two groups (P > 0.05). Corneal epithelial staining showed single-spot staining, scattered dot, localized, or large areas of fusion staining. No histopathological changes were found in the eyeballs or Hasselblad glands, and the results were evaluated as non-irritative.Conclusion The irregularity of corneal epithelial staining in rabbits did not influence the results of the ocular irritation test.

Analysis of the types and causes of invalid results in nucleic acid test for blood screening / 中国输血杂志

【Objective】 To analyze the reasons for the invalidity of blood nucleic acid test results, and to explore the countermeasures to reduce the invalidity of the test. 【Methods】 From 2019 to 2021, the number of tests performed in our laboratory for Cobas s201 blood nucleic acid screening system and the number of batches and tests with invalid results were counted, and the types and reasons of invalid results were analyzed. 【Results】 From 2019 to 2021, the Cobas s201 nucleic acid detection system detected a total of 5, 420 batches and 127, 950 pools, and the invalid rate of batches and pools were 1.83% and 1.97%, respectively. The types of invalid results can be summarized as improper operation, sample quality problems, invalid quality control (IQC), equipment failure and others. Among them, IQC and equipment failure were the main reasons for invalid results, accounting for 44.51% and 39.96%, respectively. IQC was mainly related to cross-contamination of samples and insufficient mixing of quality control products. Equipment failures mostly occurred in the robotic arm gripper of the nucleic acid extraction instrument and the TC module of the amplification instrument. 【Conclusion】 The laboratory should conduct quality monitoring for invalid results, and take targeted improvement measures, especially to reduce invalid results caused by invalid quality control and instrument failure.

Treatment of anterior shoulder instability by latarjet coracoid bone block: preliminary functional results in a subsaharan hospital

Background: The Latarjet technique aims to stabilize the shoulder by reconstructing the glenoid rim using a bone fragment taken from the coracoid bone and generally fixed to the anteroinferior part of the glenoid. The aim of this study was to assess the functional outcome of this type of treatment. Methods: This retrospective study was conducted in several health institutions in Ivory Coast from January 2008 to December 2013. Folders of 15 patients whose shoulders were treated by the Latarjet coracoid bone block procedure for anterior shoulder instability and were followed-up for a minimum of 10 years were retrieved and data collected. Functional outcomes were assessed by the Rowe score. The data were evaluated and analysed using Epi Info and Excel statistical software. Results: The functional assessment according to the Rowe score revealed three excellent results, nine good results, two average results and one poor result. One case of recurrence was observed in the postoperative period and required a revision. Conclusion: This study suggests that the Latarjet preglenoid bone block procedure is an effective surgical procedure for treating anterior shoulder instability. It allows for a significant improvement in functional outcomes as well as a satisfactory return to sporting activity.

Effect of Lubricant Use on Cervicovaginal Cytology - What's the Evidence? / Efeito do uso de lubrificante na citologia cervicovaginal - Qual a evidência?

Abstract Objective To determine if the use of lubricating gel on the speculum during the cervicovaginal cytology examination interferes with the results obtained, as well as whether it reduces reported discomfort in patients. Data sources A systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, with a search in the Pubmed/Medline, Scielo, Cochrane Library, Embase databases of articles published between January 2011 and May 2022. The keywords used were cytology, speculum, lubricant, result, and pain. Selection of studies The initial search resulted in 306 articles, of which were excluded three because they were duplicates, 257 after reading the title and abstract and 41 after reading the full text. Thus, five articles were selected for the study: four randomized clinical trials and one metanalysis. Data collection The selection of articles was performed by two investigators. The 5 selected articles were read in full and submitted to a comparative analysis. Data synthesis Screening through cervicovaginal cytology allows for early diagnosis and reduction of associated mortality, but the procedure can be associated with pain. A small amount of aqueous lubricating gel in the speculum can be used to reduce the discomfort associated with performing cervicovaginal cytology. Conclusion The use of lubricating gel in the speculum does not seem to be associated with a change in the cytology result and reduces the discomfort associated with its insertion into the vagina.

Resumo Objetivo Determinar se o uso de gel lubrificante no espéculo durante o exame de citologia cervicovaginal interfere com os resultados obtidos e se diminui o desconforto relatado por pacientes. Fontes de dados Foi realizada uma revisão sistemática segundo as recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), com pesquisa nas bases de dados Pubmed/Medline, Scielo, Cochrane Library, Embase, de artigos publicados entre janeiro de 2011 e julho de 2022. Utilizaram-se as palavras-chave citologia, espéculo, lubrificante, resultado e dor. Seleção dos estudos A pesquisa inicial resultou em 306 artigos, dos quais foram excluídos três por se encontrarem duplicados, 257 após a leitura do título e do resumo e 41 após a leitura integral. Assim, foram selecionados cinco artigos para o estudo: quatro ensaios clínicos aleatorizados e uma metanálise. Coleta de dados A seleção dos artigos foi realizada por dois investigadores. Os cinco artigos selecionados foram lidos na íntegra e submetidos a uma análise comparativa. Síntese dos dados O rastreio através da citologia cervicovaginal permite um diagnóstico precoce e redução da mortalidade associada, mas a sua realização pode estar associada a dor. Uma pequena quantidade de gel lubrificante aquoso pode ser utilizada no espéculo para diminuir o desconforto associado à realização da citologia cervicovaginal. Conclusão A utilização de gel lubrificante não está associada a alteração do resultado da citologia e diminui o desconforto associado à sua introdução na vagina.

A atuação do empresário no executivo municipal apresenta melhores resultados? / ¿El emprendedor en el Poder Ejecutivo Municipal tiene mejores resultados? / Is a business owner a better mayor?

Resumo O objetivo deste artigo é levantar as características demográficas dos prefeitos eleitos, enfatizando os candidatos que se declaram empresários, e analisar se esse perfil tem melhores resultados quanto ao desempenho, medidos com base na situação fiscal e no Índice de Educação Básica (IDEB) do município. Para tanto, o trabalho foi dividido em duas partes. Na primeira, por meio de regressão logística, buscou-se encontrar o perfil do candidato eleito, centrando-se no fato de ele ser empresário. Na segunda seção do artigo, com o emprego da metodologia de regressão multinível, foi analisado se tal perfil escolhido pelos eleitores era responsável por um desempenho superior. Com relação aos resultados, apesar de os empresários constituírem a maioria entre os candidatos, essa característica não foi significativa para o sucesso eleitoral. Na segunda parte da pesquisa, de modo geral os resultados não encontraram correlação entre o perfil dos eleitos e o desempenho da gestão municipal. Somente a idade do prefeito foi significativa na questão fiscal dos municípios. Dessa forma, os empresários não apresentam resultados diferentes da média, o que permite pressupor que esse grupo não tem melhores habilidades e julgamentos.

Resumen El objetivo de este artículo es sondear las características demográficas de los alcaldes electos elegidos, con énfasis en los candidatos que se declaran emprendedores, y analizar si este perfil tiene mejores resultados de desempeño, medido por la situación fiscal del municipio y el puntaje del IDEB (Índice de Desarrollo de la Educación Básica). Para ello, el trabajo se dividió en dos partes. En la primera, mediante regresión logística, se buscó encontrar el perfil del candidato elegido. En la segunda parte del artículo se analizó si el perfil elegido por los votantes era responsable de un desempeño superior. La metodología utilizada fue la de regresión multinivel. En cuanto a los resultados, a pesar de que los empresarios fueron mayoría entre los candidatos, esta característica no fue significativa para explicar el éxito electoral. En general, en la segunda parte de la investigación, los resultados no demostraron correlación entre el perfil de los elegidos y el desempeño de la gestión municipal. Solo la edad del alcalde fue significativa para explicar el tema fiscal de los municipios. De esta forma, los emprendedores no presentan resultados diferentes a la media, lo que nos permite concluir que este grupo no tiene mejores habilidades y juicios. Entre las limitaciones de este trabajo, está la cuestión de que la variable "emprendedor" haya sido declarada libremente por los candidatos.

Abstract This study analyzes the demographic characteristics of elected mayors in Brazil, emphasizing those who are business owners. The research observes whether mayors with a background as business owners obtain better performance in office, which is evaluated through the municipality's fiscal situation and the IDEB (basic education development index) score. The research was conducted in two parts. The first part used logistic regression and sought to identify the profile of elected mayors. The second part analyzed whether mayors who were business owners obtained a superior performance using the multilevel regression model. The study observed that the majority of mayors had a background as business owners, but this characteristic was not significant to explain electoral success. The results of the second part did not find a correlation between mayors who are business owners and their performance. The only demographic characteristic relevant to explain differences in municipalities' fiscal results was the mayor's age. Therefore, mayors who were business owners did not present results different from those who have other backgrounds, which allows us to assume that this group does not have better skills and judgments. One of the limitations of this study is that the characteristic of being a business owner was obtained by self-declaration.

DIFFERENT MODALITIES IN THE MANAGEMENT OF OCULAR SURFACE SQUAMOUS NEOPLASIA

Purpose: To study the different modalities in the management of Ocular Surface SquamousNeoplasia(OSSN).Method: A prospective study of 30 cases of OSSN was undertaken. Based on patient factors andtumour size and characteristics , 20 patients underwent surgical excision with cryotherapy and 10patients were managed conservatively with topical interferon therapy. Patients were followed up for aperiod of nine months.Results: OSSN is more common in males (80%) with mean age of 55 years (range 30-76 years).Histopathology report of excision biopsy showed 6 benign dysplasia, 8 carcinoma in situ and 6invasive squamous carcinoma. Postoperative topical interferon reduced the risk of recurrence.Of the patients who underwent interferon therapy, complete resolution was seen in 6 cases.Conclusion : Management of OSSN requires adequate excision and regular follow up to monitor anyrecurrence. Although surgical excision is still the gold standard for OSSN treatment, topicalinterferon has revolutionised the management of OSSN. Pre and Post operative adjunctive therapyshould be considered to prevent recurrence.

Adaptação cultural do questionário de avaliação de resultados em blefaroplastia: Blepharoplasty Outcomes Evaluation / Cultural adaptation of the blepharoplasty outcomes evaluation questionnarie: Blepharoplasty Outcomes Evaluation

Introdução: O emprego de questionários de qualidade de vida tem se mostrado muito útil no sentido de dar maior objetividade à avaliação de resultados de tratamentos. A internacionalização desses instrumentos, por sua vez, permite a comparação interpopulacional, mas requer uma metodologia específica, a fim de não causar distorções devido a falhas na tradução ou a diferenças culturais. O questionário Blepharoplasty Outcomes Evaluation, de língua inglesa, é uma ferramenta de simples aplicação, com perguntas objetivas com boa aplicação para esse fim. O questionário já foi testado em relação à sua confiabilidade, validade e capacidade de resposta. Métodos: Realizada tradução e adaptação cultural para a língua portuguesa, segundo a metodologia proposta por Beaton et al., na qual existem 5 estágios. Estágio 1 - tradução por meio de dois tradutores nativos de língua portuguesa. Estágio 2 - confecção de versão de síntese. Estágio 3 - tradução reversa por dois tradutores nativos de língua inglesa. Estágio 4 - revisão por um comitê avaliador. Estágio 5 - aplicação a uma população de 20 pessoas. Resultados: A partir do comitê avaliador, não houve problemas de compreensão para a população final. Conclusão: O questionário foi traduzido e adaptado com sucesso.

Introduction: The use of quality of life questionnaires has proved to be very useful in giving greater objectivity to evaluating treatment results. The internationalization of these instruments, in turn, allows for interpopulation comparison but requires a specific methodology in order not to cause distortions due to failures in translation or cultural differences. The Blepharoplasty Outcomes Evaluation questionnaire, in English, is a simple application tool with objective questions with a good application for this purpose. The questionnaire has already been tested for reliability, validity and responsiveness. Methods: According to the methodology proposed by Beaton et al., translation and cultural adaptation into Portuguese was performed with 5 stages. Stage 1 - translation by two native Portuguese-speaking translators. Stage 2 - preparation of the synthesis version. Stage 3 - reverse translation by two native English-speaking translators. Stage 4 - review by an evaluation committee. Stage 5 - application to a population of 20 people. Results: There were no comprehension problems for the final population from the evaluation committee. Conclusion: The questionnaire was successfully translated and adapted.

Application of anchored instruction combined with PBL in the clinical teaching of department of gynecology / 中华医学教育探索杂志

Objective:To analyze the application effects of anchored instruction combined with problem-based learning (PBL) in the clinical teaching of department of gynecology.Methods:Taking the implementation time (June 2020) of anchored instruction combined with PBL in the hospital, 86 clinical interns who entered the department of gynecology before the implementation (from April 2019 to May 2020) were included in control group, and this group adopted traditional teaching method; 82 interns enrolled after the implementation (between June 2020 and December 2020) were selected as observation group and were given new teaching method. The theoretical assessment results, practical operation results, independent learning ability and teaching satisfaction were compared between the two groups after 1 month of training. SPSS 22.0 was used for t test and rank sum test. Results:After 1 month of training, the scores of theoretical assessment results [(81.20±10.64) vs. (73.96±8.25)] and mini-clinical evaluation exercise (Mini-CEX) scale of observation group were significantly higher than those of control group, and the independent learning ability and teaching satisfaction evaluation were significantly better than those of control group ( P<0.05). Conclusion:Anchored instruction combined with PBL can effectively improve the independent learning ability and learning satisfaction of interns in department of obstetrics and gynecology, with good application effects.

Explore on the cultivation of research potential of eight-year program students through the results of blind evaluation of dissertations / 中华医学教育探索杂志

Objective:To understand the results of blind evaluation of dissertation of three-year doctors and eight-year medical doctors, and to explore the improvement measures of eight-year program education.Methods:The data analysis method was manipulated. A total of 47 eight-year doctoral and 88 three-year doctoral dissertations submitted by the first clinical college of Huazhong University of Science and Technology in 2020 were selected as the research material. SPSS 17.0 was used to perform Chi-square test to compare the itemized evaluation opinions of the dissertation, Spearman test was used to analyze the correlation between the defense opinions, itemized evaluation opinions and the overall evaluation.Results:The gap between eight-year and three-year doctoral dissertation is mainly manifested in innovation and research value ( χ2=9.10, P=0.003), topic and review ( χ2=5.70, P=0.017), while there is no significant difference in the overall assessment and oral defense suggestion. The main influencing factor of dissertation defense suggestion for both doctors was the dissertation standardization (eight-year: r s=0.53, P<0.001; three-year: r s=0.45, P<0.001). The evaluation results of eight-year doctor dissertation were closely related to basic knowledge and scientific research ability ( r s=0.74, P<0.001). Conclusion:There is no significant difference between eight-year doctors and full-time doctors in research attitude. But there was a certain gap in scientific research and innovation ability among them. It is suggested to clarify the teaching objectives, formulate and refine the evaluation system of dissertations, and strengthen the cultivation of scientific research interest and academic belief of eight-year study program.

A comparison of clinical characteristics between acute fatty liver of pregnancy and hemolysis, elevated liver enzymes and low platelets syndrome / 中华危重病急救医学

Objective:To compare and analyze the clinical characteristics between acute fatty liver of pregnancy (AFLP) and the hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome.Methods:This is a retrospective cohort study. The clinical data of 13 cases with AFLP and 34 cases with HELLP syndrome were collected from three tertiary referral centers in Yunnan (the First Affiliated Hospital of Kunming Medical University, the Second Affiliated Hospital of Kunming Medical University, and Yan'an Hospital of Kunming City) from January 2016 to December 2021. The patients were diagnosed to AFLP and HELLP syndrome according to the Swansea criteria and the Tennessee classification system. The general characteristics, clinical features, laboratory results within 24 hours after admission, complications, maternal and neonatal outcomes were compared to analysis the differences between the two groups.Results:① Maternal characteristics: compared with HELLP syndrome group, AFLP group had lower body mass index (BMI) and blood pressure at admission (both P < 0.01). ②Clinical features: the most common symptoms in AFLP patients were skin jaundice, abdominal pain, nausea and vomiting, edema. The main manifestations of patients with HELLP syndrome were albuminuria, hypertension, edema, headache. Some patients had multiple symptoms concurrently. ③ Laboratory results: compared with HELLP syndrome group, the levels of platelet count (PLT), total bilirubin (TBil), direct bilirubin (DBil), γ-glutamyl transferase (γ-GGT), alkaline phosphatase (ALP), total bile acid (TBA), serum creatinine (SCr) and international standardized ratio (INR) in AFLP group were significantly increased within 24 hours after admission [PLT (×10 9/L): 107.69±51.13 vs.76.71±43.25, TBil (μmol/L): 121.60 (83.20, 170.00) vs.15.25 (7.22, 29.05), DBil (μmol/L): 86.50 (58.60, 104.00) vs. 4.30 (2.22, 10.10), γ-GGT (U/L): 87.00 (37.00, 127.00) vs. 41.00 (19.00, 64.42), ALP (U/L): 199.10 (109.00, 349.20) vs. 125.50 (90.50, 155.25), TBA (μmol/L): 51.50 (16.20, 117.40) vs. 4.15 (2.02, 6.95), SCr (μmol/L): 155.80 (129.00, 237.00) vs. 79.00 (65.43, 113.70), INR: 1.28 (1.17, 1.63) vs. 0.94 (0.88, 1.08), all P < 0.05], prothrombin time (PT) was significantly prolonged [seconds: 16.10 (14.50, 19.20) vs. 12.40 (11.43, 13.40), P < 0.05]. The level of blood glucose (GLU), fibrinogen (FIB) and the activity of antithrombin Ⅲ (ATⅢ) decreased significantly [GLU (mmol/L): 5.18±1.33 vs. 6.33±1.19, FIB (g/L): 1.96±1.46 vs. 3.81±1.58, ATⅢ (%): 40.61±25.84 vs. 66.39±24.11, all P < 0.05]; ④ Complications: compared with HELLP syndrome group, the incidence of patients with hypoglycemia [30.77% (4/13) vs. 0% (0/34)], acute liver failure [53.85% (7/13) vs. 5.88% (2/34)], acute renal insufficiency [69.23% (9/13) vs. 8.82% (3/34)], coagulopathy [76.92% (10/13) vs. 38.24% (13/34)], disseminated intravascular coagulation (DIC) [53.85% (7/13) vs. 5.88% (2/34)], and multiple organ dysfunction syndrome (MODS) [53.85% (7/13) vs. 5.88% (2/34)] were significantly higher in AFLP group (all P < 0.05). ⑤ Maternal and neonatal outcome: all patients delivered after admission. The total length of hospital and intensive care unit stay were significantly longer in the AFLP group than in the HELLP syndrome group [days: 17.00 (11.00, 25.00) vs. 9.00 (7.00, 12.00), 12.00 (4.00, 22.00) vs. 3.91 (0, 7.00), both P < 0.01]. Two AFLP patients died, including one due to intracranial venous thrombosis and one due to multiple organ failure and cardiopulmonary arrest. There were no deaths in the HELLP syndrome group. Conclusions:There are significant differences in maternal characteristics, laboratory results and complications between AFLP and HELLP syndrome. TBil, γ-GGT, SCr, FIB, INR and ATⅢ activity may help to distinguish the two diseases.

Results of the nationwide assessment of radionuclide γ spectrum measurement in 2018—2020 / 中国辐射卫生

@#<b>Objective</b> To ensure the effectiveness and improve the capacity of laboratories in the measurement of γ spectra of radionuclides. <b>Methods</b> A statistical analysis was performed using relative deviation, accuracy, precision, and relative combined uncertainty for the nationwide assessment of radionuclide γ spectrum measurement. <b>Results</b> In the assessment from 2018 to 2020, our laboratory showed qualified or above results, and the performance in 2019 was excellent. The maximum relative deviation of 11 measurements from 2018 to 2020 was 18.01%. The assessment showed |Z_test|≤1 and U_test≤2.58 in 2018, |Z_test|≤1 and U_test≤1 in 2019, and U_test≤1 and U_rel≤20% in 2020. <b>Conclusion</b> Our laboratory employs the correct method for radionuclide γ spectrum measurement, and the analysis data are accurate and reliable.

Trauma informed occupational therapy school practice with adolescents with social emotional and behavioural difficulties: findings of standardised measures / Trauma informando práticas escolares em terapia ocupacional com adolescentes em dificuldades socioemocionais e comportamentais: achados a partir de medidas padronizadas

Abstract Introduction Although non-standardized qualitative and quantitative reports from 39 Irish students aged 12 to 14 years, with complex social and emotional needs and their 13 teachers had established benefits of 'Movement Matters', an occupational therapy designed participatory curriculum for learning self-regulation in mainstream schools (National Behaviour Support Service, 2015a), standardized measures were required for quality assurance by the Irish Government funded service. Objective The relevance of findings of standardized attitude measurements on the impacts of an occupation focused intervention with a discrete school population in areas of social disadvantage are discussed. Method Findings of the 'Pupil Attitude to Self and School' (PASS) (Granada Learning, 2021) and 'Strengths and Difficulties Questionnaire' (SDQ) (Youth in Mind, 2021), both well-established standardized measures of attitude and behaviours completed (pre and post intervention) by teachers, parents and students are presented. Results No statistically significant differences were found between the standardized pre and post intervention measures. However, findings indicate a disparity between how these students in complex environments experience school in comparison to large UK study populations. Conclusion This paper discusses the use of these standardized measures for capturing impacts of an occupation focused intervention in a school environment. It calls for an increased appreciation on outcomes measurement related to the intervention's aim of providing experiences of meaningful participation and well-being. Further collaborative research on outcome measurement of participation of students in complex mainstream school environments is required.

Resumo Introdução Embora relatórios qualitativos e quantitativos não padronizados de 39 estudantes irlandeses, de 12 a 14 anos, com necessidades sociais e emocionais complexas e seus 13 professores tenham estabelecido benefícios de 'Movement Matters', uma terapeuta ocupacional projetou um currículo participativo para aprender autorregulação no ensino regular (National Behaviour Support Service, 2015a), tendo sido necessárias medidas padronizadas para garantia de qualidade do serviço financiado pelo governo Irlandês. Objetivo Discutir a relevância dos resultados das medidas de atitudes padronizadas sobre os impactos de uma intervenção focada na ocupação com uma população escolar em áreas de desvantagem social. Método São apresentados dados do 'Pupil Attitude to Self and School' (PASS) (Granada Learning, 2021) e 'Strengths and Difficulties Questionnaire' (SDQ) (Youth in Mind, 2021), ambas medidas padronizadas bem estabelecidas de atitude e comportamentos (pré e pós-intervenção) por professores, pais e alunos. Resultados Não foram encontradas diferenças estatisticamente significativas entre as medidas padronizadas pré e pós-intervenção. No entanto, os resultados indicam uma disparidade sobre como esses alunos vivenciam a escola em ambientes complexos, em comparação com estudos de grandes populações no Reino Unido. Conclusão Este artigo discute o uso dessas medidas padronizadas para compreender os impactos de uma intervenção focada na ocupação em um ambiente escolar. Observa-se a necessidade de uma maior apreciação da medição de resultados relacionados ao objetivo da intervenção ao fornecer experiências de participação e bem-estar significativos. São necessárias mais investigações colaborativas sobre a medição dos resultados da participação dos alunos em ambientes complexos de escolas regulares.

Retinocoroiditis toxoplásmica y la evolución del resultado visual en pacientes inmunocompetentes / Toxoplasmic retinochoroiditis and the evolution of visual results in immunocompetent patients

Objetivo: Determinar la evolución del resultado visual en pacientes con toxoplasmosis ocular activa. Métodos: Se realizó un estudio observacional prospectivo longitudinal en 101 pacientes inmunocompetentes con toxoplasmosis ocular activa, atendidos en la consulta de Uveítis del Hospital General Docente "Abel Santamaría", desde enero de 2012 a diciembre de 2018. Se evaluaron las variables localización de la lesión, tamaño, número, episodio, grado de inflamación, complicaciones, recurrencia postratamiento y mejor agudeza visual corregida. Se analizaron los resultados utilizando frecuencias absolutas y relativas, la asociación estadística chi cuadrado, las pruebas U Mann-Whitney o Kruskall Wallis, Friedman y de rangos con signos de Wilcoxon. Resultados: Según la localización de la lesión, los resultados visuales inferiores se presentaron en los pacientes con lesiones en zona I y los mejores se obtuvieron cuando hubo afectación en zona III. Se mostró una mejor evolución del resultado visual en los que tuvieron lesiones menores o iguales a un diámetro papilar. Existió diferencia estadística entre los diferentes grados de gravedad de la inflamación, con tendencia al incremento de la mejor agudeza visual corregida en el tiempo, después del tratamiento. Conclusiones: Durante la evolución de los pacientes inmunocompetentes con toxoplasmosis ocular activa se logra mejoría de la visión(AU)

Objective: Determine the evolution of visual results in patients with active ocular toxoplasmosis. Methods: An observational longitudinal prospective study was conducted of 101 immunocompetent patients with active ocular toxoplasmosis attending the Uveitis Service at Abel Santamaría General University Hospital from January 2012 to December 2018. The variables evaluated were injury location, size, number, episode, degree of inflammation, complications, post-treatment recurrence and best corrected visual acuity. Results were analyzed with absolute and relative frequencies, chi-square statistical association, the Mann-Whitney U or Kruskall Wallis tests, the Friedman test and the Wilcoxon signed-rank test. Results: According to injury location, the lowest visual results were obtained in patients with zone I lesions, whereas the best results corresponded to zone III lesions. A better visual result evolution was achieved in patients with lesions smaller than or equal to a papillary diameter. A statistical difference was found between the various degrees of inflammation severity, with a tendency to an increase in best corrected visual acuity with the passing of time after treatment. Conclusions: Visual improvement is achieved during the evolution of immunocompetent patients with active ocular toxoplasmosis(AU)

Introducción de resultados científicos: bases teórico-metodológicas para su mejora en la educación médica / Introduction of scientific results: theoretic-methodological bases for its improvement in medical education

RESUMEN En Cuba, la transformación de la realidad por medio de la introducción de resultados científicos -en aras del desarrollo sostenible-, es una alta prioridad por parte de las primeras instancias de dirección desde 1959. La introducción de resultados investigativos ha sido abordada por prestigiosos autores desde diferentes aristas y contextos, pero existen escasas referencias relacionadas con el tema en el ámbito de las ciencias de la educación médica. En consecuencia, este artículo presenta un análisis sobre las tendencias del proceso de introducción de resultados científicos en el ámbito académico, para luego delinear cuáles pudieran ser las bases teórico-metodológicas para la mejora del proceso en el ámbito de la educación médica (AU).

ABSTRACT In Cuba, the transformation of reality through the introduction of scientific results -for the sake of the sustainable development- is a high priority for the first instances of direction since 1959. The introduction of research results has been approached by prestigious authors from different edges and in different contexts, but there are few references related to the theme in the field of the medical education sciences. Consequently, this article presents an analysis on the tendencies of the process of introducing scientific results in the academic sphere, and then outlines the possible theoretic-methodological bases for improving the process in the field of medical education (AU).