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Objective To analyzes the influence of Artificial Intelligence(AI)technology on physician workload based on the panel data of 31 provinces in China from 2012 to 2021.Methods Using MATLAB R2022b software to estimate the kernel density of physician workload and analyze the changes of physician workload in the past 10 years.Select fixed effects model and perform panel regression analysis between AI techniques and physician workload based on Stata MP 17.0 software.Results At present,there is a serious regional multi-level differentiation in physician workload.AI-assisted diagnosis,AI-assisted treatment and AI-assisted management have significantly reduced the physician workload.However,there is regional difference in the negative influence of AI technology on physician workload,with the most significant influence in eastern China and less significant in western China.Both aging and personal health investment negatively moderate the relationship between AI-assisted diagnosis technology and physician workload.Conclusion Great attention should be paid to AI,especially AI-assisted diagnosis technology,because it plays an important role in reducing the physician workload and alleviating the pressure caused by insufficient medical resources and uneven distribution in the context of aging.
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Two new species of Nematoda, Litinium macramphida sp. nov. and Cyartonema breviseta sp. nov. are described from the Yelllow Sea. Litinium macramphida sp. nov. is characterized by body relatively long, inner and outer labial sensilla setiform with same length, amphideal fovea large and drop-shaped with amphideal aperture ovoid, spicules short and wide, gubernaculum simple and boat shaped, two precloacal supplements, and tail conical with rounded tip. Cyartonema breviseta sp. nov. is characterized by body short and slender, four cephalic sensilla papilliform, amphideal fovea circular and large, spicules curved and sickle-shaped, gubernaculum with dorsal-caudal apophysis and posterior end anteriorly hooked, and tail conical.
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Enóplidos , Nematodos , Animales , Chromadorea , ChinaRESUMEN
Bolbolaimus major sp. nov. is described from Rizhao coast along the Yellow Sea. The new species is characterized by relatively large body size, cuticle strongly annulated, six outer labial sensilla setiform, four cephalic setae long, buccal cavity wide with one large dorsal tooth and two small subventral teeth, amphidial fovea unispiral shaped oval in males and circular in females, spicules curved with swollen proximal end, gubernaculum with anterior-hooked dorso-caudal apophysis, and tail conical with short spinneret. A phylogenetic analysis of maximum-likelihood and Bayesin inference based on rDNA sequences confirms the taxonomic position of Bolbolaimus major sp. nov. within the family Microlaimidae. Tree topology in Microlaimidae shows genus Microlaimus as polyphyletic group and genera in Microlaimidae are closely related.
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Nematodos , Masculino , Femenino , Animales , Filogenia , Chromadorea , China , Cola (estructura animal)RESUMEN
As one of the first institutions to carry out integrated education in China, the Shanghai Jiao Tong University School of Medicine has carried out a pilot reform of the organ system centered vertical single cycle integrated curriculum in the undergraduate medical education (five-year English stream) based on the Sino-foreign cooperative education program. The curriculum has been formed with multi-disciplinary single cycle integrated courses, longitudinal integrated courses, and three-dimensional specialized expansion electives. The curriculum focuses on the competency training of medical student. The aim is to highlight the teaching concept of early contact with clinic, attach importance to the cultivation and shaping of medical personality, achieve effective connection with post-graduation education, and realize the intersection and deep integration of social, humanities and medical professional courses through the construction of a series of course modules.
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Objective:This article aimed to systematically evaluate the safety, feasibility and short-term outcomes of laparoscopic versus open radical resection for hilar cholangiocarcinoma.Methods:Relevant medical literatures published before November 30, 2021 were searched using PubMed, EMbase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, CBM databases. Based on predetermined inclusion and exclusion criteria, articles were selected, and RevMan5.4 software was used to conduct the meta-analysis of this study.Results:Twelve comparative cohort articles were enrolled, which included 634 patients. There were 275 patients who underwent laparoscopic radical resection for hilar cholangiocarcinoma in the laparoscopic group, and 359 patients who underwent open radical resection for hilar cholangiocarcinoma in the open group. Meta-analysis showed that when compared with the open group, operation time of the laparoscopic group was significantly longer ( MD=58.36, 95% CI:13.54-103.18). However, intraoperative blood loss ( MD=-79.70, 95% CI:-90.01--69.39), hospital stay ( MD=-3.37, 95% CI:-4.29--2.45) and incision-related complications ( OR=0.36, 95% CI:0.16-0.80) were all significantly less (all P<0.05). The number of lymph node harvested, R 0 resection rates, postoperative bile leakage, intraperitoneal infection and effusion, total complication rates, and perioperative mortality and 1-year survival rates after operation between the two groups were not significantly different (all P>0.05). Conclusion:Laparoscopic radical resection for hilar cholangiocarcinoma was feasible and safe in selected patients carried out in an experienced hepatobiliary surgery center.
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Disclaimer statementThe authors have withdrawn this manuscript because the statistical methods in our manuscript need to be modified and we are going to improve the statistical methods and try to give more precise model. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.
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Taking the curriculum "society, the individual & medicine" in university of Ottawa faculty of medicine as an example, the cultivation models for comprehensive quality of medical students in China and Canada was compared. In University of Ottawa faculty of medicine, the curriculum "society, the individual & medicine" is throughout the whole medical education, including three themes of statistics and epidemiology related knowledge, health related issues and professional development. The varied teaching modes are combined with electronic teaching equipment and students' subjectivity in learning is emphasized. Drawing insights from the medical education in Canada, we should focus on promoting early contact and lifelong study of medical humanities curriculum for medical students, enriching the curriculum content, enhancing the curriculum practicality, diversifying the teaching methods, strengthening the teachers' training, improving the assessment system and establishing the long-term mechanism.
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Taking the curriculum "society, the individual & medicine" in university of Ottawa faculty of medicine as an example, the cultivation models for comprehensive quality of medical students in China and Canada was compared. In University of Ottawa faculty of medicine, the curriculum "society, the individual&medicine" is throughout the whole medical education, including three themes of statistics and epidemiology related knowledge, health related issues and professional development. The varied teaching modes are combined with electronic teaching equipment and students' subjectivity in learning is emphasized. Drawing insights from the medical education in Canada, we should focus on promoting early contact and lifelong study of medical humanities curriculum for medical students, enriching the curriculum content, enhancing the curriculum practicality, diversifying the teaching methods, strengthening the teachers' training, improving the assessment system and establishing the long-term mechanism.
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Canada is one of the leading countries in the world with a leading position in medical education and high quality of medical education.Based on the Ottawa-Shanghai joint medical school collaborative program,this article introduces and analyzes the curriculum system of University of Ottawa School of Medicine.The curriculum is designed based on organs and systems,with a focus on the integration of basic and clinical research from the early stage.It adopts a diversified and student-centered teaching method,with practice teaching running through the whole course.Moreover,it attaches importance to family medical education and strengthens the cultivation of medical humanities.Learning from the advanced teaching concepts and methods in North America may help to promote the reform of medical education in China and cultivate high-quality medical talents in line with international standards.
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Objective To explore the relationship between the liver volume atrophy rate,liver stiffness measurements(LSM) and Child-Turcotte-Pugh(CTP) value with the Laennec histopathological classification in the patients with hepatitis B cirrhosis and its value in the quantitative diagnosis of liver cirrhosis degree.Methods The clinicopathological data of liver biopsy tissue pathological slides,FibroScan,CT examination and hematological detection in 32 cases of hepatitis B cirrhosis were retrospectively analyzed.Liver cirrhosis was divided into mild,moderate and severe according to the Laennec liver cirrhosis histopathological classification.Then the relationship between the liver volume atrophy rate,LSM and CTP score with liver cirrhosis histopathological.Results Among 32 cases,9 cases(28.12%) were mild,12 cases(37.50%) were moderate and 11 cases(34.38%) were severe.The liver volume atrophy rates of mild,moderate and severe groups were (16.75±2.20)%,(23.11±6.67)% and(35.55±5.70)% respectively;LSM were(14.96±3.36),(20.21± 3.07),(37.03 ± 16.44) kPa respectively,the difference among 3 groups was statistically significant (P< 0.01).The CTP scores had no statistical difference among the 3 groups were(P>0.05).The cirrhosis histopathological grade had the positive correlation with the liver volume atrophy rate and LSM(r=0.93,0.74,P<0.01),however had no obvious correlation with the CTP scores(r=0.27,P>0.05);the liver volume atrophy rate was positively correlated with LSM and CTP score(r=0.90,0.91,P<0.01);while LSM had no obvious correlation with CTP score (r =0.15,P > 0.05).Conclusion The more severe the cirrhosis histoathological grade,the bigger the liver volume atrophy rate and the higher the FibroScan detection value;the liver volume atrophy rate and LSM may serve as the quantitative diagnosis indicators of liver fibrosis histopathological severity.
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BACKGROUND: To identify the: extent to which medical students in China experience burnout; factors contributing to this; potential solutions to reduce and prevent burnout in this group; and the extent to which the experiences of Chinese students reflect the international literature. METHODS: Systematic review and narrative synthesis. Key words, synonyms and subject headings were used to search five electronic databases in addition to manual searching of relevant journals. Titles and abstracts of publications between 1st January 1989-31st July 2016 were screened by two reviewers and checked by a third. Full text articles were screened against the eligibility criteria. Data on design, methods and key findings were extracted and synthesised. RESULTS: Thirty-three studies were eligible and included in the review. Greater levels of burnout were generally identified in males, more senior medical students, and those who already experienced poorer psychological functioning. Few studies explored social or contextual factors influencing burnout, but those that did suggest that factors such as the degree of social support or the living environment surrounding a student may be a determinant of burnout. CONCLUSIONS: Greater understanding of the social and contextual determinants of burnout amongst medical students in China is essential towards identifying solutions to reduce and prevent burnout in this group.
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Agotamiento Profesional , Estudiantes de Medicina/psicología , Agotamiento Profesional/epidemiología , Agotamiento Profesional/prevención & control , Agotamiento Profesional/psicología , China/epidemiología , Educación de Postgrado en Medicina , Educación de Pregrado en Medicina , Femenino , Humanos , Masculino , Facultades de Medicina , Factores Sexuales , Apoyo SocialRESUMEN
Objective To explore clinical profile and significance of serum golgi protein 73 (GP73) in cirrhotic patients with chronic hepatitis B virus (HBV) infection .Methods A total of 109 cirrhotic patients with HBV infection were included ,in which 60 patients were compensated cirrhosis ,and 49 patients were decompensated cirrhosis .The receiver operating characteristic curve (ROC) analysis were used to evaluate the clinical significance of GP73 for diagnosing decompensated cirrhosis in cirrhotic popula-tion .Results Serum GP73 level in cirrhotic patients was correlated with alanine aminotransferase (ALT ) and HBV DNA ,but neg-atively correlated with albumin levels .Serum GP73 levels in patients with decompensated cirrhosis was (215 .9 ± 96 .56)ng/mL , which was significant higher than (113 .7 ± 68 .95)ng/mL in patients with compensated cirrhosis .The area under ROC was 0 .82 (95% CI :0 .74 ~ 0 .90 ,P< 0 .05) .The sensitivity and specificity of GP73 diagnosing decompensated cirrhosis in cirrhotic population with chronic HBV infection were 77 .55% and 75 .00% respectively ,when the cut-off was set at 140 .5 ng/mL .Conclusion Serum GP73 level is related with liver injury and HBV replication .GP73 might be an useful marker for diagnosing decompensated cirrhosis in cirrhotic population with chronic HBV infections .
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Objective To investigate the inhibitory effects of IBI302 on experimental choroidal neovascularization (CNV).Methods Affinity of IBI302 to vascular endothelial growth factor (VEGF) family cytokines (including VEGF-A165,VEGF-A121 and placental growth factor PlGF) and complements (C3b,C4b) was determined by enzyme-linked immunosorbent assay (ELISA).The antagonist effect of IBI302 on VEGF was measured by proliferation,migration and tube formation tests of human umbilical vein endothelial cells (HUVEC).The anti-complement activity of IBI302 was measured by hemolysis test mediated by complement classical pathway and alternative pathway.Rhesus laser-induced CNV model was divided into 5 groups including model control group,bevacizumab group,IBI302 0.25 mg group,IBI302 0.50 mg group and IBI302 1.25 mg group.Fluorescein angiography and optical coherence tomography were performed on these monkeys at 14 and 28 days after drug delivery to observe the fluorescein leakage area and retinal thickness.The aqueous VEGF concentration was measured at 29 days after drug delivery.Results IBI302 showed good affinity to VEGF-A165,VEGF-A121 and PlGF,as well as C3b and C4b.IBI302 significantly inhibited the proliferation,migration and tube formation of HUVEC induced by VEGF-A165.IBI302 inhibited the hemolysis induced by complements obviously.At 14 and 28 days after drug delivery,the area of fluorescein leakage and retinal thickness in IBI302 0.25 mg group,IBI302 0.50 mg group,IBI302 1.25 mg group were reduced.The differences of the area of fluorescein leakage and retinal thickness in three IBI302 groups were not significant (P>0.05).At 29 days after drug delivery,the VEGF concentration in the aqueous of rhesus monkey in bevacizumab group [(38.644 ± 6.521) pg/ml] was decreased than that in model control group [(94.203± 17.360) pg/ml],the difference was significant (P< 0.05).The VEGF concentration in the aqueous of rhesus monkey in three IBI302 groups were less than 31.300 pg/ml.Conclusion IBI302 inhibited experimental CNV through blocking the activity of VEGF and complement.
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Objective:To explore therapeutic effect and safety of cilostazol combined clopidogrel +aspirin on aged pa‐tients after percutaneous coronary intervention (PCI) .Methods :A total of 100 aged patients with coronary heart disease undergoing PCI were randomly divided into routine treatment group (n=52 ,received aspirin and clopidogrel antiplatelet therapy) and cilostazol group (n= 48 ,received cilostazol therapy based on routine treatment group ) . Turbidimetry was used to measure platelet aggregation rate (PAR );PAR and mean platelet volume (MPV ) were compared between two groups before ,one week and one month after PCI .All subjects were followed up for six months ,incidence rates of major adverse cardiovascular events (MACE) and hemorrhage events were compared be‐tween two groups .Results:There were no significant difference in MPV and PAR between two groups before PCI . Compared with routine treatment group ,PAR significantly reduced [one week after PCI :(48.7 ± 6.3)% vs .(43.5 ± 5.7)% ,one month after PCI :(46.8 ± 5.8)% vs .(42.4 ± 5.4)% ] in cilostazol group , P0.05;incidence rate of hemorrhage in cilostazol group was significantly lower than that of routine treatment group (6.25% vs .19.23% , P< 0.01) .Conclusion:Compared with clopidogrel+aspirin therapy ,cilostazol combined clopidogrel+aspirin can more significantly inhibit platelet ag‐gregation ,and significantly reduce hemorrhage events ,so they are safe and effective in aged patients with coronary heart disease undergoing PCI .
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A new species of free-living marine nematodes, Ptycholaimellus longibulbus sp. nov., is described from the East China Sea. Ptycholaimellus longibulbus sp. nov. is characterized by having body length of about 1100-1400 µm, cephalic seta 9 µm long (half a head diameter), a relatively long double posterior pharyngeal bulb occupying 44-49% of pharyngeal length, a voluminous ventral gland with a large ampulla, cuticle with transverse rows of punctations and lateral differentiation with two longitudinal rows of thick dots, relatively long spicules 45-55 µm long, an arcuate gubernaculum 25 µm long, and a conico-cylindrical tail with a distinct long finger-like spinneret. A key to species of Ptycholaimellus is given.
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Nematodos/clasificación , Animales , China , Femenino , Masculino , Nematodos/anatomía & histología , Especificidad de la EspecieRESUMEN
With the significant reformation of the health care system in China, medical edu-cation has also been adjusted rapidly in order to meet the needs of health services and development of medical and health undertakings. However, as a result of the adjustment of medical education system and the different schooling system in different regions around the country, medical education system and academic degree in China can hardly be comparedaround the world, and the education institutions such as universities in foreign countries can't understand clearly our country's medical education system and degree very well. Based on the medical education theory and practice of Australia, this paper de-scribes and analyses the difference of medical education system between the two countries, so as to provide some idea on perfecting the medical educationtralning model in China as well as lay a founda-tion for the comparison between Chinese medical education system and mature systems of foreign countriessuch as Australia.
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OBJECTIVE:To demonstrate challenges of pharmacy automation reconstruction so as to set solutions. METHODS:Based on literature review,analysis of pharmacy automation setting and features,this paper gave the suggestions and solutions on construction cost,management model change,equipment maintenance and emergency response,etc. according to the practice of the hospital. RESULTS&CONCLUSIONS:Pharmacy automation construction should be stick to the requirements of new health re-form to lower the cost by using the out resources and interior optimal allocation,to improve efficiency by unified planning and proper design,and to ensure the system running efficiently by sufficient maintenance and contingency plan.
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Pentraxin-3 (PTX3) is an inflammatory marker thought to be more specific to cardiovascular inflammation than C-reactive protein (CRP). Our aim was to assess the prognostic value of PTX3 in patients with stable coronary artery disease (CAD) after drug eluting stent (DES) implantation. Plasma PTX3 levels were measured before percutaneous coronary intervention (PCI) and at 24 h post-PCI in 596 consecutive patients with stable CAD. Patients were followed up for a median of 3 years (range 1-5) for major adverse cardiovascular events (MACEs). We found that the post-PCI plasma PTX3 levels were significantly higher at 24 h after PCI than pre-PCI, patients with MACEs had higher post-PCI PTX3 levels compared with MACEs-free patients, patients with higher post-PCI PTX3 levels (median > 4.384 ng/mL) had a higher risk for MACEs than those with PTX3 < 4.384 ng/mL, and post-PCI PTX3, cTnI, multiple stents, and age but not high-sensitivity CRP (hsCRP) were independently associated with the prevalence of MACEs after DES implantation. The present study shows that post-PCI PTX3 may be a more reliable inflammatory predictor of long-term MACEs in patients with stable CAD undergoing DES implantation than CRP. Measurement of post-PCI PTX3 levels could provide a rationale for risk stratification of patients with stable CAD after DES implantation.
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Proteína C-Reactiva/metabolismo , Enfermedad de la Arteria Coronaria/sangre , Stents Liberadores de Fármacos , Componente Amiloide P Sérico/metabolismo , Anciano , Femenino , Estudios de Seguimiento , Humanos , Inflamación/metabolismo , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Análisis Multivariante , Paclitaxel/administración & dosificación , Intervención Coronaria Percutánea , Pronóstico , Sirolimus/administración & dosificación , Sirolimus/análogos & derivadosRESUMEN
Objective: To study the predictive value of combination scores of leukocyte and platelet counts (COL-P) for in-hospital mortality in patients with acute ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) treatment. Methods: A total of 660 STEMI patients with emergent PCI in our hospital from 2009-11 to 2013-08 were retrospectively studied. The patients were divided into 3 groups according to COL-P scores: COL-P0 group,n=283, COL-P1 group,n=319 and COL-P3 group,n=58. The relationship between the in-hospital mortality and COL-P scores was analyzed among different groups. Results: There were 88/660 in-hospital death. The patients in death group had the higher white blood cell count and lower platelet count than those in survival group, bothP<0.01. Logistic regression analysis indicated that compared with COL-P0 group, the COL-P scores at COL-P1 level (OR 4.346, 95% CI 2.134-8.850,P<0.001) and COL-P2 level (OR 10.126, 95% CI 4.061-25.250,P<0.001) were the independent risk factors for in-hospital death in STEMI patients after emergent PCI. The in-hospital mortality in COL-P0, COL-P1 and COL-P2 groups were at 4.9%, 15.4% and 43.1% respectively, allP<0.001. Conclusion: COL-P score was useful for predicting the in-hospital mortality in STEMI patients after emergent PCI, while the long term mortality estimation should be further studied.
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Objective To analyze the psychological condition of postgraduates in clinical hos-pitals of colleges and universities before and after the implementation of psychological mentor scheme so as to evaluate the effect. Methods Quantitative questionnaire (SCL-90 scale) and qualitative fo-cus interview were used to compare psychological condition of postgraduates. Totally 182 copies of questionnaires were sent to two hospitals (A and B) respectively. Then, psychological mentor scheme was carried out in A hospital. Afterwards, 206 and 140 copies of questionnaires were sent again to the hospitals respectively to compare the results. Eight student psychological consultants, 12 postgraduates and 5 postgraduate management staff were enrolled in qualitative focus interview. Excell2003 software was adopted to establish the database and SPSS 11.0 software was used for statistical analysis. Descrip-tive analysis, frequency analysis, t test, chi-square test and variance analysis were adopted for data analysis. P<0.05 signifies for statistically significant difference. Results Mental health status of both groups was better than the national level before the implementation (total SCL score: A hospital=118 . 08 ±36.20; B hospital =100.33 ±22.90). However, SCL-90 score of A hospital was decreased (total SCL score: 102.58 ±25.23) and that of B hospital (total SCL score:134.01 ±38.92) was in-creased (part of items higher than the adult national norm) at one year after conducting psychological mentor scheme. Conclusions Psychological mentor scheme can effectively relieve stress and interper-sonal stress so as to reduce the general psychological problems and can help to improve mental health of the students.