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Objective:To investigate the application effect of a sequential clinical skill curriculum system in standardized residency training.Methods:A total of 300 residents who participated in the residency training of a clinical medical school from 2020 to 2022 were selected as the research subjects, among whom 46 residents in the experimental group had received the clinical skill training course of the clinical medical school in the undergraduate stage, and 254 in the control group had not received such training in the undergraduate stage. The teaching effect of the two groups was observed from the first year to the third year after they entered the residency training base and were trained together based on the curriculum system. SPSS 24.0 statistical software was used for data analysis, and the main statistical methods included descriptive analysis, the Kolmogorov-Smirnov test, the Mann-Whitney U test, and the chi-square test. Results:Before the residents entered the residency base, class 2020 [60.0(52.0,60.0) vs. 51.0(48.0,53.0)], class 2021 [54.0(52.0,56.0) vs. 51.0(48.0,53.0)] and class 2022 [53.0(51.0,55.0) vs. 50.0(47.0,51.0)] The difference between the entry base grades of the residents in the experimental group compared to the control group was statistically significant ( P<0.05). After 36 months of residency training, the difference between the residents in the trial group and the control group in the 2020 class was not statistically significant when it came to the passing rate of the final exam ( χ2=1.20, P=0.273). At the end of 12 months of residency training, there was a statistically significant difference ( P<0.05) between the scores of residents in the experimental group compared with the control group in the theoretical examination [124.0 (123.8,125.0) vs. 115.0 (101.0,125.0)] and medical history taking [92.0 (91.0,95.0) vs. 85.1 (79.3,94.5)]. The differences were not statistically significant ( P>0.05) at the end of 6, 18, and 24 months of residency training. At the end of 6 months [93.0(90.0,97.0) vs. 89.0(86.3,95.0)], 12 months [94.0(92.0,95.0) vs. 89.0(87.0,92.0)] and 18 months [90.0(86.5,93.5) vs. 81.0(69.0,91.0)] of residency training, residents in the experimental group Physical examination scores were statistically significant compared to the control group ( P<0.05). At the end of 24 months of residency training, there was no statistically significant difference ( P>0.05) between the physical examination scores of residents in the experimental group compared with the control group in the classes of 2020 [92.0(87.5,95.3) vs. 85.0(79.0,92.0)] and 2021 [94.0(87.0,96.0) vs. 90.0(84.0,95.0)]. Conclusions:The clinical skill curriculum system can help to improve the comprehensive clinical ability of residents, and the teaching contents and methods of physical examination should be further optimized, with a focus on the training of doctor-patient communication skills and humanistic literacy among residents in the future.
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Objective To investigate and analyze the data of continuing medical education in order to understand the real need of the learners.Methods Reviewing and making statistic analysis of the data of Renji hospital's continuing medical education courses from 2007 to 2012,including the amount,title,discipline,geographical distribution,training content and the questionnaire survey.Results It shows that the learners from coastal and developed areas have a higher demand for cuttingedge technology and the new progress in medicine(49.1％),while the learners from inland and western regions prefer to learn the basic medical theory and technology (41.9％).Senior doctors tend to study cutting-edge technology and new progress medical courses (51.7％) while the junior persons prefer the basic medical knowledge (46.6％).These mean that the needs of content of continuing medical education is associated with the regions and the level of the doctors (P＜0.05).Conclusion The conclusions prompt that medical development between different regions of China may be unbalanced.Chinese government should pay more attention in terms of allocation of health resources and personnel training.It also provides advice for future courses so that it may improve the efficiency of the medical education resources.
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Objective To explore the mechanism of multi-medicine drug resistance in human ovarian cancer cell line COC1/5-Fu. Methods The apoptosis and the tolerance of COC1/5-Fu cell induced by 5-Fu were analyzed by FACS. The expression of apoptosis related genes, such as p53, bcl-2, bcl-xl and bax, in COCI/5-Fu cell line were analyzed by RT-PCR. Results The COC1/5-Fu cell has some de-gree of drug resistance to 5-Fu and several other commonly used kind of chemotherapy medicine, among of which, drug resistance of 5-Fu reach 107.0 times and Paclitaxel reach 9.0 times compared with COC1. When COC1 was treated with the concentration of 5-Fu (0μmo/L, 30μmo/L or 150 μmol/L), the AI was (6.5±1.0) %, (14.0±4.0) % and (20.0±5.0) %, respectively. The rate of apoptosis increased 1.2 time and 2.1 time, compared with not treated with 5-Fu, which were significantly different (P<0.05). But when COC1/5-Fu was treated with the same concentration of 5-Fu (30 μmo/L or 150 μmoL/L), the AI was (6.7±0.7)%, (7.1±2.2)% and (6.5±2.0)%. When treated with the same concentration of 5-Fu (30 μmo/L or 150 μmol/L) , the proportion of apoptosis was significantly increased, G0/G1 phase was increased, and S and G2/ M phases were reduced in COC1 cells, but the proportion of apoptosis and cell cycle was not changed in COC1/5-Fu cells. The expression of bcl-xl , bcl-xs and bax mRNA were significantly increased and the expression of p53 and cpp32 mRNA were significantly decreased in resistant COC1/5-Fu cells , compared with COC1 cells. Conclusion wtp53 gene mutation is related with cell cycle change of ovary cancer cell and drug resistance, which is one of multi- medicine drug resistance mechanisms of COC1/5-Fu.
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Objective To investigate the adherence mechanism of Candida albicans to host cells in molecular level. Methods and Results Yeast cell wall protein of Candida albicans were extracted, and purified fibronectin (Fn) adhesin was obtained from yeast cell wall extract. Fn adhesin was analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS PAGE), the molecular weights of Fn adhesin were 60kd and 105kd. In order to find out the effect of the protein on adherence to host cells, human buccal epithelial cells and Candida albicans cells were incubated at 37℃ for 2 hours on a rotator, and yeasts adhering to the surfaces of epithelial cells were assayed microscopically. The adherence rate of C.albicans to buccal epithelial cells was 44 7?6 28%, and after treating the epithelial cells with Fn adhesin, the adherence rate reduced to 28 3?6 18%, P