RESUMO
Objective To analyze the problems and reasons in the clinical medicine postgraduate cultivation.We stated the competency of clinical medicine postgraduates according to the transition of health demands global medical development and practical requirements for clinical personnel. Me thods Questionnaire surveys combined with interviews were conducted, and statistical analysis was performed. In the first part, we selected the permanent staff with qualifications of medical clinicians, including: chief physicians, associate chief physicians, physicians, residents, accounting for 72％ of the interviewees; And related personnel, including nurses, administrators and patients, were also interviewed, accounting for 28％ of the total. 90 questionnaires were distributed, and 86 valid questionnaires were recovered, with an effective rate of 95.56％. In the second part, graduate students with clinical professional degrees were selected for interviews, 96 questionnaires were distributed, and 92 valid questionnaires were collected, and the effective rate was 95.83％.Re s ults There was a certain gap between the expected goal and the actual situation of the post competency of clinical professional degree graduate students, and the gap had a certain statistical significance. The clinical professional degree graduate students paid more attention to the doctor-patient communication, teamwork. Conclus ions We elaborated the required post competence for clinical medicine postgraduates on the basis of its content and characteristic. We propose to strengthen the cultivation of clinical medicine postgraduates by the reform and support of the government enhanced construction of teachers improved course plan and cultivation process perfected assessment system in order to make the students competent to their posts.
RESUMO
[Objective]To determine the relationship between maternal serum IL-1, IL-6, IL-8, TNF-a and CRH levels and preterm labor in asymptomatic women at 24 to 28 weeks' gestation. [Methods] We performed a prospective cohort study from January 2015 to December 2017 for asymptomatic women at 24 to28 weeks' gestation and maternal serum. According to the pregnancy outcome, 100 cases of preterm labor were selected as experimental group and another 100 cases of term labor as control group. The levels of serum IL-1, IL-6, IL-8, TNF-a and CRH were measured by ELISA. The partial membranes of all cases were examined pathologically after labor. [Results] The levels of serum IL-1, IL-6 and IL-8 in preterm labor group were significantly higher than those in the control group (P <0.05). The levels of serum IL-6and IL-8 in preterm labor with chorioamnionitis were significantly higher than those without chorioamnionitis and term labor (P < 0.05). The level of IL-1 in preterm labor without chorioamnionitis was significantly higher than that of term labor (P<0.05). The levels of serum TNF-a and CRH had no difference between the groups (P>0.05). Receiver-operating characteristic curves demonstrated that serum IL-1, IL-6 and IL-8 predicted preterm labor. The area under the curve (AUC) of IL-1 was 0.843. The AUC of IL-6 was0.675 and IL-8 was 0.55. [Conclusion] Maternal serum IL-1, IL-6 and IL-8 in asymptomatic women at24 to 28 weeks' gestation are useful markers for prediction of preterm labor.
RESUMO
Objective To evaluate the relationship between post-stroke depression (PSD) and leukoaraiosis in a well-defined acute ischemic stroke cohort.Methods One hundred and sixty-eight patients with acute ischemic stroke,admitted to our hospital from June 2007 to March 2011,were examined by magnetic resonance imaging.The patients were made a diagnosis of post-stroke depression by the Diagnostic and Statistical Manual for Mental Disorders,Fourth Edition (DSM-IV) criteria 2 weeks after the index stroke; 60 (35.7％) patients had PSD in the acute period and 60 stroke patients without depression matched according to age and gender served as a control group were chosen.The distribution and severity of leukoaraiosis were evaluated using scale developed by Fazekas and age-related white matter changes (ARWMC) scale.The risk factors of PSD were chosen after univariate analysis and multivariate logistic regression analysis.Results In comparison with the non-PSD group,patients in the PSD group were more likely to have high deep white matter hyperintensities (DWMHs) scores and ARWMC scale scores in the frontal area with significant difference (P＜0.05).There were no significant differences in periventricular white matter hypertensities (PVWMHs) scores and ARWMC scale scores in the parieto-occipital area,temporal area,infratentorial area and basal ganglia area between the PSD and control groups (P＞0.05).In the multivariate logistic regression analysis,DWMHs remained an independent risk factor of PSD (OR:1.740,95％CI:1.194-2.536,P=0.004).Conclusion There may be an association between PSD and leukoaraiosis; severe leukoaraiosis in the deep area may increase vulnerability to develop depression in the acute period after ischemic stroke.
RESUMO
ObjectiveTo study the proper treatment of the patient with positive margins after cervical conization. MethodsA total of 220 cervical conizations were performed in the department of obstetrics and gynecology in Conception Hospital in Marseille in France from January 1, 1996 to June 30, 1998. Among them, we studied 73 patients, who had positive margins, by using cervical cytology examination and colposcopy in 3,6,12,18 and 24 months after cervical conization. Results7 cases of cancer invasive were treated with radiotherapy; 17 underwent a second conization or hysterectomy, among whom 8 had residual disease of positive margins near internal orifice of uterus (residual rate, 47. 06 ％ ); 40 remained follow- up; but 9 were lost.ConclusionCytology and colposcopy are effec- tive in the surveillance of patients with positive margins after cervical conization, and can give the indica- tion of the second conization.