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    find Author "蒲丹" 14 results
    • 臨床醫學生臨床技能多站考試中技能訓練薄弱環節分析

      目的 通過對臨床醫學生臨床技能多站考試成績分析,探討加強臨床醫學生臨床技能薄弱環節的方法。 方法 選取 2012 年 5 月 30 日—31 日四川大學華西臨床醫學院 2007 級 106 名五年制及2007 級 77 名八年制臨床醫學生參加的臨床技能多站(內科站、外科站、護理急救站)畢業考核成績進行分析。 結果 外科站臨床技能掌握情況較好(無不及格),內科站、護理急救站臨床技能掌握較差(不及格率分別為 5.5%、6.0%)。外科站、護理急救站的各項操作考試成績之間有統計學差異(P<0.05),部分臨床醫學生對外科站“縫合打結+拆線剪線”及“深部打結”操作掌握相對較差,對護理急救站“導尿術”操作掌握相對較差。 結論 只有對臨床醫學生進行全面、系統、規范的技能培訓,才能培養出合格的臨床醫學生。

      Release date:2017-09-22 03:44 Export PDF Favorites Scan
    • 醫學生對臨床技能教學中醫學知識與人文知識相結合的態度調查

      目的調查醫學生對臨床技能教學中融入人文知識的態度。 方法2013年5月-2014年8月調查269 名醫學生在臨床技能教學中對人文知識的理解程度及重視程度。 結果大部分學生(65.8%)認為技能教學中融入人文知識有必要;有58.0%的學生在臨床技能操作過程中關注較多的是操作技巧與專業知識,有少部分同學對人文知識(15.6%)和法律知識(7.1%)有所關注。 結論在臨床技能教學中學生存在只重視專業知識、忽視人文知識的現象,應在技能教學中融入人文知識,以彌補臨床技能培養中相對薄弱的環節,實現醫學知識與人文知識的有機結合。

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    • Evaluation of the Effect of Basic Life Support Intensive Training

      ObjectiveTo evaluate the effect of basic life support (BLS) intensive training for medical students who have received BLS training within one year. MethodsWe enrolled 865 medical students between January to December 2015 who had received BLS training within one year. These students were divided into three groups [undergraduate upcoming doctor (group A, n=436), postgraduate upcoming doctor (group B, n=197), and undergraduate upcoming medical technician (group C, n=232)] based on their major and educational background. In the study, they received on-the-spot BLS intensive training, and took BLS basic knowledge examination, skill examination and comprehensive capacity test before and after training. During the study, comprehensive capacity was evaluated by training scale including such items as emergency awareness, psychological diathesis, disposal ability, cooperation ability, and operation accuracy. ResultsBLS basic knowledge scores for the above three groups before and after training were respectively 58.9±9.5 vs 93.5±7.6, 52.5±4.5 vs 90.3±3.5, 54.8±5.3 vs 88.5±4.5, and the skill scores were 58.8±3.2 vs 95.3±1.7, 57.6±4.2 vs 90.5±2.3, 50.9±3.8 vs 93.5±1.8, respectively. The scores after training were significantly better than those before training (P<0.05). Comprehensive capacity was also improved significantly after intensive training (P<0.05). ConclusionsEstablishing a BLS intensive training program has important clinical significances for updating and consolidating the emergency knowledge, improving teaching quality and emergency training effect. So it is worth popularizing.

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    • A Systematic Review of Phospho-p70 Ribosomal Protein S6 Kinase Expression and Its Clinical Signi cance in Lung Cancer

      ObjectiveTo systematically evaluate the expression and clinical features of phospho-p70 ribosomal protein S6 kinase (p-p70S6K) in lung cancer. MethodsWe systematically searched the published researches about p-p70S6K expression and clinical features of lung cancer in Medline, EMbase, Chinese BioMedical Literature, China National Knowledge Infrastructure and WeiPu databases from their establishment to February 4th, 2014. According to the inclusion and exclusion criteria, the data were extracted and the Cochrane Review Manager 5 and Stata 12.0 were used for data analysis. ResultsEight studies including 953 patients were included in this systematic review. Analysis with random effects model showed that the positive expression rate of p-p70S6K in non-small cell lung cancer (NSCLC) tissues spread from 41% to 70%. In small cell lung cancer tissues, the positive expression rate of p-p70S6K ranged from 17% to 91%. The positive expression rate of p-p70S6K in NSCLC was significantly higher than adjacent normal tissues[OR=5.08, 95%CI (2.96, 8.71), P<0.00001]. Divided by status of cell differentiation, the positive expression rate of p-p70S6K between low differentiation and moderate-high differentiation groups had no statistically significant difference[OR=1.40, 95%CI (0.50, 3.92), P=0.53]. In addition, the positive expression rate of p-p70S6K was not related to lymph node metastasis[OR=1.11, 95%CI (0.56, 2.23), P=0.76]. ConclusionCompared with adjacent normal tissues, positive expression rate of p-p70S6K in NSCLC is significantly higher, indicating that p-p70S6K may be associated with the development of lung cancer. The positive expression rate of p-p70S6K in different kinds of lung cancer is still unclear, which needs further studies to explore.

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    • 安全霧化管理在機械通氣患者中的應用

      目的 探討實施ICU重癥監護病房機械通氣患者安全霧化管理的有效措施。 方法 將入選的1 243例機械通氣患者按入院順序分為兩組,2011年7月-12月收治的630例機械通氣患者為對照組,按常規方法實施霧化治療;2012年1月-6月收治的613例機械通氣患者作為觀察組,實施安全霧化管理,強調明確霧化指征,規范霧化操作、加強質量控制。 結果 觀察組呼吸機相關性肺炎(VAP)的發生率明顯低于對照組(P<0.01),ICU住院時間及住院費用較對照組低(P<0.05);兩組VAP患者中大部分為霧化治療者;兩組霧化超過6次者的VAP發生率均高于霧化6次以下者。 結論 明確霧化指征、規范霧化操作、加強質量控制是實施機械通氣患者安全霧化管理的有效措施;實施安全霧化管理能降低VAP的發生率,縮短ICU住院時間,降低醫療費用,提高醫療護理質量。

      Release date:2016-09-07 02:34 Export PDF Favorites Scan
    • The Exploring and Practicing of Scene Simulation of Medical Disputes in Clinical Skills Teaching

      ObjectiveTo explore the teaching effects of scene simulation of medical disputes in clinical skills training. MethodsBetween September 2012 and June 2013, 93 clinical medicine undergraduates in Grade 2010 (8-year study) were randomly divided into the scene simulation teaching of medical disputes group (n=47) and the control group with traditional training (n=46) for clinical skills training. Teaching effects were assessed by clinical skills operation tests. ResultsThrough scene simulation teaching of medical disputes, the trainees' clinical disposal ability, operating skills, communication skills, cultural knowledge, and legal knowledge dimension scores were all significantly better than previous tests (P<0.05). ConclusionScene simulation of medical disputes has an obvious advantage in clinical skills training.

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    • Application of iSIM to optimize medical simulation teaching

      Medical simulation teaching is a bridge course from theoretical knowledge to clinical practice. At present, the medical simulation teaching is facing many problems. The iSIM is a systematic method to optimize medical simulation teaching. It aims to maximize the effect of medical simulation teaching by various teaching methods and assistant technologies. The combination of iSIM and medical simulation teaching can develop the correct clinical thinking, improve the clinical skills and strengthen the communication skills, so as to improve the medical quality in the real clinical environment. Based on experience Center of Experimental Teaching on Clinical Skills of West China Hospital , this paper introduces how to use iSIM to optimize medical simulation teaching.

      Release date:2017-06-16 02:25 Export PDF Favorites Scan
    • 氣管插管全身麻醉術后患者肺部感染現狀

      對采用氣管插管進行全身麻醉(全麻)術后發生肺部感染的文獻進行回顧,從術前、術中、術后3個方面分析其危險因素,總結預防控制措施。分析顯示,高齡、長期吸煙史、麻醉時間與導管留置時間、術前呼吸道護理、術后鎮痛及無菌操作技術等均可影響全麻術后肺部感染的發生率,需對上述危險因素進行針對性處理,如術前戒煙、縮短麻醉時間、術前霧化吸入、插管過程嚴格無菌操作等,均可有效地預防肺部感染。

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    • Investigation on the awareness of diabetes complications in outpatients with diabetes

      Objective To investigate the awareness of diabetes complications in outpatients with diabetes. Methods A total of 300 cases of diabetic were collected from Department of Endocrinology between September 1st and October 10th, 2016. The awareness of diabetes complications in patients with diabetes was investigated by a self-made questionnaire, and the influencing factors on the awareness rate of diabetes complications were analyzed. Results The awareness rates of acute and chronic complications were all low. The awareness rate of hypoglycemia was the highest (59.0%) and the chronic pyelonephritis was the lowest (22.0%). In addition, the difference in awareness rate between different sexes was not significant (P>0.05). Educational extent had significant influence on the awareness rate of chronic pyelonephritis, retinopathy, glaucoma, myopia or hyperopia, iridocliory lesions, polyneuropathy, oculomotor and abducens nerve paralysis, vegetative nerve lesion, skin, muscle, and joints lesions, and infection complications (P<0.05). Occupation had significant influence on the awareness rate of ketoacidosis, diabetic hyperosmolar coma, hypoglycemia, diabetic cardiopathy, iridocliory lesions, polyneuropathy, oculomotor and abducens nerve paralysis, vegetative nerve lesion, skin, muscle, and joints lesions, and infection complications (P<0.05). Conclusions The awareness of diabetes complications in outpatients with diabetes is low. It is needed to strengthen the health education of diabetes complications and improve the awareness rate of complications.

      Release date:2017-06-22 02:01 Export PDF Favorites Scan
    • Application of Medical Simulation Combined with Case-based Learning in Training Trainee Doctors in Emergency Department

      ObjectiveTo investigate the effects of medical simulation (MST) combined with case-based learning (CBL) in training of trainee doctors in emergency department. MethodA total of 120 trainee doctors practicing in the emergency department between March 2008 and December 2014 were randomly divided into two groups:MST combined with CBL group and CBL group, who accepted MST combined with CBL training and merely CBL training, respectively. The training effects were evaluated in terms of theoretical knowledge, practical operation, comprehensive abilities of case analysis and questionnaire survey. The results were compared and analyzed with the t test. The P value less than 0.05 was a significant difference. ResultsTrainee doctors in MST combined with CBL group acquired higher scores in all of the indicators (P<0.05). ConclusionsMST combined with CBL is a feasible method and has a better effect in training of trainee doctors in Emergency Department.

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  • 松坂南