Objective To investigate the effectiveness of teaching morning handover in clinical teaching of traditional Chinese medicine (TCM) in general hospitals. Methods A retrospective study was conducted at the Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital of Sichuan University from April 2023 to March 2024, involving a total of 220 participants including interns, postgraduates/standardized training students, and residents/refresher students. The control group consisted of trainees who studied from April to September 2023, while the observation group included those who studied from October 2023 to March 2024. Teaching morning handover was added to the clinical morning report for the observation group, while the control group only conducted the conventional clinical morning report. Due to the differences in basic knowledge and clinical positioning, trainees except interns were classified as clinical residents. A questionnaire survey including satisfaction of teaching content, teaching methods, teaching ability and teaching management and graduation assessment including total score, theoretical assessment score, clinical process score and participation in teaching activities were compared between the two groups. Results Compared with those of the interns (n=57) and clinical residents (n=49) in the control group respectively, there was no statistically significant difference in satisfaction of teaching content, teaching methods or teaching ability of the interns (n=78) and clinical residents (n=36) in the observation group (P>0.05); however, teaching management satisfaction was significantly improved (interns P=0.002, clinical residents P=0.022). Both the interns and clinical residents in the observation group had a significantly higher total score as well as theoretical assessment score and increased participation in teaching activities (P values for interns were <0.001, 0.001, and <0.001, respectively, and for clinical residents were <0.001, 0.013, and <0.001, respectively). However, there was no significant difference observed between groups regarding clinical process score (P>0.05). Conclusion Teaching morning handover is helpful in improving the quality of TCM teaching in general hospitals and is an effective model for clinical teaching of TCM.
【摘要】 目的 探討血漿胰蛋白酶原激活肽(trypsinogen activation peptide,TAP)水平與重癥急性胰腺炎(severe acute pancreatitis,SAP)胰腺壞死的關系。方法 2008年6月1日—2008年12月31日,采用ELISA法測定本院的35例SAP患者血漿TAP水平,并與胰腺增強CT掃描結果作對比,分析血漿TAP水平與胰腺壞死的關系,以及SAP無胰腺壞死組與SAP胰腺壞死組血漿TAP水平的差異。結果 入院時血漿TAP水平預測胰腺壞死的最佳截值點是10.43 nmol/mL,其敏感性、特異性、陽性預測值、陰性預測值分別為75%、73.9%、60%、15%,陽性比為2.87,陰性比為0.338。入院第1天血漿TAP水平預測胰腺壞死的最佳截值點是6.91 μmol/L,其敏感性、特異性、陽性預測值、陰性預測值分別為90.9%、65.2%、55.6%、6.3%,陽性似然比為2.61,陰性似然比為0.001。SAP胰腺壞死組入院時、入院第一天血漿TAP水平高于SAP無胰腺壞死組(Plt;0.05)。結論 血漿TAP水平變化與SAP病情變化密切相關,病程早期檢測血漿TAP水平有助于SAP患者胰腺壞死的預測
【摘要】 目的 評價生長抑素聯合中藥在治療重癥急性胰腺炎中的有效性。 方法 應用國際Cochrane協作網系統評價方法對生長抑素聯合中藥治療重癥急性胰腺炎的隨機對照試驗（RCT）進行系統評價。計算機檢索MEDLINE（Ovid）、PubMed數據庫、中文科技期全文數據庫（VIP）、萬方數據庫、中國期刊全文數據庫（CNKI）、中國生物醫學文獻數據庫（CBM）。檢索時間均為建庫至2009年9月。文獻檢索語種為英語和中文。 結果 共納入8個RCT，436例患者，所有納入試驗在治療末均未進行隨訪。Meta分析結果顯示，生長抑素聯合中藥治療組（治療組）的病死率（13/188，6.9%）明顯低于單純生長抑素治療組（對照組）（24/174，13.7%），差異有統計學意義[Peto OR=0.46，95%CI（0.22，0.94），Plt;0.05]。治療組平均住院日低于對照組[WMD=-7.01，95%CI（-7.89，-6.13），Plt;0.000 01]。治療組腹痛緩解時間明顯低于對照組，其差異有統計學意義[WMD=-0.77，95%CI（-0.82，-0.72），Plt;0.000 01]。治療組與對照組治療第7天APACHE Ⅱ評分均下降，治療組下降幅度大于對照組，兩組比較差異有統計學意義（Plt;0.05）。治療組并發癥發生率（26/91，28.6%）與對照組（35/88，39.8%）相比，其差異無統計學意義[Peto OR=0.61，95%CI（0.32，1.13），P=0.12]。 結論 生長抑素聯合中藥治療在改善重癥急性胰腺炎的病死率、平均住院時間、腹痛緩解時間、APACHE Ⅱ評分下降幅度優于單純生長抑素治療。