目的 分析当前医患沟通学课程教学中存在的问题，探索提高教学质量的有效途径。 方法 2011年12月－2012年1月通过收集相关文献及实际教学中有关医患沟通的事例，对医患沟通中存在的问题进行归类梳理，并针对各结症提出解决措施及建议。 结果 目前国内医患沟通学教学中存在以下问题：医学生对医患沟通学课程不够重视；缺乏系统的教学质量考评体系；医患沟通学课程的理论与实践课学时比例缺乏科学的设置标准；教学方式、课程开设对象等不统一。 结论 要提高医患沟通学教学质量，其提高医学生对沟通能力重要性的认识是前提，建立健全医患沟通学课程的教学模式和考核体系是关键，为学生构建早期接触临床实践的平台是保障。
Objective To investigate the changes in terms of knowledge, attitudes, behavior, and mental status in hospital outpatients after the Wenchuan earthquake so as to provide more convenient and efficient outpatient services for patients from the disaster areas. Method A self- designed questionnaire was used to survey the outpatients in West China Hospital. Data analysis was performed with SPSS 13.0 software. Result The duration of earthquake feeling was correlated with age, gender, family address, disaster experience, and casualties of relatives and friends. Sleep quality after the earthquake was also significantly correlated with age, gender, family address, disaster experience, casualties of relatives and friends, and the duration of eartqhauke feeling. Seeking medical treatment after the earthquake was associated with the availability of medical insurance. Knowledge about post-quake epidemics was correlated with the responders’ educational background. Conclusion Stress response is related to age and disaster experience. Many factors may effect the development, extent, and duration of people’s stress response. People became more aware of risk after the quake and had a b demand for post-disaster psychological counseling.
目的 探讨原发性失眠患者日间功能损害及其影响因素。 方法 选取2010年3月－12月符合美国《精神障碍诊断与统计手册》第4版诊断标准的原发性失眠者62例，另选择性别、年龄匹配的健康睡眠者53例。失眠组和对照组均采用匹茨堡睡眠质量指数量表（PSQI）评估1个月的主观睡眠质量，多导睡眠监测（PSG）评估客观睡眠质量，并通过“主观睡眠时间/客观睡眠时间×100%”计算睡眠知觉，PSG监测后受试者完成一系列日间功能评定，包括Epworth嗜睡量表（ESS）评价嗜睡程度、Flinders疲劳量表（FFS）评价疲劳程度、贝克抑郁量表（BDI）和状态-特质焦虑量表（STAI）评估情绪状态。 结果 ① 与对照组相比，失眠组主客观睡眠质量均较差；PSQI分数更高[（14.37 ± 2.44）、（2.74 ± 1.79）分，P＜0.001）]；睡眠知觉差[（49.76 ± 33.29）、（99.36 ± 12.79）分，P＜0.001）]。② 失眠组FSS、BDI、SAI、TAI分数明显高于对照组，ESS分数低于对照组（P值均＜0.05）。③ PSQI总分与ESS呈负相关（r=−0.17，P＜0.01），与FSS、BDI、SAI、TAI分数呈正相关（r=0.54，r=0.66，r=0.70，r=0.87）（P值均＜0.01）。客观睡眠时间与ESS（r=−0.01，P=0.138）、FSS（r=−0.02，P=0.019）、BDI（r=−0.03，P=0.022）、SAI（r=−0.03，P=0.086）、TAI（r=−0.04，P=0.015）分数均无明显相关性。 结论 原发性失眠者主观睡眠质量与多项日间功能损害相关，这为有效的治疗失眠和改善日间症状提供理论依据。
Objective To systematically review the effects of problem-based learning (PBL) versus lecture-based learning (LBL) teaching models on students in surgery education in China. Methods Such databases as CNKI, WanFang Data and PubMed were electronically searched for literature on PBL versus LBL applied in surgery education in China up to June 30th, 2013. According to the inclusion and exclusion criteria, we screened literature, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. Results Sixteen studies were included totally, all of which were low in quality. Compared with LBL, PBL was superior in surgery comprehensive scores (WMD=4.98, 95%CI 3.88 to 6.09, Plt;0.000 01), fundamental theoretical knowledge (WMD=3.09, 95%CI 0.81 to 5.38, P=0.008), clinical manipulation skills (WMD=4.70, 95%CI 2.69 to 6.71, Plt;0.000 01), and practical ability (WMD=2.13, 95%CI 1.11 to 3.15, Plt;0.000 1) with significant differences. Conclusion PBL teaching method is superior to LBL in surgery education.
ObjectiveTo evaluate the effects of high intensity focused ultrasound (HIFU) on hepatic cancer cells spreading in blood.Methods AFP mRNA in peripheral blood of 19 patients with hepatocellular carcinoma was detected before and after HIFU therapy by RTPCR.Results①Before HIFU therapy, 11 of 19 cases were AFP mRNA positive (57.9%), while the control group were all negative. AFP mRNA was correlated with some clinical parameters such as serum AFP level, tumor size, portal vein embolism and extrahepatic metastasis (P＜0.05). ②In 8 cases with preoperative AFP mRNA negative, only 2 cases became AFP mRNA positive immediately after therapy, and one of the 2 cases became negative again after 72 hours. One week after HIFU therapy, the AFP mRNA positive rate (31.6%) was much lower than the preoperative positive rate (57.9%), but there was no statistical significance (Pgt;0.05). ③After one week of HIFU therapy, the AFP mRNA positive rate of the group with tumor size less than 8 cm was much lower than that of tumor size larger than 8 cm (P＜0.05). ConclusionHIFU may reduce the spreading of hepatocellular carcinoma cells in blood. It is effective for patients with tumor size less than 8 cm.
Objective To investigate the status of communication skills among medical students in order to provide targeted and operational interventions. Methods We designed the questionnaire ‘Questionnaire investigating the status of medical students’ communication skills’ to investigate the status of communication skills of medical students of the West China Clinical College. The sample was extracted by the way of stratified sampling. Results We put out 570 questionnaires and received 548 completed questionnaires. There was a statistical difference between students who came from the city and countryside in terms of communication skills. There was also a statistical difference between students with different backgrounds in communication skills. Conclusion ① Medical students have lots of advantages in interpersonal communication, but there are also lots of defects in their skill set. ② Medical students have been aware of the necessity of learning the basic theories of interpersonal communication to improve the physician-patient relationship in the future. ③ It has become a trend to carry out interpersonal education in medical universities. ④ Medical colleges need to integrate internal and external resources, professional education, moral education, and the construction of campus culture to foster medical students with good interpersonal skills.
Patient priority evaluation has been studied and applied abroad for a long time, which is a mature theory and widely used in practice now. This article uses the priority, patients, waiting list and criteria as keywords to search Wiley Inter Science, Web of Science, Scopus Pub Med, The Cochrane Library, Science Direct, Springer, and Jstor database (searching time is up to December 2017), to collect relevant indicators for patient admission priority evaluation. In addition, relevant citations and grey literature were searched, and experts from relevant fields in China were consulted to obtain more comprehensive research literature. On this basis, this article describes the concept of patient admission priority evaluation, and describes the meanings of the indicators and the countries of application from the three dimensions of clinical indicators, expected results, and social factors. It is considered that the research and implementation of the evaluation of the priority of patient admission has been relatively many. However, there are only a few related researches in the country and without unity. There is no systematic patient-related priority evaluation. It is necessary to use foreign mature theory research to establish a hospital admission priority evaluation system suitable for China’s national conditions.