基于Morning Report的中医内科教学质量评价量表的构建

目的基于Morning Report教学,构建中医内科临床教学质量评价量表,为评价中医内科学临床教学质量提供参考。方法采用目的抽样法,于2022年1—12月从首都医科大学附属北京中医医院医学教育管理人员、中医内科临床教学人员及中医内科临床医师3类人员中遴选咨询专家25名。运用文献研究法和德尔菲法确定基于Morning Report的中医内科学临床教学质量评价指标并计算各指标权重以及各参与主体所占比重。结果从学生表现和教师表现2方面构建了基于Morning Report的中医内科临床教学质量评价量表。评价学生指标包括:学习态度、探索过程、学习效果、实践能力4个一级指标,权重分别为0.1、0.1、0.1、0.2。评价教师指标包括:教学内容、教学方法、教学效果3个一级指标,权重分别为0.1、0.2、0.2。评价主体为参与Morning report教学的学生、教师及教学督导。最终构建的基于Morning Report的中医内科临床教学质量评价量表包括7个一级指标、25个二级指标。评价学生指标,各参与方权重分别为:学生20%,教师40%,教学督导40%;评价教师指标,各参与方权重分别为:学生40%,教师20%,教学督导40%。结论基于Morning Report教学的中医内科临床教学质量评价量表的构建,可以为今后开展中医内科临床教学常态化质量评价提供参考,有助于从量效评价角度促进中医内科临床教学质量的提高。

Morning Glory Syndrome or Bindweed Flower Papilla Syndrome

Introduction: Morning Glory Syndrome (MGS) is a rare anomaly of the optic nerve characterized by a flower-shaped excavation in the optic disc. This anatomical peculiarity is of growing interest due to its impact on vision and the therapeutic challenges it presents. Despite research advances, gaps persist, requiring thorough exploration to better understand this rare condition. We present the case of a young girl. Observation: A 7-year-old girl presented with persistent deterioration of vision in the right eye since birth. Visual acuity was counting fingers at 2 meters in the right eye and 10/10 in the left eye. Biomicroscopy was normal in both eyes, and fundus examination revealed a funnel-shaped excavation at the optic disc of the right eye, associated with central glial proliferation, thin blood vessels in a radial distribution, and atrophy of the neuroretinal rim. Additional tests confirmed the diagnosis of isolated unilateral Morning Glory Syndrome in the right eye. Combined treatment included appropriate optical correction and functional rehabilitation. Regular ophthalmological follow-up over a one-year period was established to monitor visual acuity evolution, optic disc stability, and detect any potential complications. The reserved prognosis was marked by the absence of ocular complications and maintenance of initial visual acuity in the right eye. Conclusion: The positive response to management underscores the importance of an integrated approach, early diagnosis, therapeutic adherence, and personalized strategies.

“Morning”和“早上”的语用一致性

每种语言都有特定的词来表示时间。例如,现代汉语中常常使用“早上”“早晨”等词表达一天当中较早的时间段,英语中常常使用“morning”“morn”等词表达该时间段。这些时间词都具有模糊性,并且随着历史的发展,这些词在语义和语用上发生了变化。传统观点认为“morning”和“早晨”是相同的概念,然而结合语料分析,现当代英语“morning”和汉语“早上”在语用上呈现语义一致倾向。

How Music Intervention Lowered Participants’ Morning Cortisol—Qualitative Case Stories

Non-pharmacological interventions for improved home care of persons with dementia and their family caregiver are and will be increasingly important for society. A music intervention study was performed on persons with persons with dementia and family caregiver. The persons with dementia and family caregiver were instructed to choose a daily routine for joint listening to recorded music. They selected the music they were interested in from a menu. The intervention period lasted for two months. Both persons with dementia and family caregiver provided daily saliva samples for the assessment of stress-related steroid hormones. In previous reports we have reported that the morning cortisol levels decreased significantly among the family caregiver when the intervention group was compared to a control group. In the present study we report narratives from four dyads, two of whom with beneficial effects of the music intervention, one dyad with no clear beneficial effects and one dyad with mixed results. The narratives illustrate the strong cohesive effect that the joint music listening could have, leading to improved social functioning paralleled by decreased morning cortisol levels particularly in the family caregiver. The narratives also illustrate reasons for failed effects.

基于PBL教学法以Morning Report为主要形式探索中医内科临床教学研究

目的:研究基于PBL教学法以Morning Report为主要形式的教学方式(简称PBL-Morning Report)在临床教学实践中的效果。方法:调查对象为在首都医科大学附属北京中医医院心血管科临床轮转的研究生规培医师、本科实习医师、社会规培医师和进修医师。将2021年1—12月在常规临床教学基础上接受PBL-Morning Report的学生设为观察组,回顾性选择2020年后半年因疫情原因仅接受常规临床教学的学生并设为对照组。观察组学生在结束转科的最后1周通过微信“问卷星”接受独立的数据调研,对照组在2021年1月通过微信“问卷星”接受回顾性调研。调研内容:基础理论掌握情况,病历书写能力,病例理解/病历汇报能力,中医思维在临床实践的应用能力,自主学习与研究能力。每项问题根据所赋值分数(0、3、6、9分)进行定量评分。结果:共发放问卷221份,回收问卷221份,其中观察组166份,对照组55份。调查内容各项评分观察组均高于对照组,差异均有统计学意义(P<0.05)。亚组分析显示,研究生规培医师除在自主学习与研究能力方面的评分观察组相较于对照组,差异无统计学意义(P>0.05),其余调查内容各项评分观察组均高于对照组,差异有统计学意义(P<0.05)。本科实习医师调查内容所有项目评分观察组均略高于对照组,但差异均无统计学意义(P>0.05)。结论:PBL-Morning Report有助于提高学生中医内科综合临床实践能力。

改良Morning Report法在中医内科学临床思维能力训练教学中的应用效果分析

目的探讨改良的Morning Report教学方法在中医内科学临床思维能力训练教学中的应用效果。方法选择2019年7月—2021年6月在首都医科大学附属北京中医医院参加心血管科临床实习的五年制本科生78名作为研究对象。所有学生在心血管科实习期间均参加4次Morning Report教学活动,在培训前后采用打分形式对学生的专业技能、医患沟通能力、医德医风等中医临床能力进行调研。结果培训后,78名学生的病史采集能力、中医四诊能力、诊断能力、辨证分析能力、处方用药能力、医患沟通能力、临床工作的有效性与计划性以及“仁、术、勤、和”职业素养均有提高,培训前后分值比较,差异有统计学意义(P<0.01)。结论改良的Morning Report教学方法在中医内科学临床教学中对学生临床思维能力的训练效果良好,学生学习的积极性和主动性提高,值得推广应用。

Dining Out on Your Doorstep

Convenience cafeterias in Beijing’s residential compounds provide a good meal option for the city’s large aging population.AT5 a.m.,workers at the cafeteria inside the 3rd Residential Compound of Jinding Street in Shijingshan District,Beijing,begin their daily work.By 7 a.m.deep fried dough cakes,steamed buns stuffed with meat,eggs stewed in sauce,and several kinds of congee porridge are ready to be served.Ma Fengqin,a 69-year-old who lives nearby,has her breakfast at the cafeteria every day.“It saves me from cooking early in the morning,and gives me more time for morning exercise,”she said,while enjoying a bowl of porridge.

Birth Defects of the Child Optic Disc: Diagnostic Challenges and Prospects for Care

Introduction: Congenital optic disc anomalies in children refer to structural variations of the optic nerve head present from birth. These deformations involve the size, shape, color, and vessels of the optic disc. Although often asymptomatic, these anomalies can impact the visual development of the child, underscoring the importance of a thorough fundus examination for early detection and appropriate medical follow-up. We present two cases of congenital optic disc anomalies in children, illustrating the diagnostic challenges and complexity of their management. Case 1: A 3-year-old girl presented with a white spot in her left eye present since birth. Uncorrected distance visual acuity was 2/10 in the right eye, while she could perceive hand movements at 2 meters with the left eye. Normal examination in the right eye showed leukocoria, microphthalmia, and a white mass at the center of the optic disc on fundus examination in the left eye. Ocular imaging, including ultrasound and optical coherence tomography (OCT), confirmed the diagnosis of persistent hyperplastic primary vitreous (PHPV) in its mixed form in the left eye. Management included prescribing full optical correction and functional rehabilitation, without resorting to surgery. The course was marked by persistent amblyopia leading to a poor prognosis. Case 2: A 7-year-old girl consulted for vision disturbance in her right eye. Visual acuity was finger counting at 2 meters in the right eye and 10/10 in the left eye. Anterior segment examination revealed no abnormalities in both eyes. However, fundus examination highlighted a large funnel-shaped excavation associated with central glial proliferation, wheel spoke vessels, and neuroretinal ring atrophy in the right eye. Optical coherence tomography (OCT) of the right eye confirmed the diagnosis of isolated unilateral Morning Glory syndrome. Management included full optical correction and orthoptic rehabilitation. The course was marked by the absence of ocular complication and maintenance of visual stability in the right eye. The prognosis seemed favorable. Conclusion: Congenital optic disc anomalies in children exhibit great clinical variability and require an individualized diagnostic and therapeutic approach.

Till Morning Comes汉译之比较与分析

高标准的文学翻译应当是在忠实于原文的前提下,使译文尽可能精美雅致,让读者体会到文学的价值并获得美的享受。本文以该标准为基础,对韩素音的著名小说Till Morning Comes的三种版本的译文做了比较,分析了译文中某些有待商榷的地方,阐述了对于译文处理的观点和建议。

Late Diagnosis of Congenital Optic Disc Abnormalities

Purpose: To show epidemiological and imaging aspects of congenital optic disc abnormalities diagnosed late. Method: It was a retrospective study, including all patients with congenital optic disc abnormalities diagnosed at a late age between January 2020 and October 2022 at the eye center of Abass Ndao Hospital. Complete ophthalmological examination was performed with eye imaging according to the cases. Results: 09 patients (10 eyes) were diagnosed with congenital optic disc abnormalities. The mean age was 29 years, with a sex ratio of 0.8. Three patients had consulted for unilateral decreased visual acuity since childhood, two for sudden vision loss and in four cases the diagnosis was fortuitous. Visual acuity was ranged from 1/200 to 20/20. Fundus examination showed myelinated retinal nerve fibers in four eyes, optic disc pit in three eyes including two complicated by maculopathy, two cases of morning glory syndrome and a case of pseudoduplication of the optic disc. Optical coherence tomography, ocular ultrasound B and OCT-Angiography were performed according to the cases. Conclusion: Congenital optic disc abnormalities are often diagnosed late. They are potentially amblyogenic and complications are not rare, worsening the visual prognosis. Their screening should be systematic by ophthalmological examination in newborns.

Rain

The morning began with the rhythmic sound of heavy rain awakening me from my sleep. As I opened my eyes, I was greeted by the soothing melody of raindrops hitting the ground outside my window.

Morning Glory综合征的眼底和荧光血管造影分析

目的提高对Morning Glory 综合征的认识水平。方法回顾1990年以来诊断为 Morning Glory 综合征的2例病例的症状、眼底及荧光血管造影(fundus fluorescein angiography FFA )等临床资料并分析。结果Morning Glory 综合征眼底视乳头有特征性的四圈结构:大视盘中央一漏斗型深凹陷,巨大的视盘上有放射状的血管,视盘周围有一圈脉络膜视网膜色素环,最外圈是视网膜脉络膜色素区。眼底荧光血管造影与其眼底结构相对应。结论眼的检查和荧光血管造影是诊断Morning Glory 综合征最直接的方法。

Regaining of morning erection and sexual confidence in patients with erectile dysfunction

Aim： To investigate how erectile dysfunction （ED） medications affect morning erection in patients with ED and how they respond to the return of morning erection. Methods： This study was conducted in 120 patients who experienced successful intercourse with either tadalafil or sildenafil. Using a random face-to-face interview and a questionnaire （about the quality and number of days getting morning erection after using the two medications）, the impact of the medications on the morning erections was investigated, and the participants were asked about their feelings on regaining morning erection. Results： Of the respondents, 81% （68% of those with sildenafil and 99% of those with tadalafil） experienced morning erections after taking an oral ED medication. The men who took tadalafil mainly for 2 days with one dose, while those who took sildenafil experienced morning erections mainly for 1 day. The major sentiment upon regaining a morning erection was, ＂having more confidence as a man＂ （74%）. Among the 96 respondents who experienced morning erections with tadalafil, 52% preferred tadalafil over sildenafil, not only because of freedom from concerns about a specific time to have relations, but also regaining morning erection. Conclusion： Regaining a morning erection affects the recovery of confidence as a man and influences the preference for tadalafil over sildenafil.

FY-3E:The First Operational Meteorological Satellite Mission in an Early Morning Orbit

Fengyun-3 E(FY-3E),the world’s first early-morning-orbit meteorological satellite for civil use,was launched successfully at the Jiuquan Satellite Launch Center on 5 July 2021.The FY-3E satellite will fill the vacancy of the global early-morning-orbit satellite observation,working together with the FY-3C and FY-3D satellites to achieve the data coverage of early morning,morning,and afternoon orbits.The combination of these three satellites will provide global data coverage for numerical weather prediction(NWP)at 6-hour intervals,effectively improving the accuracy and time efficiency of global NWP,which is of great significance to perfect the global earth observing system.In this article,the background and meteorological requirements for the early-morning-orbit satellite are reviewed,and the specifications of the FY-3E satellite,as well as the characteristics of the onboard instrumentation for earth observations,are also introduced.In addition,the ground segment and the retrieved geophysical products are also presented.It is believed that the NWP communities will significantly benefit from an optimal temporal distribution of observations provided by the early morning,mid-morning,and afternoon satellite missions.Further benefits are expected in numerous applications such as the monitoring of severe weather/climate events,the development of improved sampling designs of the diurnal cycle for accurate climate data records,more efficient monitoring of air quality by thermal infrared remote sensing,and the quasicontinuous monitoring of the sun for space weather and climate.

Comparison of split-dosing vs non-split(morning) dosing regimen for assessment of quality of bowel preparation for colonoscopy

AIM: To compare(using the Ottawa Bowel Preparation Scale) the efficacy of split-dose vs morning administration of polyethylene glycol solution for colon cleansing in patients undergoing colonoscopy, and to assess the optimal preparation-to-colonoscopy interval.METHODS: Single-centre, prospective, randomized, investigator-blind stud in an academic tertiarycare centre. Two hundred patients requiring elective colonoscopy were assigned to receive one of the two preparation regimens(split vs morning) prior to colonoscopy. Main outcome measurements were bowel preparation quality and patient tolerability.RESULTS: Split-dose regimen resulted in better bowel preparation compared to morning regimen [Ottawascore mean 5.52(SD 1.23) vs 6.02(1.34); P = 0.017]. On subgroup analysis, for afternoon procedures, both the preparations were equally effective(P = 0.756). There was no difference in tolerability and compliance between the two regimens.CONCLUSION: Overall, previous evening- same morning split-dosing regimen results in better bowel cleansing for colonoscopy compared to morning preparation. For afternoon procedures, both schedules are equally effective; morning preparation may be more convenient to the patient.

Combination therapy using evening primrose oil and electrical stimulation to improve nerve function following a crush injury of sciatic nerve in male rats

Peripheral nerve injuries with a poor prognosis are common.Evening primrose oil（EPO） has beneficial biological effects and immunomodulatory properties.Since electrical activity plays a major role in neural regeneration,the present study investigated the effects of electrical stimulation（ES）,combined with evening primrose oil（EPO）,on sciatic nerve function after a crush injury in rats.In anesthetized rats,the sciatic nerve was crushed using small haemostatic forceps followed by ES and/or EPO treatment for 4 weeks.Functional recovery of the sciatic nerve was assessed using the sciatic functional index.Histopathological changes of gastrocnemius muscle atrophy were investigated by light microscopy.Electrophysiological changes were assessed by the nerve conduction velocity of sciatic nerves.Immunohistochemistry was used to determine the remyelination of the sciatic nerve following the interventions.EPO ＋ ES,EPO,and ES obviously improved sciatic nerve function assessed by the sciatic functional index and nerve conduction velocity of the sciatic nerve at 28 days after operation.Expression of the peripheral nerve remyelination marker,protein zero（P0）,was increased in the treatment groups at 28 days after operation.Muscle atrophy severity was decreased significantly while the nerve conduction velocity was increased significantly in rats with sciatic nerve injury in the injury ＋ EPO ＋ ES group than in the EPO or ES group.Totally speaking,the combined use of EPO and ES may produce an improving effect on the function of sciatic nerves injured by a crush.The increased expression of P0 may have contributed to improving the functional effects of combination therapy with EPO and ES as well as the electrophysiological and histopathological features of the injured peripheral nerve.

Is a split-dose regimen of 2 L polyethylene glycol plus ascorbic acid tolerable for colonoscopy in an early morning visit to a comprehensive medical check-up?

To evaluate the effectiveness and tolerability of a split-dose 2 L polyethylene glycol (PEG)/ascorbic acid (AA) regimen for healthy examinees who visited for comprehensive medical check-up in the early morning.METHODSFrom February 2015 to March 2015, examinees of average risk who were scheduled for a colonoscopy in the morning were retrospectively enrolled.RESULTSThe 189 examinees were divided into split-dose and non-split-dose groups. The adequacy of bowel preparation for the split-dose group vs the non-split-dose group was 96.8% vs 85.2%, respectively, P < 0.001, and the compliance of the last meal restriction was 74.6% vs 58.2%, respectively, P < 0.001. The sleep disturbance (P < 0.001) was more prevalent in the split-dose group, however the willingness to repeat the same preparation method (P = 0.243) was not different in both groups. The split-dose regimen was the most important factor influencing adequate bowel preparation in multivariate analysis (HR = 10.89, 95%CI: 6.53-18.17, P < 0.001).CONCLUSIONA split-dose regimen of 2 L PEG/AA for an early morning colonoscopy was more effective and showed better compliance for diet restriction without any difference in satisfaction and discomfort. Introducing a split-dose regimen of 2 L PEG/AA to morning colonoscopy examinees is effective and tolerable in a comprehensive medical check-up setting.

Prophylactic juxtapapillary laser photocoagulation in pediatric morning glory syndrome

AIM:To determine the anatomic and visual outcomes of prophylactic juxtapapillary laser photocoagulation treatment alone in the prevention of retinal detachment(RD)in a cohort of pediatric patients diagnosed with morning glory syndrome(MGS).METHODS:A total of 24 eyes of 22 consecutive patients aged 0-15 y diagnosed with MGS treated with prophylactic juxtapapillary laser photocoagulation alone were reviewed.Data including demographics,ocular examination,anatomic and visual outcomes,following treatment and complications were collected.RESULTS:Two patients had bilateral laser treatment and 20 had monocular laser treatment.The age at treatment of 13(59.1%)patients was less than 12 mo.The presenting symptoms included strabismus(6/22,27.3%),decreased vision(2/22,9.1%),and routine fundus screening(14/22,63.6%).Fifteen(68.2%)patients underwent cranial magnetic resonance imaging(MRI)examinations,and 3 of those 15(20.0%)had abnormal findings in the nervous system.Based on preoperative wide-field fundus photography and B-scan echography,all(100.0%)eyes had no obvious RD.On postoperative 1 mo and 6 mo and the following follow-ups,the anatomic outcomes of all eyes remained stable.The mean follow-up duration was 27.7±17.5 mo.No severe complications were found.Preoperative visual acuity acquired from 2(9.1%)patients ranged from light perception to 20/200.Postoperative acuity acquired from 11(50.0%)patients ranged from light perception to 20/125.CONCLUSION:The preliminary anatomic and visual outcomes of prophylactic juxtapapillary laser treatment alone in pediatric MGS patients are relatively stable in a short-term follow-up.Further long-term clinical observation will be needed to confirm its efficacy and safety.

The Clinical Characteristics and Imaging Findings of Morning Glory Syndrome

To investigate the features of CT, ultrasonography and fundus fluorescein angiography （FFA） of morning glory syndrome, the data on CT, A/B-scan ultrasonography and fundus fluorescein angiography （FFA） were retrospectively analyzed in 8 cases of morning glory syndrome （MGS）. Among those cases, 6 were examined with CT, 4 with FFA and 8 with A/B-scan ultrasonography. Results showed that the characteristics of CT, A/B-scan ultrasonography and FFA in MGS included： （1） The attachment spot of optic nerve became thin and vitreous body protruded to the posterior wall of eyeball with a spherical shape on CT image; （2） in the early period of FFA, hypofluorescence appeared on the optic, the abnormal arteriae and veins around the optic papilla were displayed clearly and in the late period, optic disc was stained with fluorescein; （3） on B-scan ultrasonogram, the vitreous cavity extended to the posterior pole and optic papilla, and projected to the basal part of muscle cones and thus the posterior part of vitreous cavity looked like an upside-down bottleneck. Sometimes the echogenic band of retinal detachment could also be seen. On A-scan ultrasonogram, both vitreous cavity and bottleneck showed no ultrasonic echoes and presented a base line without any evident wave crest. It is concluded that CT, A /B-scan ultrasonography and FFA could show the imageological features of MGS from different aspects, which helps clinicians to differentiate it from other diseases such as optic disc coloboma. CT and A /B-scan ultrasonography, in particular, are considered to be reliable imageological methods for the accurate diagnosis of MGS and are superior to the traditional techniques.

Contributing Factors for Train Delays during Morning Rush Hour in Japanese Metropolitan Areas

The present study aims to reveal the contributing factors for train delays in Tokyo metropolitan area by conducting statistical analyses, focusing on passenger trains, and using a variety of information by including data concerning train cars, stations, passengers, tracks and working timetables as explanatory variables. The present study conducted 2 types of statistical analyses including the standard multiple regression analysis and the logistic regression analysis by setting “average delay time” which indicates the quantitative conditions of delays, and “occurrence of delays” which indicates the qualitative condition, as objective variables. According to the results of the logistic regression analysis, the possibility of direct operations increasing the delay occurrence rate was quantitatively indicated. Therefore, direct operations are regarded as a contributing factor for train delays concerning metropolitan areas in recent years. Additionally, it was confirmed that the concentration of demand on terminal stations is also a contributing factor for train delays. On the other hand, it is certain that direct operations contribute to improving the convenience of passengers as well as the operational efficiency of train cars. Therefore, it would be ideal to resolve delays by easing the concentration of demands which may be accomplished by recommending off-peak commuting as well as adjustments to the working timetables.