The Practice and Exploration of Applying EBM to Bilingual Teaching of Medical Genetics at OSBCM

In the process of teaching medical genetics of undergraduate clinical medicine, the practice and exploration of applying EBM to the bilingual teaching of OSBCM medical genetics are carried out. Using CBL and PBL as the carrier can make up for the shortcomings of a single teaching mode, synthesize the advantages of multiple teaching modes. It starts from integrating the basic theoretical knowledge of medicine and clinical practice knowledge, improving students’ bilingual level of medical genetics, cultivating students’ literature retrieval ability, and promoting early clinical, multi-clinical and repeated clinical consciousness for medical students. Therefore, it is more conducive to cultivate students’ ability to learn independently, accurately analyze and solve problems, improve medical students’ clinical thinking ability and scientific research awareness, improve medical students’ ability of international communication, and lay a solid foundation for improving medical students’ future post competence, innovative spirit and lifelong learning ability.

A Discussion on setting up the socialized Medical Equipment Maintenance Organization

This paper analyzes the main current characteristics of three operational modes of medical equipment maintenance (depending on the hospital maintenance capability, the manufacturers who produce and sell the plants, and the part-time organizations), and points out their common problems which are that all the three modes are not comprehensive, specialized, and socialized maintenance service organizations that are suitable to hospitals.

A Review on the 3D Printing of Functional Structures for Medical Phantoms and Regenerated Tissue and Organ Applications

Medical models, or ＂phantoms,＂ have been widely used for medical training and for doctor-patient interactions. They are increasingly used for surgical planning, medical computational models, algorithm verification and validation, and medical devices development. Such new applications demand high-fidelity, patient-specific, tissue-mimicking medical phantoms that can not only closely emulate the geometric structures of human organs, but also possess the properties and functions of the organ structure. With the rapid advancement of three-dimensional （3D） printing and 3D bioprinting technologies, many researchers have explored the use of these additive manufacturing techniques to fabricate functional medical phantoms for various applications. This paper reviews the applications of these 3D printing and 3D bioprinting technologies for the fabrication of functional medical phantoms and bio-structures. This review specifically discusses the state of the art along with new developments and trends in 3D printed functional medical phantoms （i.e., tissue-mimicking medical phantoms, radiologically relevant medical phantoms, and physiological medical phantoms） and 3D bio-printed structures （i.e., hybrid scaffolding materials, convertible scaffolds, and integrated sensors） for regenerated tissues and organs.

Survey of methods and principles in three-dimensional reconstruction from two-dimensional medical images

Three-dimensional(3D)reconstruction of human organs has gained attention in recent years due to advances in the Internet and graphics processing units.In the coming years,most patient care will shift toward this new paradigm.However,development of fast and accurate 3D models from medical images or a set of medical scans remains a daunting task due to the number of pre-processing steps involved,most of which are dependent on human expertise.In this review,a survey of pre-processing steps was conducted,and reconstruction techniques for several organs in medical diagnosis were studied.Various methods and principles related to 3D reconstruction were highlighted.The usefulness of 3D reconstruction of organs in medical diagnosis was also highlighted.

Acceptance of living liver donation among medical students: A multicenter stratified study from Spain

AIM: To analyze the attitude of Spanish medical students toward living liver donation (LLD) and to establish which factors have an influence on this attitude.METHODS: Study type: A sociological, interdisciplinary, multicenter and observational study. Study population: Medical students enrolled in Spain (n = 34000) in the university academic year 2010-2011. Sample size: A sample of 9598 students stratified by geographical area and academic year. Instrument used to measure attitude: A validated questionnaire (PCID-DVH RIOS) was self-administered and completed anonymously. Data collection procedure: Randomly selected medical schools. The questionnaire was applied to each academic year at compulsory sessions. Statistical analysis: Student´s t test, χ2 test and logistic regression analysis.RESULTS: The completion rate was 95.7% (n = 9275). 89% (n = 8258) were in favor of related LLD, and 32% (n = 2937) supported unrelated LLD. The following variables were associated with having a more favorable attitude: (1) age (P = 0.008); (2) sex (P < 0.001); (3) academic year (P < 0.001); (4) geographical area (P = 0.013); (5) believing in the possibility of needing a transplant oneself in the future (P < 0.001); (6) attitude toward deceased donation (P < 0.001); (7) attitude toward living kidney donation (P < 0.001); (8) acceptance of a donated liver segment from a family member if one were needed (P < 0.001); (9) having discussed the subject with one’s family (P < 0.001) and friends (P < 0.001); (10) a partner’s opinion about the subject (P < 0.001); (11) carrying out activities of an altruistic nature; and (12) fear of the possible mutilation of the body after donation (P < 0.001).CONCLUSION: Spanish medical students have a favorable attitude toward LLD.

Peculiarities of Medical Personnel Behavior Styles in Conflict Situations

Introduction: Leadership style is a way, a system of methods of influence of the leader on subordinates. This is one of the most important factors of the effective work of the institution, the full realization of the potential capabilities of people in the team. Leadership style, as an individual way of carrying out management activities, is mostly associated with the person of the manager. The management style is formed under the influence of the relationship between the manager and the team in the process of making and implementing management decisions, individual characteristics and preferences of the manager. The objective of the study was conflicts in the field of healthcare in the system “medical personnel of a healthcare institution—patients and relatives of patients”. The objective of the study was to determine management styles in conflict situations among medical workers. Materials and Methods: With the help of a direct individual survey, according to an anonymous questionnaire developed by us, the opinion of 582 medical workers (422 doctors and 160 nurses) of general hospitals and primary care centers of Chernivtsi and Chernivtsi region regarding the ceilings of behavior in conflict situations was studied. Results: In a conflict situation, the leading form of behavior for medics, both doctors and medical personnel, is the subordinate type (29.6% and 38.1%, respectively). The second most frequent method of conflict resolution is an authoritarian strategy (20.6% for doctors and 15% for nurses), in which personal aspirations and the achievement of one’s own goals come to the fore. Dependent style (17.8% for doctors and 13.75% for nurses) ranks third. A selfish style of behavior in a conflict situation is characteristic of 13.7% of doctors and 13.1% of nurses. A friendly style of behavior during the resolution of conflict situations is characteristic of medical workers at a rather low level (12.3% for doctors and 12.5% for nurses). Aggressive style (5.9% for doctors and 7.5% for nurses) is the least popular as a model of behavior in a conflict situation among respondents. Conclusion: The style of behavior of doctors and nurses in conflict situations is ambiguous, which is due to personal qualities, the degree of leadership, professional relationships and the specifics of the work environment.

Quantitative Assessment of Medical Waste Management in Hamad Medical Corporation—Qatar

A proper waste management system is very important in healthcare facilities because the overall benefit outweighs the cost. In the healthcare sector, hazardous health care waste (HHCW) consists of wastes that are potentially contaminated by dangerous agents. Identification and segregation of HHCW is harbinger for its proper management. The quantitative analysis study on HHCW had not been done in Qatar government hospitals. This study quantitatively analyzed the current practice for HHCW management in Hamad Medical Corporation (HMC), Qatar. The objective of this study is to provide a first comprehensive assessment of hazardous healthcare waste managements in Qatar and offers an opportunity to improve existing practice. This is a retrospective survey study carried out on secondary data collected from the department of occupational health and safety (OHS), HMC. OHS department collects and keeps records of hazardous wastes produced by HMC. Data on the HMC hospitals’ characteristics from 2017 to 2019 were retrieved from Planning and Statistics Authority’s website. World Health Organization (WHO) formula for calculating HHCW generation rate was used to calculate the rate for HMC. Data analysis results show a steady increase in HHCW generation rate in HMC, the generation rate was 2.6 Kg/patient bed/day, 2.8 Kg/patient bed/day and 3.1 Kg/patient bed/day for the years 2017, 2018 and 2019 respectively. There were also significant variations in HHCW generation rates between hospitals. The highest generation rate was 4.64 Kg/patient bed/day recorded for AWH and the lowest was 0.2 Kg/patient bed/day recorded for mental health and both hospitals contributing 23.18% and 0.29% respectively of HHCW in HMC.

The Theory of Bio-Medical Knowledge Integration(Ⅷ)──The Intrinsic Medical Informatics(IMI) and Meta-dimensions(MDs) of SNOMED

This paper presented the profile of Intrinsic Medical Informatics(IMI), which consists of Medical Cognition Informatics(MCI) and Organism Informatics(OI). MCI and OI are taken as two cornerstones of the Theory of BioMedical Knowledge Integration(BMKI). Additionally, so called Meta-dimension architecture of SNOMED is discussed in order to venture its context computing.

基于多源数据的兰州医疗机构空间布局研究

为准确判断兰州市医疗服务现状,依据人口集中度、医疗设施分布等因素,选取城关区、七里河区、安宁区、西固区4个中心城区部分街道的医疗机构为研究对象。通过收集地理信息与官方统计等多源数据,并将其分为三个层级,再借助ArcGIS软件分析方法将POI数据生成各层级医疗机构空间分布图、核密度分析图与缓冲区分析图等,分析医疗机构的聚集程度,并形成第一、二、三层级医疗机构800 m、1500 m与3000 m的服务范围覆盖率以及服务范围等级图。结果表明:(1)兰州市整体医疗资源配置空间分布不均衡。空间聚集程度上,东部明显高于西部,以城关片区为中心向周围逐渐降低。(2)从缓冲区分析图中可以发现,第一层级医疗机构主要集中在城市快速发展的区域,地区性特点突出,第二、三层级则随机分布。覆盖率上,城关片区与西固片区覆盖率更高,且第一层级医疗机构数量最多,空间分异大,第二、三层级数量少,分布相对均匀。(3)兰州市整体医疗服务水平不高。服务范围等级上,城关片区与七里河片区的医疗机构设施全面,分布较广,安宁片区与西固片区严重缺乏第二、三层级资源。建议从尊重城市规划发展要求基础上完善医疗机构的空间配置,完善分级诊疗制度,科学预测年就诊量,加强建设各等级医院的分工协作体系,以及加强韧性城市建设,增加就医需求多样化服务三方面,合理优化医疗资源的空间布局。

器官-系统整合课程在儿科学专业中的应用

国内大部分医学院校临床医学专业沿用“以学科为中心”的传统三段式教学模式,不少院校开展了以器官-系统整合课程(OSBC)为中心的医学教学模式。本文概述了两种教学模式的优缺点,并以儿科学专业为例就OSBC在临床医学类专业教学中的应用进行了探讨。

费曼学习法在有机化学教学中的探索

随着新课程改革和素质教育的发展,在现流行的教学模式中容易忽略高校学生的接受程度,为建设“实、用、新型”药学人才,针对有机化学课程知识点分散,记忆困难,抽象的逻辑思维等特点,简述费曼教学法应用于有机化学教育为教学带来的便利,对药学类院校本科生有机化学课程的掌握程度进行探索,并对费曼教学法的实际运用情况进行总结,以期为有机化学课程提供新的教学思路。

生物化学视角下医用有机化学教学探讨

医用有机化学是医学院校学生的必修基础课,课程理论性强,知识体系庞大,知识点烦琐。在有限的学时内,若教师的授课内容与医学知识相关性不高,则学生容易缺乏主动性和学习兴趣,甚至产生畏难情绪,导致教学效果不好。文章基于生物化学与有机化学的紧密联系,探讨在教学过程中通过完善知识体系、引入案例、分析结构、对比化学反应等融入生物化学知识,使学生逐渐认识到有机化学与医学的相关性,进而激发学生的学习热情,有效提升教学效果。

新时代深化医教协同背景下中医药院校基层教学组织师德建设探索

医教协同推进医学教育改革与发展,是医学人才培养的重要模式,基层教学组织直接决定教学质量优劣。新时代深化医教协同背景下,针对以往师德建设方面存在的共性问题和中医药院校的特性问题,以“医+教”双师为主体,找准关键点,认清根源、理清逻辑,切实开展师德建设。强化“医教合一”观念、开展有专业特色的双师型师德建设、内外共建促落实、建立重视实践性的师德评价体系、重新认识中华优秀传统文化的时代价值、充分认识中医学教育的精英属性、践行终身学习观念等是有效策略。

用于腹部CT肝脏肿瘤分割的注意力引导模型

针对肝脏肿瘤在腹部CT影像中占比低,人为分割与传统分割效果、性能差的问题,本文提出一种高效的两阶段注意力引导的肝脏肿瘤分割模型,该模型由肝脏器官分割模块和肝脏肿瘤分割模块构成。肝脏器官分割模块中凭借卷积神经网络得到肝脏器官分割图像作为输出,和原始CT影像叠加得到新的输入影像,最后将新输入图像导入肝脏肿瘤分割模块得到精确的肝脏肿瘤分割影像,给出了每个模块的损失函数以监督训练。利用肝脏肿瘤分割挑战提供的数据集进行了实验研究和定性比较分析。结果在Dice系数等指标上优于其他模型,提高了肝脏肿瘤分割准确率和肝脏肿瘤区域定位准确率,从而使分割出的肝脏肿瘤更接近真实边界。

医用有机化学课程中的案例教学

“医用有机化学”是医学院各专业一年级学生的必修课,该课程难度较高,核心内容与临床实践相关性较低,容易使学生产生畏难情绪。我们在教学中通过引入真实临床案例,使学生认识到有机化学知识与临床的相关性,进而激发医学生们对课程学习的热情。

《医林改错》脏腑理论模型的构建与运用

王清任一生的医学贡献凝聚于一册薄薄的《医林改错》,其构建的脏腑理论模型具有生理学与病理学的双重含义,具体可分为“气血运行模型”和“水谷运化模型”。前者侧重于病理探讨,生理描述亦多,可细分为“气运模块”与“血运模块”;后者常见于生理阐释,病理描述甚少,可细分为“水运模块”与“谷运模块”。“气运模块”的生理功能以存储和运行元气、津液为主,其病理变化以津液失常和气虚为主;“血运模块”的生理功能以存储和运行血液为主,其病理变化以血瘀为主;“水运模块”的生理功能主以运行水液,“谷运模块”的生理功能主以运化谷物,二者的病理变化均较少涉及。

全国名中医尤昭玲基于“以胞宫为中心的五脏一体观”诊治绝经前后诸证

绝经前后诸证对应西医学围绝经期综合征,或多种因素致卵巢功能衰竭而出现围绝经期综合征临床表现的患者。全国名中医尤昭玲基于《黄帝内经》“五脏一体观”,提出“以胞宫为中心的五脏一体观”,认为“五脏失调”为绝经前后诸证的主要病机,以“调和五脏”为治则,创制经验方更年方。以胞宫为中心,顺应胞宫藏泻有序的特点,绝经前分经期、排卵前、排卵后辨证施以耳穴辅助治疗,绝经后顺应胞宫藏而不泻的生理特性,辅以耳穴静养阴阳。分年龄配合药膳养巢煲或养生安神煲,临证中收获佳效。

医药类高校国际组织人才培养体系构建

在讨论国际组织人才需求和国际组织人才培养目标的基础上,本文以医药类高校改革实践为例,提出“英语+医药”和“医药+英语”两种培养模式,有针对性地进行第一课堂课程改革,辅以第二课堂和第三课堂的有机融合和互补,探讨医药类高校培养国际组织人才的路径及可行性。

融合卷积和Transformer的腹部多器官分割网络

腹部多器官分割在计算机辅助诊断中起着至关重要的作用,具有重要的研究价值。但由于腹部多器官边界模糊、背景复杂以及形状大小多变,使这项任务极具挑战性。为此,提出了一种融合卷积和Transformer的腹部多器官分割网络TCMSUnet。首先,在特征提取阶段设计了多尺度引导融合模块(GFM),利用高层特征提取的显著语义信息来引导低层特征以增强相邻特征的语义一致性,从而促进不同尺度特征的融合;随后设计了全局局部增强模块(GLE),通过空洞卷积和Transformer块结合来增强模型对全局局部上下文信息的提取,使模型在建立长距离依赖关系的同时加强特征的局部关联性;最后,在解码器部分引入多阶段损失聚合结构以加快模型的收敛并优化模型的性能。在Synapse数据集上评估了模型的性能,其平均Dice相似系数(DSC)为81.20%。实验结果表明,所提方法整体性能优于多种比较网络,并对形状大小多变的器官有更好的分割效果。

2023年版WHO基本药物示范目录特点分析及启示

对2023年版世界卫生组织的基本药物示范目录(第23版)与儿童基本药物示范目录(第9版)进行分析,首先梳理目录调整的工作流程与递交申请所需的材料;接着归纳新版目录的调整依据和特点,目录内的药物数量创历史新高、广泛纳入创新药、审慎遴选儿童药、重视临床获益证据与公共卫生可负担性。建议参考WHO经验,结合国情尽快对我国基本药物目录进行更新,注意基药目录与医保目录的区别与联系,做好目录衔接,满足基本用药需求,确保药品可及性,优化卫生资源配置。