An Empirical Study of the Socratic Method in Nongraded English Teaching in Senior High School Under the Background of the New National College Entrance Examination

With the reform of the New National College Entrance Examination(Gaokao),the nongraded education will become an inevitable trend.In senior high school,the traditional test-oriented education is popular.The knowledge is mainly taught by the teachers,and the students passively absorb it.This study examines a problem-oriented Socratic experiment in nongraded English teaching in senior high school.The teachers seek output from students,who respond by interpreting questions,fostering critical thinking,and enhancing problem-solving skills.This teaching experiment indicates that the Socratic method has a significant positive effect on cultivating nongraded senior high English students’critical thinking under the New National College Entrance Examination.

Research on the Evaluation of the Implementation Effect of Curriculum Examination Reform: Taking the Course of “Introduction to Language” as an Example

“Introduction to Language,”as the core course of the English major,mainly reveals the basic laws of language,enabling the students to have the ability to apply linguistic theories to explain language phenomena and solve specific language problems.This course is highly theoretical and has a certain degree of difficulty.The evaluation of student grades has always been based on examination reform,but several problems have been encountered during the implementation process.This article analyzes the current situation of the reform and implementation of the“Introduction to Language”course examination in applied universities and puts forth suggestions and specific measures to improve the assessment of the course,aiming to enhance the teaching effectiveness of the course and scientifically and comprehensively evaluate students’abilities.

Assessment of the triglyceride glucose index in adult patients with chronic diarrhea and constipation

BACKGROUND Accumulating evidence suggests that the gut microbiome is involved in the pathogenesis of insulin resistance(IR).However,the link between two of the most prevalent bowel disorders,chronic diarrhea and constipation,and the triglyceride glucose(TyG)index,a marker of IR,has not yet been investigated.AIM To investigate the potential association between TyG and the incidence of chronic diarrhea and constipation.METHODS This cross-sectional study enrolled 2400 participants from the National Health and Nutrition Examination Survey database from 2009-2010.TyG was used as an exposure variable,with chronic diarrhea and constipation as determined by the Bristol Stool Form Scale used as the outcome variables.A demographic investigation based on TyG quartile subgroups was performed.The application of multivariate logistic regression models and weighted generalized additive models revealed potential correlations between TyG,chronic diarrhea,and constipation.Subgroup analyses were performed to examine the stability of any potential associations.RESULTS In the chosen sample,chronic diarrhea had a prevalence of 8.00%,while chronic constipation had a prevalence of 8.04%.In multiple logistic regression,a more prominent positive association was found between TyG and chronic diarrhea,particularly in model 1(OR=1.45;95%CI:1.17-1.79,P=0.0007)and model 2(OR=1.40;95%CI:1.12-1.76,P=0.0033).No definite association was observed between the TyG levels and chronic constipation.The weighted generalized additive model findings suggested a more substantial positive association with chronic diarrhea when TyG was less than 9.63(OR=1.89;95%CI:1.05-3.41,P=0.0344),and another positive association with chronic constipation when it was greater than 8.2(OR=1.74;95%CI:1.02-2.95,P=0.0415).The results of the subgroup analyses further strengthen the extrapolation of these results to a wide range of populations.CONCLUSION Higher TyG levels were positively associated with abnormal bowel health.

ISHD:Intelligent Standing Human Detection of Video Surveillance for the Smart Examination Environment

In the environment of smart examination rooms, it is important to quickly and accurately detect abnormal behavior(human standing) for the construction of a smart campus. Based on deep learning, we propose an intelligentstanding human detection (ISHD) method based on an improved single shot multibox detector to detect thetarget of standing human posture in the scene frame of exam room video surveillance at a specific examinationstage. ISHD combines the MobileNet network in a single shot multibox detector network, improves the posturefeature extractor of a standing person, merges prior knowledge, and introduces transfer learning in the trainingstrategy, which greatly reduces the computation amount, improves the detection accuracy, and reduces the trainingdifficulty. The experiment proves that the model proposed in this paper has a better detection ability for the smalland medium-sized standing human body posture in video test scenes on the EMV-2 dataset.

The Infection Control Measures Taken in MRI Examination During the COVID-19 Pandemic Prevention and Control Period

Objective:To optimize the magnetic resonance imaging(MRI)detection process in view of the COVID-19 pandemic,standardize and strengthen the infection control and management MRI rooms.Methods:According to the Technical Guide for COVID-19 Prevention and Control in Medical Institutions(3rd Edition),with reference to the current COVID-19 infection control plan,there are three aspects involved in the planning of MRI examination:MRI room management,medical staff management and protection,and patient management,especially the use of full plastic nose strip medical masks.Infection prevention measures are formulated,scientific prevention and control are made,and accurate policies are implemented.Results:MRI examination was carried out according to the infection control and management of MRI room plan during the epidemic,so as to ensure the safety of examination,the safety of patients and the safety of medical staff and no cross infection in hospital.Conclusion:The implementation of proper infection prevention measures during MRI examination in light of COVID-19 ensures that patients wear medical surgical masks with full plastic nose strips throughout the process to avoid cross-infection,ensure the safety of doctors and patients,and maintain the health of the population.

Archival Examination of the Change in Packaging Materials of Chemical Injections

Based on the deepening awareness of the risk of changing packaging materials of injections,the national regulatory authorities and the China National Pharmaceutical Packaging Association have issued the relevant guidelines and group standards for changing packaging materials in recent years,greatly improving the research and development and technical requirements of packaging materials of injections.In 2021,Guangdong Province carried out the archival examination of the change of listed drugs,among which the proportion of the acceptance of changed injection packaging materials has increased year by year.On the basis of sorting out the archival examination work and combining with the cases of changing packaging materials of chemical injections accepted by Guangdong Province during 2021-2022,the requirements and problems of archival examination were analyzed and discussed to provide a reference and idea for applicants when studying the change in packaging materials.

The IOMT-Based Risk-Free Approach to Lung Disorders Detection from Exhaled Breath Examination

The lungs are the main fundamental part of the human respiratory system and are among the major organs of the human body.Lung disorders,including Coronavirus(Covid-19),are among the world’s deadliest and most life-threatening diseases.Early and social distance-based detection and treatment can save lives as well as protect the rest of humanity.Even though X-rays or Computed Tomography(CT)scans are the imaging techniques to analyze lung-related disorders,medical practitioners still find it challenging to analyze and identify lung cancer from scanned images.unless COVID-19 reaches the lungs,it is unable to be diagnosed.through these modalities.So,the Internet of Medical Things(IoMT)and machine learning-based computer-assisted approaches have been developed and applied to automate these diagnostic procedures.This study also aims at investigating an automated approach for the detection of COVID-19 and lung disorders other than COVID-19 infection in a non-invasive manner at their early stages through the analysis of human breath.Human breath contains several volatile organic compounds,i.e.,water vapor(5.0%–6.3%),nitrogen(79%),oxygen(13.6%–16.0%),carbon dioxide(4.0%–5.3%),argon(1%),hydro-gen(1 ppm)(parts per million),carbon monoxide(1%),proteins(1%),isoprene(1%),acetone(1%),and ammonia(1%).Beyond these limits,the presence of a certain volatile organic compound(VOC)may indicate a disease.The proposed research not only aims to increase the accuracy of lung disorder detection from breath analysis but also to deploy the model in a real-time environment as a home appliance.Different sensors detect VOC;microcontrollers and machine learning models have been used to detect these lung disorders.Overall,the suggested methodology is accurate,efficient,and non-invasive.The proposed method obtained an accuracy of 93.59%,a sensitivity of 89.59%,a specificity of 94.87%,and an AUC-Value of 0.96.

Contribution of Simulation to the Skills Laboratory for the Learning of Obstetrical Examination in an African Setting with Limited Resources

Objective: To evaluate the interest of the simulation in the learning of the obstetric examination of parturient by medical students. Materials and methods: It was an analytical cross-sectional study that took place from 1 to 28 February 2020 at the Yalgado Ouedraogo Teaching Hospital in Ouagadougou, Burkina Faso. The study population was made up of medical students at the Doctorate II level. The previous experience of the students in the obstetric examination of the parturient, the contribution of the simulation on their feelings and on their skills towards this examination were studied. The Mc Nemar Chi2 test was used to compare percentages on paired samples. Results: The level of difficulty in performing the obstetrical examination in the parturient evolved downwards after the practice of the simulation. The stress level to perform the obstetric exam has been significantly reduced. On the other hand, confidence has increased. The students’ ability to appreciate each of the elements of the obstetric examination studied had improved after the practice of simulation. Conclusion: The simulation in the skills laboratory was a great contribution and the acquisition of models of better fidelity would help to improve the contribution to the confidence building and the acquisition of skills by learners.

The Association of Mercury and ALT with Obesity in Korean Adults Using Data from the Korea National Health and Nutrition Examination Survey for 11 Years(KNHANES 2005,2008-2017)

The association between heavy metals in the blood and obesity has been examined in many studies.However,inconsistencies have been observed in the results of these studies.The present study was conducted using data from 119,181 participants of the Korea National Health and Nutrition Examination Survey(KNHANES)for 11 years in 2005 and between 2008 and 2017.The subjects with missing heavy metal blood tests,health interview data,and health examination data were excluded from the study.The study population comprised 1,844 individuals(972 men,and 872 women)who were eligible for inclusion.It was found that obesity and abdominal obesity were associated with an increase in both blood mercury(P<0.001)and alanine aminotransferase(ALT)(P<0.001).After adjusting the confounding factors,those with concurrent high levels of ALT and the highest tertile of mercury showed an increased risk of obesity(odds ratio 4.46,95%confidence interval 2.23-8.90,P<0.001)as well as abdominal obesity(odds ratio 5.36,95%confidence interval 2.57-11.17,P<0.001).The interrelationship of mercury and ALT with the parameters of body mass index(P for interaction=0.009)and waist circumference(P for interaction=0.012),respectively,have been observed to be significant,suggesting that the reciprocal relationship could contribute to obesity and abdominal obesity.

Effectiveness of Histopathological Examination of Ultrasound-guided Puncture Biopsy Samples for Diagnosis of Extrapulmonary Tuberculosis

Objective To evaluate the diagnostic value of histopathological examination of ultrasound-guided puncture biopsy samples in extrapulmonary tuberculosis(EPTB).Methods This study was conducted at the Shanghai Public Health Clinical Center.A total of 115patients underwent ultrasound-guided puncture biopsy,followed by MGIT 960 culture(culture),smear,Gene Xpert MTB/RIF(Xpert),and histopathological examination.These assays were performed to evaluate their effectiveness in diagnosing EPTB in comparison to two different diagnostic criteria:liquid culture and composite reference standard(CRS).Results When CRS was used as the reference standard,the sensitivity and specificity of culture,smear,Xpert,and histopathological examination were(44.83%,89.29%),(51.72%,89.29%),(70.11%,96.43%),and(85.06%,82.14%),respectively.Based on liquid culture tests,the sensitivity and specificity of smear,Xpert,and pathological examination were(66.67%,72.60%),(83.33%,63.01%),and(92.86%,45.21%),respectively.Histopathological examination showed the highest sensitivity but lowest specificity.Further,we found that the combination of Xpert and histopathological examination showed a sensitivity of 90.80%and a specificity of 89.29%.Conclusion Ultrasound-guided puncture sampling is safe and effective for the diagnosis of EPTB.Compared with culture,smear,and Xpert,histopathological examination showed higher sensitivity but lower specificity.The combination of histopathology with Xpert showed the best performance characteristics.

Analysis on the results of graduate examination for standardized medical residency training in general hospital---- Takes The First Affiliated Hospital of Kunming Medical University as an example

[ 目的] 对昆明医科大学第一附属医院（ 以下简称昆医附一院）2016 -2017年住院医师规范化培训结 业综合考核结果进行分析和总结,查找培训过程中存在的问题,提出提高住院医师规范化培训质量的建议. [方法] 将云南省住院医师规范化培训管理平台中公布的昆医附-院2016 - 2017年住院医师规范化培训结业综 合考核的结果录入Excel, 按照考试站点各专业考核情况进行分类统计,并对数据进行分析.[结果] 各站点考 试的合格率分别为综合知识部分95.26%,辅助检查部分88.23%,病史采集部分97.64%,体格检查部分 96. 14% ,病例分析部分97.21%,临床操作部分94.21%,门诊病例书写部分97.42%,医患沟通部分98.07%. 各专业综合考核第-阶段的不合格率：最高的为泌尿外科63. 64 %,最低的为内科学6.25%.各专业综合考核 第二阶段的不合格率：最高的为神经内科33.33%,最低的为超声科6. 67 %.[结论] 结业考核结果中,除辅助 检查部分外,其余七站均达到90 %以上的合格率,说明辅助检查判读的部分是该院参培住院医师的薄弱环节, 应加强检查结果判读培训,以确保提高住院医师规范化培训的综合质量.

Low skeletal muscle mass is associated with non-alcoholic fatty liver disease in Korean adults： the Fifth Korea National Health and Nutrition Examination Survey

BACKGROUND： Sarcopenia and non-alcoholic fatty liver dis- ease （NAFLD） share similar pathophysiological mechanisms, and the relationship between sarcopenia and NAFLD has been recently investigated. The study investigated whether low skel- etal muscle mass is differentially associated with NAFLD by gender in Korean adults. METHODS： We conducted a cross-sectional analysis of the data from the Fifth Korea National Health and Nutrition Examination Survey. The skeletal muscle index （SMI） was obtained by the appendicular skeletal muscle mass divided by the weight. NAFLD was defined as a fatty liver index （FLI） 〉60 in the absence of other chronic liver disease. RESULTS： Among the included subjects, 18.3% （SE： 1.4%） in men and 7.0% （SE： 0.7%） in women were classified as having FLI-defined NAFLD. Most of the risk factors for FLI-defined NAFLD showed a significant negative correlation with the SMI in both genders. Multiple logistic regression analysis showed that low SMI was associated with FLI-defined NAFLD, inde- pendent of other metabolic and lifestyle parameters in both genders [males： odds ratio （OR）=1.35; 95% confidence inter- val （CI）： 1.17-1.54; females： OR=1.36; 95% CI： 1.18-1.55]. The magnitude of the association between FLI-defined NAFLD and low SMI was higher in middle aged to elderly males （OR-1.50; 95% CI： 1.22-1.84） than in males less than 45 years of age （OR=1.25; 95% CI： 1.02-1.52） and in premenopausal females （OR=l.50; 95% CI： 1.12-2.03） than in postmenopausal females （OR-1.36; 95% CI： 1.20-1.54）.CONCLUSIONS： Low SMI is associated with the risk of FLI- defined NAFLD independent of other well-known metabolic risk factors in both genders. This association may differ ac- cording to age group or menopausal status. Further studies are warranted to confirm this relationship.

MR Cholangiography and Dynamic Examination of Duodenal Fluid inthe Differential Diagnosis between Extrahepatic Biliary Atresia and Infantile Hepatitis Syndrome

In order to evaluate the value of magnetic resonance cholangiography （MRC） and dynamic examination of duodenal fluid in the differential diagnosis between extrahepatic biliary atresia （EHBA） and infantile hepatitis syndrome （IHS）, 52 patients with infantile cholestatic jaundice were examined by MRC and duodenal fluid examination. Original interpretations were compared with clinical outcome. Calculated sensitivity of duodenal fluid examination in diagnosis of EHBA was 100 %, and specificity was 91.1%. Sensitivity of MRC in the diagnosis of EHBA was 94.4 % and specificity 88.24 %. The sensitivity of MRC and examination of duodenal fluid combined in diagnosis of EHBA was 94.4 % and specificity 97.06 %. We are led to conclude that MRC and dynamic examination of duodenal fluid are useful in the differential diagnosis between IHS and EHBA and the combined use of the two techniques yield better resutls.

Highlights of the physical examination in heart failure

Because decompensated heart failure (HF) patients present primarily with symptoms of congestion, the assessment of volume status is of paramount importance. Despite the addition of new technologies that can predict intracardiac filling pressures, the physical exam (PE) remains the most accessible and cost-effective tool available to clinicians. An elevated jugular venous pressure (JVP)useful cutoff is that if the JVP is greater than 3 cm in vertical distance above the sternal angle, the central venous pressure is elevated. In addition to assessment of volume status, the PE in HF can reveal adverse prognostic signs, namely: elevated JVP, presence of third heart sound, elevated heart rate, low systolic BP, and low proportional pulse pressure (＜ 25%). This article will review the evidence for the diagnostic and prognostic utility of common PE findings in HF.

Constructing the Training Curriculum of Standardized Patients for OSCE Examination for Undergraduate Nursing Students in Shanxi Medical University

Objective: The objective of this study is to construct the simulated patient training curriculum for OSCE examination for undergraduate nursing students and to explore the theoretical and practical foundation. Methods: To establish TSP training curriculum and SSP training curriculum, 30 experts were invited to finish the questionnaires which were proved by Delphi Method. Findings: We established the training curriculum of TSP and SSP, and set the weight of various curricula and teaching contents. Conclusions: The experts considered that the degree and importance of these two training curricula were comparable. This conclusion lays the foundation for applying these curricula to teaching practice and clinical practice, and enhancing the teaching outcome of undergraduate nursing students. Implications: This study provided a new way of assessing the clinic ability of nursing students.

Relationship of academic courses and clinical internships to performance on the National Qualified Examination for Registered Professional Nurses (NQEX-RPN)

Background:Success in the National Qualified Examination for Registered Professional Nurses(NQEX-RPN)is a critical issue for each nursing student and every nursing school.However,to date,little research has been conducted regarding the degree of risk for licensure failure associated with specific academic courses and clinical internships in China's Mainland.Objective:This study aimed to explore the relationship of academic courses and clinical internships to performance on the NQEX-RPN in China's Mainland.Methods:This was a retrospective descriptive study.Two hundred twenty-eight new graduates were recruited froma four-year baccalaureate nursing programin China's Mainland.The scores of academic courses and clinical internships were recorded from the Teaching and Learning administration of the university.The NQEX-RPN performance data was collected from the Provincial Health Department.Personal information was collected from the participants.Multiple stepwise regression was used to identify predictors of the NQEX-RPN.Results:Twenty-three courses and four clinical internships were positively associated with NQEX-RPN performance.Surgical nursing,Medical nursing,Computer basics and Community health care explained the 36.2%of the total variance of Theoretical Knowledge(F=31.313,p=0.000);clinical internships of obstetrics and gynecology nursing,pediatrics and surgical nursing explained the 28.1%of the total variance of Application Skills(F=28.852,p=0.000).Conclusion:Surgical-medicine nursing,Community health care,Computer basics and clinical internships are beneficial in assisting students and educators to identify the risk of students'performance in the NQEX-RPN.

Comparison of the autofluorescence bronchoscope and the white light bronchoscope in airway examination

Background and Objective: The sensitivity and accuracy of white light bronchoscopy (WLB) in airway examination are low. Autofluorescence bronchoscope (AFB) can determine early lesions in bronchial mucosa more sensitively, but it has seldom performed in China. To assess the clinical value of the AFB in airway examination, we compared the sensitivity and specificity of the AFB and WLB in detecting cancer of the airway mucosa. Methods: Between September 2009 and May 2010, bronchoscope examinations using both the AFB and WLB were performed on 136 patients, 95 men and 41 women with a median age of 61.5 years (ranged from 25 to 84 years). There were 46 lesions located in the central airway, 84 in the peripheral lung parenchyma, and 6 in the mediastinal region. All patients received local and general anesthesia and were subsequently examined with the WLB and AFB in tandem. All procedures were completed safely. Abnormal visual findings were recorded, and biopsies of the affected regions were collected for pathologic examination. Results: Of 241 regions sampled for biopsy, 76 sites contained malignant lesions, whereas 165 sites contained benign lesions. The AFB detected 72 of the 76 malignant lesions, but the WLB detected only 50. The sensitivities of the AFB and WLB were 94.7% and 65.8%, respectively, and the specificities were 57.0% and 83.6%, respectively. The negative predictive values of the AFB and WLB were 95.9% and 84.1%, respectively. Conclusions: The AFB is more sensitive than the WLB in detecting cancerous lesions in the mucosa, and is an effective airway examination.

A Cross Sectional Study of the Knowledge and Practice of Self-Breast Examination among Market Women at the Makola Shopping Mall, Accra, Ghana

Background: Breast cancer is one of the most common cancers in women worldwide. With an estimated incidence of 1,676,633 with 521,817 deaths in the year 2012, the figure is expected to hit the 82.5 millionth mark by 2015. Breast cancer screening is reported to be extremely low in most low-middle income countries like Ghana. This study was to determine the knowledge and practices of self-breast examination among market women at Makola Shopping Mall in Accra, Ghana. Methods: The study was conducted at the Makola Shopping Mall in Accra among women above the age of 20 years who owned a store and sell at the mall. Data were collected using mixed method involving in-depth interviews and questionnaire survey. Random samples of 170 participants were selected from a population of 400 for the quantitative survey. A total of eight in-depth interviews were conducted to generate qualitative data to complement the survey data. Results: Majority (60%) of the respondents were between the ages of 20 - 40 years. There’s a high literacy rate among the participants. Though awareness of self-breast examination was very high (93%), only 27% practiced self-breast examination in line with the recommended one week period after menses due to lack of knowledge of the basic skills to do self-breast examination. Conclusion: In view of the lack of knowledge resulting in non-performance of self-breast examination, continuous education on breast cancer screening should be given to the women to enable them acquire the skills of performing self-breast examination to promote early detection of the disease.

Study on the Effectiveness of the Application of Perineal Wound Model in Teaching Midwife Interns

Objective:To discuss and analyze the effectiveness of the application of perineal wound model in teaching midwife interns.Methods:The research subjects in this study were 40 midwife interns who enrolled in our hospital from January 2020 to December 2022,which were divided into a control group(consisted of 20 interns,taught with the conventional method)and a research group(consisted of 20 participants,taught with the perineal wound model)using the random number table method.The outcomes of these two groups were compared.Results:The examination results of the research group were better than control group(P<0.05);the interns of the research group were more satisfied towards the teaching method compared to the control group(P<0.05).Conclusion:Applying the perineal wound model in teaching midwife interns could effectively improve their examination achievements and teaching satisfaction,which brings a significant clinical value.