Application of Heuristic Method to the Clinical Teaching of Internal Medicine

There is an old saying,“Give a man a fish,and he will eat for a day.Teach a man to fish,and he will eat for the rest of his life.”In clinical teaching,students should not only be taught about diseases,but their intelligence should also be cultivated,along with their analytical,comprehension,and independent learning skills.The ability to solve problems enables students to think independently and acquire knowledge.This is known as the heuristic method of teaching.In this study,we mainly analyze the application value of the heuristic method in the clinical teaching of internal medicine.

Methods, units and quality requirements for the analysis of haemoglobin A_(1c) in diabetes mellitus

The formation of glycohemoglobin, especially the hemoglobin A1c(Hb_(A1c)) fraction, occurs when glucose becomes coupled with the amino acid valine in the β-chain of Hb; this reaction is dependent on the plasma concentration of glucose. Since the early 1970 s it has been known that diabetics display higher values of Hb_(A1c) because they have elevated blood glucose concentrations. Thus Hb_(A1c) has acquired a very important role in the treatment and diagnosis of diabetes mellitus. After the introduction of the first quantitative measurement of Hb_(A1c), numerous methods for glycohemoglobin have been introduced with different assay principles: From a simple minicolumn technique to the very accurate automated highpressure chromatography and lastly to many automated immunochemical or enzymatic assays. In early days, the results of the quality control reports for Hb_(A1c) varied extensively between laboratories, therefore in United States and Canada working groups(WG) of the Diabetes Controls and Complications Trial(DCCT) were set up to standardize the Hb_(A1c) assays against the DCCT/National Glycohemoglobin Standardization Program reference method based on liquid chromatography. In the 1990 s, the International Federation of Clinical Chemistry and Laboratory Medicine(IFCC) appointed a new WG to plan a reference preparation and method for the Hb_(A1c) measurement. When the reference procedureswere established, in 2004 IFCC recommended that all manufacturers for equipment used in Hb_(A1c) assays should calibrate their methods to their proposals. This led to an improvement in the coefficient of variation(CV%) associated with the assay. In this review, we describe the glycation of Hb, methods, standardization of the Hb_(A1c) assays, analytical problems, problems with the units in which Hb_(A1c) values are expressed, reference values, quality control aspects, target requirements for Hb_(A1c), and the relationship of the plasma glucose values to Hb_(A1c) concentrations. We also note that the acceptance of the mmol/mol system for Hb_(A1c) as recommended by IFCC, i.e., the new unit and reference ranges, are becoming only slowly accepted outside of Europe where it seems that expressing Hb_(A1c) values either only in per cent units or with parallel reporting of percent and mmol/mol will continue. We believe that these issues should be resolved in the future and that it would avoid confusion if mmol/mol unit for Hb_(A1c) were to gain worldwide acceptance.

An introduction to International Traditional Medicine Clinical Trial Registry(ITMCTR):A cross-regional registry focusing on theme of traditional medicine

Clinical trials play a crucial role in advancing the field of human health care.The registration of clinical trials can effectively identify potential publication bias and prevent unnecessary duplication of research efforts,serving as a source of transparent data for health care professionals and researchers,enhancing the quality of clinical research,and presenting more transparent,standardized,authentic,and useful clinical trials.To enhance the capacity for evidence production in traditional medicine from the source,the International TraditionalMedicine Clinical Trial Registry(ITMCTR),a cross-regional registry focusing on the theme of traditional medicine,was established.Under the current registration background,this study aims to introduce the problems and current status related to clinical trial registration,as well as the features and functions of the ITMCTR.The results of this study illustrate the necessity of establishing a specialized registration platform for traditional medicine to assist researchers in understanding the basic background of registration and relevant information regarding registration platforms,regardless of whether their research is related to traditional medicine or not.Ultimately,the results of this work will help researchers choose the appropriate platform for more efficient and transparent registration.