A review on rules for examination of licensing criteria for producing foods for special medical purpose in China

In this paper,the background,principles,and main contents of the rules for the examination of production licenses of foods for special medical purposes are introduced.The contents including general rules,production sites,equipment facilities,equipment layout,technological process,personnel management,management system and supplementary rules are interpreted item by item.This study has important value and historical significance for promoting the development of Chinese enterprises and industries of foods for special medical purposes.

Regional Differences in Specific Health Examination Utilization and Medical Care Expenditures in Japan

Background: Despite having one of the most successful health systems in the world, annual medical expenditures in Japan have been increasing year to year. We sought to clarify regional differences in medical expenditures by analyzing the relationship between the specific health examination coverage and medical care expenditure by prefecture of Japan. Methods: We used data from the National Database of Health Insurance Claims and Specific Health Checkups (NDB) Open Data Japan (2015) and Overview of 2015 National Medical Expenses to compare medical care expenditure per capita and proportions of persons receiving specific health examination between Japan nationally and individual prefectures. Results: National medical expenditures were 42.3 trillion Japanese yen (JPY) (3851 hundred million dollars), with a national per capita rate of JPY347,219 (USD3156). Per capita medical expenditure rates by prefecture ranged from JPY290,900 (USD2645) in Saitama Prefecture to JPY 444,000 (USD4036) in Kochi Prefecture. The proportion of persons receiving specific health examinations was 49.0% for Japan overall and ranged from 39.3% in Hokkaido Prefecture to 63.4% in Tokyo Prefecture. We observed a significant negative correlation between per capita medical expenditures and the proportion of persons receiving specific health examinations (R = 0.553, p < 0.001). Conclusion: We found a significant negative correlation between per capita medical expenditures and the proportion of persons receiving health examinations: prefectures with lower expenditures tended to have higher rates of medical examinations. Interventions to increase the proportion of persons receiving specific health examinations by prefecture could reduce per capita medical expenditures and reduce prefectural disparities in expenditures.

Providing Physical and Mental Health Support Using Medical Examination Data and Perceived Health

Without ascertaining workers’ perceived health, it is difficult to achieve behavioral modification even if health guidance is conducted. To investigate physical and mental health support emphasizing “positive health,” we used the Total Health Index (THI) survey with the purpose of elucidating the association between medical examination data and perceived health. After obtaining medical examination data from 90 men, we analyzed their responses to the THI survey. The results suggested that age and abnormal medical examination data are associated with physical and mental complaints. In the analysis by age group, we found that men in their 20s had more complaints of irregularity of daily life on the THI scale. The group who responded that they were not getting enough sleep had higher mean values of total cholesterol and fasting blood sugar. The group who responded that their meals were irregular had higher mean values of Body Mass Index, aspartate aminotransferase, and alanine aminotransferase. As confirmed by the THI, continuously supporting lifestyle improvement is important. The THI of the “health guidance” group indicated fewer physical health complaints and more aggression/extroversion than the “normal” group. In those for whom health guidance was applicable, participants who were “obese” and “hypertensive” had more aggression/extroversion and lesser extent of nervousness. Based on these findings, it was suggested that meaningful, personalized health support can be developed.

Knowledge, attitude and practice of breast self examination and breast cancer among female medical students in Taif, Saudi Arabia

Introduction and Research Problem: Breast cancer is the most common of all female cancers in Kingdom of Saudi Arabia. Different studies conducted in the Kingdom have shown that knowledge of females regarding breast cancer is poor. Aim of the study was to determine knowledge, attitude and practice among students of Saudi female medical university towards Breast Self Examination (BSE) and also to explore their knowledge about breast cancer. Research Methodology: An observational cross-sectional study was conducted at Faculty of Medicine, Taif University during October 2013. Sample size was 378 with mean age of 19.9 ± 1.5. A self administrated questionnaire was used to obtain data about knowledge, attitude and practice towards BSE and knowledge about breast cancer. Data were collected and fed to SPSS version 16. Shape of distribution for numerical data was tested by using one sample Kolmogorov-Smirnov test. Chi-Square Test & Fissure Exact Test (FET) were used for testing relation between categorical variables while correlation analysis was used to test the strength of relation between numeric variables. Main Results: The study revealed that only 8.2% of participants had good overall knowledge about breast cancer and BSE. Although 66% of the study sample had positive attitude towards BSE, only 17% reported that they practiced BSE monthly. A significant positive moderate correlation was found between overall knowledge score and attitude towards BSE (r = 0.449 & p = 0.000). The same was for the frequency of BSE practice but it was found to be in a weak magnitude (r = 0.223 & p = 0.000). Conclusion and Recommendations: Although there was lack of knowledge about breast cancer and BSE yet, positive attitude towards BSE was encouraging. Most female medical students in our sample did not perform BSE or perform it irregularly. Therefore, more intensified awareness programs among students of medical university are necessary to keep in view their current status of breast cancer and BSE knowledge. Further researches are needed to identify causes of inadequate knowledge and practice of BSE among medical students in Taif.

The current situation and issues there of related to nursing care at the time of medical examinations for children with developmental disabilities including autism

The objective of this study is to clarify the details regarding nursing care that is currently provided in terms of the situation regarding medical examinations for children with developmental disabilities and to discuss necessary nursing care. I conducted semi-structured interviews among 13 parents brining up children with developmental disabilities and analyzed the content of verbatim reports both qualitatively and functionally. Regarding those situations when they feel difficult at the time of undergoing medical examinations at the medical institute, the following four categories were extracted: painful treatment;difficulty in predicting;difficulty in communicating;and trouble in the waiting room. Regarding nursing care felt necessary at the time of undergoing medical examinations, the following six categories were extracted: technique while suppressing pain to a minimum;involvement in providing perspective;adjustment of surrounding environment;provision of opportunities to get acclimatized;provision of warm support;and understanding of patient characteristics. Many difficulties regarding medical examinations were revealed and it was found that they have concerns with regard to health management. It has been suggested that it is important to adjust the surrounding environment during medical examinations.

Effects of Back Massages on Stress Observed in Students Preparing for the National License Examination

We measured serum level of cortisol and lactate, the stiffness of trapezius, skin blood flow and VAS before and after the back massages of 25 senior college students, who had sent stressful days for 11 months starting from April, preparing for the national license examination. These students usually had complaints of stiffness of shoulder and/or lumber. Back massages significantly reduced the level of serum cortisol from 8.85 ± 0.78 to 5.95 ± 0.68 μg/dl, without affecting that of lactate. The treatment also improved the stiffness of the trapezius of students with complaints from 63.24 ± 0.78 to 59.12 ± 0.78 after the treatment without affecting skin blood flow (SKBF). In addition, back massages reduced the VAS value at the same time. These results indicate that back massages of the student are effective to improve the physical and psychological conditions of the students.

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.

Objective Assessment in Continual Medical Education (CME) Medical Objective Assessment in System Control

Existing examinations in postgraduate education and continuing medical education (CME) are not perfect. Modern assessment does not reflect disadvantages of older responders, for whom more time for reply is needed. Specialists with wide clinical experience may choose more than one correct answer in alternative questions. Reduced ability to remember in older people restricts examination without additional sources of information. We offer an individualised system for testing doctors. It provides personalised choice of examination questions using multiple choice questions with weight characteristics and absence of distractors, interactive cooperation in case of negative answers and the final decision of an expert in relation to the person tested. A special algorithm is proposed for typical questions that combines the advantages of known approaches to testing. The questioning system is complex for the creators of tests, but is more convenient and objective than existing ones for medical doctors.

Prediction of Hyperuricemia Risk Based on Medical Examination Report Analysis

This study hopes to contribute to disease detection by analyzing a medical examination dataset with 123,968 samples.Based on association rules mining and related medical knowledge,6 models were constructed here to predict hyperuricemia prevalence and investigated its risk factors.Comparing different models,the prediction performances of Lasso logistic regression,traditional logistic regression,and random forest are excellent,and the results can be interpreted.PCA logistic regression model also works well,but it is not analytical.KNN's prediction performance is relatively poor,while data dimensionality reduction can significantly improve its AUC.SVC has the worst performance and its efficiency of processing high-dimensional large dataset is extremely low.The risk factors of hyperuricemia mainly belongs to 4 categories,which are obesity-related factors,renal function factors,liver function factors,and myeloproliferative diseases-related factors.Random forest,Lasso regression,and logistic regression all treat serum creatinine,BMI,triglyceride,fatty liver,and age as key predictive variables.Models also show that serum urea,serum alanine aminotransferase,negative urobilinogen,red blood cell count,white blood cell count and the pH are significantly correlated with the risk.

Confrontation and Integration: The Present and Future of Forensic Examinations on Medical Damage in China

In China,two administrative regulations and judicial interpretations related to forensic examinations of medical damage were issued from March 2017 to June 2018.In chronological order,they were interpretation of the supreme people’s court on several questions concerning the application of law in the trial of disputes over liability for medical damage and regulations on the prevention and handling of medical disputes.Those two laws,especially the regulation,have had a fundamental impact on the pattern of forensic examinations on medical damage.This paper systematically reviews the current status and existing problems with forensic examinations on medical damage following implementation of the law of tort liability;it discusses new concepts of procedures,institutional arrangements,and the selection of examiners for forensic examinations on medical damage.We believe that through the regulation,the dualistic confrontation status of forensic examinations on medical damage will gradually change toward integration.We consider that forensic examinations of medical damage will face three challenges in the future:(1)enhancing the establishment of standards;(2)undertaking theoretical research into forensic examinations onmedical damage;and(3)promoting the development ofinterdisciplinary identification specialistsmajoring in both medicine and law.Only in this way will it be possible to rectify the current dilemma with forensic examinations on medical damage in China.

以执业医师考试为导向的医学免疫学网络试题库建设与应用

医学免疫学是一门重要的医学基础课程,也是执业医师考试的考核内容。本文以执业医师考试为导向,采用考易网络题库与考试评价系统,从试题库的建设内容和题型方面进行医学免疫学网络试题库建设,目前试题库总题量达到2 400余题,逐步应用于开设医学免疫学课程的考试,并根据临床医学和预防医学专业学生考试成绩,采用难度、区分度、信度等指标评价试卷质量,分析课程教学效果。在试题库的建设和应用过程中,需要教师不断探讨研究,更新和完善试题库,将试题库建设成为动态高效的课程考核工具。该试题库建成后,既有利于提高执业医师考试的通过率,也有利于实行考教分离,为培养新时代具有岗位胜任能力的医学人才奠定基础。

基于能力培养导向临床实习轮转模式的应用意义

目的结合国家执业医师考试及全国大学生医学技术技能大赛的考试要求,探讨基于能力导向临床实习轮转模式改革的应用效果。方法选取实习的2017级临床医学“5+3”一体化儿科及临床专业实习生各90名,随机分为试验组和对照组,每组90人。试验组采用调整后实习轮转计划,对照组采用传统实习轮转计划,应用综合考评得分、个人综合能力、自我超越、职业抱负、教学满意度评分量表进行统计比较。结果试验组综合考评、个人综合能力、岗位胜任能力、自我超越、职业抱负、教学满意度明显高于对照组,差异有统计学意义(P<0.05)。结论实习模式改革有助于提高医学生的整体素质,改善医学生的学习环境,激发医学生的临床学习兴趣和主动性,增强医学生的临床实践能力,提高医学生的满意度,同时提升国家执业医师考试通过率以及为全国大学生医学技术技能大赛培养优秀赛手,值得继续深入探索和推广应用。

北京市检查检验结果互认数据对接实践与思考

目的加强医疗机构间数据共享互通,利用信息化实现区域检查检验结果互认,缩短患者就医时间,提升诊疗效率。方法基于北京市卫生健康委检查检验结果共享互认平台,参照医政部门要求,通过松耦合方案对接市级共享互认平台提升互认效率,保障业务连续性。结果实现了数据的共享上传、下载,以及院内互认流程的信息系统改造设计与实践。随着共享数据的逐渐增多,患者的共享数据下载量及结果互认量均有大幅提升。结论本次实践表明,数据标准化是互认工作的基础,在院内系统功能设计时,要保证业务连续性、可追溯性、各个环节的数据一致性,同时兼顾医生操作的易用性和便捷性,通过信息化手段不断提升患者满意度。

标准化病人在肝胆外科急重症临床教学中的应用价值

目的探讨标准化病人在肝胆外科急重症临床教学中的应用价值。方法选取2022年4—5月在重庆医科大学附属第二医院肝胆外科轮转的规范化培训学员为研究对象,共40名。将其随机分为研究组与对照组,各20名。研究组教学引入标准化病人,对照组采用传统的教学方法。出科时比较2组学员的病史采集及体格检查水平,以及标准化病人对学员的医患沟通能力及人文关怀进行评分。结果研究组病史采集成绩高于对照组[(88.70±0.61)分vs.(82.00±0.41)分],体格检查成绩高于对照组[(89.40±0.61)分vs.(82.55±0.39)分],差异有统计学意义(P<0.05)。研究组在医患沟通及人文关怀方面的得分高于对照组,[(13.15±0.32)分vs.(9.15±0.29)分],差异有统计学意义(P<0.05)。问卷调查结果显示,研究组100%(20/20)的学员认为标准化病人的应用可以提高学习兴趣,95%(19/20)的学员认为可以提高临床思维能力,90%(18/20)的学员认为可以提高医患沟通技巧。结论在肝胆外科急重症临床教学中应用标准化病人,可以提高学员的病史采集、体格检查、医患沟通等能力,尤其增强了人文关怀的意识,提高了学员的综合素质。

中国古代医学教育与考试制度概述

我国是世界上最早实行医学教育和考试制度的国家,医学教育起源南朝刘宋时期,考试制度则源于西周,二者基于政治、思想和经济等因素的影响,不断推动中医药事业进步。研究中国古代医学教育与考试制度,总结其中的经验,寻绎其中的规律,是中国医学史研究的一个重要内容,对于我们把握中国医学教育与考试的特色与规律、更好地继承与发展中医学、培养中医学人才,具有重要的现实意义。该文主要概括中国各朝代的医学教育和考试制度,尽力发掘与勾勒我国古代医学教育与考试制度在不同时代的特点、意义及其发展、演变的规律,对于指导中医药院校的教学、培育和选取优秀中医药人才具有重要意义。

基于体检数据的糖尿病风险预测方法研究

糖尿病是一种疑难慢性病,对其实施风险预测可有效降低发病率。文章基于体检数据提出了一种糖尿病风险预测方法。该方法利用了数据挖掘思想,首先对体检电子病历数据进行预处理,其次采用递归特征消除算法进行特征选择,最后使用逻辑回归、支持向量机、XGBoost模型3种机器学习算法进行建模预测以探究适合糖尿病预测的方法。结果显示,XGBoost模型的预测精度优于逻辑回归和支持向量机,更适合用于糖尿病预测。相关研究结果验证了基于电子病历数据的糖尿病预测的有效性和可行性,具有较高的应用价值。

“一站式”检查智能预约平台的设计与实现

为解决门诊病人检查、预约难的问题,改善患者就医体验。该文借鉴流程优化、业务重组及分时段预约的理念和方法,提出“一站式”检查智能预约平台的构建。该平台的应用,系统能自动完成预约60%的门诊检查项目,患者减少了2次排队,检查等候时间平均缩短50 min。“一站式”检查智能预约平台的搭建,真正实现让患者“看病少排队”、“检查少跑腿”,在创造良好的就医环境、提高医院服务品质等方面具有重要意义。

通用型医疗服务价格项目比价关系研究——以诊察费为例

目的:为各地动态调整通用型医疗服务价格提供指导和参考,以最受关注的诊察费为例,分析区域间、项目间比价关系。方法:区域间比价关系方面,采用描述性统计分析方法;项目间比价关系方面,采用其他诊察费与主治医师门诊诊察费的比价系数中位数或中间值来确定合理的比价系数。结果:区域间比价关系不够合理,一半以上的省份项目价格与价区不匹配,部分诊察费项目省际间价格差异系数较大。项目间比价关系也不够合理,其他诊察费与主治医师门诊诊察费间的比价系数区间范围较大。结论:对于区域间、项目间比价关系不合理的诊察费项目,建议各地基于建议价区,合理设置主治医师门诊诊察费价格基准,采用项目间合理比价系数同步调整其他诊察费项目价格。

基于中医师岗位胜任力模型的考试评价体系研究

中医类考试是评价学生知识、技能、素质掌握情况的基本形式,岗位胜任力是人才培养产出的最终目标。当前岗位胜任力与中医类考试之间存在结合不紧密、结果利用不充分,以及评价不深入等问题。本研究基于中医师岗位胜任力模型,根据四大中医类考试建立考试评价体系,探讨考核结果与学生岗位胜任力的匹配度,建立了5个一级指标,14个二级指标,27个三级指标及相应具体观测点的评价体系,从院校、专业,以及个人三个角度进行评价。同时选取10所中医药院校考试数据进行分析,研究结果显示,院校代码为2101的院校学生的综合能力较好;针灸推拿专业学生整体得分情况低于中医学专业学生;随机抽取的针灸推拿学专业学生水平测试与国家执业医师资格考试成绩显示该学生国家执业医师资格考试中的中医诊断学与中药学成绩有所下降。考试评价体系能够有效将考试结果与选拔人才所需要的岗位胜任力相结合,能够提供客观的人才培养评价结果,有利于发挥考核评价的积极作用,提升中医药人才培养质量。

ChatGPT作为医学教育工具的思考——以心血管内科主治医师资格考试为例

为评估人工智能语言模型ChatGPT在医学考试中的表现,采用横断面研究方法,将Chat-GPT回答的心血管主治医师资格考试的模拟试题结果与标准答案进行比对。在排除2道图片题后,ChatGPT正确回答了333道问题中的189道,准确率为56.8%,其在四个单元的回答正确率分别为67.0%、61.0%、58.2%及11.4%。逻辑错误是最常见的回答错误原因。题目属于第四单元、案例分析题是回答错误的影响因素。研究显示ChatGPT未通过心内科主治医师资格模拟考试,尚不推荐将其用于心血管内科医师的日常教育。