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.

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.

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.

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.

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。

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。

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。

接送服务链视角下住院患者放射检查失约现象分析

目的 分析接送服务链视角下放射检查失约原因,提出改进建议。方法 收集某公立医院2022年2月8日-18日工作日期间放射科登记的检查失约科室、检查类型、检查时间、失约原因。结果 放射检查总失约率为6.01%(122/2 031)。放射检查失约首要原因是患者死亡、出院、转科,其次为患者放弃检查。非手术科室放射检查失约原因主要是患者放弃,手术科室放射检查失约原因主要是医生取消。放射检查失约原因主要有医生、患者、系统故障、检查前准备不充分4个方面。结论 放射检查失约原因呈现分科聚焦特征,信息反馈不及时问题突出,医患沟通不到位问题明显。应结合绩效手段、临床路径等规范医生诊疗行为,并探索阶梯式接送服务模式,减少放射检查失约率。

基层医院住院医师规范化培训临床技能培训学员满意度调查研究

目的研究地市级基层医院住院医师规范化培训临床技能培训模式、考核方式,为完善住院医师规范化培训临床技能培训教学管理提供依据。方法2022年12月25日,对国家住培基地湘西土家族苗族自治州人民医院/吉首大学第一附属医院2020年9月—2022年8月参加住院医师规范化培训的107名住院医师进行匿名问卷调查,对该院临床技能培训模式及考核安排的合理性和有效性进行评价分析。结果共收回有效调查问卷107份,96.27%住院医师认为该院临床技能培训对他们通过国家执业医师实践技能考试比较有帮助;90.65%住院医师认为该院临床技能培训对他们临床工作中的技能水平的提高帮助比较大;90.65%住院医师认为该院临床技能培训安排比较合理;91.59%住院医师认为该院临床技能模拟考核安排合理。结论湘西土家族苗族自治州人民医院/吉首大学第一附属医院的临床技能培训模式,受到住院医师广泛好评,取得良好的培训效果。

铜陵市1318名体检人员乙型肝炎病毒感染情况及疫苗接种率调查

目的对铜陵市1318名体检人员乙型肝炎病毒(HBV)感染情况及疫苗接种率进行调查分析。方法随机抽取铜陵市人民医院2023年1月至2023年12月体检中心接收的体检人员共计1318名,采用酶联免疫吸附法检测HBV表面抗原(HBsAg)、HBV表面抗体(HBsAb)、HBV核心抗体(HBcAb),采用问卷调查乙肝疫苗(HepB)接种率。结果1318名体检人员中,HBsAg阳性率为1.82%(24/1318),HBsAb阳性率为59.03%(778/1318),HBcAb阳性率为0.61%(8/1318),HBV感染率为0.76%(10/1318),HepB接种率为98.25%(1210/1318);1~4岁、5~14岁、15~29岁、30~69年龄组的HepB接种率为99.36%、98.61%、64.81%、39.57%,HBsAg阳性率为0.00%、0.35%、1.85%、2.98%;HBsAb阳性率为88.46%、76.04%、60.00%、42.88%;HBcAb阳性率为2.56%、3.82%、15.56%、30.46%,差异均有统计学意义(Z=12.644,3.067,2.103,10.495,10.806,P<0.05);城镇人群HBsAg阳性率低于农村人群,HBsAb阳性率及HepB接种率均高于农村人群,差异有统计学意义(χ^(2)=5.632,8.685,6.783,P<0.05);在有、无HepB免疫史及HepB免疫史不详的群体中,有HepB免疫史的群体HBsAg阳性率最低,HBsAb阳性率最高,差异有统计学意义(Z=3.722,3.081,P<0.05);经多因素Logistics回归得出有乙肝家族史、拔牙史及侵入性诊疗史均是影响HBV发生的独立危险因素(OR=1.781,1.793,1.784,P<0.05)。结论铜陵市1318名体检人员HBsAg阳性率携带率低,需注意重点扫描有拔牙史、乙肝家族史及侵入性诊疗史人群并加强HepB预防接种,以进一步提高铜陵市全体人民免疫水平。

依据民法典精神重构婚前医学检查制度的法治路径

全国人大常委会法工委在《关于2021年备案审查工作情况的报告》中提出将与国务院有关部门沟通,推动根据民法典精神适时统筹修改完善我国婚前医学检查领域的相关法律法规制度。纵览《民法典》的相关规定及其司法实践,如果没有合理的婚前医学检查制度作为支撑,《民法典》第一千零五十三条规定的婚姻撤销制度以及第一千二百二十六条规定的患者隐私权保护制度,既难以实现拟结婚当事人彼此权利的有机平衡,亦无法有效落实《宪法》为国家设定的“保护婚姻”的立法义务。同时,自愿免费婚检模式还会每年浪费20亿左右的公共财政资金。采用“知情—自主”婚前医学检查模式既可有效化解婚检领域不同法律规范和不同权利之间的冲突,又可以让免费婚检产生的公共财政资金发挥应有的财政效果,因此是该领域落实宪法精神和民法典精神的合理方式。