Impact of specialized nursing outpatient case management on postcoronary artery bypass grafting patients

BACKGROUND Some patients with coronary atherosclerotic heart disease experience major adverse cardiac events(MACE)and require readmission after Coronary Artery Bypass Grafting(CABG)surgery.This is often attributed to patients'unhealthy lifestyles and dietary habits,inadequate understanding of the disease,and poor disease management compliance.Thus,searching for more targeted nursing intervention models that can enhance patients'self-management abilities and reduce the risk of readmission after CABG surgery is significant.AIM To observe the impact of specialized nursing outpatient case management on patients after CABG surgery.METHODS A total of 103 patients who underwent CABG surgery in our hospital between April 2021 and April 2022 comprised the study sample.The patients were divided into two groups using an odd-even number grouping method.The control group received routine nursing care,while the case management group received specialized nursing outpatient case management.The differences in psychological status,adherence to medical treatment,self-care ability,knowledge mastery,quality of life scores,and the occurrence rate of MACE were compared between the two groups.RESULTS After the intervention,the case management group had lower scores on the selfrating depression scale and self-rating anxiety scale and lower MACE rate,as well as higher scores for adherence to a healthy diet,medication adherence,good lifestyle habits,regular exercise,and timely follow-up,higher scores on the Coronary Heart Disease Self-Management Scale,higher scores for managing adverse habits,symptoms,emotional cognition,emergency response,disease knowledge,general lifestyle,and treatment adherence,higher scores for understanding coronary heart disease,recognizing the importance of medication adherence,understanding selfcare points after CABG surgery,and being aware of post-CABG precautions,higher scores for physical well-being,disease condition,general health,social-psychological well-being,and work-related aspects(P<0.05).CONCLUSION Specialized nursing outpatient case management can enhance patient adherence to medical treatment,knowledge mastery,psychological well-being,and overall quality of life in patients after CABG surgery.

Development of Specialized Courses and Establishment of Teaching Materials in Nursing of Integrated Chinese and Western Medicine

Since the Third Plenary Session of the 11 thCentral Committee of the Communist Party of China( CPC),with the promotion and development of traditional Chinese medicine(TCM),the pace of TCM nursing work has been accelerated in nationwide,and a group of integrated Chinese and western medicine nurses have been cultivated preliminarily. However,professional nurses of integrated Chinese and western medicine are still deficient extremely. The target of talent cultivation,based on the theory of "focusing on humanism,expanding diathesis,and enhancing practice to highlight the accommodation and integration of nurses of integrated traditional Chinese and western medicine",is to cultivate competent,practical and interdisciplinary senior nursing talents with strong professional basis,skilled operations,rich humanistic literacy,and sharp innovative spirit who not only master modern nursing knowledge and skills,but also can perform comprehensive nursing under the guidance of TCM theory of holistic concept and syndrome differentiation and nursing. This study,through investigating and analyzing the settings of3-year nursing professional courses in about 20 senior medical colleges,including senior nursing education of TCM,reformed the development of professional nursing courses of integrated Chinese and western medicine and the establishment of educational materials according to the course settings and educational work modes,so as to analyze the current status of nursing education of integrated Chinese and western medicine,determine course targets,and establish course system and educational work modes.

Opportunities and challenges for the development of traditional Chinese medicinenursing under the new healthcare reform

Based on the “Opinions on Deepening the Reform of Medicine and Health”, “Strategic planning outline of thedevelopment of Traditional Chinese Medicine （2016-2030）” and the other relevant polices announced by StateAdministration of Traditional Chinese Medicine of the People’s Republic of China, this paper analyzes and summarizesthe opportunities and challenges for the development of Traditional Chinese Medicine nursing （TCM nursing） under thenew healthcare reform, in order to provide reference and thinking for the professional development of TCM nursing.

Practice of Integrating Specialized Courses into Ideological/Political Education——Taking “Solid Luminescent Materials” as an Example

At present,the education of specialized courses in science and engineering still focuses on imparting specialized knowledge,which seriously lacks the embodiment of educating students.Taking the specialized course“Solid Luminescent Materials”as an example,the new mode of ideological/political teaching is integrated into the specialized course,giving full play to the role of the main position of the specialized class,so as to realize the aim of teaching specialized knowledge in cooperation with educating students and imperceptibly influencing the ideological/political teaching.In this paper,the design of ideological/political knowledge points and the integration of ideological/political cases are carried out from the aspects of teaching concepts,teaching contents and teaching cases.By adhering to the cooperation between moral and financial classroom and specialized education,the educational function of university specialized courses can be effectively brought into play,which is expected to guide students to enhance their awareness of energy conservation,environmental protection,innovation and patriotism.

China Association of Chinese Medicine Paper notice for seminar on clinical application of new technologyof integrated Chinese and western medicine in treating sequelae of cerebrovascular diseases

Hosted by ChinaAssociation of Chinese Medicine,and organized by World Journal of Integrated traditional and western Medicine,seminar on clinical application of new technology of integrated Chinese and western medicine in treating sequelae of cerebrovascular diseases is planned to be held in Nanning,Guangxi in August.At that time,the seminar will invite well-known experts and scholars of brain diseases at home and abroad to given special reports on clinical work and exchange of academic papers,so as to integrate new technologies and new achievement of integrated Chinese and western medicine in the treatment of the sequelae of cerebrovascular disease.The details are as follows.

课程思政教育在医学生专业课程中的探索

目的课程思政教育是培养医学生成为一名合格医学生的“重要桥梁”。自课程思政改革以来取得了重要成就,但也面临着很多问题。本研究旨在探索新的专业课程思政教育方法和途径。方法本研究通过对2022年4—5月安徽医科大学97名在校医学生进行网络问卷调查,了解目前医学生对于课程思政的认识现状,主要包括熟悉程度、效果评价、课程思政内容的占比、关注需求、存在的问题、方法和建议等6个部分。结果64.94%(63名)学生对课程思政不太了解和完全不了解;61.86%(60名)学生认为思政教育融入课程生硬、教学形式单一、枯燥无味及脱离实际是目前课程思政教育的突出问题;62.89%(61名)学生对于课程思政的作用予以肯定,认为课程思政可以给予积极的思想指导;70%(68名)学生认为现有专业课程基本上加入了思政元素;对于理想的课程思政内容比例,49.48%(48名)的学生认为思政教育比例最好控制在20%以下;在所有关注需求中学生最关心职业素养与专业知识的融合,占86.6%;关于课程思政融入途径49.48%(48名)学生建议采用微视频结合临床案例对思政元素进行分析和挖掘。结论本研究基于目前课程思政教育调查现状探索了优化的专业课程思政教育方法模式,旨在提高医学课程思政教育的质量,推动立德树人理念在医学专业课中的具体实施和发展,培养新时代适应社会需要的全面发展型的医学生。

形成性评价在眼科住院医师规范化培训中的应用

眼科住院医师规范化培训是毕业后医学教育的重要组成部分,首都医科大学宣武医院眼科不断改进对住院医师的管理及教学方法,在住院医师规范化培训专题讲座、教学查房和病例讨论等教学活动中,引入形成性评价,以《眼科培训细则》及推荐教材为指导,确定学习及评价范围,将每月进行的教学活动内容形成理论知识测试卷,对研究对象进行闭卷考试。试卷评阅后逐一反馈给住院医师,同时对每道题完成情况进行分析,反馈给相关授课教师。通过一段时间的尝试,发现住院医师对教学活动中知识点的掌握情况明显提升。对参与的教师和住院医师进行问卷调查显示,均对此培养方式有较高的满意度。在眼科住院医师规范化培训教学活动理论授课中应用形成性评价,可以调动住院医师参加教学活动的积极性和主动性,提高专注度和自主学习的意愿,促进课后复习及相关文献书籍的学习,有助于理论知识的掌握,提高学习成绩。同时此法有助于教师及时调整授课内容和方法,提高教学效率,更好地达到教学目的。

破解海岸带环境司法困境:基于陆海统筹原则

我国海岸带环境案件存在管辖权冲突、法律适用有争议、原告资格不明确、诉讼性质认定有争鸣、诉讼程序衔接未确定、司法执行机制不完善等环环相扣的问题,造成海岸带环境司法困境。究其根源,主要在于陆海“二分法”的分类思维影响较大,其与陆海统筹合为表里的内涵尚未得到全面、深入的理解。为破解海岸带环境司法困境,既要重视海岸带环境案件的特殊性,将其确立为类型化案件并由海事法院专门管辖,又要贯彻陆海统筹原则,实现司法规则内在融贯、法治环节协调一致。

高速注采储气库井套管螺纹密封性研究

套管螺纹密封性是影响周期性高速注采作业的储库气井安全性的关键因素,因此保证储气库井的密封性完整极其重要。需要重点研究储气库井注采过程中对其套管柱密封性的影响,特别是循环注采过程中产生的交变载荷对储气库套管柱特殊螺纹接头密封结构性能的影响。基于有限元法理论,针对中国北部某储气库井所选用的特殊螺纹接头,结合储气库井实际工况和现场数据,建立套管接头螺纹有限元计算模型,研究了循环注采条件下,温度、注采压力、轴向载荷及点蚀对储气库套管螺纹密封状态的影响。结果表明,温度对套管螺纹接头的结构完整性和密封完整性影响较小,注采压力、轴向载荷和点蚀对其影响较大,需控制在一个较低值。研究可为储气库井套管柱密封失效判定及其套管柱设计提供参考。

中医特色护理门诊医护协作出诊实践分析

目的 探讨脾胃病专科中医特色护理门诊医护协作出诊开展的可行性及成效。方法 运用医院选拔原则确定出诊护师,与专科医师合作开设脾胃病专科中医特色护理门诊。通过对2023年医护协作出诊和2019年护师单独出诊的脾胃病专科中医特色护理门诊就诊患者进行问卷调查,分析对医疗护理服务的满意度。结果 脾胃病专科中医特色护理门诊医护协作出诊开展以来,护理门诊量由2019年的35人次/月上升到2023年的148人次/月,出诊时间由2019年的1次/周增设至2023年的3次/周。2023年护理门诊医护协作出诊的就诊患者对医疗护理服务的满意度高于2019年护师单独出诊,差异有统计学意义(P<0.05)。结论 脾胃病专科中医特色护理门诊医护协作出诊的开展,拓展了中医护理服务内涵,满足患者日益增长的个体化、多元化需求,提高患者对医疗护理服务的满意度。

某院碳青霉烯类抗菌药物临床应用及合理性分析

目的 探讨我院2021~2022年碳青霉烯类抗菌药物临床应用变化情况,为抗菌药物合理使用和管理提供参考。方法 统计我院2021~2022年碳青霉烯类抗菌药物各品种DDDs与AUD、各科室DDDs与AUD、会诊率及微生物送检率等数据,并进行比较分析。结果 与2021年相比,碳青霉烯类抗菌药物及各品种DDDs、AUD显著下降,大部分科室DDDs与AUD均有不同程度的降低,除了个别科室会诊百分率未达标,全院总体会诊情况有所上升,接近98%,全院用药前微生物送检率接近96%,明显超过80%,且绝大多数科室送检率控制在国家规定的范围内。结论 我院碳青霉烯类抗菌药物使用较合理,基本达到了国家规定的指标要求,继续加强碳青霉烯类抗菌药物专档管理,逐步完善该类药物临床应用管理有效措施和长效工作机制,持续提高抗菌药物临床合理应用能力和管理水平。

面向科研专病库的可视化前置数据采集系统建设探索与实践

目的解决在基于临床数据中心构建专病库的过程中,由于数据字段频繁更新、手动补录工作量大导致的临床使用依从性不高的问题。方法提出了一种可视化前置数据采集的解决方案,采用MVC三层架构和WebService服务同步数据,支持可视化自定义病例报告表单,将采集动作前置到业务系统中即采即用,保障数据及时性,定期进行质量控制,保证数据来源的准确性。结果该方案在心内畸形和神母细胞瘤科研专病库上的应用显示,专病库数据质量和使用满意度得到显著提升,单份病例数据的整理时间从30分钟缩短到10分钟。结论该方案可减轻临床医生的工作负担,加快数据积累进度,提高科研专病库数据质量,激发临床医生对专病研究的科研热情。

专科医师规范化培训教学方式改革及效果评价

目的分析心血管内科专培学员对案例教学联合团队教学方式的评价,评估教学方式改革的效果。方法将心血管内科专培学员随机分为教改组(案例教学联合团队教学)和对照组(传统讲授式教学),每组各17人。教改组采用案例教学联合团队教学,对照组采用传统讲授式教学。教改组学员接受问卷调查。两组学员均进行了理论知识和病例分析考试。结果专培学员认为案例教学联合团队教学更具优势、理论知识和病例分析考试得分也更高(p<0.05)。结论案例教学联合团队教学更具优势,可应用于心血管专培学员的教学。

中医药传统知识专门保护制度构建研究

中医药传统知识是中医药的核心内容,兼具卫生、经济、科技、文化、生态五重资源价值。目前中医药传统知识面临国外不当占有、盗用,国内传承、保护不力的双重困局,现行法律制度无法实现全面、系统保护,建立专门保护制度已成为必然选择。专门保护制度需要解决四个核心问题:对外防御侵占和不当占有,对内保护持有人权利并规范知识的获取与利用,化解持有人利益与社会公共利益之间的矛盾,处理与现行法律制度的衔接。在此基础上,提出构建中医药传统知识专门保护制度的四个机制,即阻却外国不当专利申请的防御机制、持有人权利保护机制、持有人利益与社会公共利益平衡机制、与现行法律制度的衔接机制,以更好促进中医药传统知识的保护、传承、创新、发展。

现代化中医药专利保护的制度困境与出路--基于对中医药特点与专利保护适应性的反思

符合西医药特点的专利保护制度在中医药现代化进程中难以适应。尽管现行专利制度已对涉及中药领域发明专利申请审查的特殊情形作出了具体规定,但在本土语境下据此保护主要根植于我国传统知识领域的中医药发明创造时,中医药的复杂性、整体性、道地性和时节性、差异性等特点仍未得到充分体现,并由此产生中医相关发明创造不具有专利适格性、专利审查缺乏一般性指导规则、申请文件难以通过合规性审查、申请主题的可专利性要求过高、关键性概念缺乏细化指导规则等问题。为此,可从专门审查标准的制定和商业秘密的补充保护两方面出发,寻求前述问题的具体解决方案,以应对中医药专利保护的适应性需求,从而完善中医药知识产权保护体系。

区域内生殖医学专科联盟体系构建专家共识

生殖健康是人类社会得以延续的基石。甘肃省妇幼保健院(甘肃省中心医院)生殖医学中心二部组织专家,通过全面阅读政策文件和相关文献,对生殖医学专科联盟的现状、存在问题以及可持续发展策略进行了梳理和总结。他们希望在生殖医学专科领域建立联盟工作机制,通过资源整合、信息共享和分工协作构建涵盖不孕不育症预防、治疗、生殖健康教育和生育咨询等的生殖医学专科服务体系,为患者提供系统性、连续性、便捷性和可及性的生殖健康服务。

新工科背景下“现代控制理论”课程思政教学设计与实践

新工科建设的提出,为高校的教育方式提出了新的挑战。“现代控制理论”是电子信息类、自动化类专业必修的专业核心课程,完善课程的思政建设变得尤为重要。新工科背景下,对“现代控制理论”课程进行课程思政教学的设计与实践。紧紧围绕国家和区域发展需求,结合学校发展定位和人才培养目标,主要从四个方面进行课程思政的建设,包括领域典型伟大人物的介绍、建设典型思政案例库、创建专题教学讨论区和周期性进行热门科技及工程技术的专题讲座。

专业陪审员制度探要

2023年7月27日,最高人民法院发布了《关于具有专门知识的人民陪审员参加环境资源案件审理的若干规定》,这标志着经历多年实践探索以后,专业陪审员制度终于在我国正式落地。然而,当初最高人民法院在人民陪审员制度改革试点情况报告中对专业陪审员制度暂不规定的表态言犹在耳,而且客观条件并没有发生显著改变,此时出台这项司法解释委实过于操切:专业陪审员制度不仅于法无据,上位法并不支持将人民陪审员分为普通和专业的做法;而且于情不合,凸显了陪审员人民性与精英性的内在冲突;更加于理相悖,在必要性与合理性两个层面均有所欠缺。因此,目前宜严控专业陪审员制度的适用,待《人民陪审员法》修改以后再定夺其存废去留问题。

基于专病专药思维探析姜德友临证用药经验

姜德友教授认为专药是对某病、某症有特殊针对性疗效且可用以解决疾病主要矛盾的药物,临证处方中,姜教授在辨证定方后,常以专病专药思维为指导,对病或对症加用某一专药,以求捷效。其对专病专药思维的运用以象思维为引(如以蜈蚣治疗颈椎病、以百合治疗不寐、以地龙治疗血络瘀阻等)、以奇药为基(如以鬼针草治疗高血压、以卷柏治疗糖尿病、以预知子治疗肝气郁结等),往往能直中病所,疗效较好。附验案1则。

新医科背景下高等中医药院校通识教育与专业教育融合研究

新医科建设已经成为新时期高等中医药院校教育改革的重要方向,以“新医科”建设为抓手,结合新医科“前瞻性、交叉性、融合性、开放性、实践性”的特质,针对高素质复合型、创新型“新医科”人才能力需求,培养具有专业素养和人文精神的全面和谐发展的高素质中医药人才,成为高等中医药院校的主要任务。文章从通识教育与专业教育的内涵、通识教育与专业教育融合发展的意义以及必要性,包括中医药发展面临的机遇出发,探索新医科背景下高等中医药院校通专融合的契合路径,以期为高等中医药院校的通专融合提供借鉴。