Revision of “Introduction to General Medicine” Based on the Six-Step Curriculum Development Process

Objective:Based on the six-step curriculum development process proposed by Professor Schneiderhan et al.,the course needs,the cognition,and course summative assessment results,combined with the career preferences and work value orientation of clinical medical students undertaking the course“Introduction to General Medicine”were surveyed.Methods:A self-designed questionnaire was used to collect information on the course cognition,course summative evaluation,and professional inclination of 233 junior medical students majoring in clinical medicine undertaking the course“Introduction to General Practice.”An analysis was conducted to provide a basis for curriculum revision in accordance with the structured composition of the curriculum development process.Results:(i)In terms of course cognition,before the course,67.0%of students were unaware of general medicine and general practitioners,73.0%of students had never participated in practical activities(including volunteer work),and 53.6%of students expressed interest in the course;there were significant differences in the growth environment,the frequency of participation in club activities,the cognition of general medicine/general practitioners before the course,participation in practical activities(including volunteer work),attentiveness to the current situation of medical treatment,and the interest toward the course(P<0.05);multi-factor logistics analysis showed that the factors influencing the interest toward the course include growth environment,frequency of participation in club activities,course cognition,participation in practical activities,and attentiveness to the current status of development of medical treatment.(ii)The course summative assessment results showed that 91.8%of students felt that it is necessary to learn this course,33.9%of students felt that the most important thing in the course is to learn the theoretical knowledge of general medicine and related diagnosis and treatment skills,53.2%of students felt that the most unfavorable factor affecting the learning of this course is the lack of interest in general medicine,and 64.4%of students hoped for more clinical practice to understand and participate in the work of general practitioners;paired t-test revealed differences in career preferences before and after the course(P<0.05);after the course,more students thought that general practitioner is an ideal career option.(iii)The results showed that 58.8%of students had considered their future specialty but did not have specific goals or plans,while 21.9%had considered their future specialty and had clear goals;there was a significant difference in professional inclination between genders as well as those who were attentive to the current state and development of medical treatment in our country and those who were not(P<0.05);with regard to the scores of importance in terms of the influencing factors of professional inclination,interest and possibility of professional development scored 3.92,ranking first,followed by income,which scored 3.91,and career prestige,which scored the lowest(3.62).Conclusion:Based on the needs assessment of clinical medical students,it is important to focus on improving students’interest in general medicine,especially their cognition and professional understanding of the course before the course itself,in addition to the development of relevant practical activities,and their attentiveness to the current state and development of medical treatment.The summative assessment results suggest that the implementation of this course has a positive influence on the career preferences of clinical medical students to a certain extent.Therefore,it is necessary to combine the course content with the development of general medicine,so as to stimulate students’interest in self-driven learning and in general medicine.This will attract more students whose work value orientation is influenced by interest and possibility of professional development to choose general practitioner as their future professional inclination.

Analysis of the Practice of Community-Based Self-Sampling and Its Implication on Prevention and Control of Infectious Diseases—Fengtai District,Beijing Municipality,China,2022

Summary What is already known about this topic?So far,no descriptive analysis has been conducted on community residents with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)nucleic acid self-sampling in China.What is added by this report?This report found that self-sampling had a wide age and regional distribution,with the time from selfsampling to result-reporting typically taking less than one day.Additionally,self-sampling was found to save a considerable amount of manpower and medical resources compared to regular sampling.What are the implications for public health practice?The experience of prevention and control measures during the coronavirus disease 2019(COVID-19)pandemic has provided a reference for the prevention and control of other infectious diseases through selfsampling.

Lichong decoction reduces Matrix Metalloproteinases-2 expression but increases Tissue Inhibitors of Matrix Metalloproteinases-2 ex-pression in a rat model of uterine leiomyoma

OBJECTIVE:To study the effect of Lichong decoction(LD) on expression of matrix metalloproteinase-2(MMP-2) and metalloproteinase-2(TIMP-2) in a rat model of uterine leiomyoma(UL).METHODS:UL was induced in rats using exogenous estrogen and progesterone.LD was administered(p.o.) for 4 weeks,and mifepristone(RU-486)used as a control.To observe the effect of LD on the uterine coefficient and uterine transverse diameter,a radioimmunoassay method was used to detect serum levels of sex hormones.Light microscopic analyses of pathologic changes in the tissues of UL rats were evaluated.Expression of the proteins of matrix metalloproteinases(MMPs) and tissue inhibitors of metalloproteinases(TIMPs) in uterine tissues was assessed by immunohistochemical staining and western blotting.RESULTS:A UL model in rats was established successfully.LD reduced uterine weight,uterine coefficient,and uterine transverse diameter compared with untreated controls.LD reduced levels of estradiol,progesterone,follicle-stimulating hormone,and luteinizing hormone in our UL models.LD improved the pathologic condition of uterine muscle.Expression of MMP-2 protein decreased to varying extents in LD-treated groups,but TIMP-2 levels were enhanced.LD appears to reduce MMP-2 expression and increase TIMP-2 expression in UL tissue.CONCLUSION:These data suggest that the mechanism of action of LD on ULs may involve reduction of MMP-2 expression and increase in TIMP-2 expression in rats.

Prevalence of musculoskeletal symptoms among industrial employees in a modern industrial region in Beijing,China

Background:Growing industrialization of China exposes its labor population to the risk of musculoskeletal disorders(MSDs).This study aimed to investigate the prevalence and risk factors of MSDs in a modern industrial region of Beijing.Methods:A cross-sectional study included 1415 employees in six industrial companies was conducted between January 2018 and May 2018 in Fangshan district,Beijng,China.Nordic Musculoskeletal Questionnaire(NMQ)was used to collect the information about MSDs.Demographic factors,lifestyle factors,health and medical factors,and work-related factors were collected as independent variables.Descriptive statistics,the chi-squared(/2)test,and binary logistic regression analysis were used to analyze data.Results:Among 1415 participants,498 reported MSDs.The regions involved were the neck(25.16%),shoulders(17.17%),and upper back(13.29%).There was a significant statistical difference between frontline industrial workers and other staff in the prevalence of self-reported symptoms involving the shoulders(Х^2=4.33,P=0.037),wrists and hands(Х^2=8.90,P=0.003),and ankles and feet(Х^2=12.88,P<0.001).Increased age(P=0.005,OR=1.63;P=0.001,OR=2.33),a high or a low salary(P<0.001,OR=0.49;P<0.001,OR=0.30),night-shift(P=0.027,OR=1.46),two-week-history of illness and treatment(P=0.004,OR=5.60;P=0.013,OR=4.19),concurrent chronic diseases(P=0.001,OR=3.45;P=0.092,OR=7.81),limited access to health information(P=0.004,OR=0.49),and negative attitude towards seeking healthcare(P=0.010,OR=1.77;P=0.009,OR=2.75)were associated with MSDs in frontline workers.Female gender(P<0.001,OR=2.30),high education(P=0.001,OR=1.96),no exercises(P=0.027,OR=0.59),night-shift(P=0.017,OR=1.98),concurrent chronic diseases(P=0.002,OR=3.73;P=0.020,OR=13.42),limited access to health information(P=0.013,OR=0.53),far distance to medical institution(P=0.009,OR=1.83),and negative propensity(P=0.009,OR=1.94;P=0.014,OR=2.74)were associated with MSDs in other staffs.Conclusions:The prevalence of MSDs among industrial employees has changed.Frontline workers had different prevalence and risk factors for MSDs compared with other employees.Negative propensity to healthcare,limited ways to obtain health knowledge,and concomitant chronic diseases were associated with MSDs.Surprisingly,highly educated and high-income employees had a higher risk of MSDs.

Association between serum uric acid and large-nerve fiber dysfunction in type 2 diabetes:a cross-sectional study

Background:Large-nerve fiber dysfunction,as assessed by vibration perception threshold (VPT) predicts risks of ulceration,amputation,and mortality in diabetes.Serum uric acid (UA) is closely associated with various metabolic disorders,especially diabetes.Thus,we sought to investigate the clinical relevance of UA to large-nerve fiber dysfunction,among patients with type 2 diabetes (T2D).Methods:Medical records of consecutive patients with T2D who were admitted to Beijing Friendship Hospital Pinggu Campus between May 2014 and December 2016 were collected.Data for the 824 eligible patients included in the final analysis were extracted using a structured form.A VPT value ≥15 in either foot was defined as abnormal.We compared the clinical characteristics between patients with abnormal VPT and those with normal VPT (VPT value <15 in both feet) in the overall population and in gender subgroups.Logistic regression analysis was performed to explore the association of abnormal VPT with UA level.One-way analysis of variance was used to compare VPT values across four UA quartiles.Results:UA levels were significantly lower in T2D patients with abnormal VPT than in those with normal VPT (294.5 ± 84.0 vs.314.9 ± 92.8 μmol/L,P<0.01),especially among male patients (311.7 ± 85.2 vs.336.9 ± 89.6 μmol/L,P<0.01).From the logistic regression analysis,hyperuricemia (males >420 μmol/L;females >360 μmol/L) was associated with a reduced risk of abnormal VPT (odds ratio [OR],0.60;95% confidence interval [CI],0.39–0.91;P<0.05).This association was robust in male patients (OR,0.43;95% CI,0.24–0.76;P<0.01) but not in female patients (OR,0.92;95% CI,0.47–1.82;P = 0.816),even after adjustment for confounding factors.For the younger male subgroup (age <65 years),VPT values decreased as the UA level increased (P for trend = 0.002),but this trend was not significant in older male subgroup (age ≥65 years;P for trend = 0.400).Conclusions:Low serum UA levels showed a significant association with an increased risk of large-nerve fiber dysfunction in male patients with T2D,but not in female patients with T2D.In addition,in only the younger subgroup of male patients (<65 years),lower levels of UA also correlated with higher VPT values.

Medical Consultations Option and Influencing Factors for SARS-CoV-2 Infected Individuals-Beijing Municipality,China,December 2022

Summary What is already known about this topic?In December 2022,China revised its epidemic prevention and control strategy,leading to an increase in coronavirus disease 2019(COVID-19)cases and a peak in medical consultations.Government departments implemented relevant policies to coordinate and allocate medical resources throughout China.However,there is a scarcity of research on the status of medical consultations and the factors influencing them.