ObjectiveIn this study, we aimed to investigate the medical postgraduates’ attitudes on scientific misconduct activities to provide support to scientific research integrity education.MethodsWe conducted a cross-sectional survey in 3 medical schools in Sichuan province in September 2020. Medical postgraduates were investigated to report the sociodemographic information and self-attitude on research activities.ResultsOf the 983 students completed, 73.14% were pursuing the master program and 27.9% had published SCI papers. For attitudes on scientific misconduct activities, 0.93% agreed to change negative results picture into positive by software and 5.08% consented to modify data when P value was above 0.05 slightly.ConclusionsThe results of this study show that a small portion of medical postgraduates are still not resolute on academic misconduct. We should further strengthen education and establish the bottom line thinking which cannot be touched by the academic misconduct of medical postgraduates.
Objective To report evidence-based treatment for 2 case of Ⅱ B stage non-small cell lung cancer. Methods We searched systematic reviews and randomized controlled trials in The Cochrane Library (Issue 2, 2009), MEDLINE (PubMed, January 1970 to June 2009) and ACP Journal Club (1996 to June 2009), and evaluated the evidence. Results The best clinical evidence for Ⅰ and Ⅱ stage non-small cell lung cancer patients showed that in the patients with resectable nonsmall cell lung cancer, postoperative adjuvant radiotherapy and chemotherapy could not improve survival compared with surgery alone. We did not find evidence which indicated that preoperative chemotherapy improved survival in people with resectable non-small cell lung cancer. Conclusion In accordance with the wishes of the patient and family, they do not accept the radiotherapy and chemotherapy, but choose palliative and supportive therapy.
ObjectiveTo systematically review the teaching effects of Seminar teaching model versus lecture-based learning (LBL) teaching model on clinical medical students in China.MethodsPubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Internet, WanFang Data and VIP database were electronically searched for randomized controlled trials (RCTs) on Seminar versus LBL applied in clinical medical students in China, from the establishment of database to October 2017. The Meta-analysis was performed using RevMan 5.2 software.ResultsA total of 12 RCTs with 741 students were enrolled, including 380 in Seminar teaching group and 361 in LBL teaching group. The results of Meta-analysis demonstrated that the basic theory score [standard mean difference (SMD)=1.17, 95% confidence interval (CI) (0.72, 1.62), P<0.000 01], the clinical skill score [SMD=1.33, 95%CI (0.82, 1.83), P<0.000 01], the classroom atmosphere score ［SMD=1.51, 95%CI (1.13, 1.90), P<0.000 01］, the team score [SMD=0.86, 95%CI (0.50, 1.22), P<0.000 01], and the autonomous learning ability score [SMD=2.25, 95%CI (0.31, 4.18), P=0.02] of Seminar teaching group were superior to those in the LBL teaching group.ConclusionThe Seminar teaching model is superior to the LBL teaching model in clinical medical students.
ObjectivesTo investigate the occupational stress and career burnout of postgraduates in professional degree of clinical medicine.Methods70% of postgraduates with professional degree of clinical medicine from grade 2016 to 2018 in West China Hospital of Sichuan University were sampled. The individual characteristics and occupational stress were investigated by a questionnaire, and Maslach Burnout Inventory (MBI) was used to investigate the individual career burnout. ResultsA total of 600 questionnaires were distributed and 520 valid questionnaires were retrieved, with an effective rate of 86.7%. According to the stress results, 17.5% of the students were under severe stress, 44.81% were under moderate stress, and only 1.54% were without stress. Regarding the sources of stress, 63.46% were originated from scientific research while 27.88% were originated from clinical practice. For burnout, the mean score of MBI was 40.56 with 15.00 standard deviation suggesting most of the students were in good working condition. However, a small number of students had career burnout to a certain degree and required adjustment. ConclusionsPostgraduates in professional degree of clinical medicine face the dual pressure of scientific research and clinical work. Improving the existing medical master's training system, relieving postgraduates’ stress, maintaining postgraduates’ physical and mental health are necessary and urgent. In light of this, the teaching quality of postgraduates in professional degree of clinical medicine may require improvement.
ObjectiveTo investigate changes of the psychological heath condition of postgraduates in professional degree (PPD) of clinical medicine under "clinical-practical and medical-educational combination" training mode.MethodsA cluster sampling method was adopted for 101 PPDs and 120 postgraduates in academic degree (PAD) of clinical medicine in grade 2015 of our university. The psychological health condition was evaluated using online questionnaires at the time of enrollment in 2015 and prior to graduation in 2018.ResultsA total of 82 valid questionnaires in PPD group and 96 valid questionnaires in PAD group were collected in 2018. Compared with 2015, the scores of K6 for assessing psychological distress within 1 month, PHQ-9 for the depression module and the PHQ-15 for assessing somatic symptoms within 1 month decreased in 2018 (P<0.05), while the scores of sleep time in Pittsburgh Sleep Index Questionnaire increased in 2018 (P<0.05). The scores of K6 and PHQ-15 within 12 months in the group with excellent academic achievement prior to graduation were higher than those in the other three groups (P<0.05), and the hypnotic scores of the group with poor academic achievement were higher than those of the other three groups (P<0.05).ConclusionsThe emotion, somatic symptoms and psychological feelings of PDDs and PADs are superior than those at the time of admission, and the ability of psychological stress adjustment gradually matured and improved. However, the pressures faced by PPDs and PADs may originate from different aspects, and the "clinical-practical and medical-educational combination" training mode has not included more pressure on the PPDs. Graduates with excellent academic achievements are under significant pressure. However, the ability to adjust is strong, and the physiological health condition of graduate with inferior academic achievements may require more attention from educators.
As one of the first batch of pilot universities for the education reform of clinical medicine master program, Sichuan university has conducted in-depth research on the training models in medical schools from home and abroad since 2013. Relying on the platform of medical education collaboration, we have explored and gradually formed the “five early” education model for clinical medicine master program. This article summarizes the practical experience of “five early” education model from six dimensions, namely, PDCA management system, rules and regulations, platform support, database construction, case database construction and international exchange. In addition,, the achievements in the training of medical talents with comprehensive qualities are presented from the aspects of clinical skills, scientific research achievements, international exchanges and frontier innovation, The goal is to provide effective experience for clinical medical personnel training.
ObjectiveTo investigate the willingness and influencing factors of clinical medicine graduate students to study abroad.MethodsFrom September 2019 to January 2020, a survey was conducted among the clinical medicine graduate students in West China School of Medicine, Sichuan University. An anonymous self-report questionnaire was used to investigate their willingness to study abroad, and the related influencing factors were analyzed.ResultsA total of 600 questionnaires were distributed, in which 518 valid questionnaires were collected. Among the 518 graduate students, 96.14% anticipated to study abroad, and 93.05% expected to subsidize the study abroad through the state-sponsored study abroad fund. The major obstacle for studying abroad for joint training was concerning the negative effects on domestic clinical work or scientific research work, resulting in failure to graduate; meanwhile, difficulty in applying was the primary obstacle for studying abroad for a doctorate.ConclusionsThere is a strong willingness for clinical medicine graduate students to study abroad. However, it is affected by graduation time and application.
Objective To systematically review the teaching effects of problem-based learning (PBL) combined with lecture-based learning (LBL) versus lecture-based learning (LBL) teaching models on students in surgical clinical education in China. Methods Such databases as The Cochrane Library, PubMed, CNKI, WanFang Data and VIP were electronically searched for randomized controlled trials (RCTs) on PBL+LBL versus LBL applied in surgery education in China from inception to February 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results Fourteen RCTs including 1 386 students were included. The results of meta-analysis showed, compared with LBL, PBL+LBL were superior in basic knowledge of surgery (MD=3.33, 95%CI 2.07 to 4.60, P<0.000 01), case analysis (MD=5.90, 95%CI 2.61 to 9.19,P=0.000 4), clinical skills (MD=3.38, 95%CI 0.57 to 6.19, P=0.02), comprehensive performance (MD=7.15, 95%CI 3.87 to 10.43, P<0.000 1) and teaching satisfaction (OR=3.05, 95%CI 1.90 to 4.9,P<0.000 01) with significant difference. There was no differences in inquiry/physical examination/medical record between the two groups (MD=0.82, 95%CI 0 to 1.64,P=0.05). Conclusions PBL+LBL teaching method is superior to LBL in surgical clinical education in China. Large-scale and high quality randomized controlled trials are needed to confirm the above conclusions.
ObjectiveTo evaluate the feasibility of the chitosan-poly (lactide-co-glycolide) (PLGA) double-walled microspheres for sustained release of bioactive nerve growth factor (NGF) in vitro.MethodsNGF loaded chitosan-PLGA double-walled microspheres were prepared by emulsion-ionic method with sodium tripolyphosphate (TPP) as an ionic cross-linker. The double-walled microspheres were cross-linked by different concentrations of TPP [1%, 3%, 10% (W/V)]. NGF loaded PLGA microspheres were also prepared. The outer and inner structures of double-walled microspheres were observed by light microscopy, scanning electron microscopy, confocal laser scanning microscopy, respectively. The size and distribution of microspheres and fourier transform infra red spectroscopy (FT-IR) were analyzed. PLGA microspheres with NGF or chitosan-PLGA double-walled microspheres cross-linked by 1%, 3%, and 10%TPP concentration (set as groups A, B, C, and D respectively) were used to determine the degradation ratio of microspheres in vitro and the sustained release ratio of NGF in microspheres at different time points. The bioactivity of NGF (expressed as the percentage of PC12 cells with positive axonal elongation reaction) in the sustained release solution of chitosan-PLGA double-walled microspheres without NGF (set as group A1) was compared in groups B, C, and D.ResultsThe chitosan-PLGA double-walled microspheres showed relative rough and spherical surfaces without aggregation. Confocal laser scanning microscopy showed PLGA microspheres were evenly uniformly distributed in the chitosan-PLGA double-walled microspheres. The particle size of microspheres ranged from 18.5 to 42.7 μm. The results of FT-IR analysis showed ionic interaction between amino groups and phosphoric groups of chitosan in double-walled microspheres and TPP. In vitro degradation ratio analysis showed that the degradation ratio of double-walled microspheres in groups B, C, and D appeared faster in contrast to that in group A. In addition, the degradation ratio of double-walled microsphere in groups B, C, and D decreased when the TPP concentration increased. There were significant differences in the degradation ratio of each group (P<0.05). In vitro sustained release ratio of NGF showed that when compared with PLGA microspheres in group A, double-walled microspheres in groups B, C, and D released NGF at a relatively slow rate, and the sustained release ratio decreased with the increase of TPP concentration. Except for 84 days, there was significant difference in the sustained release ratio of NGF between groups B, C, and D (P<0.05). The bioactivity of NGF results showed that the percentage of PC12 cells with positive axonal elongation reaction in groups B, C, and D was significantly higher than that in group A1 (P<0.05). At 7 and 28 days of culture, there was no significant difference between groups B, C, and D (P>0.05); at 56 and 84 days of culture, the percentage of PC12 cells with positive axonal elongation reaction in groups C and D was significantly higher than that in group B (P<0.05), and there was no significant difference between groups C and D (P>0.05).ConclusionNGF loaded chitosan-PLGA double-walled microspheres have a potential clinical application in peripheral nerve regeneration after injury.
ObjectiveTo explore the difference of myocardial injury between off-pump coronary artery bypass grafting (OPCAB) and modified perfusion on-pump coronary artery bypass grafting (ONCAB).MethodsA total of 558 patients who underwent coronary artery bypass grafting in Beijing Anzhen Hospital from 2017 to 2019 were included. According to whether or not they received modified perfusion cardiopulmonary bypass, all the 558 patients were divided into two groups including an OPCAB group (OP group) and an ONCAB group (ON group). There were 465 patients in the OP group including 282 males and 183 females with an average age of 63.58±7.87 years. In the ON group, there were 93 patients including 64 males and 29 females with an average age of 63.91±7.51 years. Creatine kinase MB (CK-MB) and cardiac specific troponin I (cTnI) were measured 24 hours before operation, 30 minutes after operation, 12 hours after operation, 36 hours after operation and 48 hours after operation.ResultsNo perioperative death occurred in all patients. CK-MB (5.00 ng/mL vs. 8.60 ng/mL, Z=–2.189, P=0.029) and cTnI (3.00 ng/mL vs. 7.80 ng/mL, Z=–5.307, P=0.000) in postoperative 12 hours in the ON group were less than those in the OP group. CK-MB (5.00 ng/mL vs. 5.60 ng/mL, Z=–2.280, P=0.023) and cTnI (0.10 ng/mL vs. 1.02 ng/mL, Z=–6.418, P=0.000) in postoperative 36 hours in the ON group were less than those in the OP group. cTnI (0.07 ng/mL vs. 0.81 ng/mL, Z=–1.946, P=0.032) in postoperative 48 hours in the ON group was less than that in the OP group.ConclusionCompared with OPCAB, modified perfusion ONCAB has less myocardial damage.