【摘要】 目的 了解科研志愿者參與科研活動的現狀及滿意度，為促進本科生科研能力培養提供決策建議。 方法 以參與四川大學華西臨床醫學院循證醫學中心及多學科綜合治療（MCQ）兩項科研志愿者活動的407名同學為調查研究對象，采用自制問卷表進行調查。對數據進行描述性分析和Logistic回歸分析。 結果 發放問卷407份，回收有效問卷351份，有效回收率86.24%。80.6%的受訪對象對目前參與科研活動現狀表示滿意。認為限制工作進展的主要因素是缺乏相關基礎知識和基本技能（占34.7%）以及缺乏時間（占31.6%）。21.1%的科研活動無固定的組織模式。96.2%的受訪對象表示有必要進行活動成果展示。是否有導師指導、是否有知識傳授和技能培訓以及對活動組織模式是否滿意是影響科研志愿者對科研活動滿意度的主要因素（P值分別為0.027、0.011和0.000）。 結論 志愿者參與科研活動的滿意度總體較高;滿意度受到多種因素影響。建立科研志愿者招募體系、完善科研能力培養層次、加強科研團隊組織建設、規范管理運作機制、嵌入科研課程并加強科研成果展示有助于提升本科生科研活動的參與率及滿意度，對醫學本科生科研能力培養具有積極作用。【Abstract】 Objective To study the current status and satisfactory degree of student volunteers’’ participation in scientific research, so as to provide suggestion for improving the scientific research capability of medical undergraduates. Methods Carried out a survey on 407 student volunteers from EBM (Evidence-Based Medicine) and MCQ (Matrix clinical quality) research program in West China Medical School, Sichuan University with self-designed questionnaires.The data was described and analyzed with logistic regression. Results A total of 351 (86.24%) valid questionnaires were retrieved among all the 407 questionnaires assigned.80.6% of the respondents were contented with the current situation of scientific volunteers’ program.34.7% of respondents thought that lack of basic knowledge and skill was the main factor that limited the progress of their research work.While for another 31.6% respondents, the main limited factor was lack of extracurricular time.21.1% of research activities were not operated in a standardized organizational mode.96.2% of the respondents emphasized on the necessity of exhibiting their works and achievements in public.“Tutor’s instructions”, “training on basic knowledge and skills” and “organizational mode” were the main factors which affect the satisfactory degree on scientific volunteer programs (P=0.027, 0.011, and 0.000, respectively) . Conclusion The satisfactory degree of students who participated in scientific volunteer programs is generally satisfying, however affected by various factors. Increase of participation rate in scientific research program can be attributed to factors such as establishment of a scientific volunteer recruitment system, improvement of students’ research capability, standard organizational modes, standard managing and operating mechanism, embed training lessons into courses
Objective Based on the acquirable and optimized evidences at present, to explore the challenge and countermeasures for the development of nursing discipline in China, and to provide suggestions for promoting the construction of nursing discipline, platform, and talent team. Methods The study materials were searched in the following electronic databases including PubMed, EMbase, Web of Science, CNKI, VIP and CBM, as well as in the official websites of World Health Organization (WHO), International Council of Nurses (ICN), World Bank, the Ministry of Health (MOH) and the Ministry of Education (MOE) of China, and the domestic universities, colleges or technical secondary schools. Then the statistical analysis was conducted using SPSS 13.0 and Microsoft Excel software. Results a) By 2012, there were 855 nursing schools, 38 212 nursing undergraduates enrolled in universities, and 130 837 nursing students enrolled in junior colleges and senior vocational schools; b) The doctor-to-nurse ratio was 1 to 0.9 in 2010. The actual demand for doctors was 2.6 million, and there were still lack of 346 000 nurses; c) The age of nurses younger than 35 years old accounted for 50%. Those with primary professional title accounted for 64% to 69%, while less than 2.5% with advanced professional title; d) The training cost for a doctor and nurse/midwife in China only accounted for 2/5 of that in India and 1/5 to 1/4 in the sub-Sahara Africa; and e) To date, only 30.1% of disaster nursing studies in China provided research data, 30.6% were clinical experience and 38.3% were review. Conclusion Education and health systems need to be extensively reformed. It is necessary to train nursing students with core competencies using transformative learning. It is necessary to update textbooks and teaching methods, and funding should be appropriately increased. Nursing should cooperate with other disciplines, and apply evidence-based nursing methods to improve the quality of healthcare services and patient satisfaction.
Evidence-based research in traditional Chinese medicine (TCM) has made many important achievements and promoted the modernization and internationalization of TCM. The ability to produce research evidence to guide clinical practice in an emergency treatment situation is a major test of the development of evidence-based Chinese medicine (EBCM) when emerging infectious diseases outbreaks. Along with the development of EBCM, TCM has experienced emerging infectious disease events such as atypical pneumonia (SARS), influenza A (HIN1), and corona virus disease 2019 (COVID-19), and the ability of TCM to conduct clinical research in emergency treatment work has been continuously improved. This article provides an overview of the clinical research conducted in TCM to resist emerging infectious diseases in the past, focusing on the clinical research results obtained in the present time of COVID-19 rescue and treatment, and discusses the role of EBCM development to enhance the clinical research capacity of TCM in emerging infectious diseases.
ObjectiveTo explore the application effect of information-based circuit teaching mode for training refresher nurses in continuous renal replacement therapy (CRRT).MethodsCRRT refresher nurses studied in West China Hospital of Sichuan University from January 2016 to December 2019 were selected. The CRRT refresher nurses who were selected as the control group (studied from January 2016 to December 2017) accepted the conventional teaching method. The CRRT refresher nurses who were selected as the test group (studied from January 2018 to December 2019) accept the information-based combined with circuit teaching mode for teaching and training. After 6 months of training, the theoretical performance, operation performance, teaching satisfaction and the incidence of adverse events were compared between the two groups.ResultsA total of 112 CRRT refresher nurses were enrolled. Among them, there were 52 nurses in the control group and 60 in the test group. The scores of theory achievement (t=?2.421, P=0.017), operation achievement (t=?2.305, P=0.023) and teaching satisfaction [including teaching effect (t=?4.067, P<0.001), operation skill (t=?5.013, P<0.001), teaching mode (t=?5.589, P<0.001) and teaching content (t=?2.586, P<0.001)] of refresher nurses in the test group were higher than those in the control group. There was no significant difference between the control group (4 cases) and the test group (1 case) in the occurrence of adverse nursing events (adjusted χ2=1.169, P=0.280).ConclusionThe information-based circuit teaching mode has achieved good results in the teaching of CRRT refresher nurses, which is conducive to improving the post competency of CRRT refresher nurses.
ObjectiveTo investigate the effects of melatonin (MT) on bone mass and serum inflammatory factors in rats received ovariectomy (OVX) and to investigate the effects of MT on the levels of inflammatory factors in culture medium and osteogenic ability of bone marrow mesenchymal stem cells (BMSCs) stimulated by lipopolysaccharide. Methods Fifteen 12-week-old Sprague Dawley (SD) rats were randomly divided into 3 groups. The rats in Sham group only received bilateral lateral abdominal incision and suture, the rats in OVX group received bilateral OVX, and the rats in OVX+MT group received 100 mg/(kg·d) MT oral intervention after bilateral OVX. After 8 weeks, the levels of serum inflammatory factors [interleukin-1β (IL-1β), IL-6, and tumor necrosis factor α (TNF-α)] were detected using ELISA assay. Besides, the distal femurs were detected by Micro-CT to observe changes in bone mass and microstructure, and quantitatively measured bone volume fraction, trabecular thickness, and trabecular number. The BMSCs were extracted from the femurs of three 3-week-old SD rats using whole bone marrow culture method and passaged. The 3rd-5th passage BMSCs were cultured with different concentrations of MT (0, 1, 10, 100, 1 000 μmol/L), and the cell viability was then detected using cell counting kit 8 (CCK-8) to select the optimal concentration of MT for subsequent experiments. Cells were devided into osteogenic induction group (group A) and osteogenic induction+1/5/10 μg/mL lipopolysaccharide group (group B-D). The levels of inflammatory factors (IL-1β, IL-6 and TNF-α) in cell culture medium were detected using ELISA assay after corresponding intervention. According to the results of CCK-8 method and ELISA detection, the cells were intervened with the most significant concentration of lipopolysaccharide for stimulating inflammation and the optimal concentration of MT with osteogenic induction, defining as group E, and the cell culture medium was collected to detect the levels of inflammatory factors by ELISA assay. After that, alkaline phosphatase (ALP) staining and alizarin red staining were performed respectively in groups A, D, and E, and the expression levels of osteogenic related genes [collagen type Ⅰ alpha 1 chain (Col1a1) and RUNX family transcription factor 2 (Runx2)] were also detected by real time fluorescence quantitative PCR (RT-qPCR). ResultsELISA and Micro-CT assays showed that compared with Sham group, the bone mass of the rats in the OVX group significantly decreased, and the expression levels of serum inflammatory factors (IL-1β, IL-6, and TNF-α) in OVX group significantly increased (P<0.05). Significantly, the above indicators in OVX+MT group were all improved (P<0.05). Rat BMSCs were successfully extracted, and CCK-8 assay showed that 100 μmol/L was the maximum concentration of MT that did not cause a decrease in cell viability, and it was used in subsequent experiments. ELISA assays showed that compared with group A, the expression levels of inflammatory factors (IL-1β, IL-6, and TNF-α) in the cell culture medium of groups B-D were significantly increased after lipopolysaccharide stimulation (P<0.05), and in a concentration-dependent manner. Moreover, the expression levels of inflammatory factors in group D were significantly higher than those in groups B and C (P<0.05). After MT intervention, the expression levels of inflammatory factors in group E were significantly lower than those in group D (P<0.05). ALP staining, alizarin red staining, and RT-qPCR assays showed that compared with group A, the percentage of positive area of ALP and alizarin red and the relative mRNA expressions of Col1a1 and Runx2 in group D significantly decreased, while the above indicators in group E significantly improved after MT intervention (P<0.05). ConclusionMT may affect the bone mass of postmenopausal osteoporosis by reducing inflammation in rats; MT can reduce the inflammation of BMSCs stimulated by lipopolysaccharide and weaken its inhibition of osteogenic differentiation of BMSCs.
ObjectiveTo explore the characteristics of the criminal cases assessed by forensic psychiatry expertise in order to provide evidence for guiding forensic psychiatric practice, preventing and reducing criminal acts of patients with mental disorders. MethodsWe collected information of 3 720 criminal cases assessed in Forensic Psychiatry Department of Sichuan University, China from January 1997 to December 2011 by using the self-made questionnaire, and analyzed the demographic data, criminological characteristics and expert consensus of psychiatric diagnosis and legal ability. ResultsOut of 3 720 criminal cases, 3 211 (86.3%) were male, and 3 022 (81.2%) were between 18 and 45 years old. A total of 1 683 (45.3%) were married or remarried. A total of 3 178 (85.4%) were under junior middle school, and 3 221 (86.6%) were farmer or unemployed. Schizophrenia (46.7%), without psychosis (13.8%), mental retardation (9.6%) were the top three kinds of diagnosis. Homicide (42.7%), intentional injury (21.5%) and rape/indecency (8.1%) were the main crimes. A total of 1 616 (43.4%) were irresponsible, and 1 172 (31.5%) were with full responsibility. There was a significant correlation between the number of criminal cases in every year and years (rS=0.94,P=0.00), and significant correlation was also found between the percentage of mental disorder caused by drugs and years(rS=0.84,P=0.00), as well as the percentage of mental retardation and years(rS=0.72,P=0.00). ConclusionThe number of cases shows an increasing trend in forensic psychiatry assessment over years. Most of the suspects of criminal responsibility are young and middle-aged male with low level of education, farmer or unemployed. The top three diagnoses are schizophrenia, without psychosis and mental retardation.
Objective To investigate the core competencies of emergency specialized nurses and the influencing factors in Sichuan Province so as to provide a basis for improving the training systems. Methods The trainees who received specialized training in West China Hospital every March and September between 2012 and 2014 were investigated with questionnaire survey. Results A total of 270 questionnaires were given out, and 246 valid questionnaires were retrieved. The scores of emergency specialized nurses’ core competencies ranged from 165 to 258, with an average of 214.55±22.56. According to the scores, 4.88% of the emergency specialized nurses’ core competencies were at a low level, 67.07% were at a middle level and 28.5% were at a high level. The influencing factors of core competencies included education, professional title, position, level of hospitals and years of working experience in the emergency department. Conclusion Core competencies of emergency specialized nurses need to be further improved and the training systems need to be improved consistently.
【摘要】 目的 觀察懸吊運動系統治療（sling exercise therapy， SET）聯合神經發育療法治療對痙攣型腦性癱瘓兒童肌張力及日常生活活動能力（activities of daily living，ADL ）的影響。 方法 2008年8月-2009年3月收治的40例雙下肢痙攣型腦性癱瘓兒童納入研究。根據隨機數字表法分為治療組與對照組，每組各20例。對照組與治療組均采用神經發育療法進行康復訓練，治療組在神經發育療法基礎上配合懸吊運動系統治療。觀察兩組患兒治療1、3個月時肌張力與ADL變化。 結果 治療1個月時，治療組患兒肌張力緩解明顯優于對照組（P＜0.05），3個月時，治療組肌張力緩解程度明顯優于對照組。兩組ADL評分比較，治療組ADL評分改善情況明顯優于對照組（P＜0.05）。 結論 懸吊運動系統治療聯合神經發育療法可明顯緩解痙攣型腦性癱瘓患兒童肌張力，提高ADL。【Abstract】 Objective To observe the effects of sling exercise therapy (SET) combined with neurodevelopmental therapy on muscle tension and activities of daily living (ADL) of children with spastic cerebral palsy. Methods Forty children with spastic cerebral palsy on bilateral lower limb were selected in our study. The children were randomly divided into a treatment group and a control group, 20 children in each group. Both the two groups were accepted rehabilitation training by neurodevelopmental therapy, while the treatment group was received SET as cooperate cure based on the neurodevelopmental therapy. The changes of muscle tension and ADL on the one and three months after treatment were observed. Results On the one and three months after treatment, the remission of muscle tension and improvement of ADL score were better than those in the control group, the differences were statistically significant(Plt;0.01). Conclusion SET combined with neurodevelopmental therapy can relieve the muscle tension, and improve the ADL of children with spastic cerebral palsy.
Objective To evaluate the level of nursing competence of clinical nurses and determine its influencing factors so as to provide scientific information for nursing human resource management. Methods A cross-sectional survey was conducted on 1 042 nurses from 8 hospitals by using the Nursing Competence Scale. Results The mean score of nursing competence was 73.99±9.81. Factors influencing the nursing competence included personal interest in nursing, working experience, working position, educational background, hospital level, teaching activities and marital status. Conclusion The surveyed clinical nurses have been equipped with basic nursing competence, however, still needs to be improved. The nursing human resource management should be based on nurses’ competence.