Objective To investigate the effects of children’s crawling-promotion-training-robot on gross motor function and cognitive function in children with global developmental delay (GDD). Methods A total of 40 children with GDD admitted to the Department of Rehabilitation Medicine, Children’s Hospital of Nanjing Medical University were selected as the research subjects. By envelope method, the children were randomly and equally divided into experimental group and control group, with 20 cases in each group. The experimental group received children’s crawling-promotion-training-robot combined with conventional rehabilitation therapy, while the control group received manual crawling training combined with conventional rehabilitation therapy. Before and after treatment, the scores of Gross Motor Function Measure Scale-88 (GMFM-88) and Gesell Developmental Scale (GDS) were respectively used to evaluate gross motor function and cognitive function. Results There was no significant difference in gender (χ2=0.100, P=0.752) and age (t=0.053, P=0.962) between the two groups. Before treatment, there was no significant difference in GMFM-88 and GDS scores between the two groups (P>0.05). After treatment, there were statistically significant differences in GMFM-88 and GDS scores between the two groups (P<0.05). The comparison within the group showed that there were statistically significant differences in GMFM-88 and GDS scores between the two groups before and after treatment. Conclusion Children’s crawling-promotion-training-robot is more effective than manual crawling training in improving gross motor function and cognitive function in children with GDD.
Objective To provide scientific evidence for the establishment of medical specialist system in China by analyzing the current situation and problems, putting forward solution thoughts and countermeasures, from the angle of medical education system, residency training program and licensed physician management. Method Principle and method of evidence-based medicine were adopted. Retrospective investigation was conducted to gain information from 1996 to 2002 about enrollment and running form of medical education, current situation of residency and specialist training. Data was then extracted and analyzed for the benefit of corresponding countermeasures. Results By the end of 2001, there were totally 1 640 thousand physicians in China. The enrollment proportion of undergraduate and junior college student steadily increased from 1996 to 2002, while the situation quite the reverse as for medical secondary school. More than 300 thousand have taken part in the licensure exam, among whom less than 15% had university diploma. About 52 000 doctors have already completed the residency training program, and 65 700 are being trained. Standardized system of specialist training and admittance is not available in China. Conclusions It was three main tough problems that mainly account for the poor quality of doctor as a whole in China, which include diversity of educational system, insufficient software and hardware of residency training program, and absence of specialist training system. An allied funded program of "research on medical specialist training and admittance" has been on the way, and research outcomes will be published soon.
Objective To evaluated the application effect of reverse digital modeling combined with three-dimensional (3D)-printed disease models in the standardized training of orthopedic residents focusing on pelvic tumors. Methods From August 2022 to August 2023, 60 orthopedic residents from West China Hospital, Sichuan University were randomly assigned to a trial group (n=30) and a control group (n=30). The trial group received instruction using reverse digital modeling and 3D-printed pelvic tumor models, while the control group underwent traditional teaching methods. Teaching outcomes were evaluated and compared between groups through knowledge tests, practical skill assessments, and satisfaction surveys. Results Before training, there was no statistically significant difference in knowledge tests or practical skill assessments between the two groups (P>0.05). After training, the trial group showed significantly better performance than the control group in knowledge tests (90.5±5.2 vs. 78.4±6.8, P<0.05), skill assessments (92.7±4.9 vs. 81.3±6.2, P<0.05), and satisfaction surveys (9.40±1.10 vs. 7.60±1.20, P<0.05). One month after training, the trial group still showed significantly better performance than the control group in knowledge tests (88.1±6.4 vs. 72.3±7.1, P<0.05) and skill assessments (90.3±5.8 vs. 75.6±6.9, P<0.05). Conclusions Reverse digital modeling combined with 3D printing offers an intuitive and effective teaching approach that improves comprehension of pelvic tumor anatomy and strengthens clinical and technical competencies. This method significantly enhances learning outcomes in standardized residency training and holds promise for broader integration into medical education.
The cleft lip and palate (CLP) is one of the most common craniofacial malformations in humans. We collected functional magnetic resonance data of 23 CLP patients before rehabilitation training (Bclp) and 23 CLP patients after rehabilitation training (Aclp), who were performing Chinese character pronunciation tasks, and performed brain activation analysis to explore the changes of brain mechanism in CLP patients after articulation disorder rehabilitation training. The study found that Aclp group had significant activation in the motor cortex, Broca area, Wernicke area and cerebellum. While the Bclp group had weak activation in the motor cortex with a small activation range. By comparing the differences and co-activated brain regions between the two groups, we found that rehabilitation training increased the activity level of negatively activated brain areas (cerebellum, left motor area, Wernicke area, etc.) to a positive level. At the same time, the activity level of weakly activated brain areas (right motor area, Broca area, etc.) was also increased. Rehabilitation training promoted the activity level of articulation-related brain regions. So that the activation intensity of articulation-related brain regions can be used as a quantifiable objective evaluation index to evaluate the effect of rehabilitation training, which is of great significance for the formulation of rehabilitation training programs.
Maculopathy caused by various fundus diseases in the late stage is a common cause of low vision. Medical technology is difficult to reverse the loss of macular function currently, so interventions that help improve the visual system, utilize residual visual function, and improve quality of life deserve attention. Damage to the fovea of the macula does not mean that the entire retinal function is impaired. There may be one or more retinal regions adjacent to the fovea that can serve as a fixation center. It is possible to form stable paracentral fixation, complete functional remodeling of the visual system, and effectively utilize residual visual function by taking appropriate training on these potential paracentral fixation points for most patients. In 2021, a clinical guideline has been published for low vision rehabilitation in China. In order to strengthen the precise management of diseases and develop a standard operating procedure for visual training specifically for patients with low vision due to macular disease, the National Clinical Research Center for Eye Diseases initiated and organized relevant domestic experts, utilizing the latest research experience at home and abroad, and through repeated discussions, this consensus (International Practice Guideline Registration Number: PREPARE-2023CN199) was formed as a reference for ophthalmologists, optometrists and rehabilitation physicians in their clinical research and practice.
According to the "Regulations on clinical application management of medical technologies", physicians intending to carry out restricted technologies must undergo standardized training and pass assessments in accordance with the clinical application management standards for the respective technology. As ventricular assist technology is classified as a nationally restricted technology, standardized training is one of the essential conditions for its application. This paper primarily explores the standardized training for the clinical application of ventricular assist technology in Shanghai, in light of its background, clinical application, and current training status. It proposes the training requirements for ventricular assist technology, animal training assessment standards, and clinical practice assessment standards in Shanghai, aiming to promote the standardized development and high-quality advancement of ventricular assist technology in Shanghai.
Objective To investigate whether an internet-based neck-specific training program can alleviate pain and disability in participants with cervical spondylotic radiculopathy (CSR). Methods Patients diagnosed with CSR at West China Hospital of Sichuan University between March 2022 and September 2022 were randomly allocated to either an telehabilitation group or a traditional treatment group. The primary outcome measures included Visual Analogue Scale, Neck Disability Index, and patient satisfaction. Secondary outcome measures included the Euroqol group’s 5-Domain questionnaire, Fear-Avoidance Beliefs Questionnaire, Hospital Anxiety and Depression Scale, Tanaka Jingjiu cervical spondylosis symptom scale (20 points) and satisfaction. Quantitative outcome measures were collected at baseline, 12th and 24th weeks after the first intervention, while qualitative outcome measures were collected at 24th weeks after the first intervention. Results A total of 90 patients were included, with 45 in each group. There was no statistically significant difference between the two groups in terms of age, gender and other demography characteristics and general data (P>0.05). There is no interaction effect (group × time) for the Tanaka Jingjiu cervical spondylosis symptom scale (20 points) (P>0.05), the interaction effects (group × time) for other quantitative outcome measures were statistically significant (P<0.05). The time effect showed significant statistical differences across all quantitative outcome measures (P<0.001), while the group effect did not exhibit any significant statistical differences (P>0.05). The comparison results within the group showed that at different time points, the differences between the two groups were statistically significant (P<0.001). There were no significant statistical differences between the two groups in terms of qualitative outcome measures (P>0.05) . Conclusions An internet-based neck-specific training program or traditional treatment for 12 weeks can effectively reduce pain and disability among CSR patients, with significant long-term effects. There was no significant difference in treatment effectiveness between the two groups.
The ideological and political education in standardized residency training plays an important role in cultivating medical talents with noble medical ethics and exquisite medical skills. Teaching evaluation is an important method to promote teaching improvement and optimization. However, there are still some problems and challenges in the evaluation of ideological and political education for standardized residency training. This article proposes the ideological and political education of standardized residency training can be comprehensively evaluated by the context-input-process-product evaluation model from four aspects: background, input, process, and result evaluation. The aim is to provide solid support and guidance for the ideological and political education route in standardized residency training.
Objective To provide scientific evidence for the establishment of medical specialist system in China by investigating the history, current situation, problems and countermeasures of medical specialties training at home and aboard. Method The principle and theroy of evidence-based medicine were adopted. The information before Dec. 31, 2003 of Pubmed, CBM, official website, some journals, most frequently used search engines and medical monograph were systematically reviewed. Included literatures were assessed and graded according to the pre-defined criterias. Results A total of 1 319 studies (1 298 in English, 21 in Chinese) were included, among which only 6 were related to the classification of medical specialties. Based on the information from official website of USA, Canada, UK, Singapore, Australia and China (including HK and Taiwan), it showed that China has the largest number of medical specialties, followed by that of USA. In China, the number of medical specialties has more than that of the disciplines in clinical field, which was followed by resident training programs. Some specialties were duplicate, or not international standardized. Conclusions The classification of medical specialties should be developed consecutively, which comprehensively considered the international trend, characteristics of doctor training and the current situation. Specialties whose training program are well-established and developed should initiate firstly. Others will be put into practice gradually after being fully exprienced.
Objective To study the effect of preoperative urination training combined with restrictive fluid therapy with enhanced recovery after surgery (ERAS) on postoperative urination in total knee arthroplasty (TKA) patients. Methods A total of 150 patients who were conducted the unilateral TKA from March to May 2018 were divided into two groups, the trial group and the control group, with 75 patients in each group. The patients in the control group did not undergo urination training before surgery and were given liberal intravenous fluid therapy on the day of surgery; while the patients in the trial group received urination training before surgery and were given restrictive fluid therapy on the day of surgery. The pre-, intra-, and post-operative infusion volume and the total infusion volume on the day of surgery of the two groups were recorded; and the urination situation, urination time for the first time and the hospital days in the two groups were compared. Results The total infusion volume on the day of surgery in the trial group and the control group was (1 581.40±277.54) and (2 395.00±257.40) mL, respectively. After operation, in the trial group, there were 73 patients with smooth urinating, 2 with smooth urinating after inducing method, and none with urethral catheterization; in the control group, there were 66 patients with smooth urinating, 3 with smooth urinating after inducing method, and 6 with urethral catheterization. The urination time for the first time after operation in the trial group and the control group was (1.85±0.91) and (2.93±1.48) hours after back to the ward, respectively. These differences between the two groups were statistically significant (P<0.05). The hospital stay in the trial group and the control group was (5.86±2.48) and (6.28±1.60) days, respectively, and the difference between the two groups was not statistically significant (P>0.05). Conclusions Preoperative urination training combined with restrictive fluid therapy (the total infusion volume controls in about 1 500 mL on the day of surgery) in the TKA patients after ERAS is good for postoperation urination. It also can reduce the rate of postoperative urinary retention, and enhance rehabilitation.