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At present, some "5+3" integration students have different levels of understanding and application problems in various stages, such as role transformation, professional knowledge and technology, communication ability and humanistic care ability, clinical thinking and evidence-based medicine concepts, clinical research thinking, learning and work attitude. This research will permeate and run through the training of "5+3" integrated students' diagnostic and therapeutic operation ability through the training of modern clinical thinking oriented by post competency, and integrate humanistic care, evidence-based medicine, learning attitude, working attitude, and attitude towards patients in the whole process to gradually complete the comprehensive training goal of clinical thinking oriented by post competency + diagnostic and therapeutic operation ability.
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Background: The incidence of inflammatory bowel disease (IBD) is increasing yearly, some of the IBD patients have extraintestinal manifestations (EIM), and EIM has impact on the treatment of IBD. Aims: To summarize the clinical characteristics of IBD patients associated with EIM, and evaluate the therapeutic effect of infliximab (IFX). Methods: The clinical data of IBD patients associated with EIM from January 2010 to December 2020 at the First Affiliated Hospital of Dalian Medical University were retrospectively analyzed, and the therapeutic effect of IFX was investigated. Results: In 811 patients with IBD, 50 (6.17%) patients had EIM. The commonly seen EIM was arthritis (78.00%) and erythema nodosum (26.00%); 52.00% had one EIM; 68.42% of UC patients with EIM involved E3, and 50.00% of CD patients with EIM involved L3. A total of 21 patients received IFX treatment, 2 weeks after medication, HB and ALB significantly increased, while ESR, CRP and PLT significantly decreased. Twenty⁃two weeks after medication, 83.33% of UC patients turned mild, and 70.00% of CD patients entered the remission phase. After the use of IFX, the first disappearance time of arthritis was significantly decreased when compared with those without using IFX (2.50 days vs. 10.50 days, P<0.05). The median time for the first disappearance of arthritis in patients with elevated CRP was significantly decreased than in patients with normal CRP (3.00 days vs. 9.00 days, P<0.05). Conclusions: Arthritis and erythema nodosum are common EMI in patients with IBD, and the treatment with IFX can significantly shorten the time of the first disappearance of some EIM.
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Cardio-oncology has developed into a new subspecialty of modern cardiology, and the clinical mentors usually need to guide students to focus on this frontier field. However, there are many deficiencies in the field of cardio-oncology training in China, and there is a lack of perfect teaching and training objectives and evaluation system. In order to adapt to the goal and orientation of talent training in cardio-oncology, the First Affiliated Hospital of Dalian Medical University adopts a multi-disciplinary teaching mode. Corresponding teaching contents and training objectives are set according to the trainees at different levels of training, and various teaching methods and assessment forms are cooperated to explore and establish the training and assessment system of cardio-oncology for doctors at different levels. The system is put into practice, and the teaching effect is outstanding which has been widely recognized by teachers and students.
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Objective To investigate the relationship between insulin resistance and hepatic function in elderly liver cirrhosis (LC)patients with diabetes (LC-DM)and to provide evidence for clinical treatment.Methods Thirty cases of elderly LC,30 cases of elderly LC-DM,30 younger patients (<60 years)with LC-DM and 30 healthy subjects were enrolled.Levels of fasting plasma glucose(FPG)and fasting plasma insulin(FINS)were examined to evaluate the homeostasis model for assessment of insulin resistance (HOMA-IR),which was used for comparison between the groups.Moreover,the relationship between HOMA-IR and the Child Pugh classification was also analyzed.Results Patients in the elderly LC group were associated with significantly higher levels of FINS (9.58±3.62 vs.6.03±1.99 mU/L,P<0.05)and HOMA-IR(2.47±0.88 vs.2.12±0.99,P<0.05),compared with the control group.Meanwhile,levels of FPG,FINS and HOMA-IR in the elderly LC-DM group were (5.83 ± 1.40) mmol/L,(15.63 ± 6.37) mU/L and 6.33 ± 2.59,respectively,significantly higher than those[(5.03±0.83)mmol/L,(9.58±3.62)mU/L,2.47±0.88]in the elderly LC group and those[(5.31±0.58)mmol/L,(6.03±1.99)mU/L,2.12±0.99]in the control group (all P<0.05).However,levels of FPG,FINS and HOMA IR were similar between the elderly LC-DM group and the younger LC-DM group(P>0.05).In the elderly LC-DM group,more patients(66.7 %) had Child-Pugh C liver function compared with the elderly LC group(36.7 %)and the younger LC-DM group(40.0%)(both P<0.05).Of those in the LC and LC-DM groups,levels of HOMA IR were 7.39±2.25 in patients with Child-Pugh C,which were significantly higher than those in patients with Child Pugh B function(4.90± 1.76) and with Child Pugh A liver function(2.69± 1.02)(both P<0.05).Conclusions Hyperinsulinemia and insulin resistance are more pronounced in elderly LC DM than in elderly LC,with poor liver function and prognosis.
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[Abatract] In order to improve the result of clinical practice for undergraduate students of clinical medicine, combined with the professional characteristics of hematology and teaching syllabus, Hematology Department in the First Affiliated Hospital of Dalian Medical University developed practi-cal teaching content and tried using a variety of teaching methods and teaching means such as multi-media aided teaching, case teaching and simulation teaching method and so on. Besides, multiple station examination was established; teaching feedback and supervision were strengthened. The prac-tice proved that the reform measures were conducive to the cultivation of medical students' practical skills and clinical thinking, which helped to speed up the transformation from the students to the role of doctors.