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Objective:To construct an evaluation the index system of entrustable professional activities for resident training doctors in psychiatric department,and to provide reference for formulating training strategies and assessment standards.Entrustable professional activities refers to the ability of trainees to perform and complete spe-cific clinical tasks independently after they have been trusted.Methods:Through documental analysis and semi-structured interviews,the item database of entrustable professional activities for psychiatric resident training physi-cians was established.Delphi consultation was conducted among 63 experts in the field of psychiatry from 7 national resident training bases and 3 medical colleges in China.Indicators were comprehensively screened and sorted out,and indicators at all levels and their weights were determined by the analytic hierarchy process.Results:A hierarchi-cal evaluation index system of entrustable professional activities for psychiatric resident training doctors was con-structed,including 4 first-level indicators,17 second-level indicators and 68 third-level indicators.The weights of the first-level,second-level and third-level indicators were determined.Conclusion:The evaluation index system of en-trustable professional activities is comprehensive and systematic,which is suitable for clinical work and convenient for practical application.It could provide quantitative standards for the assessment of psychiatric residents and pro-mote the improvement of training quality.
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Objective To investigate the influencing factors of the cognitive deficits in schizophrenic patients with diabetes.Methods 578 inpatients with schizophrenia and 400 healthy adults were collected.578 schizophrenic patients were divided into schizophrenia group with type 2 diabetes (combined group,n=277) and schizophrenia without type 2 diabetes (single disease group,n=301).The cognitive function of all subjects were examined by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).The clinical symptoms of patients with schizophrenia were measured with the Positive and Negative Syndrome Scale (PANSS).Fasting glucose,lipids,hemoglobin A1c (HbA1c) and insulin levels were measured.Results The total score and factor scores of RBANS in the combined group were lower than those in the healthy control group (total score (70.51 ± 14.43) vs (80.04 ± 15.14),immediate memory (62.65 ± 16.81) vs (75.66± 17.33),visual span(83.60±20.81) vs (87.61 ± 15.61),verbal function(85.58± 14.64) vs (93.88± 13.10),attention function (73.66± 17.52) vs (87.42±20.37),delayed memory(75.27± 17.80) vs (86.27± 15.27),all P＜0.05).The total score of RBANS,immediate memory and attention function factor were lower in the combined group than that in the single disease group ((70.51±14.43) vs (75.02±15.25),(62.65±16.81) vs (67.37±19.12),(73.66±17.52) vs (84.17±15.22),all P＜0.05).Multiple linear stepwise regression analysis showed that education,negative symptoms,positive symptoms,BMI,HbAc 1,course of disease and antipsychotic type were the influencing factors of cognitive impairment in schizophrenic patients with diabetes.Conclusion The cognitive impairment of schizophrenic patients with diabetes is more serious and affected by many factors.Targeted early intervention can help reduce cognitive impairment.
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ObjectiveTo compare the capability of optimized acellular(OA) allograft and xenograft reparing rat sciatic nerve defect by observing the immunological rejection, early functional recovery and nerve regeneration in the adult rats, which had been made a 1.0cm long gap in the continuity of the sciatic nerve.MethodsThe right sciatic nerve of adult Sprague-Dawley(SD) rats were exposed and 1.0cm long segment of the nerves were removed and repaired by fresh rabbit nerve and autofrafts, OA rat and rabbit nerve. After 1 and 3 months respectively,sciatic functional index (SFI),electrophysiological and histology studies were detected to evaluate immunological rejection,early functional recovery and nerve regeneration. ResultsThe immunological rejection, functional recovery and nerve regeneration in OA xenografts were compared with that in OA allografts, autografts and fresh allografts. One month after the surgery, the levels of CD8+ T cells and macrophages that infiltrated the grafts,the SFI and the axon density at the midpoints of them were similar within OA grafts and autografts(P ＞ 0.05),but all statistically distinguishable from fresh allografts(P ＜ 0.05).And better results were got after 2 months(P ＜ 0.05).ConclusionsThe results imply that OA xenografts is as good as OA allografts,which can be immunologically tolerated and that the removal of cellular material and preservation of the matrix are beneficial for promoting regeneration and functional recovery through an OA procedure.And this gives another promising option to repair peripheral nerve defect.