RESUMO
BACKGROUND: Understanding resident physicians' perceptions of competency-based medical education(CBME) may help improve approaches for implementing such education in standardized resident training (SRT). We conducted surveys of residents in China to identify their perceptions of CBME and determine the degree to which such education impacts their career plans. METHODS: Questionnaire contained a total of 24 questions, which were answered using multiple choice or yes/no, was distributed to residents who were undergoing SRT, regardless of specialty, at 7 accredited training bases located across six provinces of China. The survey aimed to investigate residents' reasons for participating in SRT, perceptions of CBME, interest in receiving CBME-associated courses, and attitudes towards CBME. RESULTS: Overall, 441 residents completed the questionnaire.17.7% (78/441) responded "no clear objective" before the participated in SRT. Only 3.9% (17/441) fully understood the objectives, training contents, and assessment system of the current "competency-based" standardized training program for residents in China. Residents ranked clinical skills and patient care, interpersonal communication, and professionalism, as the three most important competencies. Most were interested in the CBME residency programs. 90.7% felt that implementing CBME could help them clarify their professional direction and improve their career planning. CONCLUSION: Residents had positive perceptions of the incorporation of CBME into SRT. Administrators, educational leaders, and clinical faculty should seek to further publicize and increase the popularity of CBME.
Assuntos
Educação Baseada em Competências , Internato e Residência , Médicos , Humanos , China , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Hemorrhagic chronic radiation proctitis (CRP) is a common late complication of irradiation of the pelvis and seriously impairs life quality. There is no standard treatment for hemorrhagic CRP. Medical treatment, interventional treatment, and surgery are available, but they are limited in their applications due to nondefinite efficacy or side effects. Chinese herbal medicine (CHM), as a complementary or alternative therapy, may provide another option for hemorrhagic CRP treatment. CASE SUMMARY: A 51-year-old woman with cervical cancer received intensity-modulated radiation therapy and brachytherapy with a total dose of 93 Gy fifteen days after hysterectomy and bilateral adnexectomy. She received six additional cycles of chemotherapy with carboplatin and paclitaxel. Nine months after radiotherapy treatment, she mainly complained of 5-6 times diarrhea daily and bloody purulent stools for over 10 d. After colonoscopy examinations, she was diagnosed with hemorrhagic CRP with a giant ulcer. After assessment, she received CHM treatment. The specific regimen was 150 mL of modified Gegen Qinlian decoction (GQD) used as a retention enema for 1 mo, followed by replacement with oral administration of 150 mL of modified GQD three times per day for 5 mo. After the whole treatment, her diarrhea reduced to 1-2 times a day. Her rectal tenesmus and mild pain in lower abdomen disappeared. Both colonoscopy and magnetic resonance imaging confirmed its significant improvement. During treatment, there were no side effects, such as liver and renal function damage. CONCLUSION: Modified GQD may be another effective and safe option for hemorrhagic CRP patients with giant ulcers.
RESUMO
This study synthesized the NaGdF4@NaGdF4: Yb, Tm@NaGdF4: Yb, Nd upconversion nanoparticles (UCNPs), combined with another three-layer structure NaYF4@NaYF4: Yb, Er@NaYF4 UCNPs, with a core-shell-shell structure, effectively suppressing fluorescence quenching and significantly improving upconversion luminescence efficiency. Two types of modified UCNPs were coupled with antibodies against fenpropathrin and procymidone to form signal probes, and magnetic nanoparticles were coupled with antigens of fenpropathrin and procymidone to form capture probes. A rapid and sensitive fluorescence immunoassay for the simultaneous detection of fenpropathrin and procymidone was established based on the principle of specific binding of antigen and antibody and magnetic separation technology. Under the optimal competitive reaction conditions, different concentrations of fenpropathrin and procymidone standards were added to collect the capture probe-signal probe complex. The fluorescence values at 542 nm and 802 nm were measured using 980 nm excitation luminescence. The results showed that the detection limits of fenpropathrin and procymidone were 0.114 µg/kg and 0.082 µg/kg, respectively, with sensitivities of 8.15 µg/kg and 7.98 µg/kg, and they were applied to the detection of fenpropathrin and procymidone in tomatoes, cucumbers, and cabbage. The average recovery rates were 86.5~100.2% and 85.61~102.43%, respectively, with coefficients of variation less than 10%. The results showed good consistency with the detection results of high-performance liquid chromatography, proving that this method has good accuracy and is suitable for the rapid detection of fenpropathrin and procymidone in food.