To meet the needs of society,the Academic Degrees Committee of the Chinese State Council set up a Medical Degree in 1998 to train senior clinicians.In order to reveal the influencing factors of the education quality of clinical medicine doctoral programmes,this paper used a questionnaire to evaluate the education experience of clinicians with clinical MD degrees of Peking University Health Science Center.

Objective ST-T complex change, which represents the ventricle repolarization phase, is the main clinical indicator in detecting myocardial ischemia (MI) based on electrocardiogram (ECG) signals.However, its feature point location is not accurate due to interferences. In this paper, a new approach about myocardial ischemia analysis was proposed based on QRS complex. Methods QRS complex, representing the ventricle depolarization process, was used to analyze myocardial ischemia, and some parameters were extracted synthetically in time domain. Then they were used for statistical analysis of myocardial ischemia states and non-myocardial ischemia states. Results Five parameters had significant differences after verification of Non-MI signals in MIT-BIH database and MI signals in long-term ST database (LTST) and they were: QRS upward and downward slopes, transient heart rate, R angle and Q angle in a triangle QRS. Conclusion Five parameters extracted from QRS complex had significant differences. The proposed method provides an important basis for myocardial ischemia detection.

Objective To investigate the CT and MRI features of ovarian fibroma.Methods CT and MRI findings of 42 patients with ovarian fibroma confirmed by operation and pathology were analyzed retrospectively.Twenty-one patients were examined by CT,26 cases was examined by MRI,and 5 cases were examined by CT and MRI.Results In 42 cases of ovarian fibroma,there were simple type in 29 cases,degenerative type in 11 cases,and special type in 2 cases.All the cases had single lesion,morphology were round or elliptic or lobulated,clear boundary in 40 cases,partial fuzzy boundary in 2 cases,3 cases with calcification,hemorrhage in 1 case.The maximum tumor diameter were 1.4-26.7 cm,median value was 5.5 cm.Simple type of ovarian fibroma were equal density on CT,low signal on T1WI and T2WI.Degeneration type was patchy,fissure,low density areas on CT or high signal on T2WI,and the tumor parenchyma was almost no enhancement or only slight enhancement.A large number of hemorrhages had been found in 1 special type patient,and significantly enhanced in the other special type patient.Special type were misdiagnosed as malignant tumor.Conclusion CT and MRI performance of ovarian fibroma has some characteristics,but diagnosis still need to rely on pathology.

Objective To analyze the problems of doctor of medicine in China,and to explore the efforts to improvethe training quality of doctor of medicine.Methods The paper selected 5medical colleges which participated the thematic evaluation of doctor of medicinedegreeauthorization centers in 2014,then analyzed the relevant data of doctor of medicine during 2011-2015,such as education condition,enrollment scale,training objective,curriculum setting,scientific research trainingand clinical practice by descriptive study.Results The average of affiliated hospitals is 6.0.The number of medical doctor entrance exam increased by 1.5 times during 2011-2015.The training institutions set up clear training objective of applied talents.A three-stage cultivation mode of course learning,clinical practice and scientific research training is widespread enforcement.However,the subject and basiccondition varies in different schools.The teachers’ professional level is uneven.The quality of candidates needsto be improved.Curriculum design is lack of pertinence.Standardization of clinical practice andscientiFlc training system is not enoughat the same time.Conclusions The suggestions to promote the reform of full-time doctor of medicineare:improving the subject building;increasethe number of students enrollment appropriately;strengthening pertinence of curriculum system;perfecting quality evaluating system;exploring the training mode called “5 + 3 + X”.

Objective To provide a basis for humanity education in the university by a survey of clinical graduates' recognition of humanity education and humanity curriculum. Method An anony-mous questionnaire was adopted and 514 questionnaires were distributed to the 2014 clinical gradu-ates in Peking University Health Science Center about their understanding of humanity education and humanity curriculum. The investigation data was double entried in Epidata 3.1, apply SPSS 19.0 to make the descriptive analysis, chi-square test. Results 69.3% (167/241) students believed humanity education enhanced their professionalism and competency;52.7%(127/241) students believed humanity education enhanced their doctor-patient communication; 36.4% (174/478) students believed their hu-manity knowledge came from their instructors' personal example and teaching;31.1%(149/479) students said the best way of humanity education was through social practice;59.7%(286/479) students consid-ered the combination of classroom lecturing and discussion as the best way to humanity education. As to the major weaknesses in humanities education, 46.9%(113/241) students chose insufficient curriculum, 23.2%(56/241) chose lack of practical value and 23.7%(57/241) chose monotonous teaching methods;Conclusion The best approach to humanities teaching is to combine class lecture with class discus-sion. Besides, hidden curriculum also contributes to humanity education. The enhancement of clinical graduates education relies heavily on humanity education and its emphasis should be laid on the training of humanity teachers, the study of humanity curriculum and learning from other universities.

Electrocardiogram (ECG) is a convenient, economic, and non-invasive detecting tool in myocardial ischemia (MI). Its clinical appearance is mainly exhibited by ST-T complex change. MI events are usually instantaneous and asymptomatic in some cases, which cannot be forecasted to have a precautionary measure in time by doctors. The automatic detection of MI by computer and a cued warning of danger in real time play an important role in diagnosing heart disease. With the help of the medical staff, some quantitative approbatory indicators, such as ST-segment deviation, the amplitude of T-wave peak and the rate of ST and heart rate (HR), were combined to judge MI using fuzzy reasoning. After MIT-BIH database and the long-term ST database (LTST) verification, sensitivity and positive predictive values reached 75% and 78% respectively, and specificity and negative predictive values were 85% and 87% respectively. In addition, the proposed method was close to human way of thinking and understanding, and easy to apply in clinical detection and engineering fields.
Electrocardiography ; Fuzzy Logic ; Humans ; Myocardial Ischemia ; diagnosis ; Signal Processing, Computer-Assisted

ST-segment is the main clinical appearance in myocardial ischemia detection based on electrocardiogram (ECG) signals. However, it is highly sensitive to interferences (baseline wandering, postural changes, electrode interference, etc.), which cause the feature points of ECG ST-segment to be difficult to detect accurately. Currently, the common detection methods of ST-segment are: R+x and J+x, but they are affected badly by T-wave morphological variability and J point location. For these reasons, firstly we proposed a convenient and accurate approach for T-wave onset in this paper. It did not need to locate T-wave peak and was robust to baseline wandering and T-wave morphology. Secondly, we proposed a squeeze approach for ST-segment detection based on R-wave peak and T-wave onset. After the Long-Term ST database (LTST) verification, the proposed method has shown a good timeliness and robustness, and the accuracy of ST-segment detection has reached above 92%.
Algorithms ; Electrocardiography ; methods ; Humans ; Myocardial Ischemia ; physiopathology ; Signal Processing, Computer-Assisted

Objective There are 6 leads of limb lead ECG,and the cardiac electrical axis can be estimated by any combination of two leads.In this paper,the estimation accuracy of all 15 pairs of limb-lead combinations was compared.Methods Using the open database of 12-lead electrocardiograms(at a sampling frequency of 500 Hz with duration of 10 seconds during resting state)from PhysioNet,totally 21 306 ECG records were extracted with age≥18 years which labeled as single sinus type(axis normal),including 6 153 records with Sinus Rhythm,10 916 records with Sinus Bradycardia,3 466 records with Sinus Tachycardia,and 771 records with Sinus Irregularity.Moreover,totally 2 323 axis deflection recordings with age≥18 years were extracted,including 1 526 records with Axis left shift,and 797 records with Axis right shift.Cardiac electrical axis was estimated with the net amplitude(or area)of QRS complex(algebraic sum of positive and negative amplitude or area)by any pair of leads from{Ⅰ,Ⅱ},{Ⅰ,Ⅲ},{Ⅰ,aVR},{Ⅰ,aVL},{Ⅰ,aVF},{Ⅱ,Ⅲ},{Ⅱ,aVR},{Ⅱ,aVL},{Ⅱ,aVF},{Ⅲ,aVR},{Ⅲ,aVL},{Ⅲ,aVF},{aVR,aVL},{aVR,aVF},{aVL,aVF},respectively.Results For the amplitude-based method,the recognition accuracy for the normal,left and right axes from{Ⅰ,Ⅱ}and{Ⅱ,aVL}is 93.56%and 93.50%,respectively,which is better than that of the traditional classical method{I,aVF}(92.93%).For the area-based method,the recognition accuracy from{Ⅲ,aVR},{Ⅰ,aVR},{Ⅰ,Ⅱ},{aVR,aVF},{Ⅱ,aVL}and{Ⅱ Ⅲ}is 92.66%,92.53%,92.29%,92.19%,92.10%and 91.91%,respectively,which is better than the traditional classical method{Ⅰ,aVF}(91.82%).Conclusion The accuracy of amplitude-based method is higher than that of area-based method.Lead pair{Ⅰ,Ⅱ}and{Ⅱ,aVL}have higher accuracy than traditional classical{Ⅰ,aVF}in automatic estimation of cardiac electrical axis for both amplitude and area method.

Objective To analyze the problem on cultivating master of nursing specialist (MNS)in China and to explore the measures on education reform for them.Methods We selected 28 nursing schools which participated in special evaluation for MNS in 2014.And then,we collected and descriptively analyzed relevant data on MNS during 2011 -2015 on culturing conditions,enrollment scale,training objective,course offered,clinical practice and so on.Results The average professional practice base of MNS was 7.1 among investigated schools.Besides,the enrollment proportion of master with professional degree rose steadily which reached 48.2% in 2015.Cultivating schools established training objective for practical talents of MNS.A three-stage cultivating mode of course learning,clinical practice and scientific research training was universally applied. However,there were also many problems involving that subject conditions and foundation among different schools were largely different;the construction of teaching staff still needed to be strengthened,the number of enrollment was small,training objective was not clear,course offered was lack of characteristics.Conclusions Education reform for MNS can be promoted in improving the discipline construction,strengthening the construction of teaching staff,identifying cultivation orientation,extending cultivation direction by combining industry needs, strengthening standardization construction of curriculum system,enhancing clinical practice ability guided by competence of nursing position and so on.

The effects of catechin on inflammatory response of BV-2 cells were investigated using the lipopolysaccharide (LPS) model. BV-2 cells were incubated with LPS (1 mg·L^-1) for 12 h in the microglia inflammatory model in vitro. After catechin and LPS co-incubation for 12 h, MTT, ELISA and Western blot were used to detect cell viability, cytokines, cell migration and protein expression. In addition, transwell assay was conducted to investigate the effect of catechin on cell chemokaxis. Catechin did not show any cytotoxicity effect on BV-2 cells, but reversed the change in cell morphology and inhibited the release of TNF-α and IL-1β, cell chemotaxis and phosphorylation of NF-κB/p65. In conclusion, Catechin could inhibit the LPS-induced inflammatory response in BV-2 cells.