In the process of building a high level resident standardized training base, the competency training of the management staff is an important mission.The connotation of management staff`s competency is divided into three levels: knowledge competence, work competence and problem-solving competency.The training of management staff`s competency needs to be decomposed and analyzed on three levels of competency, and to be implemented according to the specific training process.

Objective To evaluate the reliability of objective structured clinical examination based on standardized patients in clinical skill test for medical students.Methods To analyze the scores of 8 stations OSCE by applying multivariate generalizability theory.Results The relative G coefficient of the 8 stations OSCE was 0.886, and the absolute G coefficient was 0.883.Conclusions Multivariate generalizability theory is an objective and scientific method to evaluate the OSCE stations, and the analysis results facilitate to improvement the practice interms of quality and efficacy.

Quantities of teaching-helping activities are present in among hospitals because of gap in education quali-ty.Effectiveness of those helping activities depends on establishment of a scientific teaching -helping system.Teach-ing-helping system among hospitals is based on the establishment of teaching system of hospital , scientific and scheduled helping process management , and a clear claim of effectiveness .Peking Union Medical College Hospital reviewed its teaching-helping activities and developed a theoretical model of effectiveness of teaching -helping among hospitals .

Objective:To analyze whether triglyceride-glucose (TyG) index is associated with increased risk of cardiovascular diseases (CVD) and the value of TyG index in predicting CVD risk among Kazakh and Uighur population of Xinjiang.Methods:In this study, 5 375 Kazakh and Uygur people of Xinyuan county and Jiashi county were selected as the research objects. Subjects were divided into four groups based on the quartile of the TyG index level. Cox regression model was used to analyze the association between TyG index with the risk of CVD. The dose-response relationship between TyG index and CVD risk was described by restricted cubic splines. The area under the receiver operating characteristic curve, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to estimate the value of TyG index for predicting CVD. Mediating effect analysis was conducted to analyze the mediating effect of TyG index in the association between body mass index and CVD.Results:The age of subjects was 41.06（30.11，53.00）years old, with 46.30%（2 489/5 375）was male. After multivariate adjustment, there was an increasing trend between the risk of CVD and the higher TyG index Ptrend<0.001, compared with subjects of TyG index in Q1, the HR (95% CI) of Q2, Q3, and Q4 groups was 1.53, 1.23 and 1.73, respectively. Restricted cubic splines showed that TyG index was the linearly associated with the risk of CVD. TyG index could improve the prediction ability of Framingham model for the risk of CVD (NRI=0.106, P=0.010; IDI=0.003, P=0.030). The mediating effect analysis showed that in the relationship between body mass index and CVD, the TyG index had a mediating effect ( P<0.001), and the ratio of mediating effect was 12.69%. Conclusion:TyG index is an independent predictor of CVD risk among kazakh and Uygur population in Xinjiang and has a good predictive value for the risk of CVD.

Objective:The incidence of infections in patients with malignant hematologic diseases is extremely high and significantly affects their prognosis.Identifying early and precise biomarkers for infection is crucial for guiding the treatment of infections in these patients.Previous studies have shown that procalcitonin(PCT)can serve as an early diagnostic marker for bloodstream infections in patients with malignant hematologic diseases.This study aims to compare serum PCT levels in these patients with different pathogens,disease types,infection sites,and severity levels. Methods:Clinical data and laboratory results of infected patients with malignant hematologic diseases treated at the Department of Hematology,the Third Xiangya Hospital of Central South University from January 2018 to August 2023 were collected.General patient information was retrospectively analyzed.Serum PCT levels were compared among patients with different pathogens,types of malignant hematologic diseases,infection sites,and infection severity;Receiver operator characteristic(ROC)curves were used to determine the cut-off values and diagnostic value of serum PCT levels in diagnosing bloodstream infections versus local infections and severe infections versus non-severe infections.Mortality rates after 4-7 days of anti-infective treatment were compared among groups with rising,falling,and unchanged PCT levels. Results:A total of 526 patients with malignant hematologic diseases were included.The main pathogens were Gram-negative bacteria(272 cases,51.7%),followed by Gram-positive bacteria(120 cases,22.8%),fungi(65 cases,12.4%),viruses(23 cases,4.4%),and mixed pathogens(46 cases,8.7%).The main types of malignant hematologic diseases were acute myeloid leukemia(216 cases,41.1%),acute lymphoblastic leukemia(107 cases,20.3%),and lymphoma(93 cases,17.7%).Granulocyte deficiency was present in 68.3%(359 cases)of the patients during infection,with severe infection in 24.1%(127 cases).Significant differences in serum PCT levels were found among patients with different types of pathogens(P<0.001),with the highest levels in Gram-negative bacterial infections.Significant differences in serum PCT levels were also found among patients with different types of malignant hematologic diseases(P<0.05),with the highest levels in lymphoma patients.Serum PCT levels were significantly higher in systemic infections and severe infections compared to local infections and non-severe infections(both P<0.001).ROC curve analysis showed that the cut-off values for diagnosing bloodstream infections and severe infections were 0.22 and 0.28 ng/mL,with areas under the curve of 0.670 and 0.673,respectively.After 4-7 days of anti-infective treatment,the mortality rates of the PCT declining,PCT unchanged,and PCT rising groups were 11.9%,21.2%,and 35.7%,respectively,and pairwise comparisons were statistically significant(all P<0.05). Conclusion:PCT can be used as an auxiliary indicator for early identification of different pathogens,infection sites,and severity levels in patients with malignant hematologic diseases combined with infections.Dynamic monitoring of PCT levels after empirical antibiotic treatment provides important guidance for assessing patient's prognosis.

Objective:To analyze whether triglyceride-glucose (TyG) index is associated with increased risk of cardiovascular diseases (CVD) and the value of TyG index in predicting CVD risk among Kazakh and Uighur population of Xinjiang.Methods:In this study, 5 375 Kazakh and Uygur people of Xinyuan county and Jiashi county were selected as the research objects. Subjects were divided into four groups based on the quartile of the TyG index level. Cox regression model was used to analyze the association between TyG index with the risk of CVD. The dose-response relationship between TyG index and CVD risk was described by restricted cubic splines. The area under the receiver operating characteristic curve, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to estimate the value of TyG index for predicting CVD. Mediating effect analysis was conducted to analyze the mediating effect of TyG index in the association between body mass index and CVD.Results:The age of subjects was 41.06（30.11，53.00）years old, with 46.30%（2 489/5 375）was male. After multivariate adjustment, there was an increasing trend between the risk of CVD and the higher TyG index Ptrend<0.001, compared with subjects of TyG index in Q1, the HR (95% CI) of Q2, Q3, and Q4 groups was 1.53, 1.23 and 1.73, respectively. Restricted cubic splines showed that TyG index was the linearly associated with the risk of CVD. TyG index could improve the prediction ability of Framingham model for the risk of CVD (NRI=0.106, P=0.010; IDI=0.003, P=0.030). The mediating effect analysis showed that in the relationship between body mass index and CVD, the TyG index had a mediating effect ( P<0.001), and the ratio of mediating effect was 12.69%. Conclusion:TyG index is an independent predictor of CVD risk among kazakh and Uygur population in Xinjiang and has a good predictive value for the risk of CVD.

Objective:To explore the mechanism of illness perception between the perceived burden and quality of life of the primary caregivers of patients with persistent vegetative state or minimally conscious state, so as to provide reference for improving the quality of life of primary caregivers.Methods:This study was a cross-sectional study. From August 2021 to January 2022, the primary caregivers of 160 patients with persistent vegetative state or minimally conscious state in the Hyperbaric Oxygen Ward of the Second People's Hospital of Hefei were selected as the research object by the convenience sampling. The General Information Questionnaire, Perceived Caregiver Burden Scale for Caregivers, Brief Illness Perception Questionnaire, and the CarerQol Instrument were used for investigation. Pearson correlation was used to analyze the correlation of illness perception, perceived burden, and quality of life of the primary caregivers of patients with persistent vegetative status or minimally conscious state. Stepwise regression was used to analyze the mediating effect of illness perception, and structural equation model was constructed and verified using AMOS23.0.Results:The scores of illness perception, perceived burden and quality of life of the primary caregivers of patients with persistent vegetative state or minimally conscious state were (60.54±9.48) , (32.08±5.83) and (7.83±2.31) respectively. The total score of illness perception was positively correlated with the total score of quality of life ( r=0.597, P<0.01) , the total score of quality of life was negatively correlated with the total score of perceived burden ( r=-0.630, P<0.01) , and the total score of perceived burden was negatively correlated with the total score of illness perception ( r=-0.623, P<0.01) . Illness perception played a part of mediating effect between the perceived burden and quality of life of the primary caregivers of patients with persistent vegetative state or minimally conscious state, and the mediating effect accounted for 20.22% of the total effect value. Conclusions:The perceived burden of caregivers can directly predict the quality of life, and can also indirectly affect the quality of life through illness perception. Reducing the illness perception level of the primary caregivers is conducive to decreasing the illness perception burden, improving their quality of life and the level of care.

Objective: To explore the analgesic effect of electroacupuncture on neuropathic pain and the role of PI3K/AKT pathway in microglial activation in spinal cord. Methods: Chronic constriction injury model was established using Sprague-Dawley rats to mimic neuropathic pain. The pain intensity was then detected by paw withdrawal threshold and thermal withdrawal latency. Real-time quantitative PCR (qRT-PCR), Western blot were used to evaluate the activation of PI3K/AKT pathway as well as microglia in L4-5 of all rats. Proinflammatory cytokines TNF-α and IL-6 were analyzed by Enzyme-linked immunosorbent assay (ELISA). Results: It was demonstrated that chronic constriction injury-induced hyperalgesia was significantly improved by LY294002 intrathecal administration and electroacupuncture stimulation at “Zusanli” 足三里 (ST36) and “Yanglingquan” 阳陵泉 (GB34). Also, treatment with electroacupuncture significantly reduced the activation of microglia and downregulated the levels of TNF-α and IL-6, which was similar to the outcomes of LY294002 intrathecal administration. Furthermore, the expression and phosphorylation of PI3K/AKT signaling was markedly suppressed by electroacupuncture treatment. Conclusions: These findings indicated that electroacupuncture exhibited the analgesic effect on CCI rats by inhibiting the activation of microglia and production of proinflammatory cytokines in spinal cord through blocking the microglial PI3K/AKT signaling activation

Objective To investigate the association between gallstones (GS) and metabolic syndrome (MS) in southern Xinjiang, China, and to provide experience for the prevention and control of metabolic diseases in southern Xinjiang. Methods The patients with GS who visited First Division Hospital, Second Division Korla Hospital, and Third Division Hospital of Xinjiang Production and Construction Corps from March 2015 to March 2019 were enrolled as case group, and cluster sampling was used to select the individuals who underwent physical examination in Third Division 51st Regiment Hospital during the same period of time were enrolled as control group. According to inclusion and exclusion criteria, 1140 cases were enrolled in each group after 1∶ 1 matching based on age and sex. The t -test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups; a logistic regression analysis was used to investigate the influencing factors for GS. Dummy variables were included by logistic regression to evaluate multiplicative interaction between MS components, and the parameter estimate and covariance matrix of the logistic regression model and interaction calculation table were used to calculate and evaluate additive interaction between MS components. Results The risk of GS in MS patients was 2.33 times that in non-MS patients (odds ratio [ OR ]=2.33, 95% confidence interval [ CI ]: 1.86-2.92). In addition, the components of MS also increased the risk of GS, including blood glucose ( OR =2.94, 95% CI : 2.36-3.68), blood pressure ( OR =1.50, 95% CI : 1.26-1.80), blood lipids ( OR =1.48, 95% CI : 1.25-1.75), and body mass index ( OR =1.44, 95% CI : 1.21-1.70). After adjustment for multiple factors, the risk of GS gradually increased with the increase in the number of metabolic abnormalities, i.e., one abnormality ( OR =1.55, 95% CI : 1.22-1.99), two abnormalities ( OR =2.13, 95% CI : 1.66-2.72), three abnormalities ( OR =3.48, 95% CI : 2.59-4.69), and four abnormalities ( OR =4.65, 95% CI : 2.79-7.84). No additive or multiplicative interaction was found between MS components. Conclusion GS is closely associated with MS in southern Xinjiang, and the risk of GS gradually increases with the increase in MS components. No additive or multiplicative interaction is found between GS and MS components.