Objective:To explore the correlation between the oxygenation index and the monitored parameters of lung injury view in ventilator,so as to provide a basis for monitoring the change of oxygenation index by the parameters of lung injury view.Methods:A total of 28 patients who received mechanical ventilation treatment and admitted to respiratory department of the First Affiliated Hospital with Nanjing Medical University from May 14 to September 30,2024 were selected.The monitored parameters of lung injury views of them during mechanical ventilation treatment with invasive ventilators were collected,including platform pressure(Pplat),driving pressure(ΔP),mechanical energy(Emech),ratio of tidal volume to ideal body weight(TVe/IBW),etc..Then,the data of oxygenation index were obtained.Finally,135 valid data were screened out.The 84 pieces of data with oxygenation index≤300mmHg were included in low oxygen group,and 51 data with oxygenation index>300mmHg were included in normal group.The correlations between oxygenation index and Pplat,ΔP,Emech,TVe/IBW were conducted by pairwise analysis.Results:In the low oxygen group,the oxygenation index was[(196.302±74.522)mmHg]significantly negative correlation with Emech[(12.686±5.401)J/min](ρ=-0.425,P<0.05),but not was significant correlation with Pplat,ΔP,and TVe/IBW(P>0.05).In the normal group,there were not significant correlations between the oxygenation index and Pplat,ΔP,Emech and TVe/IBW(P>0.05).There was a significant negative correlation between Emech and rank of oxygenation index(β=-0.389,P<0.05)in the low oxygen group.Conclusion:The visualization function of the Emech of the monitored parameters in lung injury view of ventilator can provide help for monitoring the changes of oxygenation index of patients in the low oxygen group,and can improve the oxygenation of patients by optimizing mechanical energy.However,it is necessary to balance the contradiction between ventilation intensity and protection for lung.

The accurate and timely detection of biochemical coagulation indicators is pivotal in pulmonary and critical care medicine. Despite their reliability, traditional laboratories often lag in terms of rapid diagnosis. Point-of-care testing (POCT) has emerged as a promising alternative, which is awaiting rigorous validation. We assessed 226 samples from patients at the First Affiliated Hospital of Guangzhou Medical University using a Beckman Coulter AU5821 and a PUSHKANG POCT Biochemistry Analyzer MS100. Furthermore, 350 samples were evaluated with a Stago coagulation analyzer STAR MAX and a PUSHKANG POCT Coagulation Analyzer MC100. Metrics included thirteen biochemical indexes, such as albumin, and five coagulation indices, such as prothrombin time. Comparisons were drawn against the PUSHKANG POCT analyzer. Bland-Altman plots (MS100: 0.8206‒0.9995; MC100: 0.8318‒0.9911) evinced significant consistency between methodologies. Spearman correlation pinpointed a potent linear association between conventional devices and the PUSHKANG POCT analyzer, further underscored by a robust correlation coefficient (MS100: 0.713‒0.949; MC100: 0.593‒0.950). The PUSHKANG POCT was validated as a dependable tool for serum and whole blood biochemical and coagulation diagnostics. This emphasizes its prospective clinical efficacy, offering clinicians a swift diagnostic tool and heralding a new era of enhanced patient care outcomes.
Humans ; Point-of-Care Testing ; Critical Care ; Blood Coagulation Tests/methods* ; Male ; Blood Coagulation ; Female ; Middle Aged ; Reproducibility of Results ; Prothrombin Time ; Aged ; Adult ; Point-of-Care Systems

Objective:In order to explore the changes of vascular endothelial function parameters and their correlation with prognosis in patients with aneurysmal subarachnoid hemorrhage (aSAH) after intracranial aneurysm embolization.Methods:A retrospective cohort study was conducted to select 126 patients diagnosed with aSAH in the Department of Neurointerventional of Beijing Fengtai You′anmen Hospital from August 2021 to August 2023. There were 69 males and 57 females, with an age of (52.27±3.34) years, aged 45-62 years. The patients were grouped according to the glasgow prognostic score (GOS) at three months after the prognosis of intracranial aneurysm embolization, including 81 cases in the good prognosis group and 45 cases in the poor prognosis group. The main indexes were calcitonin gene-related peptide (CGRP), endothelin-1, vascular endothelial growth factor (VEGF), S100β, glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), and the secondary indicators were the Hunt and Hess Scale (Hunt-Hess), the National Institutes of Health Stroke Scale (NIHSS), and the Glasgow coma scale (Glasgow), coma scale (GCS), Immunoglobulin A (IgA), Immunoglobulin M (IgM) and Immunoglobulin G (IgG). A generalized mixed-effect model was established to analyze the effect of vascular endothelial function on adverse prognosis, and ROC curve was used to analyze the impact of changes in vascular endothelial function on adverse prognosis. The restriction cubic spline model was used to analyze the dose-response relationship between the changes of postoperative endothelial function indexes and the poor prognosis of intracranial aneurysm embolization in aSAH patients. The Log-rank test was used for Kaplan-Meiker survival analysis. The mean ± standard deviation ( ± s) was used for the normally distributed continuous data, and the independent samples t-test was used for comparison between groups. The chi-square test was used for comparison of enumerated data between groups. Results:There were statistically significant levels of Hunt-Hess, NIHSS, GCS, cerebral vasospasm (CVS) and shunt dependence in the two groups ( P<0.05), and the CGRP of the two groups increased significantly after surgery, and after 2 weeks of treatment, the CGRP of the patients in the good prognosis group was (58.36±3.84) pg/mL, which was significantly higher than that in the poor prognosis group (49.36±4.55) pg/mL. After 2 weeks of treatment, endothelin-1 and VEGF in the good prognosis group were (62.74±27.46) pg/mL and (110.55±34.82) ng/mL, respectively, which were significantly lower than those in the poor prognosis group (92.64±28.44) pg/mL and (145.45±32.19) ng/mL, respectively, and the differences between the two groups were statistically significant ( P<0.05), The neurological indexes of the two groups were significantly decreased, and the S100β, GFAP and NSE in the good prognosis group were (6.75±2.73) ng/L, (6.85±1.54) mg/L and (8.24±4.51) ng/L after 2 weeks of treatment, which were significantly lower than those in the poor prognosis group (8.76±2.44) ng/L, (8.63±1.63) mg/L and (13.84±3.19) ng/L, respectively. There was a statistically significant difference between the two groups ( P<0.05).Before and after the correction factors, the vascular endothelial function indexes of aSAH patients at different time points were significantly correlated with their neurological function indicators. The 14-day change of vascular endothelial function index was significantly correlated with poor prognosis ( P<0.05). The results of subgroup analysis showed that vascular endothelial function indicators and poor prognosis were statistically significant in the range of Hunt-Hess≥2 points, NIHSS≥14 points, GCS≥11 points, CVS, shunt dependence, S100β<10.81 ng/L, GFAP≥9.93 mg/L, NSE≥29.00 ng/L, IgA<2.46 g/L, IgM≥1.70 g/L, and IgG<11.50 g/L ( P<0.05). The results of ROC curve showed that the area under the curve (AUC) of CGRP, endothelin-1 and VEGF were 0.869, 0.834 and 0.874, respectively. There was a nonlinear dose-response relationship between CGRP, endothelin-1 and VEGF and the poor prognosis of intracranial aneurysm embolization in aSAH patients. Conclusion:The vascular endothelial function of aSAH patients with aSAH can be improved after intracranial aneurysm embolization, and it is related to neurological function, and the better the endothelial function index, the higher the probability.

Objective:To explore the correlation between the oxygenation index and the monitored parameters of lung injury view in ventilator,so as to provide a basis for monitoring the change of oxygenation index by the parameters of lung injury view.Methods:A total of 28 patients who received mechanical ventilation treatment and admitted to respiratory department of the First Affiliated Hospital with Nanjing Medical University from May 14 to September 30,2024 were selected.The monitored parameters of lung injury views of them during mechanical ventilation treatment with invasive ventilators were collected,including platform pressure(Pplat),driving pressure(ΔP),mechanical energy(Emech),ratio of tidal volume to ideal body weight(TVe/IBW),etc..Then,the data of oxygenation index were obtained.Finally,135 valid data were screened out.The 84 pieces of data with oxygenation index≤300mmHg were included in low oxygen group,and 51 data with oxygenation index>300mmHg were included in normal group.The correlations between oxygenation index and Pplat,ΔP,Emech,TVe/IBW were conducted by pairwise analysis.Results:In the low oxygen group,the oxygenation index was[(196.302±74.522)mmHg]significantly negative correlation with Emech[(12.686±5.401)J/min](ρ=-0.425,P<0.05),but not was significant correlation with Pplat,ΔP,and TVe/IBW(P>0.05).In the normal group,there were not significant correlations between the oxygenation index and Pplat,ΔP,Emech and TVe/IBW(P>0.05).There was a significant negative correlation between Emech and rank of oxygenation index(β=-0.389,P<0.05)in the low oxygen group.Conclusion:The visualization function of the Emech of the monitored parameters in lung injury view of ventilator can provide help for monitoring the changes of oxygenation index of patients in the low oxygen group,and can improve the oxygenation of patients by optimizing mechanical energy.However,it is necessary to balance the contradiction between ventilation intensity and protection for lung.

Objective:To analyze the role of learning engagement and learning burnout in the relationship between supervisors' guidance and the personal ability of postgraduates in the Professional Master's Program in Clinical Medicine.Methods:A total of 4 016 postgraduates in the Professional Master's Program in Clinical Medicine from 61 colleges were surveyed in 2020. Common method bias was assessed using the Harman's single factor test and total score was determined by the entropy weight method. Causality and mediation effect were analyzed by linear regression, and mediation effect was tested by Bootstrapping.Results:The average scores of supervisors' guidance, learning burnout, learning engagement and personal ability were (4.13±0.87), (2.49±1.11), (3.88±0.83), and (3.71±0.78), respectively. Supervisors' guidance significantly and positively impacted learning engagement ( β=0.689, P<0.001) and personal ability ( β=0.504, P<0.001). Learning engagement played a partial mediating role (89.30% of mediation effect) between supervisors' guidance and personal ability. Learning burnout (interaction term β=0.078, P<0.001) positively regulated the relationship between supervisors' guidance and learning engagement. Conclusions:Learning engagement can mediate the effect of supervisors' guidance on the personal ability of postgraduates in the Professional Master's Program in Clinical Medicine, and learning burnout positively regulates the effect of supervisors' guidance on learning engagement. Strengthened supervisors' guidance, increased attention to students' learning burnout, and enhanced learning engagement can further improve the personal abilities of postgraduates in the Professional Master's Program in Clinical Medicine.

Objective:To investigate the "burnout-engagement continuum" status of postgraduate supervisors of the Professional Master's Program in Clinical Medicine and to identify key populations.Methods:From October to November 2023, an anonymous online questionnaire survey was conducted to determine the "burnout-engagement continuum" status of postgraduate supervisors of the Professional Master's Program in Clinical Medicine. The scores of different dimensions of job burnout are expressed as mean±standard deviation, and the distribution of supervisors of different status is presented in frequency and percentage. All data analyses were performed in R 4.3.1. Distribution of the five profiles among supervisors of different status was compared using the chi-square test and compared pairwise using the Bonferroni method.Results:A total of 2 664 valid questionnaires were collected. The scores of emotional exhaustion, cynicism and personal accomplishment were（2.46±0.95),（1.74±0.89), and（4.23±0.90), respectively. The prevalence of job engagement, inefficacy, overexertion, disengagement, and burnout among the supervisors were 42.76%（1 139/2 664), 43.54%（1 160/2 664), 33.03%（880/2 664), 14.71%（392/2 664), and 13.66%（364/2 664), respectively. In terms of demographics, the distribution of the "burnout-engagement continuum" was significantly different by age, sex, marital status, and highest education level（ P<0.05). In terms of work-related characteristics, the distribution of the "burnout-engagement continuum" was significantly different by income, professional title, administrative position, and working hours on weekdays and holidays（ P<0.05). The distribution of engagement, inefficacy, and overexertion was significantly different between the eastern and western regions（ P<0.05). Conclusions:There is a high percentage of individuals with burnout among postgraduate supervisors of the Professional Master's Program in Clinical Medicine, and inefficacy is a common negative state. Supervisors who work in the western regions, are under 45 years of age, are male, are married, have a doctorate degree, hold associate senior professional title, have lower relative income, are not holding administrative duties, and work more than 10 hours on workdays and more than 4 hours on holidays are key populations that require increased attention. The psychological state of supervisors can be improved by providing them with more resources, work benefits, and incentives.

Objective:To investigate the satisfaction with team construction and occupational burnout among postgraduate supervisors in clinical medicine in China, and to analyze the relationship of the above two factors with the willingness to hold a position again in the school.Methods:A survey covering 3 409 postgraduate supervisors in clinical medicine across 33 colleges and universities was conducted. Analysis of variance, multiple linear regression analysis, and logistic regression analysis were performed to explore the relationship of satisfaction with team construction and occupational burnout with the willingness to hold a position again in the school among supervisors.Results:In various dimensions of satisfaction with team construction among postgraduate supervisors in clinical medicine, the mechanism of selection scored the highest (4.74±0.53), followed by indicators for selection (4.71±0.56), supervisor training (4.66±0.58), supervisor assessment (4.64±0.65), incentives for teaching (4.61±0.65), and career development (4.56±0.74). Indicators for selection ( OR=2.121) and career development ( OR=2.461) were positively correlated with supervisors' willingness to hold a position again in the school. The degree of being cynical, one of the assessment dimensions of occupational burnout, played a partially mediating role between satisfaction with supervisor team construction and the willingness to hold a position again in the school. Conclusions:Postgraduate supervisors in clinical medicine in China are generally satisfied with supervisor team construction. The degree of their satisfaction and occupational burnout influence their willingness to hold a position again in the school. Therefore, colleges and universities should optimize indicators for selection and provide more diverse career development opportunities for supervisors to enhance supervisors' satisfaction and loyalty.

Objective:To understand the evaluation of graduate education quality by medical graduate supervisors in China, to identify the shortcomings of graduate education quality, and to put forward corresponding suggestions.Methods:From October to November 2023, a self-designed questionnaire was used to investigate the evaluation of school management, supervisor team construction, graduate training process, and graduate training results by 6 025 medical graduate supervisors from 37 universities in China. SPSS 26.0 was used to conduct t-test and analysis of variance to explore the differences in scores given by different supervisor groups for various aspects. Results:The scores given by medical graduate supervisors for school management, supervisor team construction, graduate training process, and graduate training results were (4.63±0.60), (4.59±0.62), (4.58±0.59), and (4.54±0.62), respectively. Supervisors who work in clinical medicine, aged 46-55 years, with 5 or fewer years of teaching experience, supervising master's students, instructing only professional degree students, instructing three or fewer students, holding a bachelor's degree as their highest degree, with the title of professor, holding an administrative position, and working an average of 8-9 hours per day on weekdays and 4 or fewer hours per day on holidays, gave higher scores on all aspects of graduate education quality ( P<0.05). Conclusions:The supervisors gave high scores on the quality of medical graduate education. It is suggested that the quality of graduate education should be continuously improved by optimizing school management systems, strengthening the construction of supervisory teams, and focusing on the process and results of graduate education.

Objective:To analyze the scores and differences of various aspects of public health graduate education management in China, and to provide suggestions for universities to enhance graduate education management.Methods:Based on the data from the 2021 National Survey on Education Satisfaction and Job Evaluation of Medical Graduate Supervisors, we described the public health graduate education management in China from the five perspectives of student enrollment, curriculum, practice, research, and school management. The t-test and analysis of variance were used to analyze the differences in individual characteristics. Multiple linear regression was used to analyze factors influencing the scores of public health graduate education management. Results:Supervisors gave the highest score to curriculum and teaching (mean score, 4.00±0.77), followed by management system and input (mean score, 3.97±0.87), research conditions and achievements (mean score, 3.93±0.80), practical education conditions and effects (mean score, 3.80±0.91), and discipline attractiveness and enrollment quality (mean score, 3.70±0.84). Supervisors who supervised professional degrees, doctoral students, and located in the eastern region gave relatively high scores to public health graduate education, and those with associate professor titles gave relatively low scores.Conclusions:The quality of students recruited for public health graduate education needs to be improved, curriculum design and teaching method need to be adjusted, practice conditions need to be improved, research funding is insufficient, and the construction of academic communication platforms needs to be improved. The relevant universities/colleges need to strengthen the management and increase the investment to promote the high-quality development of public health graduate education.

Objective Clarify the basis of the commonly used Tibetan medicinal material"YeGexing",the chemical structure and pharmacological activity were investigated,then provide a basis for standardizing clinical medication,quality control,and rational use of resources.Methods Using literature research;plant taxonomy identification summary of chemical composition investigation and pharmacological activity identification,combined with resource distribution,clinical use status investigation and analysis.Results Tibetan medicine"Yegexing"involved 7 species in 2 families,4 genera,that is Sambucus Linn.from Caprifoliaceae,Senecio L.,Synotis(C.B.Clarke)C.Jeffrey et Y.L.Chen,Saussurea DC.from Compositae.The earliest used"Yegexinggabao"or"white"should be Senecio dianthus.and Senecio solidagineus.in the literature;"Yegexingnabao"or"black"should be Saussurea epilobioides.and Sambucus adnate.;S.raphanifolius.(S.diversifolius.),S.chrysanthemoides.(S.laetus.).S.chinensis.are the main substitutes used in Yunnan,Gansu,and western Sichuan,and are commonly used in the market.YeGexing mainly contains terpenes,flavonoids,alkaloids,phenolic acids and other chemical components;YeGexing black is mainly used for"healing",white is mainly used for"anti-inflammatory",which corresponds to modern pharmacological research on anti-inflammatory,antioxidant,antibacterial and other activities.Conclution In view of the fact that the origin of"Yegexing"involves a variety of plants from different families and genera,"Yegexing"has become a collective name for these plant medicinal materials.According to the lextual results and the research progress on chemical structure and pharmacological activity,from the perspective of conducive to standardizing clinical medication,ensuring efficacy and quality of medicinal materials,its name and variety should be standardized as:"??????(???????????????????/)Yegexinggabao"(that is,the white one),the source is S.dianthus.(S.erythropappa.),S.solidagineus.(S.solidaginea.),S.raphalanifolius.(S.diversifolius.),S.chrysanthemoides.(S.laetus.);"(???????????????????????/)Yegexingnabao"(that is,the black one),the source is S.epilobioides.and S.adnata.and S.chinensis are independent medicines.We should strengthen the investigation of the resources and use status of substitutes in various places,the comparative research on the medicinal material basis and biological activity of different resource species,and standardize their varieties-names-bases to make rational use of their resources.