1.Consistency verification of reverse screening strategy for syphilis in maternal and child populations and assocliation between S/CO value and false positive rate of CLIA
Weiming LU ; Jiewen LI ; Chunming GU ; Junfei GUO ; Kefeng LAI ; Xianhua ZHENG ; Mingyong LUO
The Journal of Practical Medicine 2025;41(20):3249-3255
Objective To compare the diagnostic performance of two syphilis reverse testing protocols recommended by the U.S.Centers for Disease Control and Prevention(USCDC)and the European Centre for Disease Prevention and Control(ECDC)within maternal and child populations,and to explore the factors contributing to false-positive results in chemiluminescent immunoassays(CLIA).Methods A retrospective analysis was performed on serological test results from 109,003 patients collected between 2021 and 2023.All participants were initially screened for specific syphilis antibodies using CLIA,and those with positive results underwent confirmatory testing with both the toluidine red unheated serum test(TRUST)and the Treponema pallidum particle agglutination assay(TPPA).The kappa statistic was employed to assess the diagnostic agreement between the USCDC and ECDC protocols,while also analyzing the distribution patterns of CLIA false-positive results across varying S/CO value ranges and demographic groups.Results Both protocols achieved a syphilis positivity rate of 0.34%.The hospital's high-prevalence syphilis screening program identified no cases with CLIA-positive or TRUST-positive but TPPA-negative results,suggesting high specificity in this population.The two protocols demonstrated perfect agreement with a Kappa value of 1.0,indicating no significant difference in diagnostic performance between maternal and child populations.CLIA exhibited a true positive rate of 71.04%,which was positively correlated with S/CO values:21.88%when 1.010.The highest false positive rate for CLIA(38.75%)was observed among young adults,while the largest proportion of false positives-reaching 40.00%—was associated with pregnancy and abortion status.Conclusions The two reverse detection methods for syphilis exhibit comparable diagnostic efficacy in women and children from populations with low syphilis prevalence.CLIA demonstrates high sensitivity;however,when the S/CO ratio is less than 10,particularly in adult women of childbearing age,clinicians should remain vigilant for potential false-positive results to prevent misdiagnosis and unnecessary medical interventions.
2.Consistency verification of reverse screening strategy for syphilis in maternal and child populations and assocliation between S/CO value and false positive rate of CLIA
Weiming LU ; Jiewen LI ; Chunming GU ; Junfei GUO ; Kefeng LAI ; Xianhua ZHENG ; Mingyong LUO
The Journal of Practical Medicine 2025;41(20):3249-3255
Objective To compare the diagnostic performance of two syphilis reverse testing protocols recommended by the U.S.Centers for Disease Control and Prevention(USCDC)and the European Centre for Disease Prevention and Control(ECDC)within maternal and child populations,and to explore the factors contributing to false-positive results in chemiluminescent immunoassays(CLIA).Methods A retrospective analysis was performed on serological test results from 109,003 patients collected between 2021 and 2023.All participants were initially screened for specific syphilis antibodies using CLIA,and those with positive results underwent confirmatory testing with both the toluidine red unheated serum test(TRUST)and the Treponema pallidum particle agglutination assay(TPPA).The kappa statistic was employed to assess the diagnostic agreement between the USCDC and ECDC protocols,while also analyzing the distribution patterns of CLIA false-positive results across varying S/CO value ranges and demographic groups.Results Both protocols achieved a syphilis positivity rate of 0.34%.The hospital's high-prevalence syphilis screening program identified no cases with CLIA-positive or TRUST-positive but TPPA-negative results,suggesting high specificity in this population.The two protocols demonstrated perfect agreement with a Kappa value of 1.0,indicating no significant difference in diagnostic performance between maternal and child populations.CLIA exhibited a true positive rate of 71.04%,which was positively correlated with S/CO values:21.88%when 1.010.The highest false positive rate for CLIA(38.75%)was observed among young adults,while the largest proportion of false positives-reaching 40.00%—was associated with pregnancy and abortion status.Conclusions The two reverse detection methods for syphilis exhibit comparable diagnostic efficacy in women and children from populations with low syphilis prevalence.CLIA demonstrates high sensitivity;however,when the S/CO ratio is less than 10,particularly in adult women of childbearing age,clinicians should remain vigilant for potential false-positive results to prevent misdiagnosis and unnecessary medical interventions.
3.Audiological characterization of the GJB2 gene c.109G>A (p.V37I) hotspot variant during childhood and comparison between family members.
Zhoushu ZHENG ; Jiangyang XUE ; Lu DING ; Jiewen PAN ; Meihong WANG ; Yinghui ZHANG ; Danyan ZHUANG ; Yihui YANG ; Ming TANG ; Haibo LI
Chinese Journal of Medical Genetics 2025;42(9):1061-1068
OBJECTIVE:
To determine the prevalence of GJB2 gene c.109G>A (p.V37I) variant among infants with congenital hearing loss and analyze the initial audiological characteristics of children harboring the variant, compare the audiometric difference among individuals with various genotypes, and explore genetic and audiological manifestations of the affected families.
METHODS:
One hundred twenty six infants diagnosed with congenital hearing loss at the Neonate Screening Center of Ningbo City from June 2021 to December 2024 were selected as the study subjects. The neonates, in addition with members from 16 of their families, had undergone genetic screening for variants of 208 hotspot sites within 24 deafness-associated genes. For cases identified with monoallelic variants and concurrent hearing loss, the full GJB2 gene was sequenced. Meanwhile, a retrospective analysis was carried out on 23 children whom were confirmed to have hearing loss and the c.109G>A variant by whole exome sequencing from March 2022 to December 2024. And 102 children who were excluded to have hearing loss and pathogenic variants by whole exome sequencing were selected as normal controls. Audiological features of individuals harboring the c.109G>A variant were compared. This study has been approved by the Medical Ethics Committee of The Affiliated Women and Children's Hospital of Ningbo University (Ethics No.: EC2023-009).
RESULTS:
For the 126 infants with congenital hearing loss, prospective screening has identified 58 (46.03%) to harbor the c.109G>A variant. These included 38 homozygotes and 16 compound heterozygotes. Retrospective review of the 23 c.109G>A positive children has identified 15 as homozygotes and 8 as compound heterozygotes. Genetic testing of the 16 pedigrees has identified 7 homozygotes and 1 compound heterozygote. For the homozygotes combined (n = 53), 96.2% exhibited bilateral symmetric hearing loss, with 78.3% showing high-frequency sloping patterns, and 98.1% having a hearing threshold ranging from 20 to 65 dB. For the compound heterozygotes combined (n = 24), 95.8% showed symmetric loss, with 59.4% having high-frequency sloping, and 97.9% had a hearing threshold ranging from 20 to 65 dB. Both groups showed significantly elevated ABR/PTA thresholds compared with the normal controls (P = 0.000). The compound heterozygous group had higher ABR thresholds (43.3 ± 15.0 dB nHL) compared with the homozygous group (39.1 ± 12.0 dB nHL, P = 0.005).
CONCLUSION
Infants harboring the GJB2 c.109G>A variant primarily manifest as mild-to-moderate, symmetric, high-frequency sloping hearing loss. Nearly one-third of affected children have thresholds between 20 to 35 dB nHL, suggesting that ABR > 35 dB nHL alone may underestimate the hearing impairment in this population. Compared with homozygotes, compound heterozygotes with the the GJB2 c.109G>A variant can confer a more severe hearing loss.
Humans
;
Connexin 26/genetics*
;
Female
;
Male
;
Infant, Newborn
;
Infant
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Hearing Loss/genetics*
;
Retrospective Studies
;
Child, Preschool
;
Child
;
Genotype
;
Connexins/genetics*
;
Mutation
4.Audiological characterization of the GJB2 gene c. 109G>A (p.V37I) hotspot variant during childhood and comparison between family members
Zhoushu ZHENG ; Jiangyang XUE ; Lu DING ; Jiewen PAN ; Meihong WANG ; Yinghui ZHANG ; Danyan ZHUANG ; Yihui YANG ; Ming TANG ; Haibo LI
Chinese Journal of Medical Genetics 2025;42(9):1061-1068
Objective:To determine the prevalence of GJB2 gene c. 109G>A (p.V37I) variant among infants with congenital hearing loss and analyze the initial audiological characteristics of children harboring the variant, compare the audiometric difference among individuals with various genotypes, and explore genetic and audiological manifestations of the affected families. Methods:One hundred twenty six infants diagnosed with congenital hearing loss at the Neonate Screening Center of Ningbo City from June 2021 to December 2024 were selected as the study subjects. The neonates, in addition with members from 16 of their families, had undergone genetic screening for variants of 208 hotspot sites within 24 deafness-associated genes. For cases identified with monoallelic variants and concurrent hearing loss, the full GJB2 gene was sequenced. Meanwhile, a retrospective analysis was carried out on 23 children whom were confirmed to have hearing loss and the c. 109G>A variant by whole exome sequencing from March 2022 to December 2024. And 102 children who were excluded to have hearing loss and pathogenic variants by whole exome sequencing were selected as normal controls. Audiological features of individuals harboring the c. 109G>A variant were compared. This study has been approved by the Medical Ethics Committee of The Affiliated Women and Children′s Hospital of Ningbo University (Ethics No.: EC2023-009). Results:For the 126 infants with congenital hearing loss, prospective screening has identified 58 (46.03%) to harbor the c. 109G>A variant. These included 38 homozygotes and 16 compound heterozygotes. Retrospective review of the 23 c. 109G>A positive children has identified 15 as homozygotes and 8 as compound heterozygotes. Genetic testing of the 16 pedigrees has identified 7 homozygotes and 1 compound heterozygote. For the homozygotes combined ( n=53), 96.2% exhibited bilateral symmetric hearing loss, with 78.3% showing high-frequency sloping patterns, and 98.1% having a hearing threshold ranging from 20 to 65 dB. For the compound heterozygotes combined ( n=24), 95.8% showed symmetric loss, with 59.4% having high-frequency sloping, and 97.9% had a hearing threshold ranging from 20 to 65 dB. Both groups showed significantly elevated ABR/PTA thresholds compared with the normal controls ( P=0.000). The compound heterozygous group had higher ABR thresholds (43.3 ± 15.0 dB nHL) compared with the homozygous group (39.1±12.0 dB nHL, P=0.005). Conclusion:Infants harboring the GJB2 c. 109G>A variant primarily manifest as mild-to-moderate, symmetric, high-frequency sloping hearing loss. Nearly one-third of affected children have thresholds between 20 to 35 dB nHL, suggesting that ABR > 35 dB nHL alone may underestimate the hearing impairment in this population. Compared with homozygotes, compound heterozygotes with the the GJB2 c. 109G>A variant can confer a more severe hearing loss.
5.Audiological characterization of the GJB2 gene c. 109G>A (p.V37I) hotspot variant during childhood and comparison between family members
Zhoushu ZHENG ; Jiangyang XUE ; Lu DING ; Jiewen PAN ; Meihong WANG ; Yinghui ZHANG ; Danyan ZHUANG ; Yihui YANG ; Ming TANG ; Haibo LI
Chinese Journal of Medical Genetics 2025;42(9):1061-1068
Objective:To determine the prevalence of GJB2 gene c. 109G>A (p.V37I) variant among infants with congenital hearing loss and analyze the initial audiological characteristics of children harboring the variant, compare the audiometric difference among individuals with various genotypes, and explore genetic and audiological manifestations of the affected families. Methods:One hundred twenty six infants diagnosed with congenital hearing loss at the Neonate Screening Center of Ningbo City from June 2021 to December 2024 were selected as the study subjects. The neonates, in addition with members from 16 of their families, had undergone genetic screening for variants of 208 hotspot sites within 24 deafness-associated genes. For cases identified with monoallelic variants and concurrent hearing loss, the full GJB2 gene was sequenced. Meanwhile, a retrospective analysis was carried out on 23 children whom were confirmed to have hearing loss and the c. 109G>A variant by whole exome sequencing from March 2022 to December 2024. And 102 children who were excluded to have hearing loss and pathogenic variants by whole exome sequencing were selected as normal controls. Audiological features of individuals harboring the c. 109G>A variant were compared. This study has been approved by the Medical Ethics Committee of The Affiliated Women and Children′s Hospital of Ningbo University (Ethics No.: EC2023-009). Results:For the 126 infants with congenital hearing loss, prospective screening has identified 58 (46.03%) to harbor the c. 109G>A variant. These included 38 homozygotes and 16 compound heterozygotes. Retrospective review of the 23 c. 109G>A positive children has identified 15 as homozygotes and 8 as compound heterozygotes. Genetic testing of the 16 pedigrees has identified 7 homozygotes and 1 compound heterozygote. For the homozygotes combined ( n=53), 96.2% exhibited bilateral symmetric hearing loss, with 78.3% showing high-frequency sloping patterns, and 98.1% having a hearing threshold ranging from 20 to 65 dB. For the compound heterozygotes combined ( n=24), 95.8% showed symmetric loss, with 59.4% having high-frequency sloping, and 97.9% had a hearing threshold ranging from 20 to 65 dB. Both groups showed significantly elevated ABR/PTA thresholds compared with the normal controls ( P=0.000). The compound heterozygous group had higher ABR thresholds (43.3 ± 15.0 dB nHL) compared with the homozygous group (39.1±12.0 dB nHL, P=0.005). Conclusion:Infants harboring the GJB2 c. 109G>A variant primarily manifest as mild-to-moderate, symmetric, high-frequency sloping hearing loss. Nearly one-third of affected children have thresholds between 20 to 35 dB nHL, suggesting that ABR > 35 dB nHL alone may underestimate the hearing impairment in this population. Compared with homozygotes, compound heterozygotes with the the GJB2 c. 109G>A variant can confer a more severe hearing loss.
6.Expert consensus on the biobank development of oral genetic diseases and rare diseases and storage codes of related biological samples from craniofacial and oral region
Wenyan RUAN ; Yanli ZHANG ; Shuguo ZHENG ; Yao SUN ; Zhipeng FAN ; Yaling SONG ; Hongchen SUN ; Wenmei WANG ; Jiewen DAI ; Zhenjin ZHAO ; Tingting ZHANG ; Dong CHEN ; Yongchu PAN ; Yuegui JIANG ; Xudong WANG ; Liwei ZHENG ; Qinglin ZHU ; Miao HE ; Baoshan XU ; Zhonglin JIA ; Dong HAN ; Xiaohong DUAN
Chinese Journal of Stomatology 2023;58(8):749-758
The biological samples of oral genetic diseases and rare diseases are extremely precious. Collecting and preserving these biological samples are helpful to elucidate the mechanisms and improve the level of diagnose and treatment of oral genetic diseases and rare diseases. The standardized construction of biobanks for oral genetic diseases and rare diseases is important for achieving these goals. At present, there is very little information on the construction of these biobanks, and the standards or suggestions for the classification and coding of biological samples from oral and maxillofacial sources, and this is not conducive to the standardization and information construction of biobanks for special oral diseases. This consensus summarizes the background, necessity, principles, and key points of constructing the biobank for oral genetic diseases and rare diseases. On the base of the group standard "Classification and Coding for Human Biomaterial" (GB/T 39768-2021) issued by the National Technical Committee for Standardization of Biological Samples, we suggest 76 new coding numbers for different of biological samples from oral and maxillofacial sources. We hope the consensus may promote the standardization, and smartization on the biobank construction as well as the overall research level of oral genetic diseases and rare diseases in China.
7.Role of thromboelastography in assessing the risk of spontaneous bleeding in patients with liver cirrhosis
Decui PEI ; Sisi WEN ; Haichun HU ; Xiuxia ZHENG ; Linfei LI ; Jiewen DENG
Journal of Clinical Hepatology 2021;37(7):1582-1588.
ObjectiveTo investigate the association between thromboelastography (TEG) parameters and bleeding in patients with liver cirrhosis and whether TEG can be used to predict the risk of spontaneous bleeding in patients with liver cirrhosis, and to provide a basis for its preventive treatment. MethodsA retrospective analysis was performed for the clinical data of 174 patients with liver cirrhosis who attended Huadu People’s Hospital from May 2018 to April 2020 and did not receive invasive procedure, and according to the condition of bleeding, they were divided into non-bleeding group(n=64), gastrointestinal bleeding group(n=61), and mucocutaneous/oronasal bleeding group(n=49). The medical record system and laboratory information system were used to collect related information and laboratory test results for statistical analysis. The t-test was used for comparison of normally distributed continuous data between two groups; an analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups. MedCalc software was used for receiver operating characteristic (ROC) curve analysis, and the area under the ROC curve (AUC) was calculated for commonly used coagulation markers and TEG parameters in predicting the risk of bleeding in patients with liver cirrhosis. Cut-off value, sensitivity, specificity, positive predictive value, and negative predictive value were determined, and the Z test was used for comparison of indices in predicting mucocutaneous/oronasal bleeding. ResultsOf all 174 patients, 110 (63.2%) experienced spontaneous bleeding, among whom 61 (55.5%) had gastrointestinal bleeding and 49 (44.5%) had mucocutaneous/oronasal bleeding. There were significant differences in maximum amplitude (MA) and K between the bleeding group and the non-bleeding group (t=2.241 and -2.605, both P<0.05). There were significant differences between the mucocutaneous/oronasal bleeding group and the non-bleeding/gastrointestinal bleeding groups in platelet count (PLT) and the TEG parameters of clot formation time, a-angle, MA, and coagulation index (CI) (F=3.947, H=12.867, F=4.007, F=8.498, F=5.420, all P<0.05). Among the TEG parameters, reaction time and Lys30 were generally within the normal range, while there was a prolonged kinetics (K) time and reductions in a-angle, MA, and CI. PLT ≤40×109/L, MA ≤357 mm, K time >4.2 minutes, a-angle ≤51.6, and CI ≤-5.9 could be used to predict spontaneous mucocutaneous/oronasal bleeding in patients with liver cirrhosis (all AUC >0.7), with positive predictive values of 82.4, 88.9, 81.0, 72.7, and 73.7, respectively, and negative predictive values of 68.3, 72.5, 73.0, 69.4, and 66.7, respectively. ConclusionPLT and the TEG parameters of K time, a-angle, MA, and CI can predict spontaneous bleeding caused by abnormal coagulation in liver cirrhosis, while conventional coagulation parameters prothrombin time and activated partial thromboplastin time cannot predict such bleeding, which provides a basis for the treatment of coagulation disorder and transfusion of blood components for patients with liver cirrhosis.
8.Study on the accuracy of cardiopulmonary physiological measurements by a wearable physiological monitoring system under different activity conditions.
Haoran XU ; Wenya CHU ; Xiaoli LIU ; Shasha ZHANG ; Zhicheng YANG ; Jiewen ZHENG ; Xiaolin GAO ; Zhengbo ZHANG ; Desen CAO
Journal of Biomedical Engineering 2020;37(1):119-128
This paper aims to study the accuracy of cardiopulmonary physiological parameters measurement under different exercise intensity in the accompanying (wearable) physiological parameter monitoring system. SensEcho, an accompanying physiological parameter monitoring system, and CORTEX METALYZER 3B, a cardiopulmonary function testing system, were used to simultaneously collect the cardiopulmonary physiological parameters of 28 healthy volunteers (17 males and 11 females) in various exercise states, such as standing, lying down and Bruce treadmill exercise. Bland-Altman analysis, correlation analysis and other methods, from the perspective of group and individual, were used to contrast and analyze the two types of equipment to measure parameters of heart rate and breathing rate. The results of group analysis showed that the heart rate and respiratory rate data box charts collected by the two devices were highly consistent. The heart rate difference was (-0.407 ± 3.380) times/min, and the respiratory rate difference was (-0.560 ± 7.047) times/min. The difference was very small. The Bland-Altman plot of the heart rate and respiratory rate in each experimental stage showed that the proportion of mean ± 2SD was 96.86% and 95.29%, respectively. The results of individual analysis showed that the correlation coefficients of the whole-process heart rate and respiratory rate data were all greater than 0.9. In conclusion, SensEcho, as an accompanying physiological parameter monitoring system, can accurately measure the human heart rate, respiration rate and other key cardiopulmonary physiological parameters under various sports conditions. It can maintain good stability under various sports conditions and meet the requirements of continuous physiological signal collection and analysis application under sports conditions.
9.Expression of secreted frizzled-related protein 4 in DNA mismatch repair-deficient and mismatch repair-proficient colorectal cancers.
Kexu CHEN ; Hanlin LIANG ; Jiewen PENG ; Yanfang ZHENG
Journal of Southern Medical University 2018;38(11):1300-1305
OBJECTIVE:
To investigate the expressions of secreted frizzled-related protein 4 (SFRP4) in stage Ⅱ DNA mismatch repair-deficient (dMMR) and mismatch repair- proficient (pMMR) colorectal cancers and explore their clinical significance.
METHODS:
We collected fresh stage Ⅱ colon cancer tissues with different MMR status detected by immunohistochemistry (IHC). The differentially expressed mRNAs between dMMR and pMMR tumors were identified by Affymetrix Human oeLncRNA gene chip, and the expression of SFRP4 in these cancer tissues and in colorectal cancer cell lines were detected using Western blotting and real- time quantitative PCR. The apoptosis rates of HCT116 cells with and without siRNA- mediated transient SFRP4 knockdown were determined using flow cytometry. We further investigated the expression pattern of Ki-67 and its correlation with SFRP4 expression.
RESULTS:
Compared with pMMR colon cancer tissues or cells, both dMMR colon cancer tissues (=0.014) and cells (=0.0079) showed significantly increased expression of SFRP4, which was in negative correlation with Ki-67 (=0.041). In HCT116 cells, transient SFRP4 knockdown resulted in decreased cell apoptosis, including both early apoptosis (=0.003) and late apoptosis (=0.024).
CONCLUSIONS
Up-regulation of SFRP4 in dMMR stage Ⅱ colon cancer promotes apoptosis and inhibits proliferation of the cancer cells, and may improve the prognosis of dMMR colon cancer.
Apoptosis
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Cell Proliferation
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Colon
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metabolism
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pathology
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Colonic Neoplasms
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genetics
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metabolism
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pathology
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Colorectal Neoplasms
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genetics
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metabolism
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pathology
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DNA Mismatch Repair
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Gene Knockdown Techniques
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HCT116 Cells
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Humans
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Ki-67 Antigen
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metabolism
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Prognosis
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Proto-Oncogene Proteins
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genetics
;
metabolism
;
Up-Regulation
10.Analysis of the related factors on scores of the clinical dietitians' post-training exam in China
Gang WANG ; Yaoguang ZHENG ; Ning WANG ; Jiewen ZOU ; Quanghui ZHANG
Chinese Journal of Medical Education Research 2016;15(5):433-436
Objective Based on the analysis of relevant factors on scores of the first clinical dietitian post-training examination (CDPTE) in China,to explore the clinical dietitians' post competency evaluation basis.Method 108 students who completed the clinical nutritionist training (60 physicians,nurse or technician 48) were imposed comprehensive evaluation designed according to the concept of post competency.Through analysis and comparison,the correlation factors of the candidates' passing rate and their mastering rate of the module were studied.Results The results of all the candidates' comprehensive theoretical examination increased with the degree and the source of the candidates.Among them,the college students' pass rate was 76.47%,undergraduates' pass rate was 86.21%,Graduates' pass rate was 96.97%;the pass rate in western region was 85%,the central part was 85.71%,the eastern part was 89.55%.All the candidates' knowledge module mastery rate in the comprehensive examination of the theory from high to low in order was:for hospital diet (73.7%),enteral nutrition and parenteral nutrition (72.7%),public nutrition (70.7%),nutrition screening and assessment (66.7%),common nutrition related diseases (65.4%),clinical nutrition related health students regulations,medical psychology and ethics basic knowledge (40.0%).The examination pass rate was related to the educational level of the examinee and the source area,while the knowledge module mastery rate was closely related to the work of clinical nutrition.Conclusion We concluded that the CDPTE could objectively reflect the candidate's clinical competence and professionalism and it was designed on the basic principle of post competency.CDPTE has a positive significance for scientific assessment of clinical dietician,guide for training,and evaluation of training effects as well.The scores of CDPTE can objectively reflect the examinees' clinical competence and professionalism and CDPTE can achieve the goal of evaluating the candidates' competency,and it is of practical significance for scientific evaluation of clinical practice,guiding learning and evaluating the training effect.

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