Objective:To provide theoretical support and practice model for improving the clinical medical education supervision system of university-affiliated hospitals.Methods:This study focused on the group of reserve teaching supervision experts. Through literature research, questionnaire survey, and expert interview, the Competency Evaluation Criteria for Reserve Teaching Supervision Experts was constructed, which was implemented according to the training framework of "theory, practice, summary, and feedback". The paired t-test was performed using SPSS 24.0. Results:The research team formulated the Competency Evaluation Criteria for Reserve Teaching Supervision Experts through expert interviews. Six basic competencies and three advanced competencies for reserve teaching supervision experts were identified and their weights were assigned. A supervision team was established with supervision experts (including reserve teaching supervision experts) and teaching staff at a ratio of 1∶6.9, achieving an increase in the coverage of supervised specialties. A toolkit for enhancing the supervision capabilities of reserve experts was developed, and its effectiveness was analyzed. Statistical analysis showed that the overall score gap between reserve teaching supervision experts and senior supervision experts gradually narrowed. In terms of teaching demeanor and teaching effectiveness, there were no significant differences between the two types of experts. However, in terms of teaching content scores, there was a significant difference between reserve teaching supervision experts and senior supervision experts ( P<0.05). Conclusions:The training mechanism of reserve teaching supervision experts can effectively bridge the structural defects of the traditional supervision team. However, further emphasis is needed on the standardization and professionalization of teaching content supervision.

Objective:To provide theoretical support and practice model for improving the clinical medical education supervision system of university-affiliated hospitals.Methods:This study focused on the group of reserve teaching supervision experts. Through literature research, questionnaire survey, and expert interview, the Competency Evaluation Criteria for Reserve Teaching Supervision Experts was constructed, which was implemented according to the training framework of "theory, practice, summary, and feedback". The paired t-test was performed using SPSS 24.0. Results:The research team formulated the Competency Evaluation Criteria for Reserve Teaching Supervision Experts through expert interviews. Six basic competencies and three advanced competencies for reserve teaching supervision experts were identified and their weights were assigned. A supervision team was established with supervision experts (including reserve teaching supervision experts) and teaching staff at a ratio of 1∶6.9, achieving an increase in the coverage of supervised specialties. A toolkit for enhancing the supervision capabilities of reserve experts was developed, and its effectiveness was analyzed. Statistical analysis showed that the overall score gap between reserve teaching supervision experts and senior supervision experts gradually narrowed. In terms of teaching demeanor and teaching effectiveness, there were no significant differences between the two types of experts. However, in terms of teaching content scores, there was a significant difference between reserve teaching supervision experts and senior supervision experts ( P<0.05). Conclusions:The training mechanism of reserve teaching supervision experts can effectively bridge the structural defects of the traditional supervision team. However, further emphasis is needed on the standardization and professionalization of teaching content supervision.

Objective:To verify the effect of Fu′s massage combined with physical therapy technology in rapidly relieving neck and low back pain caused by long-haul flight.Methods:Forty-two male volunteers were divided into 8, 12, 16, 24 and 48 h groups according to the simulated flying hours. After the completion of the simulated long-haul flight, the 5 groups of volunteers were immediately treated with Fu′s massage combined with physical factors for neck and low back pain. The Visual Analogue Scale (VAS) was used to evaluate the cervical and lumbar pain of volunteers after simulated flight and after treatment, and the treatment effect was before treatment analyzed.Results:There were significant differences in the VAS scores of cervical and lumbar regions before treatment among volunteers with different flying hours ( H=-30.15, -28.25, both P<0.001). The VAS scores of cervical and lumbar regions of volunteers in the 24 h and 48 h groups were higher than those in the 8 h group ( P=0.002, <0.001, =0.002, <0.001). The VAS scores of cervical and lumbar regions of volunteers in the 48 h group were higher than those in the 12 h group ( P=0.016, 0.001). The VAS score of cervical region of volunteers in the 48 h group was higher than that in the 16 h group ( P=0.033). After the intervention of Fu's massage combined with physical therapy, the VAS scores of cervical and lumbar regions in each group were lower than those before treatment, and the differences were significant ( t/ Z=-3.00-17.00, all P<0.05 or 0.01). Conclusions:Fu′s massage manipulation combined with physical treatment can effectively relieve the neck and low back pain caused by long-haul flight, which can be widely used as a relief method.

Objective To compare the predictive value of ORBIT score and HAS-BLED score for bleeding risk after warfarin anticoagulation following heart valve replacement. Methods The clinical data of 304 patients who underwent heart valve replacement and required warfarin anticoagulation therapy were retrospectively analyzed. The patients were stratified and grouped based on the ORBIT score and HAS-BLED score. The correlation between risk stratification based on different scores and postoperative bleeding events during warfarin anticoagulation was analyzed. The consistency of risk stratification between the two scoring methods and their predictive value for bleeding events were compared. Results Among 304 patients, there were 32 bleeding patients and 272 non-bleeding patients. The postoperative ORBIT and HAS-BLED scores of the bleeding patients were higher than those of non-bleeding patients(P < 0.05). The bleeding risk of medium and high-risk patients based on the ORBIT score was 6.092 (95%CI, 2.694 to 13.775) times and 9.373 (95%CI, 1.465 to 59.943) times higher than that of low-risk patients, respectively. The bleeding risk of medium and high-risk patients based on the HAS-BLED score was 3.750 (95%CI, 1.383 to 10.166) times and 14.250 (95%CI, 5.489 to 36.995) times higher than that of low-risk patients, respectively. The analysis of the receiver operating characteristic curve showed that the area under the AUC (95%CI, 0.589 0.698 9) of ORBIT score for predicting the risk of postoperative warfarin anticoagulation bleeding was 0.646 (95%CI, 0.589 to 0.699), with a sensitivity of 46.88% and a specificity of 87.87%, and an optimal cutoff value of 3 points. The AUC of HAS-BLED score predicting the risk of postoperative anticoagulation bleeding with warfarin was 0.768 (95%CI, 0.717 to 0.814), with a sensitivity of 75.00% and a specificity of 69.85%, and an optimal cutoff value of 2 points. The Delong test results showed that there was a statistically significant difference in AUC between the two scores (D=0.122; 95%CI, 0.001 to 0.245; Z=1.962; P < 0.05). Conclusion Both ORBIT score and HAS-BLED score have certain predictive value for bleeding risk during warfarin anticoagulation after heart valve replacement, but the predictive efficiency of HAS-BLED score is better.

Objective:To verify the effect of Fu′s massage combined with physical therapy technology in rapidly relieving neck and low back pain caused by long-haul flight.Methods:Forty-two male volunteers were divided into 8, 12, 16, 24 and 48 h groups according to the simulated flying hours. After the completion of the simulated long-haul flight, the 5 groups of volunteers were immediately treated with Fu′s massage combined with physical factors for neck and low back pain. The Visual Analogue Scale (VAS) was used to evaluate the cervical and lumbar pain of volunteers after simulated flight and after treatment, and the treatment effect was before treatment analyzed.Results:There were significant differences in the VAS scores of cervical and lumbar regions before treatment among volunteers with different flying hours ( H=-30.15, -28.25, both P<0.001). The VAS scores of cervical and lumbar regions of volunteers in the 24 h and 48 h groups were higher than those in the 8 h group ( P=0.002, <0.001, =0.002, <0.001). The VAS scores of cervical and lumbar regions of volunteers in the 48 h group were higher than those in the 12 h group ( P=0.016, 0.001). The VAS score of cervical region of volunteers in the 48 h group was higher than that in the 16 h group ( P=0.033). After the intervention of Fu's massage combined with physical therapy, the VAS scores of cervical and lumbar regions in each group were lower than those before treatment, and the differences were significant ( t/ Z=-3.00-17.00, all P<0.05 or 0.01). Conclusions:Fu′s massage manipulation combined with physical treatment can effectively relieve the neck and low back pain caused by long-haul flight, which can be widely used as a relief method.

In order to further strengthen the training and management of clinical teachers, broaden the career development channels of clinical teachers, and truly stimulate their teaching enthusiasm and initiative, this study further classifies clinical teachers according to the principle of the Snell model, focuses on the training of educational clinicians, and explores the training mechanism of teaching talents in line with the actual development needs of hospitals affiliated to universities from the aspects of selection, training, incentive, and assessment. The results of practice show that related practices have a good effect, and the mean number of teaching achievements was 1.98 for the 56 educational physicians, which was 3.9 times that for non-educational physicians. The per capita teaching achievements of educational physicians tended to increase every year compared with those of non-educational physicians. The training path for educational physicians provides useful experience for the construction of clinical teaching team and the high-quality development of education and teaching, and at the same time, it is necessary to further strengthen the dynamic adjustment of talent echelon, the improvement of operating mechanism, and the introduction of new technology.

Objective:This paper examines the access control mechanisms of a big data platform and explores its integration with the ChatGPT artificial intelligence platform for nursing management. The aim was to pilot a self-monitoring and follow-up big data platform for valve disease patients in the Northeastern region of China and assess its effectiveness, providing healthcare professionals with a more practical follow-up tool.Methods:Convenience sampling was used to select 32 patients who underwent mechanical valve replacement surgery or postoperative follow-up at the affiliated hospital of North Sichuan Medical College between January and October 2022 by a retrospective study, were taking oral warfarin anticoagulant therapy, and were willing to use the platform. Based on their platform usage data from November to December 2022, the 32 patients were divided into two groups according to their INR compliance rates: a high compliance group (16 patients) and a low compliance group (16 patients). Evaluate the operational effectiveness of the platform and its impact on patient anticoagulation efficacy based on its usage frequency and INR value compliance rate.Results:The number of login times and INR values written by patients in the high-standard-rate group were (11.31 ± 3.38) and (7.00 ± 1.63) times respectively, which were higher than those in the low-standard-rate group (9.44 ± 3.39) and (6.06 ± 1.88) times, the difference were not statistically significant (all P>0.05). The number of INR values written within the normal range and the number of occurrences of warning values by patients in the high-standard-rate group were (6.38 ± 1.50) and 1.00(0, 2.00) times, which were different than that in the low-standard-rate group (4.05 ± 1.57) and 2.00(2.00, 3.50) times, the differences were statistically significant ( t = 4.26, Z = - 2.22, P<0.05). Conclusions:The self-monitoring and follow-up big data platform for patients after artificial mechanical valve replacement equipped with ChatGPT can optimize and standardize the nursing follow-up workflow, improve nursing work efficiency, reduce the workload of medical staff. At the same time, it provides a better self-management platform for patients after artificial mechanical valve replacement. Assist patients in monitoring INR values and predicting possible changes in their condition, providing corresponding warnings and recommendations helps patients better participate in self-anticoagulation management, and improves the quality of life of patients.

Objective To summarize the experience of minimally invasive tracheotomy under veno-venous extracorporeal membrane oxygenation(VV-ECMO)in 4 cases of severe pneumonia,and to provide examples for airway management of severe pneumonia patients.Methods A retrospective study method was conducted.Four cases of severe pneumonia patients who underwent extracorporeal membrane oxygenation(ECMO)at the intensive care unit(ICU)of Shandong Provincial Hospital Affiliated to Shandong First Medical University from November 2022 to March 2023 were selected as the study subjects,clinical data on the general conditions,imaging examinations before and after admission to ICU,changes in biochemical indexes before and after ECMO technique,and the performance of bedside minimally invasive tracheotomy were collected.Bedside tracheotomy was performed to assist ventilation for patients according to the change of condition.The changes and prognosis of the patients were observed.Results Four patients with severe pneumonia were treated with bedside tracheotomy-assisted ventilation in the state of continuous VV-ECMO,the oxygen saturation was maintained between 0.98-1.00,the airway was cleared and sputum evacuation was smooth,the vital signs were stable after the operation,and the machine was gradually withdrawn.Conclusion During the treatment of severe pneumonia,the safe and rapid completion of bedside minimally invasive tracheotomy in patients with severe pneumonia under continuous VV-ECMO is a new challenge shared by doctors and nurses of otorhinolaryngology,head and neck surgery,and critical care emergency care unit.The four successful cases of bedside tracheotomy after VV-ECMO treatment we report suggest that bedside minimally invasive tracheotomy can safely and rapidly assist airway management,and may provide more useful experiences for the treatment of severe pneumonia and possible new acute respiratory infectious diseases in the future.

Objective To discuss the risk factors of C5 never palsy incidence after cervical open-door laminoplasty. Methods This study involved 254 patients with cervical spondylotic myelopathy, who underwent expansive open-door lam?inoplasty in our hospital between January 2009 and December 2012. Patients were divided into two groups according to the incidence of C5 palsy after operation. Group A included 20 patients with C5 palsy and group B included 234 cases without C5 palsy. The risk factors for postoperative C5 palsy were compared between two groups. The factors may affect the inci?dence of C5 palsy were analyze. Results All cases received follow-up with an average follow-up time (24.9±2.6) months. Values of cervical curvature index (CCI), lamina open angles and spinal cord shift were significantly greater in group A than those of group B (P<0.05). There were no significant differences in preoperative intramedullary high signal, ossification of posterior longitudinal ligament and intervertebral foramen stenosis between two groups (P>0.05). Results of Logistic regres?sion analysis of multiple factors showed that lamina open angles, the pathogenic factors of C5 palsy included the spinal cord shift and postoperative CCI [OR(95%CI):2.035(1.684-2.359), 3.542 (2.465-9.254) and 9.126(4.425-17.273). Conclusion The angle of open door too large, CCI and spinal cord shift are risk factors for postoperative C5 palsy.

Bacterial cell division is strictly regulated in the formation of equal daughter cells. This process is governed by a series of spatial and temporal regulators, and several new factors of interest to the field have recently been identified. Here, we report the requirement of gluconate 5-dehydrogenase (Ga5DH) in cell division of the zoonotic pathogen Streptococcus suis. Ga5DH catalyzes the reversible reduction of 5-ketogluconate to D-gluconate and was localized to the site of cell division. The deletion of Ga5DH in S. suis resulted in a plump morphology with aberrant septa joining the progeny. A significant increase was also observed in cell length. These defects were determined to be the consequence of Ga5DH deprivation in S. suis causing FtsZ delocalization. In addition, the interaction of FtsZ with Ga5DH in vitro was confirmed by protein interaction assays. These results indicate that Ga5DH may function to prevent the formation of ectopic Z rings during S. suis cell division.
Bacterial Proteins ; chemistry ; genetics ; metabolism ; Cell Division ; Cell Shape ; Cytoskeletal Proteins ; chemistry ; genetics ; metabolism ; Mutation ; Oxidoreductases ; deficiency ; genetics ; metabolism ; Protein Binding ; Streptococcus suis ; enzymology