Objective:To analyze the results of the practice test and formal test of the annual professional proficiency test for residents in 2022, to investigate related influencing factors and the effectiveness of the practice test, and to propose the measures for improving the results of the annual professional proficiency test.Methods:The scores of the annual professional proficiency test were analyzed for 202 residents who participated in the test in 2022, and the data on sex, education background, type of personnel, whether they passed the medical licensing examination, and practice test scores were analyzed to investigate related influencing factors. SPSS 23.0 and GraphPad Prism 8 were used for the chi-square test, the t-test, the one-way of variance, and the Fisher's exact test. A multiple linear regression analysis was used to identify influencing factors, and a Pearson correlation analysis was also performed. Results:The scores of the annual professional proficiency test for 202 residents were normally distributed with the highest number of the residents with a score of 90-99 points and the lowest number of the residents with a score of <70 points. The residents who passed the medical licensing examination had a significantly higher score of the annual professional proficiency test than those who failed the examination ( t=2.87, P=0.005), and the residents who passed the three practice tests had a significantly higher score of the annual professional proficiency test than those who failed the practice tests ( P<0.05). The score of the second practice test, the score of the third practice test, and the passing of medical licensing examination were independent influencing factors for the score of annual professional proficiency test ( R2=0.236, R2=0.201, F=6.60, P<0.05). The correlation analysis showed that the scores of the three practice tests were positively correlated with the final score ( r=0.189, 0.373, and 0.311, P<0.05). Conclusions:Improving the passing rate of medical licensing examination and strengthening pre-examination practice tests can help to improve the score of annual professional proficiency test. At the same time, it is necessary to improve the quality of training through the measures such as strengthening the homogenization management of different types of students, improving the attention and enthusiasm of all levels, and accelerating the construction of question banks.

Objective:To understand the effect of standardized residency training for residents with different identity types, and put forward targeted optimization and improvement measures to achieve the homogenization of training effect.Methods:Combined with literature review and expert consultation results, a self-designed questionnaire was conducted for 324 residents who completed their courses in 2019 and 2020. The effective recovery rate of the questionnaire was 87.65%. By comparing the passing rate of first-time medical admission and completion examination of different identity types, and the training standards of six core competencies, the training effect conclusion was drawn. T-test and Fisher exact probability test were also made by SPSS 21.0. Results:The passing rates of first-time doctors and completion examinations were higher in professional masters and units than in the general population, with the highest passing rates reaching 100% (10/10) and 97.3% (72/74) respectively. There was no statistical difference between the passing rates of residents with different identity types. The overall standard of the six core competencies of the integrated professional masters was better than that of the society and unit personnel. There were statistical differences between the groups in the training standards of the four abilities of the residents with different identity types in professional literacy ( P=0.048), patient management ( P=0.030), communication and cooperation ( P=0.026) and learning promotion ( P=0.003). There was no significant difference in professional ability ( P=0.131) and teaching ability ( P=0.061). Conclusion:There is no difference in the passing rate of residents with different identity types in a military hospital, which achieves the goal of homogenization training to a certain extent. However, there are obvious differences in the standards of the six core competencies, and further optimization measures need to be explored.

Objective To explore the association between iron metabolism indexes and the risk of gestational diabetes mellitus(GDM)in pregnant women with advanced age.Methods A total of 292 pregnant women,whose age were≥35 years old and gave birth in Taicang First People's Hospital from April 2021 to April 2023,were retrospectively included and divided into GDM group and non-GDM group.The differences of iron metabolism indexes[serum ferritin(SF),serum iron(SI)and hemoglobin(Hb)]measured from the 20 to 24 weeks of gestation were compared between the two groups.Multivariable Logistic regression model was used to explore the association of SF,SI and Hb with GDM.Based on the data of single nucleotide polymorphism from IEU OpenGWAS(http://gwas.mr-cieu.ac.uk/)and FinnGen datasets,two samples Mendelian randomization analysis were conducted to explore the causal relationship between iron metabolism indexes and GDM by using the methods of Inverse Variance Weighted(IVW).Results In the maximally ad-justed multi-factor logistic models,the statistically significant association between SF measured from 20 to 24 weeks of gestation and the risk of GDM was found[odds ratio(95％confident interval)=1.02(1.01-1.04),P=0.001].The association between Hb and GDM was marginally significant[odds ratio(95％confident interval)=1.04(1.00-1.07),P=0.044],but no association between SI and GDM reached statistical significance.However,Mendelian randomization analysis showed there was no significant evidence for causal association between SF,Hb and GDM.Conclusion SF examined at 20 to 24 weeks of gestation could be used as a biomarker of GDM in the pregnant women with advanced age,but no evidence supported the causal association between SF and GDM.

Objective:To understand the profile type of serum Epstein-Barr virus (EBV) antibodies in children with infectious mononucleosis (IM), and to analyze the significance of viral capsid antigen (VCA) IgG antibody affinity in the diagnosis of IM.Methods:Retrospective analysis was performed on the results of the serum anti-EBV antibody profile and plasma EBV nucleic acid test of 150 hospitalized children with IM diagnosed in Beijing Children′s Hospital, Capital Medical University, from May 2016 to May 2019.Anti-EBV antibody profiles, including anti-VCA-IgG, anti-VCA-IgM, anti-early antigen (EA) IgA, anti-EBV nuclear antigen (EBNA) IgG, and anti-VCA-IgG affinity, were detected by enzyme-linked immunosorbent assay (ELISA). Plasma EBV nucleic acids were detected by real-time quantitative PCR.Results:There were mainly two types of anti-EBV antibody profiles in 150 children with IM: (1)130 cases who were positive for anti-VCA-IgM/IgG, negative for anti-EBNA-IgG and positive for anti-VCA-IgG antibodies with low affinity, accounting for 86.7% (130/150 cases), of which 50 cases were positive for anti-early antigen IgA; (2)18 cases who were negative for anti-VCA-IgM, positive for anti-VCA-IgG, negative for anti-EBNA-IgG and positive for anti-VCA-IgG antibody with low affinity, accounting for 12.0% (18/150 cases), of which 5 cases were positive for anti-EA IgA.EBV DNA was measured in 132 children, with a posi-tive rate of 37.9% (50/132 cases).Conclusions:There were several types of serum EBV antibody profiles in children with IM, 12.0% of patients with IM in this study were negative for anti-VCA-IgM, and the diagnosis of IM was confirmed by the affinity of anti-VCA IgG.

Objective:To observe any effects of electroacupuncture (EA) at acupoints CV23 and GV16 in activating c-Fos genes in the brain regions related to swallowing.Methods:Twenty C57 mice were randomly divided into a blank group, an EA at CV23 group, an EA at GV16 group and an EA at CV23+ GV16 group, each of 5. All except the mice in the blank group were given EA at the relevant acupoints CV23 or GV16 or both, respectively, for 15min. Samples were collected from all of the groups 50min after the EA treatment, and immunofluorescence staining was used to quantify the expression of the c-Fos gene in the brain regions controlling swallowing.Results:In the nucleus tractus solitarii the average number of c-Fos positive cells of the CV23 group was (445.1±43.14)/mm 2, significantly higher than the (297.47±25.54)/mm 2 of the GV16 group. No significant differences were observed in the average number of c-Fos positive cells in parabrachial nucleus. In the primary motor cortex the average number of c-Fos positive cells in the GV16 group was significantly higher than in the other two groups. In the primary sensory cortex the CV23+ GV16 group had a significantly higher average number. Conclusions:EA at the CV23 most strongly activates the c-Fos gene in the nucleus tractus solitarii. For c-Fos activation in the primary motor cortex GV16 is the most effective point. For c-Fos activation in the primary sensory cortex, EA at CV23 and GV16 together is recommended. These results may guide the selection of acupoints in treating dysphagia.

Objective:To analyze the clinicopathological features of chordoid glioma.Methods:A total of 12 cases of chordoid gliomas from 2009 to 2020 in Xuanwu Hospital of Capital Medical University and General Hospital of Chinese People′s Liberation Army were retrospectively analyzed. The clinical and imaging characteristics, pathologic and molecular characteristics were analyzed, and the relevant literature was reviewed.Results:All 12 patients (4 males and 8 females) aged from 25 to 67 years (mean 39 years) and mainly had a history of headache or/and vision loss. MRI showed that the lesions located in the third ventricle, and they showed abnormal enhancement. Pathologically, these 12 cases displayed the morphologic characteristics of chordoid gliomas, including papillary structures in two cases. Immunohistochemically, GFAP and vimentin were expressed in all 12 cases (12/12). TTF1 was also expressed in all cases (10/10). CD34 and CKpan were seen in 11 cases (11/12). EMA with dot-and/or-ring like positivity was seen in 9 cases (9/10). Tissues were available in nine chordoid gliomas for Sanger sequencing to detect PRKCA and IDH gene mutation, and eight cases (8/9) showed PRKCA gene D463H mutation. None of these cases showed IDH1 R132 and IDH2 R172 mutation. All 12 patients underwent surgery, and four were lost to follow up. The remaining eight patients were progression or recurrence free at last follow-up in January 2021.Conclusions:Chordoid gliomas have relatively distinguishing clinical and histopathological features. PRKCA gene mutation in chordoid gliomas can be considered as a biomarker for the diagnosis and differential diagnosis of chordoid gliomas, and may provide a direction for future targeted therapy.

To strengthen the management of residents standardized training process, so as to further improve the homogenized construction of residents standardized training, we constructed a standardized assessment system for residents training process according to the principle of "teaching-examination separation", including a new independent team of examiners, standardization of the assessment process, and expansion of standardized test bank of practical skills and medical cases. Results showed that the rates of attendance, 360-degree evaluation completion, and post-department examination, and annual assessment were all improved. The new assessment system of "teaching-examination separation" for residents standardized training strictly ensures the training quality and plays an active role in promotion of training by tests, being fair and just, and improving the efficiency and homogenization of resident standardized training, which is worthy of further research and popularization.

OBJECTIVE: To compare laboratory and clinical outcomes of fertilization-embryo transfer (IVF-ET) in patients with endometriosis using antagonist protocol, long agonist protocol or prolonged agonist protocol. METHODS: Totally 313 patients with endometriosis were recruited in Reproductive Centers of the Second Affiliated Hospital of Zhejiang University School of Medicine,Jiaxing Women and Children's Hospital,and Ningbo Women and Children's Hospital from April 2017 to October 2018, including 81 patients treated with antagonist protocol (antagonist group), 148 treated with long agonist protocol (long agonist group) and 84 treated with prolonged agonist protocol (prolonged agonist group). The clinical and laboratory data of the patients were retrospectively analyzed to investigate the effect of ovarian stimulation protocols on the IVF-ET outcomes of patients with endometriosis. RESULTS: The average age in the antagonist group patients was significantly higher than those in the other two groups (all <0.05),and anti-mullerian hormone (AMH) level and antral follicle numbers were significantly lower than those in the other two groups (all <0.01). The numbers of average retrieved oocyte, fertilized oocyte and available embryo in the antagonist group were significantly lower than those in the long agonist group (all <0.05), but were similar with those in the prolonged agonist group (all >0.05). Fertilization rate and available embryo rate were comparable among the three groups (all >0.05). Considering analysis per cycle with embryo transfer, the human chorionic gonadotrophin (HCG) positive rate, clinical pregnancy rate and total implantation rate showed no significant difference among the three groups (all >0.05). The implantation rate after fresh embryo transfer in the antagonist group was lower than that in the long agonist group (<0.05), but was similar with that in the prolonged agonist group (>0.05). While the implantation rate of freeze-thaw embryo transfer showed a higher trend in the antagonist group, but there was no significant difference (>0.05). The patients were further divided into diminished and normal ovarian reserve subgroups, the per cycle with embryo transfer, the HCG positive rate, clinical pregnancy rate and total implantation rate still showed no significant difference between two subgroups (all >0.05), no matter in which ovarian stimulation protocol groups. Besides, in women with diminished ovarian reserve, the available embryo rate in antagonist group was significantly higher than that in the long agonist group (<0.05). The amount and duration of Gn application in antagonist group were significantly lower than those in long and prolonged agonist groups (all <0.05). CONCLUSIONS Patients with endometriosis who used the antagonist protocol in IVF procedure could reduce the cost and time of Gn treatment, when combined with frozen-embryo transfer strategy the antagonist protocol has comparable clinical pregnancy outcome with long or prolonged agonist protocol, especially in those with diminished ovarian reserve, the higher available embryo rate can be achieved.
Embryo Transfer ; Endometriosis ; therapy ; Female ; Fertilization in Vitro ; Humans ; Ovulation Induction ; methods ; Pregnancy ; Retrospective Studies

Objective To understand the current situation and existing problems in the training of healthcare-asso-ciated infection(HAI)management,and provide scientific basis for strengthening the management of HAI preven-tion and control system.Methods A questionnaire survey was adopted to investigate situation of training on HAI in 15 provincial-level HAI training agencies in China during the past 30 years,and basic condition of training on HAI management in recent 5 years.Results Among 15 provincial-level training agencies,66.67%(n=10)were respon-sible by HAI management quality control centers,80.00% have already conducted training in each city,53.33%carried out training for 10 to 20 times,33.34% performed training for ≤2 times per year.Of 33 728 trainees in 2011-2015,41.30% were 41-50 years old,61.82% were nursing staff,50.56% had bachelor degree,43.96%were with the intermediate professional title.Most trainers were HAI prevention and control experts in their respec-tive province,accounting for 68.07%,the curriculums were mainly designed on professional course,and only 26.78% were involved in management.Conclusion Professional structure of HAI management personnel is not reasonable,faculty is imbalance,knowledge update is lacking,and HAI training and education system need to be improved further.

Objective To summarize adverse reactions of common traditional Chinese medicine injection for the treatment of cardiovascular and cerebrovascular diseases,and put forward the countermeasures.Methods Adverse reactions of common traditional Chinese medicine injection for the treatment of cardiovascular and cerebrovascular diseases were arranged,and the reasons were analyzed.Results Adverse reactions were mainly skin and cardiovascular system diseases and so on,and were related with the quality of medicinal material,preparation process,and so on.Conclusion We should strengthen every link of production,from the medicinal plant to clinical use,improve the quality of traditional Chinese medicine injection,and strengthen the supervision to reduce the incidence of adverse reactions and ensure drug safety.