Objective:To construct a medical student professionalism evaluation system based on the Delphi method and provide a scientific tool for evaluation of medical education and clinical practice.Methods:Based on the Accreditation Council for Graduate Medical Education, the Canadian Medical Education Directives for Specialists, and the Chinese Resident Core Competency Framework, the indicators were selected through two rounds of Delphi consultation with 11 experts. The final medical professionalism evaluation system included 29 indicators in eight categories: professional ethics, dedication, humanistic qualities, systematic improvement ability, the process of medical professionalism, personal growth and help-seeking, patient-centered care, and teamwork. SPSS 29.0 software was used for data analysis, including descriptive statistics (mean ± standard deviation), analytic hierarchy process to determine the weights, and calculation of Cronbach's α coefficient, Spearman-Brown split-half reliability coefficient (0.929), and scale-level content validity index. The significance level was set at α=0.05. Results:The expert authority coefficients for the two rounds of consultation were 0.863 and 0.867, and the variations of Kendall coefficient of coordination were all <25.00%. The final evaluation system contained eight first-level indexes (the highest weight was 14.362% for professional ethics) and 29 second-level indicators. The system demonstrated high reliability and validity (Cronbach's α coefficient=0.912, scale-level content validity index/average=0.910). Conclusions:The professionalism evaluation system for medical students constructed in this study is scientific and practical, and can provide a reference for the quality assessment of medical education. The high reliability and validity of the evaluation system suggest that it is suitable for clinical practice and teaching feedback, though further localization to align with Chinese characteristics is necessary for further refinement.

Objective:To construct a medical student professionalism evaluation system based on the Delphi method and provide a scientific tool for evaluation of medical education and clinical practice.Methods:Based on the Accreditation Council for Graduate Medical Education, the Canadian Medical Education Directives for Specialists, and the Chinese Resident Core Competency Framework, the indicators were selected through two rounds of Delphi consultation with 11 experts. The final medical professionalism evaluation system included 29 indicators in eight categories: professional ethics, dedication, humanistic qualities, systematic improvement ability, the process of medical professionalism, personal growth and help-seeking, patient-centered care, and teamwork. SPSS 29.0 software was used for data analysis, including descriptive statistics (mean ± standard deviation), analytic hierarchy process to determine the weights, and calculation of Cronbach's α coefficient, Spearman-Brown split-half reliability coefficient (0.929), and scale-level content validity index. The significance level was set at α=0.05. Results:The expert authority coefficients for the two rounds of consultation were 0.863 and 0.867, and the variations of Kendall coefficient of coordination were all <25.00%. The final evaluation system contained eight first-level indexes (the highest weight was 14.362% for professional ethics) and 29 second-level indicators. The system demonstrated high reliability and validity (Cronbach's α coefficient=0.912, scale-level content validity index/average=0.910). Conclusions:The professionalism evaluation system for medical students constructed in this study is scientific and practical, and can provide a reference for the quality assessment of medical education. The high reliability and validity of the evaluation system suggest that it is suitable for clinical practice and teaching feedback, though further localization to align with Chinese characteristics is necessary for further refinement.

Objective: To explore the linear associations between social support, coping strategies, depression, anxiety, and cognitive function among people with type 2 diabetes mellitus (T2DM) using a path-analytic method. Methods: This cross-sectional study enrolled 496 individuals hospitalized due to T2DM. Well-trained investigators conducted face-to-face interviews with the participants using the Social Support Rating Scale, the Chinese version of Medical Coping Modes Questionnaire, the Hospital Anxiety and Depression scale, and the Mini Mental State Examination to measure social support (including objective support, subjective support, and support utilization), coping strategies (including confrontation, avoidance, and acceptance-resignation), depression/anxiety, and cognitive function, respectively. A path analysis was used to elucidate the linear associations between social support, coping strategies, depression, anxiety, and cognitive function. Results: In the final path model with satisfactory model fit, objective support was found to be associated with cognitive function not only directly but also indirectly through confrontation coping and depression, and acceptance-resignation coping and depression/anxiety. Further, subjective support was found to be associated with cognitive function indirectly through depression/anxiety, as well as serially through acceptance-resignation coping and depression/anxiety. Support utilization was found to be associated with cognitive function indirectly through confrontation coping and depression, as well as through acceptance-resignation coping and depression/anxiety. Conclusion Social support, coping strategies, depression, and anxiety were associated with cognitive function among people with T2DM, and these associations were best explained by a serial mediation model from social support, coping strategies, and depression and anxiety to cognitive function.

Objective:To investigate clinical characteristics for in-stent reocclusion lesions after coronary stent implantations in aged patients.Methods:229 patients diagnosed with chronic total reocclusions were recruited from Jan 2005 to Dec 2019 in this retrospective study.According to age, patients were divided into a 40-49 year-old group(n=60), a 50-59 year-old group(n=58), a 60-69 year-old group(n=55), and a 70-80 year-old group(n=56)to examine different lesion characteristics after coronary stent implantations.Results:In the 40-49 year-old group, the 50-59 year-old group, the 60-69 year-old group and the 70-80 year-old group, the rates of multi-vessel reocclusions were 11.6%, 15.5%, 21.8% and 25.0%, respectively( χ2=10.03, P=0.01). For each group, lesions with concurrent proximal and middle coronary reocclusions accounted for 8.3%, 12.0%, 30.9% and 35.7%, respectively( χ2=11.83, P=0.005); Reocclusions with severe coronary calcification accounted for 6.6%, 15.5%, 36.3% and 37.5%, respectively( χ2=11.56, P=0.006); Long coronary reocclusion lesions(36-47 mm)accounted for 15.0%, 17.2%, 21.8% and 25.0%, respectively( χ2=11.56, P=0.007); Coronary reocclusions with diffuse long calcified lesions accounted for 8.3%, 13.7%, 32.7% and 35.7%, respectively( χ2=10.80, P=0.01). Conclusions:The clinical characteristics of in-stent reocclusion lesions after coronary stent implantations include multiple chronic total coronary reocclusions, concurrent proximal and middle coronary reocclusions, heavily calcified coronary reocclusions, long coronary reocclusions and diffuse long calcified coronary reocclusions in aged patients.

OBJECTIVES: Hypertension is a serious complication of pregnancy-related acute kidney injury (PR-AKI). This study aimed to determine the effect of hypertension on the prognosis of PR-AKI, maternal outcomes, and fetal outcome. METHODS: Patients with PR-AKI in a hospital from January 2008 to June 2018 were enrolled for this study. Patients with or without hypertension were grouped by 1꞉1 propensity matching score. The effect of hypertension on the prognosis of PR-AKI was evaluated by multivariate Cox regression before and after matching. RESULTS: Of the 30 680 women who attended the Department of Obstetrics, 126 patients were diagnosed as PR-AKI, the incidence was 0.41%. The age was (29.04±2.32) years. There were 50 cases in the hypertension group, accounting for 39.68%. Using the propensity score method, 48 pairs of patients were successfully matched, and the covariates between the two groups were balanced. After matching and adjusting for relevant clinical factors, Cox regression analysis showed that risk of end-stage renal disease (ESRD) was increased in the hypertension group compared with the normal blood pressure group (HR=2.951, 95％ CI 1.067 to 8.275, =0.034). The risk of risk of adverse maternal outcome was increased (HR=2.815, 95% CI 1.271 to 6.233, =0.009), and the risk of fetal adverse outcome was increased (HR=1.437, 95% CI 1.028 to 4.623, =0.021). CONCLUSIONS Hypertension is an independent risk factor for ESRD, adverse maternal outcomes, and adverse fetal outcomes in the PR-AKI patients.
Acute Kidney Injury ; Cohort Studies ; Female ; Humans ; Hypertension ; complications ; Incidence ; Pregnancy ; Prognosis ; Propensity Score ; Retrospective Studies ; Risk Factors