Objective:To combine the SPARK learning model with five-step questioning method, construct a new teaching regimen, and evaluate its effectiveness in the resident training in the department of thyroid and breast surgery, and to provide theoretical basis and practical reference for optimizing the training model of specialist physicians.Methods:A total of 104 clinicians in the department of thyroid and breast surgery who participated in standardized training from December 2022 to December 2024 were selected as research subjects. Based on the time of teaching reform (January 2024), 52 clinicians who participated in standardized training from December 2022 to December 2023 were included in the control group; they received the routine teaching method mainly based on the linear teaching process of "theory teaching, clinical demonstration, skill training, and case discussion", which emphasized knowledge transmission and skill imitation. The 52 clinicians who participated in standardized training from January to December 2024 were assigned to the experimental group; they received SPARK learning model combined with the five-step question teaching method. Teaching evaluation included assessment of basic theory, clinical skills, and clinical thinking as well as satisfaction with teaching. The t test and chi-square test were performed using SPSS 26.0. Results:The basic theory assessment and clinical skill assessment scores were significantly higher in the experimental group than in the control group. The scores of all thinking ability dimensions were significantly higher in the experimental group than in the control group [diagnostic decision-making: (21.85±1.15) vs. (18.35±3.42); treatment plan: (24.62±1.52) vs. (20.28±4.13); complication management: (14.82±0.73) vs. (12.17±2.53); evidence-based medicine application: (15.18±0.92) vs. (12.48±2.85); multidisciplinary collaboration: (14.95±0.83) vs. (12.73±3.08); and cost benefit analysis: (8.25±0.42) vs. (6.82±1.53)]. The satisfaction scores were significantly higher in the experimental group than in the control group.Conclusions:Through the organic combination of systematic knowledge construction and critical thinking training, the teaching method integrating SPARK learning model and five-step questioning method can significantly enhance the specialized core competence of residents in the department of thyroid and breast surgery and their decision-making ability to cope with complex clinical scenarios.

Objective:It aims to systematically evaluate the current status of knowledge,attitude,and practice(KAP)regarding universal commercial medical insurance among residents of the sample province from the demand-side perspective.Methods:Utilizing a quota sampling method,face-to-face surveys were conducted via the Questionnaire Star platform to collect demographic characteristics and KAP data of the participants.Comparisons of differences among different groups were made using t-tests,analysis of variance,and chi-square tests.Furthermore,multiple linear regression and structural equation modeling were utilized to analyze the influencing factors of KAP,as well as the pathways among these three factors.Results:Out of the 415 valid questionnaires collected,there were notable differences in KAP among respondents with diverse demographic backgrounds.Regression analysis revealed that education level,frequency of health check-ups,and engagement in other commercial health insurances significantly influenced knowledge;education level,involvement in other commercial health insurances,and self-assessed health status were pivotal in shaping attitudes;whereas age,education level,frequency of health check-ups,and participation in other commercial health insurances were critical in affecting practice.The path analysis results indicate that knowledge of universal commercial medical insurance has a significant direct association with attitude(β=0.379,P＜0.001)and practice(β=0.323,P＜0.001).It also influences practice through attitude as a mediator(β=0.016,P＜0.001),but the direct effect of attitude on practice is not significant(β=0.04,P=0.403).Conclusion:While residents in the sample province exhibit a positive attitude towards universal commercial medical insurance,there is a need to enhance their level of knowledge and engagement in practice.It is recommended to strengthen targeted educational and promotional measures to promote the healthy and sustainable development of universal insurance.

Objective:To investigate the current situation of knowledge, attitude and practice of medical personnel in areas with high incidence of fever with thrombocytopenia syndrome (SFTS) in Anhui Province, in order to provide a scientific basis for conducting systematic training for medical personnel.Methods:From July to August 2024, a multi-stage random sampling method was used to select medical personnel from village, township, county, and city level medical institutions in high incidence areas of SFTS in Anhui Province (Hefei City, Liu'an City, Chuzhou City, Xuancheng City) for an online questionnaire survey on their knowledge, attitude, and practice status. The survey included demographic data, knowledge, attitude, and practice related to SFTS, and a binary logistic regression model was used to analyze the influencing factors of SFTS knowledge qualification rate.Results:A total of 2 718 valid questionnaires were collected, with an effective response rate of 99.60% (2 718/2 729). Among them, 1 384 were males, accounting for 50.92%. The majority were medical personnel aged 41 to 50 years old, with undergraduate degrees, junior professional titles, working in township health centers or community health service centers, as clinical physicians, and with a working experience of no more than 10 years. They accounted for 31.97% (869/2 718), 50.48% (1 372/2 718), 35.54% (966/2 718), 38.52% (1 047/2 718), 62.33% (1 694/2 718), and 30.61% (832/2 718), respectively. The overall correct rates of medical personnel's relevant knowledge, attitude and practice were 77.52% (31 605/40 770), 94.53% (12 847/13 590) and 89.73% (12 194/13 590), respectively. There were statistically significant differences in the knowledge qualification of medical personnel of different genders, ages, education levels, professional titles, hospital levels, job positions, and years of work experience ( P < 0.05). The results of binary logistic regression analysis showed that professional title, hospital level, work position, and work experience were the influencing factors of knowledge qualification rate ( P < 0.05). Conclusions:Medical personnel have a relatively positive attitude and high level of practice towards SFTS, but their knowledge level still needs to be improved. It is recommended to provide targeted knowledge training for medical personnel in different positions to promote early detection, diagnosis, and treatment of SFTS.

Objective:To investigate the current practice of nasogastric tube care and the training needs among nurses in the emergency departments of tertiary hospitals in Beijing, to provide a basis for further standardizing nasogastric tube care practices.Methods:A convenience sampling method was used to select head nurses and nurses from the emergency departments of 47 tertiary hospitals in Beijing in June 2024. A self-designed questionnaire on the current practice of nasogastric tube care and training needs was administered to the participants.Results:A total of 47 emergency departments from tertiary hospitals in Beijing were surveyed, of which only 25 departments implemented nasogastric tube techniques. In the key practices of nasogastric tube care, nine hospitals met the overall implementation standards, while 16 hospitals had substandard implementation. The key practices with poor standardization included the frequency of changing the nasogastric tube dressing, blind insertion (spiral nasogastric tube) through the pylorus, the recommended temperature for enteral nutrition liquids, and the timing for flushing the nasogastric tube. There were statistically significant differences ( P<0.05) in the presence of specialized nasogastric tube care teams and the use of case discussions or workshops for department training between hospitals with good and poor implementation. Moreover, 89.5% (496/554) of the nurses indicated a need for training related to nasogastric tube maintenance, and 91.9% (509/554) expressed willingness to participate in technical training or seminars. Statistically significant differences ( P<0.05) were found between emergency specialized nurses and non-specialized nurses in terms of preferred training frequency, duration, format, and content (sharing of the latest research and advancements) . Conclusions:Nasogastric tube techniques have not been widely implemented in the emergency departments of tertiary hospitals in Beijing. The standardization of nasogastric tube care needs further improvement, and there is a significant demand for training among emergency nurses, indicating an urgent need for specialized nasogastric tube training programs.

Objective:It aims to systematically evaluate the current status of knowledge,attitude,and practice(KAP)regarding universal commercial medical insurance among residents of the sample province from the demand-side perspective.Methods:Utilizing a quota sampling method,face-to-face surveys were conducted via the Questionnaire Star platform to collect demographic characteristics and KAP data of the participants.Comparisons of differences among different groups were made using t-tests,analysis of variance,and chi-square tests.Furthermore,multiple linear regression and structural equation modeling were utilized to analyze the influencing factors of KAP,as well as the pathways among these three factors.Results:Out of the 415 valid questionnaires collected,there were notable differences in KAP among respondents with diverse demographic backgrounds.Regression analysis revealed that education level,frequency of health check-ups,and engagement in other commercial health insurances significantly influenced knowledge;education level,involvement in other commercial health insurances,and self-assessed health status were pivotal in shaping attitudes;whereas age,education level,frequency of health check-ups,and participation in other commercial health insurances were critical in affecting practice.The path analysis results indicate that knowledge of universal commercial medical insurance has a significant direct association with attitude(β=0.379,P＜0.001)and practice(β=0.323,P＜0.001).It also influences practice through attitude as a mediator(β=0.016,P＜0.001),but the direct effect of attitude on practice is not significant(β=0.04,P=0.403).Conclusion:While residents in the sample province exhibit a positive attitude towards universal commercial medical insurance,there is a need to enhance their level of knowledge and engagement in practice.It is recommended to strengthen targeted educational and promotional measures to promote the healthy and sustainable development of universal insurance.

Objective:To investigate the current situation of knowledge, attitude and practice of medical personnel in areas with high incidence of fever with thrombocytopenia syndrome (SFTS) in Anhui Province, in order to provide a scientific basis for conducting systematic training for medical personnel.Methods:From July to August 2024, a multi-stage random sampling method was used to select medical personnel from village, township, county, and city level medical institutions in high incidence areas of SFTS in Anhui Province (Hefei City, Liu'an City, Chuzhou City, Xuancheng City) for an online questionnaire survey on their knowledge, attitude, and practice status. The survey included demographic data, knowledge, attitude, and practice related to SFTS, and a binary logistic regression model was used to analyze the influencing factors of SFTS knowledge qualification rate.Results:A total of 2 718 valid questionnaires were collected, with an effective response rate of 99.60% (2 718/2 729). Among them, 1 384 were males, accounting for 50.92%. The majority were medical personnel aged 41 to 50 years old, with undergraduate degrees, junior professional titles, working in township health centers or community health service centers, as clinical physicians, and with a working experience of no more than 10 years. They accounted for 31.97% (869/2 718), 50.48% (1 372/2 718), 35.54% (966/2 718), 38.52% (1 047/2 718), 62.33% (1 694/2 718), and 30.61% (832/2 718), respectively. The overall correct rates of medical personnel's relevant knowledge, attitude and practice were 77.52% (31 605/40 770), 94.53% (12 847/13 590) and 89.73% (12 194/13 590), respectively. There were statistically significant differences in the knowledge qualification of medical personnel of different genders, ages, education levels, professional titles, hospital levels, job positions, and years of work experience ( P < 0.05). The results of binary logistic regression analysis showed that professional title, hospital level, work position, and work experience were the influencing factors of knowledge qualification rate ( P < 0.05). Conclusions:Medical personnel have a relatively positive attitude and high level of practice towards SFTS, but their knowledge level still needs to be improved. It is recommended to provide targeted knowledge training for medical personnel in different positions to promote early detection, diagnosis, and treatment of SFTS.

Objective:To combine the SPARK learning model with five-step questioning method, construct a new teaching regimen, and evaluate its effectiveness in the resident training in the department of thyroid and breast surgery, and to provide theoretical basis and practical reference for optimizing the training model of specialist physicians.Methods:A total of 104 clinicians in the department of thyroid and breast surgery who participated in standardized training from December 2022 to December 2024 were selected as research subjects. Based on the time of teaching reform (January 2024), 52 clinicians who participated in standardized training from December 2022 to December 2023 were included in the control group; they received the routine teaching method mainly based on the linear teaching process of "theory teaching, clinical demonstration, skill training, and case discussion", which emphasized knowledge transmission and skill imitation. The 52 clinicians who participated in standardized training from January to December 2024 were assigned to the experimental group; they received SPARK learning model combined with the five-step question teaching method. Teaching evaluation included assessment of basic theory, clinical skills, and clinical thinking as well as satisfaction with teaching. The t test and chi-square test were performed using SPSS 26.0. Results:The basic theory assessment and clinical skill assessment scores were significantly higher in the experimental group than in the control group. The scores of all thinking ability dimensions were significantly higher in the experimental group than in the control group [diagnostic decision-making: (21.85±1.15) vs. (18.35±3.42); treatment plan: (24.62±1.52) vs. (20.28±4.13); complication management: (14.82±0.73) vs. (12.17±2.53); evidence-based medicine application: (15.18±0.92) vs. (12.48±2.85); multidisciplinary collaboration: (14.95±0.83) vs. (12.73±3.08); and cost benefit analysis: (8.25±0.42) vs. (6.82±1.53)]. The satisfaction scores were significantly higher in the experimental group than in the control group.Conclusions:Through the organic combination of systematic knowledge construction and critical thinking training, the teaching method integrating SPARK learning model and five-step questioning method can significantly enhance the specialized core competence of residents in the department of thyroid and breast surgery and their decision-making ability to cope with complex clinical scenarios.

Objective:To investigate the current practice of nasogastric tube care and the training needs among nurses in the emergency departments of tertiary hospitals in Beijing, to provide a basis for further standardizing nasogastric tube care practices.Methods:A convenience sampling method was used to select head nurses and nurses from the emergency departments of 47 tertiary hospitals in Beijing in June 2024. A self-designed questionnaire on the current practice of nasogastric tube care and training needs was administered to the participants.Results:A total of 47 emergency departments from tertiary hospitals in Beijing were surveyed, of which only 25 departments implemented nasogastric tube techniques. In the key practices of nasogastric tube care, nine hospitals met the overall implementation standards, while 16 hospitals had substandard implementation. The key practices with poor standardization included the frequency of changing the nasogastric tube dressing, blind insertion (spiral nasogastric tube) through the pylorus, the recommended temperature for enteral nutrition liquids, and the timing for flushing the nasogastric tube. There were statistically significant differences ( P<0.05) in the presence of specialized nasogastric tube care teams and the use of case discussions or workshops for department training between hospitals with good and poor implementation. Moreover, 89.5% (496/554) of the nurses indicated a need for training related to nasogastric tube maintenance, and 91.9% (509/554) expressed willingness to participate in technical training or seminars. Statistically significant differences ( P<0.05) were found between emergency specialized nurses and non-specialized nurses in terms of preferred training frequency, duration, format, and content (sharing of the latest research and advancements) . Conclusions:Nasogastric tube techniques have not been widely implemented in the emergency departments of tertiary hospitals in Beijing. The standardization of nasogastric tube care needs further improvement, and there is a significant demand for training among emergency nurses, indicating an urgent need for specialized nasogastric tube training programs.

To explore screening tools for children with autism spectrum disorder (ASD), which are convenient for primary hospitals, it can provide basic data for formulating ASD prevention policies. This was a cross-sectional study by cluster sampling. Huyi District and Xincheng District were extracted for investigation in Xi′an City. From July 2021 to September 2022, all children aged from 3 months to 36 months who live in the two districts were subjected to primary screening. The child care physician used the routine screening tool "warning signs checklist for screening psychological, behavioral and developmental problems of children" and cartoon pictures of "early high-risk warning signs of autism", the children who were positive in the initial screening were referred to the district level maternal and child health hospital for re-screening, and those who were positive in the re-screening were referred to Xi ′an Children′s Hospital for diagnosis. The results showed that a total of 17 905 children aged from 3 months to 36 months were initially screened in the two districts, including 10 588 children aged from 18 months to 36 months, 50 children who were positive in the initial screening and 50 children who were re-screened. 23 children (18 boys and 5 girls) were diagnosed with ASD. The prevalence rate of ASD in children was 2.17‰ (95% confidence interval:1.29‰-3.06‰). 42 children were positive for "warning signs checklist" at the preliminary screening, and 19 were confirmed as ASD. 27 children were positive for "cartoon pictures" in the preliminary screening, and 23 were confirmed with ASD. The "cartoon pictures" in the preliminary screening and diagnosis of consistent rate was higher than the "warning signs checklist", two kinds of screening methods comparison were statistically significant difference in the odds of consistent (χ 2=11.01, P=0.001). In conclusion, relying on the three-level network of maternal and child health care, it is conducive to the whole process management of screening and diagnosis of children with ASD, and to guide the formulation of prevention policies. The cartoon pictures of "early high-risk warning signs of autism" can assist the identification of children with ASD based on the "warning signs checklist", which is simple, effective and suitable for promotion in the community health care.

Objective To establish an HPLC fingerprint of Dingdang Qigui Decoction and analyze and evaluate it using chemical pattern recognition technology;To determine the contents of 5 effective chemical components in Dingdang Qigui Decoction;To provide a basis for its quality control.Methods The analysis was performed on Agilent 5 TC-C18(2)column(250 mm×4.6 mm).The mobile phase comprised of acetonitrile-0.1%phosphoric acid aqueous solution with the gradient elution at a flow rate of 1.0 mL/min.The detection wavelength was set at 260 nm.The column temperature was maintained at 30℃and the injection volume was 10 μL.SPSS 26.0 and SIMCA 14.1 were used to perform clustering analysis and principal component analysis on the 10 batches of Didang Qigui Decoction.The landmark components for inter batch differences were selected through orthogonal partial least squares discriminant analysis(OPLS-DA).Results The HPLC fingerprint with eighteen common peaks of Didang Qigui Decoction in 10 batches of sample was established,and the similarities of samples were between 0.828 and 0.989.Five indicative components were identified and quantitatively analyzed by comparing with the reference substances,which were paeoniflorin,mauroisoflavone glucoside,hesperidin,cinnamaldehyde and aloe rhodopsin.The linear ranges was 10.000 0-320.000 0 μg/mL,2.500 0-80.000 0 μg/mL,10.000 0-320.000 0 μg/mL,10.000 0-320.000 0 μg/mL,0.078 1-5.000 0 μg/mL,respectively,and their mean recovery ranged from 100.30%to 104.09%.Clustering analysis and principal component analysis divided 10 batches of samples from Didang Qigui Decoction into 2 categories.Through OPLS-DA screening,hairy pistil isoflavone glycosides,paeoniflorin,and hesperidin were selected as landmark components for quality differences.Conclusion The quality evaluation method for Didang Qigui Decoction established in this study is simple,sensitive,accurate,and reproducible,which can provide a basis for the quality evaluation of Didang Qigui Decoction.