Objective:To investigate the mediating effect of dyadic coping on the relationship between self-disclosure and fertility anxiety in women of childbearing age with thyroid cancer.Methods:A total of 258 women of childbearing age diagnosed with thyroid cancer who received treatment at the Department of Thyroid Surgery, First Hospital of Shanxi Medical University between January and October 2024 were selected using convenience sampling. Participants completed a general information questionnaire, the Chinese version of the Reproductive Concerns After Cancer scale (RCAC), the Dyadic Coping Inventory (DCI), and the Distress Disclosure Index (DDI). Structural equation modeling was constructed using SPSS PROCESS v4.1 to examine the mediating role of dyadic coping between self-disclosure and fertility anxiety. Pearson correlation analysis was used to assess the relationships among self-disclosure, dyadic coping, and fertility anxiety.Results:A total of 258 questionnaires were distributed, and 245 valid responses were collected, with an effective response rate of 94.96% (245/258). Among the 245 participants, the mean score of DDI was (37.38±8.42), RCAC was (53.54±12.53), and DCI was (117.10±29.07). Self-disclosure was positively correlated with dyadic coping ( P<0.01), while both self-disclosure and dyadic coping were negatively correlated with fertility anxiety ( P<0.01). Dyadic coping played a partial mediating role between self-disclosure and fertility anxiety, accounting for 43.38% of the total effect. Conclusions:Fertility anxiety in women of childbearing age with thyroid cancer deserves close clinical attention. Interventions should focus on enhancing patients' self-disclosure and dyadic coping abilities to effectively reduce fertility-related anxiety.

Objective:To investigate the mediating effect of dyadic coping on the relationship between self-disclosure and fertility anxiety in women of childbearing age with thyroid cancer.Methods:A total of 258 women of childbearing age diagnosed with thyroid cancer who received treatment at the Department of Thyroid Surgery, First Hospital of Shanxi Medical University between January and October 2024 were selected using convenience sampling. Participants completed a general information questionnaire, the Chinese version of the Reproductive Concerns After Cancer scale (RCAC), the Dyadic Coping Inventory (DCI), and the Distress Disclosure Index (DDI). Structural equation modeling was constructed using SPSS PROCESS v4.1 to examine the mediating role of dyadic coping between self-disclosure and fertility anxiety. Pearson correlation analysis was used to assess the relationships among self-disclosure, dyadic coping, and fertility anxiety.Results:A total of 258 questionnaires were distributed, and 245 valid responses were collected, with an effective response rate of 94.96% (245/258). Among the 245 participants, the mean score of DDI was (37.38±8.42), RCAC was (53.54±12.53), and DCI was (117.10±29.07). Self-disclosure was positively correlated with dyadic coping ( P<0.01), while both self-disclosure and dyadic coping were negatively correlated with fertility anxiety ( P<0.01). Dyadic coping played a partial mediating role between self-disclosure and fertility anxiety, accounting for 43.38% of the total effect. Conclusions:Fertility anxiety in women of childbearing age with thyroid cancer deserves close clinical attention. Interventions should focus on enhancing patients' self-disclosure and dyadic coping abilities to effectively reduce fertility-related anxiety.

The assessment of physicians'clinical competence is pivotal for fostering their professional growth and enhancing the quality of healthcare services.Despite this,a universally recognized and standardized system for as-sessing physicians'clinical competence remains to be established in China.Drawing on international practices in clini-cal competence assessment,provided a summary of the commonly utilized tools and methods for evaluating physi-cians'clinical competence.It also proposed recommendations for the development of a clinical competence assess-ment system in China.In the current practice of assessing physicians'clinical competence in China.It advocated for the establishment of a unified framework for clinical competence assessment,encouraging graded and classified as-sessments and a patient-centered,quality-improvement-oriented system for evaluating clinical competence.The uti-lization of big data will bring new opportunities for the assessment of healthcare personnel and the overall quality of medical services in China.

Objective It combines medical big data and machine learning techniques to explore clinical outcomes based clinical physician performance evaluation method.Methods The non-negative principal component analysis(NPCA)was used in cases.Based on the non-negative sparse principal component analysis(NSPCA),a comprehen-sive index fitting was performed on 11 clinical performance indicators of 170 clinicians treating cardiovascular diseases.At the same time,confidence intervals were constructed based on root cause assessment techniques to calculate the range of indicators for each clinician.Results The coincidence rate of outpatient discharge diagnosis,the rate of grade A healing of surgical incision,the proportion of surgical patients,the rate of 3-day diagnosis,the proportion of third-grade and fourth-grade surgery,the completion of surgery and the number of operations were significant in dis-tinguishing the work performance of clinicians.However,the average length of hospital stays before surgery,the rate of unplanned readmission within 30 days,the average length of hospital stays of discharged patients,the main diag-nosis and cure/improvement,and the number of patients admitted were not significant in distinguishing the clinical work performance of clinicians.The overall work performance of all clinicians can be ranked through comprehensive index fitting,and the further evaluation of high,middle and low performance of each specific index can reveal the potential reconstruction dimensions of each clinician.Conclusion It utilizes machine learning techniques to achieve a comprehensive evaluation of clinical performance,utilizing medical big data as the foundation.It holds the potential to provide important support for a more scientific and objective assessment of clinical performance.

Objective Focusing on the evaluation system of senior health professional titles in Shanghai,it discusses the rationality of the existing policies from the perspective of clinicians who plan to participate in the promotion,and put forward suggestions for optimizing the content and form of the evaluation.Methods Online questionnaire surveys had been conducted for all clinicians who participated in the application for Shanghai's senior health professional titles in 2020 to collect the personal information and their attitudes towards the professional title review system.R 4.0.2 soft-ware was used to conduct statistical description,cluster analysis,chi-square test,non-parametric test,etc.Results A to-tal of 1,674 people from 32 clinical specialties were surveyed.According to the two factors of growth space and growth speed,the participating subjects are divided into four different categories of groups,which are named according to the sample characteristics:Stars,Mainstay and Veteran.There are no differences among the three groups in the familiarity,and difficulty evaluation of clinical indicators for the senior health professional title evaluation system.The proportion of Veteran considered unreasonable is relatively high.There are differences among the three groups in overall difficulty level,scientific research difficulty and qualification difficulty.Conclusion The incentive attribute of the health technical person-nel senior title evaluation system should be continuously strengthened,and the differentiated characteristics of the de-velopment of health talents should be paid attention to.Big data can be used to highlight the quantification and differen-tiation of clinical competency evaluation indicators,which can effectively improve the scientific level of professional title evaluation.

Objective:To investigate the advantages of Da Vinci robotic thyroidectomy in treatment of the unilateral papillary thyroid microcarcinoma (PTMC).Methods:The clinical data of 49 patients with unilateral thyroid cancer admitted to the First Hospital of Shanxi Medical University from June 2018 to March 2020 were retrospectively analyzed, and they were divided into Da Vinci robotic group (the experimental group, 18 cases) and conventional surgery group (the control group, 31 cases) according to the surgical method. The clinicopathological characteristics, perioperative and postoperative related indexes changes, length of hospital stay, incidence of surgical complications, and operation cost of both groups of patients were analyzed. Visual analogue scale (VAS) was used to evaluate postoperative pain.Results:There were statistically significant differences in age, marriage and education background of both groups (all P < 0.05). There were statistically significant differences in the number of central lymph node dissection [(4.3±2.0) vs. (6.5±3.9)], operation time [198.5 min (166.3 min, 228.5 min) vs. 82.0 min (60.0 min, 102.0 min)], pain score of 24 h after surgery [3 scores (3 scores, 4 scores) vs. 2 scores (2 scores, 3 scores)], postoperative total drainage volume [49.0 ml (40.8 ml, 56.5 ml) vs. 37.0 ml, (29.0 ml, 44.0 ml)], operation cost [33,200 yuan (33,100 yuan, 34,000 yuan) vs. 5,200 yuan (4,200 yuan, 5,900 yuan)], and differences were statistically significant (all P < 0.05). No postoperative complications such as hemorrhage, fat liquefaction and subcutaneous ecchymosis occurred in all patients of the two groups. Conclusion:Da Vinci robotic thyroidectomy is safe and reliable in treatment of the unilateral PTMC, and it has good therapeutic effects.

With the population aging,the number of elderly with Alzheimer's disease or other types of dementia is increasing,which seriously threatens the health and quality of life in elderly.The early screening and detection of dementia among high-risk population and appropriate interventional measures would delay the disease course,and maintain patients' self-care abilities and dignity.Computerized neuropsychological assessment devices are economic and efficient,and suitable for screening in large population.This article reviews the theory,characteristics and application of internet-based neuropsychological assessment for age-related cognitive impairment,as well as the prospect in the future studies.

e chain-link flap is the good way in the treatment of large areas of the lower leg soft tissue defects.

AIM: To compare the effects, adverse reactions and emotion change of venlafaxine vs furazolidone for harmful alcoholics.　METHODS: Sixty-eight patients with harmful alcoholics were divided into two groups. Thirty-four patients (M34; age 37 a± s 6 a) were treated with venlafaxine, 25-50 mg, po, tid, for 8 wk. The other thirty-four patients (M34;age 38 a±6 a) with furzolidone, 0.1-0.2 g, po, tid, for 8 wk, with drinking alcohol at regular intervals during treating with furazolidone.　RESULTS: The total effective rate was 79% in venlafaxine group at 3 mo. There were no obvious adverse reactions, the anxiety disorder and depressive disorder during treating with venlafaxine. And the total effective rate was 65% in furazolidone group (P<0.05). There were obvious adverse reactions such as hypotension, myocardial ischemia, anxiety disorder and depressive disorder after treating with furazolidone.　CONCLUSION: Adverse reaction of venlafaxine on harmful alcoholics is smaller than furazolidone and the effect of venlafaxine on alcoholics is better than furazolidone.