ObjectivesTo systematically review the training needs of managing staffs in tertiary hospitals in China, to understand the requirements of in-service training for hospital managing staffs, and to provide references for the target and content of tertiary hospital managing staff training.MethodsPubMed, EMbase, CNKI, WanFang Data and VIP databases were searched to collect cross-sectional studies on the training needs of managing staffs in tertiary hospitals in China. The retrieval time was from inception to July 29th, 2018. Two reviewers independently screened literature, extracted the data and descriptive analysis was conducted on the training needs of managing staffs in tertiary hospitals.ResultsA total of 11 studies were included. The results of systematic review suggested that: as for the requirements of training content, hospital management, leadership, personnel training, human resource management and innovation awareness were the most demanding training contents. As for the training methods, experience exchange, case study and topic teaching were the most popular. As for the training time, 2 to 3 days of quarterly training was the most acceptable training time.ConclusionsThere are great training requirements for managing staffs in tertiary hospitals in China, with a large amount of training content and diversity methods. In future, training objectives and methods should be designed to meet the requirements of managing staffs, so as to enhance training quality and achieve training goals.
Earthquake emergency medical rescue evidence-based decision-making is a typical case of real-world evidence deriving from real-world data, conducting real-world research, and producing real-world evidence for solving real-world problems. This article focuses on the use of evidence-based science in the real-world through a problem-oriented, evidence-based decision making way, as well as transferring of results to practice and continuing outcome evaluation.
Objective To assess the performance of post-disaster reconstruction of Yushu earthquake at the first anniversary, so as to summarize the Yushu modes of post-disaster reconstruction and provide references for reconstruction work after extreme natural disasters at home and abroad. Methods All the materials seen during the first year after Yushu Earthquake were collected, such as all documents, information notifications and work reports issued by the Central Government and the Ministry of Health, and all the information from the website of News Office of the State Council, the Ministry of Health, Qinghai Provincial People’s Government, and Xinhuanet. The literatures about Yushu Earthquake were also searched from CNKI. All the data were retrospectively analyzed to describe the reconstruction tasks and summarize the effectiveness. Results?a) The reconstruction faced upon special difficulties, including short construction time, cold climate and hypoxia, poor transport, lack of construction resources, economic backwardness, weak logistics and higher cost of reconstruction; b) The performance was significant, e.g., the government completed an investment of 5.01 billion yuan. The goal of urban and rural housing construction was fully completed. Public and municipal infrastructure construction made an important breakthrough. The projects related to livelihood were rapidly implemented. The counterpart’s education at remote was basically completed. Conclusion?As the largest reconstruction in the highest altitude area after a magnitude 7.0 earthquake, Yushu’s reconstruction learns from the experience in Wenchuan, keeps the foothold of its own features and conditions, challenges the limits of high altitude with cold and hypoxia climate, forms a post-disaster reconstruction mode with Chinese characteristics, demonstrates the speed and quality of reconstruction, and provides the valuable experience for domestic and foreign counterparts.
Objective To strengthen and improve the decision of emergency medical rescue and provide the experience for the world, the article evaluates the performance of emergency command in Yushu Earthquake.Methods All the materials seen during the first year after Yushu earthquake were collected, such as all documents, information notifications and work reports issued by the Central Government and the Ministry of Health, and all the information from the website of News Office of the State Council, Ministry of Health, State Seismology Bureau, Qinghai Provincial People’s Government, and Department of Health of Qinghai Province. The data were also searched from CNKI and descriptively analyzed after the retrospective study. Results Based on the experience from Wenchuan Earthquake, the emergency command in Yushu Earthquake was characterized by: a) Promptly starting a Level-1 response; b) Setting up and completing an integrated work mechanism of military, police and the local government; and c) Achieving an accurate command under the guidance of precise information. Conclusion As the successful precedent of large-scale medical and health rescue at the high-altitude area in the world, the experience of Yushu Earthquake supplements and enriches the Wenchuan’s, and provides references for both domestic and overseas disaster medical emergency response.
This article briefly introduces the status and problems of research and application on medical professionalism in China; proposes the concept of translational medicine and the challenges of introduction of translational medicine to physician professionalism research and translation. Some measurements or approaches to promote research translation on medical professionalisms are proposed to shorten the distance from research outcomes to practical application, in order to carry out evidence-based construction of modern medical professionalism of Chinese characteristics and build a harmonious doctor-patient relationship.
Objective To evaluate the performance of emergency medical rescue (EMR) within 1 month after Lushan earthquake, and to prove and enrich the experience from Wenchuan earthquake, so as to provide useful references for global earthquake EMR with regard to decreasing death and disability rates. Methods All the following date published within 1 month after 4.20 Lushan earthquake were collected and analyzed, including official information, public documents, news release, relevant information from websites and victims’ medical records in the West China Hospital, then the relevant domestic and foreign literature about EMR (including EMR of Wenchuan earthquake). And then comparative analysis was conducted to evaluate the performance of EMR in Lushan earthquake. Results a) Being 87 km apart from each other, the main seismic zones of Lushan and Wenchuan located in the south west and middle north of Longmenshan fault zone, respectively. Although only 1 earthquake magnitude differed between them, the disaster area, and the number of affected population, deaths, disappearances, injured, severe injured and migration population in Wenchuan earthquake were 40, 23, 353, 853, 27, 14 and 51 times higher than those in Lushan earthquake, respectively. b) Learned from Wenchuan experience, the manpower scheduling in Lushan earthquake was quicker: the assembled medical personnel peak of Lushan vs. Wenchuan was 87.62% vs. 56.06 % in golden 72 hours post-quake. c) Supplies scheduling was more rational: the utilization rate was higher under the guidance of accurate information of demand. d) Medical treatment was more rational and efficient: the critical injured were treated following “Four concentration treatment principles”; saving life and restoring function at the same time; treatment and physical-mental rehabilitation at the same time; treatment and evidence production and implementation at the same time. e) Medical institutions and service returned to normal in time: 96.7% (440/455) of government owned township medical institutions in 21 affected towns returned to normal and provided medical services at their original sites. Conclusion By learning form Wenchuan experience, the following performance is implemented in Lushan earthquake: medical rescue guided by the accurate information; supplies scheduling guided by the accurate demand; both critical injured treatment,and physical-mental rehabilitation guided by the accurate assessment of injuries. So the medical rescue within 1 month after Lushan earthquake is quicker, more rational and efficient. After 20 days post quake zero death of critical injured was achieved. The early physical-mental rehabilitation fastens the functional reconstruction of the injured and helps them return to the society. So it suggests that the Lushan EMR enriches and develops the reference value of EMR experience of Wenchuan earthquake.
Since the medical research has becomes one of the basic responsibilities of medical staff, the education of medical research ethics plays a key role in standard transformation in the study of research ethics and publishing ethics. Based on the teaching of medical ethics for medial undergraduates, this paper discusses the feasibility of research ethics as the breakthrough point of medical ethics course to cultivate the scientific thought and ethic awareness of medical students, analyzes the shortages existing in the traditional teaching of medical ethics, and finally puts forward suggestions of the construction of medical humanism coping with the rapid improvement of medical science.
ObjectiveTo investigate the effects of ezrin on transforming growth factor beta (TGF-β) mediated epithelial mesenchymal transition (EMT). MethodsHuman bronchial epithelial 16HBE cells were stimulated by TGF-β to induce EMT. The mRNA and protein levels were analyzed by RT-PCR and Western blot. Lentivirus (LV)-Ezrin-shRNA was employed to investigate the effects of ezrin deficiency on cell morphology and expressions of EMT associated biomarkers including E-cadherin, vimentin, and alpha smooth muscle actin (α-SMA). The effects of recombinant ezrin protein on 16HBE were also examined. ResultsThe expression of ezrin was down-regulated in 16HBE activated by TGF-β. Due to ezrin depletion, the cell morphology changed from a typical multilateral paving stone-like appearance to a mesenchymal-like fusiform appearance along with the decreased expression of epithelium biomarker E-cadherin and the increased mesenchymal cell markers, vimentin and α-SMA. Recombination protein ezrin increased the expression of E-cadherin whilst reducing vimentin and α-SMA. ConclusionTGF-β promotes EMT of 16HBE cells at least partly via inhibiting the expression of ezrin.
Objective To study the effect of secreted frizzled-related protein 1 (SFRP1) on airway remodeling in chronic obstructive pulmonary disease (COPD). Methods Forty-five patients with stable COPD and 21 healthy controls were collected in Jiangsu Province Hospital from June 2014 to June 2016. The level of SFRP1 in serum was detected by ELISA. The expression of SFRP1, E-cadherin and α-smooth muscle actin (α-SMA) in human bronchial epithelial cells (16HBEs) were detected by Western blot. Results The level of SFRP1 in serum of the COPD patients was significantly higher than that in the healthy controls [(80.65 ± 15.01) pg/ml vs. (23.89 ± 2.59) pg/ml, P<0.05]. There were negative correlations between serum SFRP1 levels and lung function parameters (FEV 1, FEV 1%pred, and FVC) in the COPD patients (correlation coefficient r value were –0.368 9, –0.382 6 and –0.417 3, respectively, all P<0.05). The level of serum SFRP1 in the COPD smokers was significantly higher than that in the COPD non-smokers [(97.74 ± 21.95) pg/mlvs. (52.51 ± 14.87) pg/ml, P<0.05]. The expression of SFRP1 could be up-regulated by cigarette smoke extract in 16HBEs. The expression of E-cadherin of 16HBEs was up-regulated by recombinant SFRP1, but the expression of α-SMA of 16HBEs was down-regulated by recombinant SFRP1. Conclusion SFRP1 may be involved in the pathogenesis of airway remodeling of COPD by regulating the expression of E-cadherin and α-SMA of bronchial epithelial cells.