Objective To investigate the closing method of wound after removalof the traditional pedicled abdominal flap. Methods Accordingto the design,the pedicled abdominal flaps were cut and lifted, and then the incision were extended from both sides on base of the flap to anterior superior iliac spine, respectively. After separating on superficial fascia, two flaps were obtained. The wound of donor site was closed completely by these two pedicled flaps. Twelvepatients with skin defects on hands or forearms were treated using the reformedmethod of traditional pedicled abdominal flap. Results All of the 12 reformed pedicled abdominal flaps survived, and only one had local necrosis on the distalpart of the abdominal flap, about 1.5 cm ×2.0 cm. Conclusion This new designcould provide a good method to close the abdominal wound after removal of pedicled abdominal flap.
Objects The center of Evidence Based Medicine (EBM) in China has organized several extra-curricular trainings in summer vacations for medical students, so as to enable them get involved in the practice of Evidence Based Medicine, we were wondering whether these training courses served as an effective supplement to EBM education in class and what it exactly brought to us, with a primary concern about research capability in field of EBM. Methods We conducted questionnaire survey with undergraduate students whose enrolling years range from 2001 to 2005 in West China Medical School of Sichuan University, and divided them into a stratification of five groups according to enrolling years. Then we paired the trained students with untrained ones at a ratio of 1׃2. The final number of included students was 216, of which 72 had been trained while other 144 had not. Epidata 3.0, Excel and SPSS 13.0 were used for data collecting and analyzing, respectively. Chi-square test was adopted for result interpretation. Results Compared to those without training experience, trained students were prone to choose medical specialized databases (Plt;0.05) when they search for some academic publications. In terms of selecting and quality evaluation, the trained were more dependent on systematic reviews (Plt;0.05). Meanwhile, they also showed critical thinking more than that of untrained (Plt;0.05). In addition, the fruit of published theses was in favor of those trained ones. Conclusions Those who have taken part in extra-curricular training of EBM surpass those untrained in ability of scientific research. To some extent, we are still in shortage of educational resources; this extra-curricular training course can play a complementary role for EBM education, as effective and necessary.
Objectives To describe the factors determining choice of health financing systems. Methods Search words chosen by both health policy experts and the review search coordinators after discussion and pilot. 19 electronic databases, 2 international health institutes websites, 2 grey literature databases, and search engine Google were included in the databases. Any literature about health financing reforms on country level was included. Pre-designed data extraction form was used for collecting the information. The data was analyzed and described by pre-designed analytic framework.Result A total of 59 studies were included in this review. The driving forces included political, economic, social, and health systems factors. Development level of economy was the most crucial factor for transformation of health financing systems. The health system could directly led to the transition between different health systems, both Italy and France transform their financing system from social health insurance to national health system. The key persons such as premier of Thailand and Germany, leader of political and social organization in Israel and Korea are the driving forces of health financing reforms. Conclusion Developing countries can learn from the countries which have achieved universal coverage through health financing reform. Underlying factors influencing formulation of a health financing system need to be considered before taking actions in reforming the current system. Efforts in transforming the health financing systems need to be made from political, economic, and health systems sides.
It is an inexorable trend that evidence-based medicine (EBM) is being adopted at clinical medicine education in the 21st century. EBM neurology has been developing with the progress of the world of evidence-based medicine and clinical neurology. New requirements have been proposed in neurology education with the development of EBM. The adoption of EBM in modern clinical education will be a great influence: promoting the further development of neurology, cultivating talented doctors, and improving the quality of treatment.
Ethical issues in clinical research are receiving increasing attention. The application of research projects, the registration of clinical trials and the publication of scientific researches have always been involved with ethical issues. This paper elaborates ethical development and changes in Chinese clinical research from the aspects of the development of medical ethics, the establishment of ethics laws and regulations, international certification of medical ethics committee, the advantages, challenges, opportunities and innovation and development of TCM clinical research ethics as well as the certification system of TCM research ethics.
Within the context of the "Healthy China Strategy" and the "Biology-Psychology-Society" medical model, the goals, content and methods of medical education have undergone tremendous changes. To keep up with the pace of development of medical technology and medical concepts, medical education requires major reforms, and medical teaching models requires reconstruction. Based on previous investigations and discussions and considering the West China medical education as an example, this paper summarizes the difficulties that will be faced in the transformation and reform of modern medical education and discusses and analyzes the future direction of medical education reform.
In response to the education and teaching reform, West China School of Medicine/West China Hospital, Sichuan University, initiated a general course on clinical engineering technology assessment and evaluation for the undergraduates in 2018. Through the course practice in the past two years, the number of students increased significantly, and we also achieved certain teaching achievements. At the same time, the teaching evaluation among undergraduates was excellent. Nevertheless, there are still certain deficiencies in the content of teaching, teaching methods and faculty. Therefore, this article summarizes the experience and lessons since the start of the course, and proposes corresponding teaching reform measures, providing reference for the establishment or reform of related interdisciplinary courses such as clinical engineering technology assessment and evaluation in the future.