医疗保险总额预付试点三级医院患者就医感受调查

目的 调查上海市实行医疗保险总额预付的三级医院中患者的就医感受。方法 经培训的调查员应用结构式调查问卷对上海市10家实行医疗保险总额预付的三级医院的699名患者进行面对面访谈，数据分析主要采用描述性统计。结果 城保患者对门诊医生明显减少处方金额（或处方天数）的感受强于非城保患者，城保和非城保患者的住院就医感受差异无显著统计学意义。结论 医疗保险总额预付对上海三级医院患者就医感受的总体效应似偏弱，而且有限的影响主要集中于门诊而非住院环节。     

Neotypification of the genusTrichosporon

The currently accepted type species of the genusTrichosporon Behrend isT. beigelii. This species has formerly been regarded as identical toT. cutaneum. However, these fungi are now known to represent separate species with different ecology. The first species described inTrichosporon wasT. ovoides, an agent of human white piedra. A neotype strain is designated for this species, while a lectotype strain is indicated forT. cutaneum. The nameT. beigelii is considered as doubtful and consequently cannot be maintained.     

INVITED SPECIAL PAPER: History of the botanical teaching laboratory in the United States

The establishment of teaching laboratories for botany in the United States was strongly influenced in the early part of the 19th century by the founding of a laboratory of natural history at the Rensselaer School by Amos Eaton who inspired numerous educators, particularly women. By midcentury and later, botany programs were established at land-grant colleges and the so-called “new Botany” movement spread from them. In the latter part of the century additional changes were brought about by the influence of German laboratory activity and botanists’ reactions to the introduction of the Huxley-Martin biology programs to America. During these times, Americans were improving their own manufactured microscopes, laboratory supplies, and equipment capabilities. By the beginning of the 20th century, laboratory teaching of botanical subjects was widely accepted as normal in universities and colleges, as well as in some high schools.     

Ethical obligation and legal requirements: On informed consent practices in Bangladesh

Informed consent to medical intervention is fundamental in both ethics and law. But in practice it is often not taken seriously in developing countries. This paper provides an appraisal of informed consent practices in Bangladesh. Following a review of the ethical and legal principles of informed consent, it assesses the degree to which doctors adhere to it in Bangladesh. Based on findings of non-compliance, it then investigates the reasons for such non-compliance through an appraisal of informed consent practices in Bangladesh and provides recommendations aimed at improving such practices. The significance of this paper lies in unveiling the interdependence between the ethical and legal traits of informed consent and their ramifications on strengthening the patient-oriented approach of duty to care.     

任务驱动法在“微生物学实验”混合式教学中的实践

通过“微生物学实验”课程多年来的混合式教学实践发现,学生的主动性是学习效果的核心要素。鉴于在以往的教学实践中,无论采用何种教学手段,总有部分学生的学习主动性不能得到体现。我们近年来采用轮流组长责任制下的任务驱动教学法,极大地调动了所有学生的学习动力。每位学生在担任组长工作时从课前任务、课堂执行、课后总结等方面都发挥了重要作用,而不担任组长时也会积极主动地配合组长工作。最终,实验课程学习成绩优秀率占比、体现素质能力培养的成绩分项都显著提升。同时,课程教学也收获了良好的学生认可和反馈。     

Prevalence of transthyretin cardiac amyloidosis in elderly patients diagnosed with heart failure

ObjectiveThere is increased interest in studying ATTR-CA, a pathology that primarily affects patients of geriatric age and is frequently underdiagnosed. We aim to establish the prevalence of ATTR-CA in a cohort of patients with a history of HFpEF and to describe its characteristics.MethodsWe conducted a prospective observational study. Patients ≥75 years, clinical history of HFpEF, atrial dilation ≥34 ml/m² and left ventricular wall thickening >13 mm, were included. Demographic and analytical parameters were collected, and a comprehensive geriatric assessment was performed, along with a transthoracic echocardiogram and cardiac scintigraphy. Finally, telephone follow-up was carried out at 6 and 12 months.Results50 patients were recruited, mean age 86 ± 6 years, 54% women. Age and functional class (I–II vs. III–IV) were factors associated with presenting with ATTR-CA. Patients with positive scintigraphy had a median time to admission of 5.2 months (confidence interval [CI] 95% 0–10.9), while in those with negative scintigraphy, it was 12.2 months (95% CI 11.7–12.8); log-rank: p = 0.064. Patients with positive scintigraphy had a median time to the combined endpoint (death and readmission) of 1.9 months (95% CI 0–6.1), and patients with negative scintigraphy of 11.9 months (95% CI 11.7–12); log-rank: p = 0.027.ConclusionsATTR-CA appears to be a prevalent etiology in elderly patients within the spectrum of HFpEF. Patients with a diagnosis of ATTR-CA had a shorter time to admission for HF and the combined event of death and admission than patients with a negative result on scintigraphy.     

“环境工程微生物学”线上线下混合式教学的改革与实践

“环境工程微生物学”是环境工程专业的一门基础课程,但由于环境微生物学概念抽象、内容繁冗,大部分学生在课堂上注意力不集中,难以理解和应用生物氧化过程、微生物在环境工程中的作用等内容,教学效果较差。为提高学生的学习效果和教师的教学感受,基于超星泛雅网络教学平台,对环境工程微生物学的教学内容、教学方法、考核方式等进行线上线下混合式教学改革与实践。实践结果表明改革后的课程激发了学生内在学习的动力,使学生具有了自学和继续学习的能力,在知识、能力、素质这3个方面取得了成效,并有效提升了学生的专业能力和综合素质;同时,课程教师的教学方法、教学能力、教学感受以及信息技术均得到提升和改进,加强了课程创新实践,提升了环境工程类专业课程的教学质量。     

制药工程“微生物学实验”课程的项目化教学探索与实践

为了培养学生的自主学习能力和实践创新能力,按照工程教育专业认证要求基于成果导向教育(outcome based education, OBE)理念设计课程教学,将制药工程微生物学实验课实验教学项目设置成入门、进阶和自主3种项目等级。实验项目内容由浅入深、逐级递进、层层相关,教学过程以学生为中心,并结合线上教学手段和竞赛机制的支持。实践结果表明,经过项目化教学改革,在教师教学和学生学习成效两个方面均得到明显提升,学生在论文撰写能力、动手能力等方面也有了明显的进步,值得后续进一步总结和推广。     

News from the Biological Stain Commission No. 12

Abstract

In this 12^th issue of News from the Biological Stain Commission (BSC) under the heading of Regulatory affairs, the Biological Stain Commission’s International Affairs Committee presents information from the meetings of ISO/TC 212/WG 1 Quality and competence in the medical laboratory and ISO/TC 212/WG 3 In vitro diagnostic products both held on 2 – 3 June 2010, plus information on the second plenary meeting of ISO/TC 212 Clinical laboratory testing and in vitro diagnostic test systems held on 4 June 2010. All meetings took place in Seoul, Republic of Korea. Finally, information is provided concerning the 25^th meeting of CEN/TC 140 In vitro diagnostic medical devices held on 23 June 2010 in Berlin, Germany.     

What is the best age to circumcise? A medical and ethical analysis

Circumcision is often claimed to be simpler, safer and more cost-effective when performed in the neonatal period as opposed to later in life, with a greater benefit-to-risk ratio. In the first part of this paper, we critically examine the evidence base for these claims, and find that it is not as robust as is commonly assumed. In the second part, we demonstrate that, even if one simply grants these claims for the sake of argument, it still does not follow that neonatal circumcision is ethically permissible absent urgent medical necessity. Based on a careful consideration of the relevant evidence, arguments and counterarguments, we conclude that medically unnecessary penile circumcision—like other medically unnecessary genital procedures, such as ‘cosmetic’ labiaplasty—should not be performed on individuals who are too young (or otherwise unable) to provide meaningful consent to the procedure.