Intra-hospital transport of critically ill, mechanically ventilated patients is associated with significant physiological risks. Adaptive Minute Ventilation (AMV) is a closed-loop ventilation mode that automatically maintains target minute ventilation. While AMV has shown promise in intensive care unit settings, its performance during intrahospital transport has not yet been evaluated. This trial aims to assess the safety and efficacy of AMV compared with conventional ventilation strategies during patient transport. This is a single-centre, open-label, randomized controlled non-inferiority trial conducted at Peking Union Medical College Hospital. Fifty adult patients receiving invasive mechanical ventilation and requiring transport will be randomly assigned (1:1) to either AMV or their pre-transport ventilation mode. The primary endpoint is the change in arterial carbon dioxide pressure (PaCO₂) from 30 min before to 10 min after transport. Secondary outcomes include changes in oxygenation index (PaO₂/FiO₂), peak airway pressure, dynamic compliance, and rapid shallow breathing index. Randomization will be performed using permuted block randomization. Both intention-to-treat and per-protocol analyses will be conducted. Missing data will be handled using multiple imputation. The study protocol has been reviewed and approved by the Ethics Committee of Peking Union Medical College Hospital (Approval No. I-25PJ0781). It was registered in the Chinese Clinical Trial Registry (ChiCTR2500109659) on 23 September 2025 as a retrospective registration. This trial will be the first randomized study to evaluate AMV during intrahospital transport of critically ill patients. The findings will address an important evidence gap in transport ventilation strategies, potentially informing clinical practice on whether AMV provides a safe and effective alternative to conventional modes. By employing a non-inferiority design and standardized transport protocols, the study seeks to generate robust and clinically relevant evidence despite its single-centre setting and relatively small sample size. Approved by the Ethics Committee of Peking Union Medical College Hospital (Approval No. I-25PJ0781). Trial registration: ChiCTR, ChiCTR2500109659. Registered 23 September 2025, https://www.chictr.org.cn/hvshowproject.html?id=284847.

BackgroundThe emergency department (ED), usually deemed not the most frequent setting for palliative care (PC), has increasingly been mentioned for its potential critical role in end-of-life patient care. However, how the training affects PC performance remains to be investigated. This study aims to investigate the current PC standard of care and effectiveness of PC training in a Chinese emergency care medical consortium hospital.MethodsWe conducted an anonymous online census targeting the emergency care providers in the consortium hospital. The questionnaire included respondents’ demographics, PC knowledge, PC practice, and whether they have received any PC training. Outcome variables included: confidence in clinical implementation, perceptions about death, and attitudes toward PC implementation with Likert five score rating. Factors associated with better PC knowledge and performance were identified by analysis of the association between rating scores and participant characteristics.Results923 staff participated in the study, while 429 (46.5%) received PC training. Training participation was significantly associated with age, education, occupation, rank, working years, and experience of family members’ death (p < 0.05). Training improved the total score of knowledge and practice of PC (median 90 vs. 100, p < 0.001), the confidence in clinical PC management (confidence score: 36 vs. 40, p < 0.001), and attitudes toward PC implementation (attitude score: 37 vs. 40, p = 0.048). Offline lecture-based learning was the primary training form in this hospital. The ORs of case-based learning, online lecture video, and community training project to higher total scores were 1.94 (95% CI 1.18–3.17, p = 0.009), 2.09 (1.23–3.56, p = 0.006) and 0.17 (0.04–0.63, p = 0.008), respectively. Meanwhile, cased-based learning, online lecture video, and community training project contributed significantly to the confidence score. So did the lecture offline to the score of perception about death (perception score). The OR of meeting online to attitude score was 1.69 (1.05–2.73, p = 0.030).ConclusionPalliative care training is associated with better self-rating of PC among ED care providers. However, there is a significant gap for improvement, particularly for the community training programs.

Background Current guidelines recommend that the door-to-wire (D2W) time should be <90 min in patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). This study evaluated the effect of a 24/7 on-site PCI team strategy on the D2W time.Methods In this single-centre, retrospective study, patients with STEMI undergoing primary PCI within 1 year before (control group, n=143) and 1 year after (intervention group, n=96) implementing a 24/7 on-site PCI team strategy were enrolled. This strategy required that the PCI team was always available in hospital to minimise the time required to make the catheterisation laboratory ready for PCI. The primary endpoint was the D2W time, and the secondary endpoints were the rate of delayed PCI (D2W time ≥90 min) and the on-site time of the PCI team members. Multivariate analysis was conducted to determine the independent predictors of delayed PCI in the intervention group.Results The D2W time was shorter (52 vs 97 min, p<0.001), the rate of delayed PCI was lower (19.8% vs 55.2%, p<0.001), but the on-site time of the PCI team members (35 040 vs 9960 hours) was longer in the intervention group than in the control group. Time-to-obtain electrocardiogram >10 min (p=0.027) and time-to-make STEMI diagnosis >9 min (p=0.001) were independent predictors of delayed PCI after implementing the strategy.Conclusions Implementing a 24/7 on-site PCI team strategy was associated with reductions in the D2W time and the rate of delayed PCI but an increase in the on-site time of the PCI team members.

Recently, the incidence and prevalence of NTM have been increasing nationwide in many countries. This study aimed to identify risk factors associated with the prognosis and mortality of non-HIV nontuberculous mycobacterial disease patients. This retrospective study was conducted at Peking Union Medical College Hospital. The electronic medical records in the hospital’s database from January 2013 to December 2022 were retrospectively reviewed. Relevant data, including clinical characteristics, laboratory findings, microbiological tests, treatments, and outcomes were collected and subjected to statistical analyses. The search identified 745 patients diagnosed with NTM infection, of whom 147 met the inclusion criteria. NTM pulmonary disease was the most commonly observed (n = 93; 63.3%), followed by disseminated infection (n = 43; 29.3%). The most frequent NTM species was Mycobacterium avium complex (55.8%), followed by Mycobacterium abscessus (21.2%). The incidence of Aspergillus and Pseudomonas aeruginosa infection was significantly higher in the NTM pulmonary disease group than in the disseminated NTM group. Cumulative mortality in the total patients was 24.49% at 5 years. High Charlson Comorbidity Index (CCI), high neutrophil-to-lymphocyte-ratio (NLR), haematological disease, and disseminated infection were identified as independent predictors of unfavourable outcomes. The area under the curve (AUC) values for NLR and neutrophil-to-monocyte-plus-lymphocyte-ratio (NMLR) were 0.751 and 0.763 with optimal cut-off values of 9.50 and 3.83, respectively, for prediction of mortality in patients with NTM disease.

Azvudine is recommended for patients with coronavirus disease 19 (COVID-19); however, its optimum therapeutic time window and its impact on mortality of patients are unclear. This single-centre, retrospective study from 1 November 2022 to 27 February 2023 conducted at the Peking Union Medical College Hospital was to discuss the dosing window of azvudine and compare the prognostic impact on COVID-19 patients of azvudine use within and after the defined time window. Therapeutic time window referred to the time interval between the onset of the disease and the drug administration. 28-day all-cause mortality and the incidence of 28-day disease progression were assessed using univariate logistic regression and adjusted for covariates through multivariate logistic regression analysis. A total of 421 COVID-19 patients using azvudine and 720 patients not using any anti-SARS-CoV-2 drugs were enrolled. After propensity score matching, 302 patients treated with azvudine and 302 patients without antiviral drugs were included. Multivariate logistic regression analysis showed that the use of azvudine was significantly protective until 8 days of symptom onset for COVID-19 patients. Compared with the latter, treatment with azvudine reduced the all-cause mortality rate (OR 0.55, 95% CI 0.30-1.00) and disease progression rate (OR 0.52, 95% CI 0.29-0.93) to 28 days. The study indicated that the benefit of azvudine seemed more significant within 8 days of symptoms onset and the administration of azvudine reduced the risk of death in adult COVID-19 patients. In the future, large randomized controlled trials (RCT) studies are needed to confirm our conclusions because of the inherent limitation of single-centre, retrospective study.

Sudden cardiac arrest represents a global health challenge characterized by high mortality and morbidity rates. Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly considered as an effective treatment for cardiac arrest; however, its application remains a subject of debate. Furthermore, limited studies have analysed out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) populations within the same context. This study involved the selection of patients who experienced cardiac arrests and were supported by ECPR in 939 tertiary hospitals across 31 provinces between 2016 and 2021. The data was derived from the ECMO Quality Improvement Project. Among the 939 tertiary hospitals, a total of 6374 patients who had cardiac arrest events were identified, categorized as OHCA (1465) and IHCA (4909). Survivors in the IHCA group were comparatively younger (50 [IQR: 33–62] vs. 53 [IQR: 38–64], p < 0.001) and more likely to be female (34.2

Pathogen identification is essential in sepsis and septic shock. Metagenomic next-generation sequencing (mNGS) is a novel pathogen detection method with several advantages over traditional tests. However, the consistency between mNGS and traditional pathogen tests requires further investigation. We aimed to assess the consistency between mNGS and traditional pathogen tests and to identify the factors influencing this consistency. This systematic review and meta-analysis involved a comprehensive search of mNGS and traditional pathogen tests in PubMed, Embase, Scopus, Web of Science, and the Cochrane Library. Data from included studies were extracted, and kappa consistency between mNGS and traditional tests was calculated. Study quality was evaluated using the QUADAS-2 tool. The search identified 415 studies, of which 27 were included in the analysis, involving 4112 individuals. Meta-analysis showed a pooled consistency of 0.319 ± 0.013 (p < 0.001), indicating a moderate relationship. In terms of sample type, cerebrospinal fluid showed the highest pooled kappa consistency at 0.500 ± 0.029 (p < 0.001). Immunocompromised patients had a lower pooled kappa consistency of 0.294 ± 0.014 (p < 0.001) compared to 0.321 ± 0.028 (p < 0.001) in immunocompetent patients. Positive percent agreement of mNGS was 83.63

Acute kidney injury (AKI) is a common and serious complication in critically ill patients, significantly associated with increased mortality. This systematic review and meta-analysis evaluates the impact of protein intake on the incidence of renal adverse events in this population. We included randomized controlled trials (RCTs) comparing higher (> 1.3 g/kg/day) versus lower (≤ 1.3 g/kg/day) protein intake in adult intensive care patients. PubMed, Embase, and Web of Science were searched from 1980 to April 2025. The risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB2) tool. Random-effects models were used to calculate the pooled odds ratio (OR) with 95

This study aimed to verify whether neutrophil extracellular traps (NETs) was related to the severity of respiratory tract infections (RTI) and establish a prognostic model for severe respiratory infections. Peripheral blood mononuclear cells (PBMC) were isolated from RTI patients for RNA sequencing. Weighted Graph Co-expression Network Analysis was performed to identify gene modules and analyze the correlation between gene modules and clinical features. The prognostic model was established by LASSO regression. The concentration of IL-8 in plasma was measured by Enzyme linked immunosorbent assay (ELISA). The gene expression levels in PBMC were detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR). In total, 120 patients with RTIs were enrolled between July 2022 and March 2024. Enrichment analysis showed that NETs formation was enhanced during the early stages of pneumonia and sepsis. IL-8 had the strongest correlation with NETs formation, and the concentration of IL-8 in the plasma of patients with sepsis was significantly higher than that in patients with pneumonia and healthy controls (p < 0.001). NET-related genes were positively correlated with the SOFA score and 7-category ordinal scale. The expression level of MPO and PADI4 in sepsis patients were higher than that in community-acquired pneumonia (CAP) alone and healthy controls. The AUC of the prognostic prediction model for severe CAP composed of two genes (PADI4-CD177) showed the best performance, with an AUC of 0.917. This study confirmed that NETs formation was activated in RTI and the 2-gene signature provided a rapid and highly accurate biomarker for predicting the prognosis of severe CAP, which awaits further verification in a prospective cohort.

BACKGROUND:Cytomegalovirus infection manifests varying clinical characteristics and severity in diverse populations with different immune statuses. The signs and symptoms of gastrointestinal involvement are nonspecific. Here, we present a case of cytomegalovirus colitis in an immunocompetent adolescent, which manifested as intestinal pseud-obstruction.CASE PRESENTATION:A 15-year-old man who had contracted novel coronavirus infection one month earlier was admitted to our hospital with fever, abdominal pain, and hematochezia. His abdomen was distended, and laboratory evaluation revealed a decrease in the blood count, an increase in inflammatory indicators and hepatic impairment. Imaging shows bowel wall thickening and dilatation of the colon. A diagnosis of intestinal infection combined with acute intestinal pseud-obstruction was made. Diarrhea persisted despite conservative treatment with empirical antibiotics. A colonoscopy was performed. Pathology confirmed cytomegalovirus infection. Ganciclovir therapy was initiated, and subsequent review showed a good recovery.CONCLUSIONS:The case was diagnosed as cytomegalovirus colitis. We reviewed the reports of 9 cases of bowel obstruction, including our own, and found that the majority of the adult patients were elderly with underlying disease. Clinical and endoscopic manifestations are typically nonspecific, and imaging shows typical signs of intestinal obstruction. The final diagnosis was confirmed by pathology. Most of them have a good prognosis. We suggest that cytomegalovirus colitis can also lead to intestinal obstruction and that viral reactivation in immunocompetent individuals may be associated with inflammatory conditions and viral coinfection, particularly with the novel coronavirus.

Background. High-quality chest compression (CC) is the crux of survival for cardiac arrest patients. While, rescuers’ position setting relative to patients during CC was unrecommended in the present guidelines. We aimed to assess the impact of position settings on CC quality during cardiopulmonary resuscitation (CPR) and to test the heterogeneity related to rescuers’ characteristics. Methods. We conducted randomized, crossover, simulation trials with clinical students unfamiliar with CPR. The participants received standard training on performing CC and were divided randomly into two groups. The two groups separately performed CC with standing and kneeling positions in turn, forming the crossover design. The trials were performed with standard manikin models. CC quality indicator data were recorded by the tracking and feedback system automatically. Result. 156 participants finished at least one round of trial, with 126 participants finishing both rounds. Records for CC with kneeling and standing positions showed statistically significant differences in the correct rate, pause happening, average depth, and happening of over-depth compression. Regression analysis also implied that larger compression depths with the standing position were related to larger height and BMI of the participants. Conclusion. When performing CC, the standing position will lead to lower CC quality by larger chance of pause happening and over-depth compression. In addition, compression depth gaps between CC with kneeling and standing position were related with rescuer characteristics including height and BMI, with a threshold effect.

Background Chylopericardium is a rare condition characterized by the accumulation of chyle in the pericardial space. It is most commonly caused by thoracic duct injury. Chylopericardium following esophagectomy is extremely rare but can cause life-threatening complications. This report presents a case of chylopericardium post-esophagectomy, resulting in cardiac tamponade and cardiac arrest. A systematic literature review was also conducted to facilitate the understanding of this rare condition. Case presentation A 41-year-old male was admitted to our hospital with intermediate to highly differentiated squamous cell carcinoma of the mid-thoracic esophagus (clinical T4NxM0). He underwent thoracoscopic-laparoscopic esophagectomy with cervical anastomosis. On postoperative day 1, patient had a cardiac arrest secondary to cardiac tamponade, requiring emergency ultrasound-guided drainage. The drained fluid was initially serous but became chylous after the administration of enteral nutritional emulsion. As a result of significant daily pericardial drainage, patient subsequently underwent thoracic duct ligation. The amount of drainage was substantially reduced post-thoracic duct ligation. Over a period of 2 years and 7 months, patient recovered well and tolerated full oral diet. A comprehensive literature review was conducted and 4 reported cases were identified. Among these cases, three patients developed pericardial tamponade secondary to chylopericardium post-esophagectomy. Conclusion Chylopericardium is a rare but serious complication post-esophagectomy. Prompt echocardiography and thorough pericardial fluid analysis are crucial for diagnosis. Thoracic duct ligation has been shown to be an effective management approach for this condition.

Abstract Background: In recent years, the incidence of Nontuberculous mycobacteria (NTM) disease has been increasing worldwide. This study aimed to identify risk factors affecting the prognosis and mortality of non-HIV NTM patients. Methods: This retrospective study was conducted at Peking Union Medical College Hospital. The electronic medical records in the hospital’s database from January 2013 to December 2022 were retrospectively reviewed. Relevant data, including clinical characteristics, laboratory findings, detected microorganisms, treatments, and outcomes were collected and subjected to statistical analyses. Results: The search identified 745 patients diagnosed with NTM infection, of whom 147 met the inclusion criteria. Pulmonary NTM was most commonly observed (n=93; 63.3%), followed by disseminated infection (n=43; 29.3%). The most frequent NTM species was Mycobacterium avium complex (55.8%), followed by Mycobacterium abscessus (21.2%). The incidence of Aspergillus and Pseudomonas aeruginosa infection was significantly higher in the pulmonary NTM group than in the disseminated NTM group. Cumulative mortality in the total patients was 24.49% at 5 years. High charlson comorbidity index (CCI), high neutrophil-to-lymphocyte-ratio (NLR), hematological disease, and disseminated infection were identified as independent predictors of unfavorable outcomes. The area under the curve (AUC) values for NLR and NMLR were 0.751 and 0.763 with optimal cut-off values of 9.50 and 3.83, respectively, for prediction of mortality in NTM patients. Conclusions: High CCI, high NLR, hematological disease, and disseminated infection were identified as independent predictors of mortality in non-HIV NTM patients.

The study was to evaluate the clinical outcomes of azvudine versus nirmatrelvir-ritonavir against omicron strains of coronavirus disease 2019 infections and determine their comparative effectiveness. This retrospective study included 716 patients who received nirmatrelvir-ritonavir (NR group) or azvudine (FNC group) at Peking Union Medical College Hospital between 1 November 2022 and 27 February 2023. Patients in the FNC group (n = 304) were younger, exhibited less severe symptoms, started antiviral therapy later, received corticosteroids more frequently, and used tocilizumab less frequently than patients in the NR group (n = 412). Within 28 d of therapy, 40 (9.7%) and 20 (6.6%) deaths were in the NR and FNC groups, respectively. No differences were observed between drugs and mortality rates (odds ratio [OR] 0.78, 95% CI 0.40-1.5, P = 0.45), clinical improvement (OR 0.79, 95% CI 0.79-1.3, P = 0.38), and clinical progression (OR 1.0, 95% CI 0.58-1.8, P = 0.96). More patients in the NR group experienced platelet decline than those in the FNC group (17.6% vs. 8.9%, P = 0.034). This study indicated that the effectiveness and safety of azvudine were comparable to those of nirmatrelvir-ritonavir.

晨间报告(简称晨报)是一种基于临床案例开展的小型教学讨论会,本质是案例教学法在住院医师规范化培训阶段的应用.该文结合《住院医师规范化培训晨间报告实施指引(2022年版)》(简称《晨报实施指引》)的主要内容,对晨间报告的定义、目的、实施准备、实施步骤等进行解读.同时,分析了晨报与临床病例讨论的异同、指导医师在晨报中的作用、如何保证晨报质量、如何凸显以住院医师为中心等核心问题,帮助指导医师在深入理解《晨报实施指引》的基础上,更有效地组织和实施这一教学活动.

ObjectiveTo evaluate the impact of the "point to downstream hospital multi-department" emergency medical consortium model between Peking Union Medical College Hospital (PUMCH) and Beijing Longfu Hospital on the treatment of critically ill patients.MethodsClinical data of ICU patients at Beijing Longfu Hospital from December 2018 to November 2020 were retrospectively collected. The patients were categorized into two groups based on whether the emergency medical consortium was established: the pre-establishment group (December 2018 to November 2019) and the post-establishment group (December 2019 to November 2020). Clinical data, disease spectrum, examination/treatment utilization, and in-hospital mortality were compared between the two groups.ResultsA total of 350 ICU patients meeting the inclusion and exclusion criteria were included in this study. The pre-establishment group comprised 126 patients, while the post-establishment group had 224 patients(including 162 transferred via the consortium). In the pre-establishment group, the disease spectrum primarily consisted of common critical illnesses, with the top three diseases being acute cardiovascular diseases (34.1%), severe pneumonia (25.4%), and post-surgical cases (19.0%). In the post-establishment group, there was a greater diversity in the disease spectrum, with the top three diseases being severe pneumonia (31.2%), renal dysfunction (13.8%), and acute cerebrovascular disease (9.8%). Compared to the pre-establishment group, the post-establishment group had a lower average age [68.50(57.00, 79.00) years vs. 78.00(68.25, 84.00) years, P < 0.001], higher acute physiology and chronic health evaluation Ⅱ score [18.00(14.00, 24.00) points vs. 15.00(12.00, 22.75) points, P=0.005] and sequential organ failure assessment (SOFA) score [5.00(3.00, 7.25) points vs. 3.00(2.00, 6.00) points, P < 0.001], higher rates of central venous catheterization (52.7% vs. 20.6%, P < 0.001), continuous renal replacement therapy(22.3% vs. 4.0%, P < 0.001), vasoactive drug use (21.4% vs. 11.9%, P=0.037), and epinephrine usage (17.0% vs. 7.1%, P=0.015), and hospital stay [(11.61±9.41)days vs. (10.06±7.63)days, P=0.260], hospital costs [(18 982.35(9251.80, 51 677.59) CNY vs. 39 113.11(19 500.03, 68 981.90) CNY, P=0.067], and in-hospital mortality (12.1% vs. 10.3%, P=0.753) showed no significant changes. Furthermore, after the establishment of the emergency medical consortium, the ICU of Beijing Longfu Hospital admitted and treated 25 cases of difficult-to-treat patients (no difficult-to-treat patients were seen before the establishment of the emergency medical consortium) and used a number of new technologies, including bedside bronchoscopy in 9 cases and bedside ultrasound examination in 105 cases. Multivariable Logistic regression analysis results indicated that after adjusting for factors such as age and SOFA score, the establishment of the emergency medical consortium had no significant impact on in-hospital mortality among ICU patients ( OR=0.994, 95% CI: 0.401-2.464, P=0.990). ConclusionsAfter the establishment of the "point to downstream hospital multi-department" emergency medical consortium between PUMCH and Beijing Longfu Hospital, the complexity and severity of diseases treated in Beijing Longfu Hospital's ICU increased, but the in-hospital mortality rate did not significantly rise. The emergency medical consortium model may contribute to enhancing the capacity for treating critically ill patients in downstream hospitals.

Boerhaave syndrome is a rare but potentially life-threatening condition that involves a full-thickness tear of the oesophagus. It accounts for around 15% of all cases of oesophageal perforations and is associated with up to 40% of mortality. Vomiting has been found to be associated with the development of Boerhaave syndrome. However, the aetiology of vomiting varies broadly in the available literatures from alcohol indulgence to marathon running, and from panic attack to radiotherapy for cancer. We present here an unusual case of Boerhaave syndrome where the patient developed spontaneous oesophageal perforation in the setting of renal colic.

目的 探讨医学生从传统医学课程阶段过渡到临床环境下急诊临床实践阶段的自我调节学习的改变,为优化课程体系及探索新的教育教学方法提供方向.方法 通过问卷调查及深入访谈的方法,应用自我调节学习量表,采用Likert量表的6级进行计分.评估共118名医学生,包括北京协和医学院临床医学专业八年制本科生在传统医学课程阶段、急诊临床实践阶段及临床医学专业"4+4"改革试点班急诊临床实践阶段,自我调节学习的情况及相关影响因素.采用SPSS 23.0进行单因素方差分析.结果 北京协和医学院八年制医学生,男48人(占40.7%),女70人(占59.3%).对八年制传统医学课程阶段、八年制急诊临床实践阶段及"4+4"试点班急诊临床实践阶段3组进行分析.结果 显示,八年制急诊临床实践阶段较八年制传统医学课程阶段自我调节学习总分下降[(326.2±31.9)vs.(347.7±40.2)].对自我调节学习各分量表分别进行分析,在学习动机分量表中,外在目标设定方面,八年制急诊临床实践阶段低于八年制传统医学课程阶段[(8.9±2.3)vs.(10.0±2.9)],"4+4"试点班急诊临床实践阶段高于八年制急诊临床实践阶段[(11.0±3.5)vs.(8.9±2.3)];在学习策略分量表中,3组差异无统计学意义;在资源管理分量表中,八年制急诊临床实践阶段较八年制传统医学课程阶段在时间和学习环境[(6.5±1.1)vs.(7.5±1.9)]、学习管理[(37.7±4.0)vs.(40.3±3.0)]及学习求助[(32.7±5.3)vs.(37.5±9.5)]方面显著下降,"4+4"试点班急诊临床实践阶段较八年制急诊临床实践阶段在学习管理[(40.2±7.3)vs.(37.7±4.0)]及学习求助[(38.7±7.6)vs.(32.7±5.3)]方面显著增加.结论 临床医学专业医学生从传统医学课程阶段过渡到急诊临床实践阶段,自我调节学习发生明显改变.外在目标设定下降及资源管理减少,可能是八年制医学生在临床环境下急诊临床实践阶段自我调节学习降低的重要原因.

该文介绍了《住院医师规范化培训教学阅片指南(2022年版》(简称《教学阅片指南》)的发布背景与意义,分析了目前教学阅片实践中的主要问题.参照《教学阅片指南》 的章节顺序,对教学阅片的目的、组织安排、准备、实施、评价和反馈及注意事项等进行了详细的论述,帮助指导医师在深入理解《教学阅片指南》 的基础上,有效地组织和实施这一教学活动,提升教学效果,达成教学目标.