Objective:To discuss the application and effects of blended learning (B-Learning) mode in medical courses and education at home and abroad.Methods:Based on the identified keywords, the research retrieved 93 relevant literature from 2000 to 2017 in journal databases (e.g. Premier, Cinahl and Medline), and published journals. After two rounds of analysis, 19 domestic and foreign literature were obtained, which evaluated the application and teaching effects of the B-Learning mode in the context of medical education. Among them, there were control studies and qualitative studies.Results:There are differences in the implementation and implementation of the B-Learning model in various countries; the teaching intervention measures and the scope of intervention of the B-Learning teaching model are diverse; the B-Learning model can make up for the gap between the theoretical and practical courses in the medical education process. It helps medical students to master their knowledge and improve their clinical skills; it is necessary for teachers to carefully design teaching courses and teaching research before class to improve the teaching effect of B-Learning.Conclusion:Combining modern educational technology with traditional teaching methods can effectively improve the medical knowledge level and clinical practice skills of medical students.

目的:基于形式概念分析方法挖掘针灸治疗肩痹的选穴规律.方法:以《430种疾病针灸表解》为数据源,从证型、腧穴两方面收集肩痹数据,建立肩痹处方数据库,运用形式概念分析法,采用Lattice Miner软件进行数据挖掘和规则提取.结果:针灸治疗肩痹的核心腧穴为肩髃、肩髎、合谷、肩井、臑会、秉风;应用频次最高经络为手阳明大肠经、手少阳三焦经、手太阳小肠经;在所提取规则中,肩髎-合谷、肩髃-合谷支持度最高,其次是肩髃-肩髎、肩髃、肩髎-合谷.结论:通过数据挖掘发现针灸治疗肩痹以手三阳经为主,选穴原则以近部取穴为主,搭配远部取穴,重视"近部取穴-远部取穴-辨证取穴"相结合.本研究将形式概念分析应用于中医数据挖掘,可有效发现中医诊疗数据中所隐含的潜在知识,为中医临床治疗选穴规律发现提供理论支持与科学依据.

目的 利用文献计量分析方法探索患者相似性的研究热点领域.方法 使用VOSviewer软件对检索库中有关患者相似性文献进行分析,分别从发文量、发文期刊、作者合著网络、热点研究领域等方面进行统计分析.结果 国际上患者相似性文献量整体呈上升趋势,发文量最多的国家为美国.主要的热门研究领域有电子健康档案、疾病预测、相似性方法和精准医学,且随着个性化时代的到来,研究人员越来越关注精准医学领域.结论 近年来,患者相似性热点研究领域不断扩大,精准医学新兴研究热点突出,相似性研究方法趋于综合性.

Objective:To apply the B-learning teaching mode into the Medical Statistic course, and to comparatively analyze the students' knowledge, attitude, and practice (KAP). Methods:In this study, undergraduates were investigated by self-designed questionnaires, and the reliability and validity of the questionnaire were evaluated. SAS 9.3 statistical software was used to analyze the KAP evaluation and the influencing factors of online learning with chi-square test, t test and multiple regression analysis. Results:There were significant differences in students' cognitive status in three aspects: the role of online videos ( P=0.012 9), whether to submit assignments ( P=0.040 7), and whether to participate in discussions ( P=0.009 4). In terms of attitude, there were significant differences between the role of B-learning process ( P=0.027 1) and online learning interest ( P=0.013 7). And in the terms of practice, there were significant differences in the time of online learning ( P=0.002 4), weekly login times for online learning ( P=0.015 4) and ways to solve difficulties ( P=0.004 5). Conclusion:The B-learning mode applied to the course of Medical Statistics has greatly improved students' ability in knowledge, attitude and practice (KAP), and achieved good teaching effects.

通过分析国内外大数据统合、分析、预测技术的研究现状,提出在健康医疗大数据驱动下,疾病风险与预测数据分析存在的问题,在应用层面探析用于居民健康危险因素识别与高危人群发病风险预测的方法与技术.旨在为改善人口健康,实现"健康中国2030"全民健康目标,探索提出新型高效的科学途径和对策.

目的 探索当前"医养结合"养老服务模式的实施现状方法 采用问卷法、访谈法等对淄博市医养结合的养老模式实施现状进行调研.结果 588名调查对象中,愿意选择医养结合的老人占62.59％,调查表明医疗保健(OR=1.035)、护理服务(OR=1.008)、同住老人的友善(OR=1.025)、是否纳入医疗保险体系(OR=1.012)是影响城乡居民养老机构选择重要因素.结论 期望提高护工专业水平和服务态度,重视老年人心理健康保健,提高老人的生活资量."医养结合"新型养老模式是老龄化社会养老发展的必由之路,必将成为养老服务业发展的重要方向.

This paper uses the network platform of questionnaire and We Chat social media to carry out the questionnaire, uses the IBM SPSS 22.0 software to carry out the statistical analysis, and uses statistic description, regression analysis and other statistical methods to carry out the data analysis, the results show that the recommended time of recommendation system and user's performance expectation can significantly affect the accept willingness and adoption behavior, user privacy consciousness can significantly influence users' accept willingness of recommend information, finally, proposes a personalized recommendation service development strategy from two aspects of system angle and user angle.

大数据时代背景对教育领域产生颠覆性的作用,网络环境下大学生的社交模式由传统向新型模式转型.采用问卷调查法、访谈法收集资料进行数据分析,发现大学生学习模式由传统的灌输式到主动获取信息,由传统学习媒介转向多样化的学习媒介.新型学习模式的建立逐渐取代传统学习模式,大数据时代的技术革新迎来新一轮教育模式变革,将高等教育事业向前推进一大步.

Objective To analyze the current situation of reform on medical insurance payment mode in county-level public hospitals,discover problems on payment reform and propose recommendations for county-level public hospitals.Methods Questionnaires and field research are used to collect data,and soft SPSS19.0 are used to make data analysis.Results Among these county-level public hospitals in Shandong Province participating in the reform of first and second batches,there are 160(92.5％) hospitals carrying out health insurance payment reform,and health insurance payment is in still a single way.26.2％ and 11.4％ disease categories are over 50 diseases in disease limited price payment and disease quota payment hospitals.63.8％ medical institutions' assessment results are related with medical payment.Conclusion According to the results,it is necessary to promote the method of multiplex payment,and increase the number of diseases payment according to the disease categories.During the process of reforming of medical payment,it is necessary to overcome tripartite resistance coming from "medical,insurance,and suffering".This will play a positive role on multiple forms of payment of medical institutions.

目的 通过对乡镇卫生院投入产出指标的分析,掌握新农合制度下农村基层医疗服务效率现状,更好地评价基层医疗服务质量,促进农村基层医疗服务质量的提高.方法 采用随机抽样的方法抽取烟台8个县16个乡镇卫生院,对相关数据进行数据包络分析.结果2013—2015年3年间各卫生院医疗服务效率平均值均在0.95以上,说明在新农合制度下,乡镇卫生院能够较好的服务当地的人民群众. 但烟台市医疗服务质量发展不平衡,16个卫生院在3年内的48个计算结果中,共有27个数据包络分析有效,有效率为56.25%,并且县区a和县区g 3年内医疗服务质量均处于有效水平,县区c3年内均未达到有效水平.在一定程度上反映,经济较为发达的地区农村基层医疗服务质量较好.结论 当前烟台市乡镇卫生院服务效率存在明显地区差异,存在进一步提升空间,需进一步加大管理力度,提高医疗卫生资源配置效率.

目的 调查5所三甲医院住院患者对入院流程的满意度,并分析患者入院流程满意度影响因素,以期为进一步提高医院服务质量提供参考.方法 对黑龙江省5所三甲医院住院患者进行入院流程满意度问卷调查,采用多元线性回归分析满意度影响因素.结果 住院患者入院流程总体满意度得分为4.43±0.60,乡镇患者入院流程满意度低于城市患者(β=-0.166 9);再次住院患者入院流程满意度低于首次住院患者(β=-0.101 9).结论 医院需加强院内指示标志的覆盖范围及导诊服务,提供一站式入住院办理服务,加强患者入院教育,注重持续改进医院入院流程.

目的 探讨沿海地区老年人群骨质疏松性骨折的影响因素,分析老年人骨折危险因素的分布特点,为预防和降低老年人群骨质疏松性骨折发生提供科学的理论依据和支持.方法 对沿海地区老年人群进行问卷调查,探讨基本人口学特征、膳食特点、运动习惯、既往病史等指标因素与骨质疏松性骨折之间的相关性.使用IBM SPSS 22.0软件采用统计描述、假设检验、logistic回归等统计学方法进行分析.结果 多因素logistic回归分析表明年龄(OR=2.831)、体重指数(OR=-2.943)、吸烟(OR=1.874)、饮酒(OR=2.377)、吃豆制品(OR=-3.398)、喝牛奶或酸奶(OR=-3.254)、户外运动(OR=-1.592)、高血压(OR=1.719)等八项指标是影响沿海城市老年人骨质疏松性骨折发生的主要影响因素.其中,体质指数、经常吃豆制品、经常喝牛奶或酸奶及户外运动为骨折的保护因素,而年龄、吸烟、饮酒和高血压史是骨折的危险因素.结论 沿海地区老年人骨折与性别、体重指标、饮食因素、生活习惯等多方面因素有关,应控制适当体重、调节健康饮食、调整良好生活习惯,以有效预防沿海地区老年人(特别是老年女性)骨质疏松症及骨折.

Objective The aim of this study is to assess the associated factors of Henoch-Schonlein purpura( HSP) in Chinese children. This study has important public implications for developing strategies of preventing HSP. Methods In this hospital-based, case-control study, we recruited 353 HSP cases and 61 control participants during 2012 and 2015. We collected related information of 414 HSP in children and the control group through questionnaires. Student's t-test, Pearson Chi-square test and Wilcoxon test were used respectively to compare the difference between the case and control group; We applied logistic re-gression model to analyze the associated factors of HSP in children. Results Univariate analysis revealed that the differences in age, mother and father's level of education were significant between the case and control group. Univariate analysis also revealed that the differences in diet regularity, eating cold, fried and spicy food, meat, drinks, milk and dairy products, fruits and vege-tables between the two groups were statistically significant. Similarly, the differences in way of birth, breast-feeding, mixed feed-ing and mother contacting harmful substances before becoming pregnant between the two groups were statistically significant. After the adjustment of age, sex and mother's level of education, multivariate Logistic regression demonstrated that living in rural are-as, the enough sleep time, consumption frequencies of fruit, sweet and meat and mother's level of education were protective fac-tors for HSP in children. Multivariate Logistic regression also demonstrated that mixed feeding, feeding after chewing, illness during pregnancy, and consumption frequencies of cold, spicy food and nuts were the risky factors for HSP. Conclusion Suffi-cient sleep time, less cold and spicy food and plenty of meat and fruit can reduce the risk of HSP in children. Advocating breast-feeding, avoid feeding after chewing can also prevent children from HSP.

Objective To establish data information system for allergic patients using modern technology, and to provide scientific research data for the treatment and prevention of allergy and allergic diseases.Methods Based on Web B/S( Browser/Server) architecture, data information system for allergic patients was established, with Apache as the Web server and PHP as the development language, using MySQL relational database.Results The data information system of nearly 15000 allergic pa-tients in hospital was established.This system included general conditions, symptoms and diagnosis, family history, dietary hab-its and living environment and lab test reports of allergen.The system could be used for data collection free of time limit, modifi-cation of questionnaire, electronic storage, precise location of data or range queries, deletion and correction of data as well as im-port and export of data in standard format.Conclusion The system can provide doctors data of allergic patients for allergic clini-cal diagnosis, treatment and prevention of allergic diseases and related research and it will be an efficient auxiliary tool for clini-cal and scientific research.

目的 以计量经济学课程为例,对形成性评价在医学类院校统计学专业课程考核中的应用进行探索.方法 在探讨形成性评价内涵的基础上,通过对形成性评价在计量经济学课程考核中应用的可行性、必要性进行讨论,探讨计量经济学形成性评价的实施方案;自制“计量经济学课程形成性评价调查问卷”对学生进行调查并对结果进行分析.结果 在计量经济学课程中采用形成性评价效果良好.结论 形成性评价在计量经济学及医学类院校统计学专业其他课程考核中有广阔的应用前景.

Objective To investigate the satisfaction of inpatients in tertiary teaching hospitals and analyze the influence factors of satisfaction. Methods The survey was done with a stratified sampling method to randomly select the samples. The questionnaires were used to collect the data and the statistical methods were simple and multivariate linear regression analysis. Results The satisfaction of inpatients in tertiary teaching hospitals was high and the average score was 92. 94±11. 81. The satis-faction of rural inpatients was lower than urban inpatients. The more the household average month income, the higher the satisfac-tion. The satisfaction of patients who were firstly admitted in hospital was higher than that of the others. Conclusion The cover-age of hospital indicating signs should be increased. The hospital guide service and the medical charge management should be im-proved. The hospitals should increase the publicity of booking register, in order to improve the satisfaction of rural and lower in-come inpatients.

目的 了解新医改背景下大学生对医疗保险的认知与满意度情况,为提高大学生参加医疗保险的满意度提供科学合理建议与意见.方法 采用简单随机抽样,对烟台市四所高校进行现场问卷调查,运用AHP法进行满意度评价分析.结果 四类高校满意度得分分别为综合类325.82、师范类326.32、工商类311.32和医科类338.377.其中医科类院校满意度最高,工商类学院偏低,各类高校满意度得分差异有统计学意义.结论 新医改大学生医疗保险的实施效果良好,但仍存在诸多问题.在综合评价过程中,通过参考资料构建的适合评价大学生医疗保险实施效果的指标体系模型,将为社会有关部门评价大学生医疗保险提供重要参考依据.

Medical Statistics is a required course for today's medical professional graduate,and statistical tables is the most common part for expressing results in the paper.Although most of the textbooks have clear requirements on the principle of statistical tables,graduates often have many problems such as not having ability to draw right tables in the practical application.During teaching statistical tables we took practice-oriented practical application,realized tables with Microsoft Word,and received good results.

<正>医学统计学是当前医学高等院校医学生、特别是研究生的重要课程。而统计软件课程是在医学统计学理论学习的基础上,通过具体统计软件的学习,使学生掌握基本统计分析技能,熟悉常用统计分析方法的操作过程,能够解读和表达运行结果,加强和提高学生统计分析素养。目前统计软件课程的设置或是单独设置课程,或者在医学统计理论之后的实习课中进行统计

Objective To assess genetic polymorphism of sulfortransferase lAl(SULT1A1) Arg213His and its relationship with the incidence of uterine leiomyoma.Methods Epidemiological questionnaire survey and molecular biology detection were conducted in a hospital-based 1∶ 1 case-control study with 123 uterine leiomyoma patients and 123 healthy female examinees recruited from Affiliated Hospital of Binzhou Medical College from August to October 2009.ResultsThere was a significant difference(χ2=9.085,P=0.011) in the SULT1A1 Arg213His polymorphism between uterine leiomyoma patients and control subjects.The frequencies of wild-type(G/G),mutant heterozygotes(G/A),and homozygous mutant(A /A) in the two groups were 58.5%,39.0%,2.5% and 76.4%,22.0%,1.6%,respectively.Compared with G/G genotype,the odds ratio of suffering from uterine leiomyoma for the individuals with G/A,A/A,and G/A+A/A genotypes were 2.321(95% confidence interval:1.322,4.074),1.958(95%CI:0.319,12.03),and 2.296(95%CI:1.325,3.978),respectively.Multivariate logistic regression analyses showed that the risk factors of uterine leiomyoma included pelvic inflammation,stressful life event,hypertension,induced abortion,oral contraceptive use,with mother or sister suffering from uterine leiomyoma,vaginitis,cervicitis,and polymorphism of SULT1A1 gene,whereas the delayed menstruation was proved to be a protective factor of the disease.Conclusion The Arg213His genetic polymorphism of SULT1A1 is a risk factor for the incidence of uterine leiomyoma.And it can be controlled by prevention and treatment of gynecological inflammation,hypertension and stressful life events.