目的 探讨将临床业务数据用于住院医师规范化培训(简称住培)培训质量评价的途径.方法 以广东省中医院重点专业基地2018年招录、2021年结业的住院医师180人为研究对象,选取住培期间有代表性的临床业务指标,如住院医师独立管床人数占比、住院医师主管病人病例组合指数(case-mix index,CMI)总值等进行统计分析.结果 临床业务数据能在一定程度上反映住院医师的临床能力及住培基地的培训质量.结论 有效的临床业务数据可作为住院医师岗位胜任力评估的补充途径,也可作为住培基地培训质量评价的客观指标之一.但如何科学地选取评价数据,值得进一步研究探讨,且培训基地在鼓励住院医师"独立行医"的同时,须有相应措施保障医疗安全和医疗质量.

作为全国中医行业推广建设现代医院管理制度的标杆,广东省中医院高度重视人才工作,坚定不移地实施人才战略,着力打造人才工程,践行感恩文化并将感恩文化作为人才工程的"导航系统",不断完善和创新爱才、育才、用才和聚才的工作机制,把医院建设成为人才茁壮成长的沃土和名医的摇篮,提升医院核心竞争力,使医院实现了跨越式的发展.

目的 通过利用“理论与实践一体化建设的住院医师规范化培训师资建设体系”,对我院规培带教老师进行师资培训,对比培训前后的带教水平.方法 利用《广东省中医院带教老师师资能力评价表》,分别对同一批带教老师培训前与培训后进行评分.采取统计学方法对“理论与实践一体化建设的住院医师规范化培训师资建设体系”进行科学评价.结果 通过对培训前后《广东省中医院带教师资能力评价表》得分情况进行对比,发现培训后各个维度的得分情况明显高于培训前的得分.结论 “理论与实践一体化建设的住院医师规范化培训师资建设体系”有助于提高带教老师的带教质量,提高规培医生的满意度.

Objective:To construct the post competency index system of the standardized training of traditional Chinese medicine(TCM)residents, and to provide reference for the curriculum design of TCM residents′ standardized training.Methods:Based on the analysis of relevant literature, 22 experts engaged in clinical, teaching or administrative management of TCM residential training were consulted by Delphi method from August to December 2019, and the evaluation indexes were screened and the importance was assigned. Then, analytic hierarchy process was used to determine the weight of each index. In January 2020, the index system was tested by questionnaire survey.Results:The competency evaluation index system of TCM residents was composed of 7 first-level indexes and 61 second-level indexes. The first-level indexes included occupational values and professionalism(weight: 0.208 2), clinical skills(weight: 0.208 2), mastery and application of medical knowledge and related knowledge(weight: 0.208 2), communication skills(weight: 0.198 4), management and teamwork ability(weight: 0.114 1), critical thinking and learning research ability(weight: 0.033 4), group health and health systems(weight: 0.029 5). The total Cronbach α coefficient of the self-evaluation questionnaire designed according to the evaluation index system was 0.976. The results of KMO test and Bartlett spherical test respectively were 0.954 and 0.000, indicating that the questionnaire had high reliability and validity, and the evaluation index system could reflect the post competency level of TCM residents. Conclusions:The index system of TCM resident competency is highly reliable. TCM resident training should strengthen the cultivation of TCM clinical thinking, and urgently need to supplement the content of medical humanities education.

Objective To investigate the reason,diagnosis and preventive measures of the ectopic intrauterine device (IUD) and summarize the treatment methods of it under different circumstances,in order to provide reference for the decrease of ectopic intrauterine device and complications of dislodgment of abnormal IUD.Methods The study reported and analyzed retrospectively a case of vesical calculus induced by an ectopic intrauterine device which was taken out by the hysteroscopy,cystoscopy and lithotripsy successfully,and then reviewed the referring to related literatures.Results The ectopic IUD of the bladder came with vesical calculus is a rare complication of IUD,which will not only cause the contraceptive failure,but also increase the difficulty of removing the IUD and the occurrence of complications such as uterine perforation,massive bleeding and peripheral organ injury during the process of taking out the device.Conclusion The dislodgment of abnormal IUD and calculus by hysteroscopy combined with cystoscopy lithotripsy,which is safe,effective,but minimally invasive and small damaged,could reduce the operative complications and improve the safety and success rate.

目的 观察补肾活血方治疗肾虚型黄体功能不健性月经失调的疗效和作用机理.方法 45例肾虚型黄体功能不健性月经失调患者,随机分为补肾活血方组(30例,给予补肾活血方治疗)和常规治疗组(15例,给予地屈孕酮治疗),比较两组疗效差异.结果 补肾活血方组治疗总有效率90.0%明显高于常规治疗组60.0%,差异具有统计学意义(P<0.05).两组治疗前经期、经量(量化评分)、周期(量化评分)比较差异均无统计学意义(P>0.05);治疗后两组经期、经量(量化评分)、周期(量化评分)均优于治疗前,且补肾活血方组均优于常规治疗组,差异均具有统计学意义(P<0.05).治疗前两组孕酮(P)、雌二醇(E2)、P/E2比较差异均无统计学意义(P>0.05).治疗后两组患者P、P/E2均较治疗前升高,且常规治疗组P高于补肾活血方组,差异均具有统计学意义(P<0.05);治疗后补肾活血方组E2较治疗前升高,常规治疗组E2较治疗前降低,且补肾活血方组E2高于常规治疗组,差异均具有统计学意义(P<0.05).结论 肾虚型黄体功能不健性月经失调患者经中医补肾活血方治疗的效果可观,表明了中医辨证论治,个体化治疗的优势.

五行五脏之间存在着巧妙的升降关系,《圆运动的古中医学》作者彭子益将这种人体正常的五行升降关系总结为“左升右降,四维如轮,中央为轴”.补中益气汤是李东垣创立的治疗饮食劳倦、内伤中热证的方剂,后世尊其为治疗气虚发热之代表方,但对其治疗机制众说纷纭,未有定论.基于圆运动的五行理论,笔者认为补中益气汤能治疗气虚发热的机制在于纠正了阳气“左降右升”的运行错误,恢复了阳气“左升右降”的正常运行规律.

目的：探究低剂量助孕丸、高剂量助孕丸和达芙通对肾虚型自然流产模型大鼠其子代生长发育及行为学的影响。方法将14只SPF级母鼠随机分成5组，模型组、低剂量助孕丸组、高剂量助孕丸组、达芙通组、空白组，繁殖出子代小鼠，记录子鼠第1、7、13、19天的体重并绘制出生长曲线图，观测初生子鼠翻身试验、3周时平行爬杆实验爬行距离及跌落次数。结果①不同干预组对子鼠D7、D13、D19的体重影响差异有统计学意义(P<0.01)，②不同干预组对子鼠初生翻身试验的影响差异无统计学意义(P>0.05)，③不同干预组对子鼠平行爬杆实验爬行距离、跌落次数的影响差异有统计学意义(P<0.01)。结论肾虚型自然流产模型大鼠对其子代的体重、平行爬杆距离及跌落次数均有影响，达芙通、助孕丸能对该类子鼠的体重、平行爬杆距离及跌落次数产生积极的影响，助孕丸的影响与其剂量有关，达芙通、助孕丸对子鼠生长发育的影响会随着子鼠的生长而改变。