《流行病学》作为公共卫生与预防医学的主干课程,对于培养高质量公共卫生人才至关重要。在大数据、人工智能和互联网技术迅猛发展的时代背景下,传统的单一教学模式已无法满足现代医学教育的需求。线上线下混合教学模式逐渐成为高等医学教育的主要教学方式。这种模式结合了线上资源的丰富性和线下课堂的互动性,能够拓展教学内容,提高学生的自主学习能力。通过大数据分析和人工智能技术,可以提供个性化学习体验和实时反馈,优化教学效果。然而,这一模式在实际应用中仍面临诸如资源整合不够、师生互动不足等挑战。文章以广州医科大学为例,分析了《流行病学》课程中混合教学模式的优势与不足,并提出了针对性的改进建议。通过这些建议,旨在提升混合教学模式的有效性,为未来教学改革提供新的思路和参考。

Epidemiology,as a core course in public health and preventive medicine,is crucial for training high-quality public health professionals．With the rapid development of big data,artificial intelligence,and internet technologies,traditional single-mode teaching methods no longer meet the demands of modern education．The blended learning model,combining online and offline teaching,has gradually become a primary method in higher medical education．This model integrates the richness of online resources with the interactivity of offline classes,expanding instructional content and enhancing students' self-directed learning abilities．By leveraging big data analysis and artificial intelligence,personalized learning experiences and real-time feedback can be provided to optimize teaching effectiveness．However,this model still faces challenges such as inadequate resource integration and insufficient teacher-student interaction in practical application．This study uses a medical university as a case study to analyze the advantages and limitations of the blended learning model in epidemiology courses and proposes targeted improvement suggestions．The aim is to enhance the effectiveness of blended learning and provide new insights and references for future teaching reforms．

目的 为临床合理使用替考拉宁以及更好地管理接受替考拉宁治疗的患者。方法 从药学角度对2022年日本《2022 JSC/JSTDM临床实践指南:替考拉宁治疗药物监测》(简称《指南》)涉及替考拉宁治疗的9个临床问题进行解读。结果 《指南》指出药-时曲线下面积/最小抑菌浓度是替考拉宁的关键药动学/药效学参数。替考拉宁治疗药物监测(TDM)的目的是明确目标谷浓度(C_min),对于严重或复杂的耐甲氧西林金黄色葡萄球菌(MRSA)感染,指南建议替考拉宁C_min为20~40 mg/L。肾功能正常或轻度受损的非复杂性的MRSA感染,目标C_min为15~30 mg/L。严重和/或复杂性MRSA感染,如感染性心内膜炎和骨髓炎,替考拉宁C_min为20~40 mg/L。结论 《指南》针对不同病理状态下患者替考拉宁目标C_min的确定,为临床治疗中替考拉宁TDM、个体化给药提供参考。

Objective To make rational use of teicoplanin and better management of patients treated with teicoplanin. Methods Nine clinical issues related to the treatment of teicoplanin in Clinical practice guidelines for therapeutic drug monitoring of teicoplanin: a consensus review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring (Japan, 2022) were interpreted from the perspective of pharmacy. Results The guidelines indicated that the area under drug-time curve/minimum inhibitory concentration was the key pharmacokinetic/pharmacodynamic parameters of teicoplanin.The purpose of therapeutic drug monitoring (TDM) of teicoplanin is to specify the target trough concentration (C_min), which guidelines recommend for severe or complex methicillin-resistant Staphylococcus aureus (MRSA) infection is 20-40 mg/L.The target C_min for uncomplicated MRSA infection with normal or mildly impaired renal function is 15-30 mg/L.For severe and/or complex MRSA infections, such as infective endocarditis and osteomyelitis, the C_min of teicoplanin was 20-40 mg/L. Conclusions The guidelines are aimed at the determination of target C_min of teicoplanin in patients with different pathological conditions, and provide reference for individual drug administration and teicoplanin TDM in clinical treatment.

目的 探索基于患者居家护理服务需求且以三甲医院为实施主体的“互联网+护理服务”模式,以期为“互联网+护理服务”的开展提供借鉴。方法 成立“互联网+护理服务”小组,基于患者需求进行平台建设,组建“互联网+护理服务”团队,经过同质化培训持证上岗,提供专科护理、母婴护理以及基础护理共25项服务内容。服务结束后,调查患者对“互联网+护理服务”的满意度。结果 截至2022年10月,该平台注册护士438名,注册患者1 000人。共开展“互联网+护理服务”居家护理服务841人次,排名前三位的服务项目是母婴护理、留置/更换鼻饲管护理、留置/更换尿管护理。患者居家服务好评率为100％,对护理服务的整体满意度为（4.86±0.22）分。患者对护士指导居家护理知识的满意度最高,为（4.89±0.33）分,对平台收费的满意度最低,为（4.12±0.78）分。结论 “互联网+护理服务”为居家护理提供了更加方便快捷的渠道,使资源利用更有效,患者认可度高。

Objective To explore the“Internet + Nursing Service”model based on the needs of patients' home care, which the grade A class 3 hospital hospital was the main institution of implementation, and to provide the reference for implementing “Internet + Nursing Service”．Methods We set up a working group, built a platform according to needs, and set up the “Internet + Nursing service”team, who worked with the certificate after homogenization training．The program provided 25 kinds of services, including specialist nursing, maternal and child care, basic nursing, provides high-quality and convenient home care services．After the service, the patients' satisfaction was investigated．Results By October 2021, the platform had 438 registered nurses and 1000 registered patients．A total of 841 people were provided with “Internet + Nursing service”home care services, and the top three services were maternal and infant care, nasal feeding tube care with indentation/replacement, and urinary tube care with indentation/replacement．The favorable rate of home service was 100%, and the overall satisfaction with nursing services was（4.86±0.22）points．Patients had the highest level of satisfaction with nurses' guidance on home nursing knowledge, which was（4.89±0.33）points, and the lowest level of satisfaction with platform fees, which was（4.12±0.78）points．Conclusions “Internet + Nursing Service”provides a more convenient and fast access for home nursing, making resource utilization more effective and with high patient recognition．

新的形势对预防医学专业人才提出了更高的要求,为了提高预防医学专业学生综合素质和培养创新思维能力,我院近年来开展了多种形式的“第二课堂”教学,取得了积极的作用。

目的 探讨TBL(Team-Based Learning)教学在临床实践教学中的应用效果。方法 将2015年外科实习学生分为应用传统教学的对照组与应用TBL教学的实验组,教学效果采用出科考核成绩、实习效果调查和TBL教学法可行性调查问卷进行评估。结果 两组学生出科考核成绩无明显差异, TBL有助于提高学生解决临床问题的综合能力、课堂参与度、自觉知识掌握度、实习满意度。结论 TBL可以增强学生主动思考学习、团队协作能力,在临床实践教学中切实可行。

Objective To explore the application effect of TBL (Teaching Team-Based Learning) in clinical practice teaching. Methods The surgical internship students of the year 2015 were divided into the control group with traditional teaching and the experimental group with TBL teaching. The teaching effect was evaluated by the examination results, the internship effect survey and the TBL pedagogical feasibility questionnaire. Results There was no significant difference between the two groups in their test scores. TBL helped to improve students' comprehensive ability to solve clinical problems, classroom participation, degree of self-knowledge and internship satisfaction. Conclusion TBL may enhance students' ability of active thinking and learning, teamwork and practicing in clinical practice teaching.

目的 探讨品管圈活动提高出院产妇母乳喂养调查问卷在随访系统回复率中的效果。方法 成立“品管圈组织”,确立“提高出院产妇母乳喂养调查问卷在随访系统的回复率”为主题,对活动前2月~14月回复率低进行原因分析,拟定实施对策,比较实施前后问卷的回复率。结果 出院产妇母乳喂养调查问卷在随访系统的回复率由29.9%提高到了71.7%,差异有统计学意义(P<0.001)。结论 通过品管圈活动可提高出院产妇母乳喂养调查问卷在随访系统的回复率。

Objective To explore the application and effect of the quality control circle(QCC) on the response rate in the obstetric patient discharge questionnaire on breast-feeding in the follow-up system. Methods We set up a quality control circle, identified the project of improving the response rate in the obstetric patient discharge questionnaire on breast-feeding in the follow-up system, analyzed the reasons of the low response rate from February to April. Then, we established and implemented improvement measures and compared the result before and after implementation. Results The response rate in the obstetric patient discharge questionnaire on breast-feeding in the follow-up system was raised from 29.9% to 71.7% (P<0.001). Conclusion With application of QCC program, the response rate in the obstetric patient discharge questionnaire on breast-feeding in the follow-up system is improved.

目的 分析全科医学教学中应用第三方满意度调查,结合学生需求的实践效果。方法 2016年3—12月接收全科医学学生者60例,按照常规方法进行,2017年3—12月全科医学学生62例,教学中应用第三方满意度调查结合学生需求方法,观察教学效果。结果 第二年时,学生期末考试总成绩、病例题成绩、实习报告成绩,课外自学时间、利用网络自学时间、与他人讨论学习时间,教学效果总体评分、课间实习评分均高于第一年,差异有统计学意义(P＜0.05)。结论 全科医学教学中应用第三方满意度调查结合学生需求方法后,可有效的提升教学效果,增强学生的自学能力及自学意识。

Objective To analyze the practical effect of applying the third party satisfaction survey to the needs of the students in the teaching of general medicine. Methods From March 2016 to December 2016, 60 cases of general practice medical students were enrolled. According to the routine method, 62 cases of general medical students from March 2017 to December 2017 were selected. Third party satisfaction survey and student demand method were applied in teaching, and the teaching effect was observed. Results In th second year, students' final exam scores, the total score, case questions internship report scores, extracurricular self-study time, self-study time, learning time, using the network to discuss with othersthe teaching effect of practice during the total score, all above were higher than the first year, there was significant difference (P<0.05). Conclusion The application of third party satisfaction survey combined with students' needs method in general practice teaching may effectively improve teaching effect; enhance students' self-learning ability and self-learning consciousness.

目的 探讨品管圈活动在提高神经外科卧床患者便秘预防措施落实率中的的应用效果。方法 成立品管圈,确定以“提高神经外科卧床患者便秘预防措施落实率”为主题,进行现状调查,设定目标,进行要因分析,制定并实施措施,比较品管圈活动前后护士落实便秘预防措施情况。结果 实施品管圈活动后,神经外科卧床患者便秘预防措施落实率从活动前的41.59%上升至活动后85.6%,差异有统计学意义(P＜0.05)。结论 品管圈活动可以有效提高神经外科卧床患者便秘预防措施落实率,降低便秘的发生率,减轻患者痛苦,改善患者生活质量。

目的 探讨拔岗晋级结合激励机制在护士岗位管理的实践和体会。方法 在护士岗位管理中运用拔岗晋级结合激励机制,收集实施岗位管理前后1年护士满意度、患者满意度、护士职业获益感、护士职业投入、离职率资料,进行统计学分析。结果 实施后护士满意度、患者满意度、护士职业获益感、护士职业投入较实施前提高(P<0.05),离职率下降(P<0.05),差异有统计学意义。结论 建立在拔岗晋级及激励机制上的护士岗位管理能提高护士满意度,降低护士离职率,稳定护士队伍,能够提高护士职业获益感、护士职业投入,从而提高护士工作的主观能动性和工作积极性,为高质量护理服务和优质护理服务长效机制的建立奠定了基础,促进优质护理服务的可持续发展,提高护理管理效能。

Objective To explore the application and experience of job promotion combing with excitation mechanism in nurses position management. Methods We used job promotion combing with excitation mechanism in nurses position management to compare the satisfaction rate, perceived career benefit, work engagement and separation rate of nurses. Results After the application, the satisfaction rate, perceived career benefit and work engagement of nurses were increased, while separation rate of nurses was decreased(P<0.05), the difference has statistical significance. Conclusion The application may increase the satisfaction rate, perceived career benefit and work engagement of nurses, and decrease the separation rate of nurses, elevate the subjective initiative and work enthusiasm. Nursing quality is improved continuously. The management efficacy is promoted.

目的 对信息协作平台的社区结直肠癌三级防治及干预体系进行探索与实践。方法 对纳入本次研究的2 492名社区人群进行问卷调查,包括健康人群1 118人,1 374例肿瘤患者。分析健康人群和肿瘤患者关于肿瘤防治知识及途径的认知情况,比较健康人群和肿瘤患者就诊首选医院,了解肿瘤患者就诊流向和行为以及发现患癌的途径。结果 在肿瘤患者中知道癌前病变、早期肿瘤症状、高危人群的比例显著高于健康人群[26.93%(370/1 374)、39.96%(549/1 374)、46.00%(632/1 374)比14.49%(162/1 118)、21.91%(245/1 118)、26.92%(301/1 118)]。健康人群认为肿瘤三级防治网络可行、会参加三级防治网、有必要开展癌症筛查、会参加筛查的比率显著高于肿瘤患者[98.83%(1 105/1 118)、91.95%(1 028/1 118)、98.12%(1 097/1 118)、98.03%(1 096/1 118)比81.95%(1 126/1 374)、79.98%(1 099/1 374)、80.93%(1 112/1 374)、85.95%(1 181/1 374)],差异均有统计学意义(P<0.05)。健康人群把三甲医院视为就诊首选医院的比率显著低于肿瘤患者[32.56%(364/1 118)比86.97%(1 195/1 374)](P<0.05)。肿瘤患者中发现肿瘤及确诊医院、肿瘤复诊、康复医院的选取主要以三甲综合医院为主。在肿瘤患者中因身体不适到医院就诊发现患癌的比率显著高于单位员工体检、自检发现、社区卫生服务中心体检发现的比率。结论 我国目前肿瘤发病率和死亡率正处在快速上升的阶段,利用网络优势,加大肿瘤防治知识的宣传力度,建立社区、区域二级医院、三级医院优势互补的三级肿瘤防控体系,是当前我国肿瘤防治的迫切需求。

Objective To explore and practice the community tertiary prevention and intervention system for colorectal cancer based on information collaboration platform. Methods A questionnaire survey was conducted among 2 492 community residents which were included in this study, including the healthy crowd of 1 118 people, 1 374 cases of tumor patients. The study was to analyze the knowledge of cancer prevention and treatment in healthy people and cancer patients, to contrast the preferred hospital by healthy people and cancer patients, to acquaint the flow direction in seeking medical service, behavior and way to diagnosis cancer of tumor patients. Results In patients with cancer, the understanding proportion of patients with precancerous lesions, early tumor symptoms, and high risk groups was significantly higher than that in healthy people [26.93% (370/1 374), 39.96% (549/1 374), 46.00% (632/1 374) vs 14.49% (162/1 118), 21.91% (245/1 118), 26.92% (301/1 118)]. In healthy people, the proportion of identification of tumor three-grade prevention and control network, willing to participate in the tertiary prevention and control network, necessity to carry out cancer screening, willing to participate in screening was significantly higher than that in patients with cancer [98.83% (1 105/1 118), 91.95% (1 028/1 118), 98.12% (1 097/1 118), 98.03% (1 096/1 118) vs 81.95% (1 126/1 374), 79.98% (1 099/1 374) and 80.93% (1 112/1 374), 85.95% (1 181/1 374)]. There were significantly differences (P<0.05). Healthy people preferred to choose common hospital instead of 3A hospital as the first choice [32.56% (364/1 118) vs 86.97% (1 195/1 374)] (P<0.05). Discovery and diagnosis of cancer, further consultation, and rehabilitation were mainly carried out in 3A hospital. In patients with cancer, the cancer discovery ratio because of physical discomfort for medical attention was significantly higher than that in unit staff physical examination, self-inspection found, and physical examination in community health service center. Conclusion At present, the incidence and mortality of cancer in our country is in a stage of rapid rising. It's an urgent need for cancer prevention and control in China that making use of the advantage of network to improve the propaganda of the knowledge of cancer prevention and control, and establishing complementary advantages of the tertiary cancer prevention and control system by community, regional hospitals, and 3A hospitals.