1994年中国引进患者自控镇痛（PCA）,经过国人改造升级如今已取得了令人瞩目的成绩：2007年《术后患者自控镇痛临床研究与推广应用》获教育部科学技术进步奖二等奖和中华医学科技奖三等奖;2011年具有中国自主专利产权和创新数字医疗的智能化患者自控镇痛（Ai-PCA）诞生,2019年《智能化术后患者自控镇痛管理关键技术及其临床应用》获得中国抗癌协会科技奖二等奖;2023年《中国分娩镇痛规范及推广应用》获得华夏医学科技奖二等奖。笔者撰写述评,提出努力推进Ai-PCA高水平高质量发展的措施,呼吁国内学者重视引领数智镇痛医疗规范化,于2024年在《中华疼痛学杂志》刊出由余守章教授牵头制定的《患者自控镇痛临床应用规范专家共识》,助力中国数智镇痛医疗技术向智慧化前行,为人民群众切实享受到舒适镇痛提供更优质的服务。

Since the introduction of Patient-Controlled Analgesia（PCA）in China in 1994,the domain has witnessed its substantial advancements．The project,Clinical Research and Promotion of Postoperative Patient-Controlled Analgesia,achieved the Ministry of Education’s Second Prize for Scientific and Technological Progress and the Chinese Medical Association’s Third Prize in 2007．The innovation continued in 2011 with the development of an intelligent PCA system（Ai-PCA）endowed with Chinese independent patent rights and innovative digital medical technology．In 2019,the Key Technologies and Clinical Application of Intelligent Postoperative Patient-Controlled Analgesia Management was honored with the second-class Science and Technology Award by the Chinese Anti-Cancer Association．Furthering this trend．In 2023,the Standards and Promotion of Labor Analgesia in China secured the second-class prize in Medical Science and Technology from Huaxia Medical Science and Technology．This commentary suggest strategies for the qualitative enhancement of Ai-PCA and urge domestic scholars to spearhead the standardization of Ai-PCA．Expert Consensus on Clinical Application Standards for Patient-Controlled Analgesia leaded and edited by Pro．She has published,in 2024,which fervently supports the advancement of China’s Ai-PCA technology towards a more intelligent future,to provide the public with higher quality and more comfortable pain management services．

目的 探讨基于迷你临床演练评估（Mini-CEX）的可视化思维导图联合案例教学在全科住院医师规范化培训中的应用效果。方法 选取参加全科住院医师规范化培训的52例学员并分为试验组（n=26）和对照组（n=26）。对照组采取以案例讲授为主的传统教学模式,试验组采取基于Mini-CEX的可视化思维导图联合案例教学模式。对比两组Mini-CEX评分、考核成绩及教学满意度。结果 试验组Mini-CEX测评的问诊技巧、体格检查、临床判断、诊治能力、技能操作及整体表现得分均高于对照组（P<0.05）。试验组理论知识[（86.89±4.75）分 vs （82.96±4.87分）]、专业技能[（84.20±3.46）分 vs （70.18±4.93）分]及病历书写成绩[（80.64±5.26）分 vs （75.58±5.94）分]均高于对照组（t分别为2.678、13.685、2.764,P分别为0.009、<0.001、0.007）。试验组住院医师教学满意度高于对照组（P<0.05）。结论 基于Mini-CEX的可视化思维导图联合案例教学模式用于全科住院医师规范化培训,有助于提高教学效果及教学满意度。

Objective To evaluate the effect of visual mind mapping combined with case teaching based on mini-clinical evaluation exercise（Mini-CEX）for standardized training of general practitioners．Methods A total of 52 students who participated the standardized training of general practitioners were selected and divided into an experimental group（n=26）and a control group（n=26）．The control group adopted the traditional teaching mode based on case teaching and the experimental group adopted the visual mind mapping combined with case teaching based on Mini-CEX．The Mini-CEX score,assessment results and teaching satisfaction of two groups were compared．Results The interrogation skills,physical examination,clinical judgment,diagnosis and treatment ability,skill operation and overall performance of Mini-CEX in experimental group were higher than control group（P<0.05）．Theoretical knowledge score（[86.89±4.75] vs [82.96±4.87]）,professional skills score（[84.20±3.46] vs [70.18±4.93]）and medical record writing score（[80.64±5.26] vs [75.58±5.94]）of experimental groups were higher than control group（t=2.678,13.685,2.764,P=0.009,<0.001,0.007）．The teaching satisfaction of residents in experimental group was higher than control group（P<0.05）．Conclusions The visual mind mapping combined with case teaching based on Mini-CEX for standardized training of general practitioners is helpful to improve teaching effect and teaching satisfaction．

目的 探讨规范化康复护理在脊髓型颈椎病前路手术术后功能恢复的影响。方法 将60例行颈椎前路椎间隙减压植骨融合内固定术的患者分为观察组和对照组各30例。对照组实施常规护理,观察组实施规范化康复护理措施。分别在出院时、出院后1、3、6个月进行日本骨科协会脊髓功能JOA评分、颈椎功能残障指数NDI评分、疼痛视觉模拟VAS评分、生活自理能力评分以及记录两组住院时间、术后并发症发生率。结果 手术后观察组与对照组的平均住院时间、术后并发症、术后脊髓功能恢复情况、颈椎功能恢复、生活自理能力的差异有统计学意义(P<0.05);观察组的平均住院时间均低于对照组(P<0.05);术后脊髓功能功能评分、生活自理能力评分均高于对照组(P<0.05);颈椎功能残障指数评分、术后并发症发生率均低于对照组(P<0.05)。结论 规范化康复护理可以促进脊髓型颈椎病行前路手术术后脊髓、颈椎功能的恢复,减少住院时间,减少术后并发症的发生,提高患者生活自理能力,提高生活质量。

Objective To investigate the effect of standardized rehabilitation nursing on functional recovery of cervical spondylotic myelopathy (CSM) after anterior operation. Methods Sixty patients were divided into two groups: observation group (n = 30) and control group (n = 30). Routine nursing was carried out in the control group and standardized rehabilitation nursing measures were carried out in the observation group. At the time of discharge, 1,3,6 months after discharge, the JOA score of spinal cord function of the Japanese Orthopaedics Association, the NDI score of cervical spine disability index, the VAS score of visual analogue of pain, the score of self-care ability of life were taken. The length of hospitalization of the two groups and incidence of postoperative complications were recorded. Results There were significant differences in average hospitalization time, postoperative complications, recovery of spinal cord function, recovery of cervical spine function and ability of living self-care between the observation group and the control group after operation (P<0.05). The average hospitalization time in the observation group was lower than that in the control group (P<0.05), and the scores of spinal cord function and self-care ability after operation were higher than those in the control group (P<0.05). The score of cervical disability index and the incidence of postoperative complications were lower than those of the control group (P<0.05). Conclusion Standardized rehabilitation nursing may promote the recovery of spinal cord and cervical spine function, reduce hospital stay, reduce postoperative complications, improve the self-care ability of patients and improve the quality of life.

      目的   探讨基于迷你临床演练评估（Mini-CEX）的可视化思维导图联合案例教学在全科住院医师规范化培训中的应用效果。方法   选取参加全科住院医师规范化培训的52例学员并分为试验组（n=26）和对照组（n=26）。对照组采取以案例讲授为主的传统教学模式，试验组采取基于Mini-CEX的可视化思维导图联合案例教学模式。对比两组Mini-CEX评分、考核成绩及教学满意度。结果   试验组Mini-CEX测评的问诊技巧、体格检查、临床判断、诊治能力、技能操作及整体表现得分均高于对照组（P＜0.05）。试验组理论知识［（86.89±4.75）分 vs （82.96±4.87分）］、专业技能［（84.20±3.46）分 vs （70.18±4.93）分］及病历书写成绩［（80.64±5.26）分 vs （75.58±5.94）分］均高于对照组（t分别为2.678、13.685、2.764，P分别为0.009、＜0.001、0.007）。试验组住院医师教学满意度高于对照组（P＜0.05）。结论   基于Mini-CEX的可视化思维导图联合案例教学模式用于全科住院医师规范化培训，有助于提高教学效果及教学满意度。

       Objective  To evaluate the effect of visual mind mapping combined with case teaching based on mini-clinical evaluation exercise（Mini-CEX）for standardized training of general practitioners．Methods  A total of 52 students who participated the standardized training of general practitioners were selected and divided into an experimental group（n=26）and a control group（n=26）．The control group adopted the traditional teaching mode based on case teaching and the experimental group adopted the visual mind mapping combined with case teaching based on Mini-CEX．The Mini-CEX score，assessment  results and teaching satisfaction of two groups were compared．Results  The interrogation skills，physical examination，clinical judgment，diagnosis and treatment ability，skill operation and overall performance of Mini-CEX in experimental group were higher than control group（P＜0.05）．Theoretical knowledge score（［86.89±4.75］ vs ［82.96±4.87］），professional skills score（［84.20±3.46］ vs［70.18±4.93］）and medical record writing score（［80.64±5.26］ vs ［75.58±5.94］）of experimental groups were higher than control group（t=2.678，13.685，2.764，P=0.009，＜0.001，0.007）．The teaching satisfaction of residents in experimental group was higher than control group（P＜0.05）．Conclusions  The visual mind mapping combined with case teaching based on Mini-CEX for standardized training of general practitioners is helpful to improve teaching effect and teaching satisfaction．

       目的   对该培训基地师资2021—2023年教学能力进行评价，了解和分析“1+3+n”的院级督导推行前的2021年、“1+3+n”的院级督导推行后的 2022年、2023年师资的教学能力变化。方法   采用问卷调查法收集评价数据，采用SPSS.27.0对教学评价资料进行统计分析，采用净推荐值计算教学口碑，对多年度结果进行纵向比较分析。结果  2021—2023年教学评价次数共5 483次；2021—2023年对师资教学设计能力评价由实施前的8.8提高到9.6、教学实施能力由实施前的9.0提高到9.5、教学热情由实施前的9.0提高到10.0、时间投入由实施前的9.3提高到10.0，不同年份组间比较的差异均有统计学意义（P＜0.001）；课程净推荐值由实施前的60.5%提高到81.3%，师资课程推荐者占比由实施前的65.5%提高到83.2%，贬损者占比由实施前的5.0%降低到1.9%，差异有统计学意义（χ ² =175.4，P＜0.001）。结论   “1+3+n”院级督导模式的相关举措，对师资教学能力的提高具有促进作用，且该促进作用持续存在，师资教学能力逐年递增。

    Objective  To evaluate the teaching ability change of teachers  from 2021 to 2023，including of teachers’ teaching ability in 2021 before the implementation of "1+3+n" college-level supervision，and in  2022  and  2023  after the implementation of "1+3+n" college-level supervision．Methods  Questionnaire survey was used to collect evaluation data，SPSS.27.0 was used to make statistical analysis of teaching evaluation data，and NPS（Net Promoter Score）was used to evaluate teaching quality．Results  From 2021 to 2023，there were 5483 teaching evaluations．From 2021 to 2023，teaching design ability evaluation score increased from 8.8 before the implementation to 9.6，teaching implementation ability evaluation score increased from 9.0 before the implementation to 9.5，teaching enthusiasm evaluation score increased from 9.0 before the implementation to 10.0，time investment evaluation score increased from 9.3 before the implementation to 10.0，and the differences between different years were statistically significant（P＜0.001）．The courses quality increased from 60.5% before the implementation to 81.3%，and the proportion of teachers' course recommenders has increased from 65.5% before the implementation to 83.2%，while the proportion of detractors has decreased from 5.0% before the implementation to 1.9%，with statistical significance（χ ² =175.4，P＜0.001）．Conclusions  The measures of "1+3+n" college-level supervision mode promote the improvement of teachers’ teaching ability，the promotion effect persists，and the teaching ability increases year by year．