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The training of clinical operational skill is an important part of medical education. Direct observation of procedural skills (DOPS) is a method to evaluate clinical operational skills. It has both teaching and evaluation functions. The evaluator directly observes the operation process of the evaluated and gives evaluation and feedback in time. This paper introduces the reliability, validity, feasibility, acceptability and educational significance and the current application of DOPS.

Purpose: Idiopathic pulmonary fibrosis (IPF) is an irreversible respiratory disease. In this study, we evaluated the efficacy of salidroside (SAL), the main component of Rhodiola rosea, in treating IPF. Methods: The pharmacological effects of SAL against epithelial-mesenchymal transition (EMT) and IPF were assessed through in vivo and in vitro experiments. Targets for SAL in treating IPF were identified from various databases and a PPI network was constructed. Functional analyses of target genes were performed using GO, KEGG, DO, and GSEA. Core target genes were identified using LASSO logistic regression and support vector machine (SVM) analysis, followed by molecular docking simulations. Predicted targets and pathways were validated through Western blotting, qRT-PCR, and IHC. Results: Our results demonstrated that SAL ameliorated alveolar epithelial cells (AECs) EMT and mitigated bleomycin -induced pulmonary fibrosis. Through network pharmacology, we identified 74 targets for SAL in the treatment of IPF (PFDR< 0.05) and analyzed their biological functions. Based on these findings, we further applied machine learning techniques to narrow down 9 core targets (PFDR< 0.05). Integrating the results from molecular docking, KEGG, and GSEA analyses, we selected three key targets—IGF1, hypoxia-inducible factor 1-alpha (HIF-1α), and MAPK (PFDR< 0.05)—for further investigation. Our study revealed that SAL inhibits the IGF1 signaling pathway, thereby improving AECs senescence and cell cycle arrest. By inhibiting the HIF-1α pathway, SAL alleviates endoplasmic reticulum stress and reduces intracellular ROS accumulation. Moreover, SAL suppresses the activation of the MAPK signaling pathway, leading to a decrease in inflammation markers in AECs and lung tissue. Conclusion: Experimental results suggest that SAL effectively ameliorates BLM-induced EMT and IPF, likely through the inhibition of IGF1, HIF-1α, and MAPK signaling pathways. This study holds potential translational prospects and may provide new perspectives and insights for the use of traditional Chinese medicine in the treatment of IPF. [ABSTRACT FROM AUTHOR]

Objective Postdoctoral program in clinical medicine is a new approach to China's exploration of medical elite training. Since 2016, the Department of Surgery of Peking Union Medical College Hospital has explored and gradually established an advanced training system in order to cultivate clinical post-doctoral skills. The purpose of this research is to review and analyze the construction process and training effects of the advanced skill-raining system, and discuss the advantages of the training system and the direction of further improvement. Methods Postdoctoral students of surgical clinical medicine from 2016 to 2019 were evaluated and analyzed on surgical skills, results of the establishment of the system, and the output of scientific research. Results With the currently established preliminary system of progressively training surgical skills, three generations of 26 clinical postdoctoral trainees of surgery have been successfully trained. The surgical postdoctoral students trained by this system have significantly higher annual assessment results of surgical skills than training residents of the same year. In addition, during the establishment of this system, 19 teaching-related reform projects have been established, and 14 papers related to this system have been published. Conclusions The advanced training system of surgical skills has shown obvious advantages in the training process of surgical postdoctoral doctors. The construction and perfection of the system still needs to be further improved in combination with the actual needs of postdoctoral surgeons in surgery and the goal of standardized training for residents.