RESUMEN
Objective To evaluate comprehensively the effectiveness of transitional care for patients with diabetic in china. Methods Cochrane Handbook for systematic reviews of interventions was followed,and strictly designed search strategies,pub-lished literatures were searched through Chinese biomedical literature database(CBM),Wanfang,CNKI,VIP database.These data-bases were searched to collect the randomized controlled trials of transitional care for patients with diabetic in China.The retrieval time was limited from 2000 to 2014,All the literatures were selected according to the strictly designed strategies .A Meta analysis was performed by RevMan5.0 software.Results Totally 8 trials were included.Meta analysis showed that 6 months after the in-tervention,the continuing nursing and the control group in the incidence of complications of hypoglycemia had no significant differ-ence[RR= 0.69,95%CI (0.21,2.27 ),P = 0.540 ],while fasting glucose had significant difference [WMD = - 1.54,95%CI (-2.89,-0.1 9),P =0.030].12 months after the intervention,the continuing nursing and control groups in the incidence of com-plications of hypoglycemia [RR = 0.34,95%CI (0.1 6,0.72 ),P = 0.005 ],in fasting plasma glucose [WMD = - 1.03,95%CI (-2.78,0.72),P =0.250],in glycated hemoglobin [WMD =-1.73,95%CI (-2.43,-1.04),P <0.01]had significantly differ-ence.18 months after the intervention,the continuing nursing and control groups in the incidence of complications of hypoglycemia were significantly different[RR=0.28,95%CI (0.12,0.67 ),P = 0.004].Conclusion Transitional care intervention on patients with diabetes can reduce fasting blood glucose,glycated hemoglobin,and the incidence of complications,but the complications of in-tervention time should be greater than 6 months.
RESUMEN
After years of respiratory medicine clinical practice teaching , we have discovered that there exist some problems such as teachers' job burnout, teachers' lowprofessional knowledge level of clinical teaching and lack of teaching ability, medical students' fear, low self-esteem, psycho-logi-cal fear and emotional weariness breeding as well as the patients and their family members ' refusal of practice because of their worrying about being a test and so on. To solve these problems , we have put forward some proposals such as recognizing and rewarding teachers to affirm their teaching levels , organizing teachers to participate in academic conferences, seminars, etc. to expand their professional knowledge in order to improve their overall quality. And at the same time, we have adopted PBL teaching method, applied multimedia technology and network platforms, put emphasis on basic skills training, the improvementof departmental rotation assessment, the establishment of teaching files and doctor-patient communication and other ways to improve clinical teaching quality and develop interns' clinical thinking ability to help them transitto clinicians.