ABSTRACT
Objective:To evaluate the effect of ladder teaching of problem-based learning (PBL) after theoretical lecture in the standardized training of ophthalmology.Methods:This study collected the data of the resident trainees in the ophthalmology standardized training base of the PLA General Hospital from September 2015 to June 2020. According to the accepted teaching methods, they were divided into the ladder teaching method group (ladder group) and the pure PBL teaching method group (PBL group). The exam results of the first and second stages of the trainees, the pass rate of the first stage exam (ophthalmology theory), the pass rate of the second stage exam (clinical application), and the overall pass rate of the first and second stages were recorded for statistical analysis. Quantitative evaluation on the teaching effect of the "ladder teaching method of theory teaching followed by PBL" in the standardized training of ophthalmology in this training base was made. SPSS 24.0 was used to conduct t-test, rank-sum test and Chi-square test. Results:The results of the first stage examination (ophthalmology theory) in the ladder group were higher than those in the PBL group [(87.22±8.45) vs. (74.47±10.68)], with a statistically significant difference ( P < 0.01); the pass rate of the first stage examination (ophthalmology theory) in the ladder group was higher than that in the PBL group (95.83% vs. 85.00%), with no significant difference ( P = 0.213). The pass rate of the second stage examination (clinical application) in the ladder group was higher than that in the PBL group (95.65% vs. 76.47%), with no significant difference ( P = 0.070); the overall pass rate of routine training (first and second stages) in the ladder group was higher than that in the PBL group (91.67% vs. 65.00%), with a statistically significant difference ( P = 0.029). Conclusion:The ladder teaching of PBL after the theory teaching has a satisfactory effect in the standardized training of ophthalmology. This teaching method is easier to help the students to successfully complete the standardized training and pass the standardized training examination.
ABSTRACT
Objective:To investigate the influencing factors of surgical site infection (SSI) after abdominal surgery.Methods:The retrospective cross-sectional study was conducted. The clinical data of 567 patients undergoing abdominal surgery in 6 medical centers, including 445 cases in the Zhengzhou Central Hospital Affiliated to Zhengzhou University, 54 cases in the the First Affiliated Hospital of Zhengzhou University, 49 cases in the Shangqiu First People's Hospital, 10 cases in the Luoyang Central Hospital, 5 cases in the First Affiliated Hospital of Henan University of Science and Technology and 4 cases in the Henan Provincial People's Hospital, from June 1 to June 30, 2020 were collected. There were 284 males and 283 females, aged (51±18)years. Observation indicators: (1) incidence of SSI after surgery; (2) influencing factors of SSI. Follow-up was conducted using outpatient examination and telephone interview to detect the incidence of SSI. Patients without implant were followed up within postoperative 30 days, and patients with implant were followed up within postoperative 1 year. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measure-ment data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was performed using the chi-square test or Fisher exact probability. Univariate analysis was performed using the corresponding statistical methods. Multivariate analysis was performed using the Logistic stepwise regression model advance method. Results:(1) Incidence of SSI after surgery. All the 567 patients were followed up after surgery as planned. There were 27 cases with SSI after surgery including 9 cases with superficial incision infection, 9 cases with deep incision infection, 9 cases with organ/gap infection. Of the 27 cases with SSI after surgery, 18 cases with positive results of incisional microbial culture including 8 cases with positive results of Escherichia coli, 6 cases with positive results of Klebsiella pneumonia, 3 cases with positive results of Enterococcus faecium and 1 case with positive result of Pseudomonas aeruginosa. (2) Influencing factors of SSI. Results of univariate analysis showed that age, preoperative hemoglo-bin, preoperative albumin, preoperative fasting blood glucose, preoperative intestinal preparation, surgical type, surgical site, surgical incision type, duration of intensive cure unite, duration of post-operative hospital stay, duration of total hospital stay, operation time, hospital expense were related factors affecting the incidence of SSI of patients undergoing abdominal surgery ( χ2=40.12, Z=?4.22, ?2.21, ?4.75, χ2=7.07, 16.43, 38.06, 17.50, Z=?4.43, ?4.42, ?7.14, ?7.15, ?5.90, P<0.05) and the American Association of Anesthesiologists Classification, preoperative oral antibiotics, surgical methods and postoperative intensive care unit stay were related factors affecting the incidence of SSI of patients undergoing abdominal surgery ( P<0.05). Results of multivariate analysis showed that age, preopera-tive fasting blood glucose, preoperative intestinal preparation, surgical type, surgical site as appendix and rectum, surgical methods, surgical incision type as infective incision and polluted incision, operation time were independent factors affecting the incidence of SSI of patients undergoing abdo-minal surgery ( odds ratio=7.69, 1.21, 0.27, 5.82, 5.19, 19.08, 0.23, 27.76, 4.97, 1.01, 95% confidence intervals as 2.04?28.95, 1.04?1.41, 0.08?0.94, 1.36?24.85, 1.10?24.43, 4.48?81.25, 0.06?0.87, 2.54?303.53, 1.12?22.14, 1.01?1.02, P<0.05). Conclusion:Age, preoperative fasting blood glucose, preoperative intestinal preparation, surgical type, surgical site as appendix and rectum, surgical methods, surgical incision type as infective incision and polluted incision, operation time are independent factors affecting the incidence of SSI of patients undergoing abdominal surgery.
ABSTRACT
AIM:To investigate the effect of cis-dichlorodiamine platinun ( cDDP) resistance on proliferation , apoptosis, migration and angiogenesis of esophageal cancer cell line KYSE 150.METHODS:Using the method of increa-sing concentration of cDDP in culture for 10 months, the human esophageal carcinoma cDDP-resistant cell line named KYSE150/cDDP was established successfully .The drug sensitivity was measured by MTT assay .The changes of the biolog-ical behaviors between the parental cell line and resistant cell line were determined by morphological observation assay , MTT assay, colony formation assay , DAPI staining, wound healing assay and tube formation experiment .RESULTS: No significant morphological difference between KYSE 150 cells and KYSE150/cDDP cells was observed .Compared with KYSE150 cells, the drug resistance index of KYSE150/cDDP cells was 6.35, and the viability of KYSE150/cDDP cells was decreased.The colony formation rate of KYSE150/cDDP cells was (15.00 ±3.05)%, while the colony formation rate of KYSE150 cells was (86.70 ±6.57)%.The apoptotic rate of KYSE150/cDDP cells was (0.63 ±0.09)%, and that of KYSE150 cells was (8.46 ±1.33)%.Compared with KYSE150 cells, KYSE150/cDDP cells showed a stronger healing ability of scratch, and the migration rate was higher than that of KYSE 150 cells.The results of tube formation experiment showed that the vessel number in KYSE150/cDDP group was 76.20 ±3.18, while the vessel number in KYSE150 group was 50.60 ±1.33.The protein expression of MMP-2 and VEGFR2 in KYSE150/cDDP cells was higher than that in KYSE150 cells.CONCLUSION: KYSE150/cDDP cells present drug-resistant phenotype and show a slow growth rate . The ability of apoptosis is decreased , and the abilities of cell migration and angiogenesis are increased .This may be an im-portant reason for the failure of clinical chemotherapy for esophageal cancer .
ABSTRACT
Objective To observe the value of adenosine deaminase(ADA)in differential diagnosis of hydrothorax.Methods In this study,93 subjects were collected in the second Xiangya hospital from Oct 2007 to Mar 2008.The patients were divided into three groups.which were the malignant hydrothorax group,the tuberculous hydrothorax group and the transudative hydrothorax group.We measured the adenosine deaminase(ADA)in pleural effusion of every patients with continuous monitored enzymatic method.Results The values of ADA in the three group were(14.24±12.90)U/L,(49.36±15.75)U/L and(10.12±7.87)U/L,respectively.There were significant differences for the values of adenosine deaminase(ADA)among the three groups,For instance,The value of adenosine deaminase(ADA)in the tuberculous hydrothorax group was greatly different with that of the transudative hydrothorax group(P＜0.01).Conclusion Detection of adenosine deaminase(ADA)has highly differential diagnosis value and can be as supplementary method to diagnose tuberculous hydrothorax.
ABSTRACT
@#ObjectiveTo investigate the effects of psychological intervention on patients with acute coronary syndrome (ACS) accompanied by psychogenic disturbance.Methods112 patients with ACS were evaluated with depression status inventory (DSI) and symptom checklist-90 (SCL-90). The cases accompanied with depression were randomly divided into the psychological intervention group (group A) and drug group (group B). Patients of group A were treated with psychological intervention besides routine therapy. The curative effects of the two groups were compared.Results79 cases (70.5%) had depression. Their scores of somatization, depression, anxiety, fear, paranoid ideation, and total score and positive symptom distress level of SCL-90 were significantly different compared with the normal group. After psychological intervention, to patients of the group A, the DSI score fell and symptoms improved significantly (P<0.01), the in-patient duration shorten (P<0.05).ConclusionPsychogenic factors is not neglectable in the process and prognosis of ACS. Effective psychological intervention can promote the patient's healing.
ABSTRACT
OBJECTIVE:To study the?-lactamase production in multi-drug resistant acinetobacter baumannii isolated in clinic.METHODS:Susceptivity to antibiotics of the bacteria was measured by K-B and agar diffusion methods.The?-lac-tamase production of acinetobacter baumannii was examined by nitrocefin disc test,then their plasmid and chromosome ex-tracted as templete,the genes coded the?-lactamase were amplified by PCR with commercial kits.Furthermore,the sequence and homology of PCR products were analyzed.RESULTS:Total12acinetobacter baumannii in this study were?-lacta-mases-producing strains with a high resistance to cephalosporin.However,it is sensitive to carbapenem-antibiotics and cephalosporin with?-lactamase inhibitors,and6strains of them were confirmed that there were?-lactamases AmpC gene on plasmid by PCR amplification and sequence analysis.CONCLUSIONS:The?-lactamases AmpC mediated by plasmid would be main factor in the high resistance to cephalosporin of acinetobacter baumannii isolated clinically.
ABSTRACT
Objective To assess the effect of chloramine disinfection on the formation of drinking water disinfection by-products(DBPs )and their mutagenicity.Methods The bacterial indices,chloroform and carbon tetrachloride content in the finished water samples using liquid chlorine and chloramine disinfection respectively were determined in August,2001(plentiful water season)and in March,2002(low water season).The mutagenicities of organic extracts from the water samples were tested using Ames test.The levels of DBPs and the mutagenic activities of water samples treated with different disinfection methods were compared.Results The total count of bateria and coliform bacteria were0/ml and0/L respectively at free chlorine con-centration of about 1mg /L in the chloraminated drinking water,which decreased81%-84%compared with those of the chlori-nated drinking water samples.The carbon tetrachloride concetration were all