RESUMEN
Objective:To investigate the application effect of the humble tutor mode in the teaching of nursing interns in operating room.Methods:A total of 40 nursing interns in the Operating Room of Affiliated Hospital of Jining Medical University from August 2020 to June 2021 were selected as control group, and 46 nursing interns from August 2021 to September 2022 were selected as experimental group. The interns in the control group received teaching with the conventional tutor mode, and those in the experimental group received teaching with the humble tutor mode. The two groups were compared in terms of the scores of theoretical knowledge and operation skills, voice behavior, self-efficacy, and humble tutor perception. SPSS 19.0 was used to perform the t-test, the chi-square test, and the correlation analysis. Results:At the time of department rotation, the experimental group had significantly higher scores of theoretical knowledge (93.86±3.53) and operation skills (90.90±5.68) than the control group ( P<0.001). Compared with the control group, the experimental group had significantly higher scores of voice behavior [(35.22±7.60) vs. (30.43±5.96), P=0.002], self-efficacy [(28.17±5.03) vs. (24.38±3.39), P<0.001], and humble tutor perception [(37.04±4.34) vs. (26.33±6.63), P<0.001]. Humble tutor perception was positively correlated with voice behavior ( r=0.89, P<0.001), self-efficacy ( r=0.72, P<0.001), operation skills ( r=0.66, P<0.001), and score of theoretical knowledge ( r=0.39, P=0.007). Conclusion:The humble tutor mode has a significant effect in operating room teaching and can improve the assessment scores of theoretical knowledge and operation skills, promote the formation of humble tutors, and strengthen the teaching effect of voice behavior and self-efficacy in nursing interns.
RESUMEN
【Objective】 To investigate the prevalence and risk factor of hepatitis E virus(HEV) infection among blood donors in Wuhan. 【Methods】 A total of 1 302 serum samples (including 1 076 with normal ALT and 226 with elevated ALT) from blood donors were randomly collected from January to December 2021 in Wuhan Blood Center. Anti-HEV IgG, IgM and HEV antigen (Ag) were examined by enzyme-linked immunosorbent assay (ELISA). The IgM or Ag positive and elevated ALT samples were subjected to real time-PCR to detect HEV RNA. Multivariable logistic regression modeling was used to examine the risk factors associated with HEV prevalence. 【Results】 Overall, the positive rates of anti-HEV IgG, IgM, and Ag were 16.44%, 1.0% and 0.08%, respectively. However, none of the serum samples were HEV RNA positive. The prevalence of anti-HEV IgG and anti-HEV IgM was similar in samples with increased ALT and normal ALT (IgG 13.72% vs 17.01%, P>0.05; IgM 1.33% vs 0.93%, P>0.05). Multivariate analysis revealed a strong statistical association between age and HEV IgG seroprevalence. The prevalence increased with increasing age, from 5.4% (18~25 years old) to 68.7%(the highest) in blood donors above 46 years (P<0.05). 【Conclusion】 HEV showed a seroprevalence among blood donors in Wuhan, some of whom were recent infections, suggesting a threat to the safety of blood transfusions. A low anti-HEV prevalence in young adults (18~25 years) is indicative of a susceptible population and implicates a higher risk of HEV infections in this age group in the future.
RESUMEN
Objective:To investigate the safety, efficacy and application indication of intra-operative cell salvage (IOCS) in cesarean section.Methods:A total of 1 265 pregnant women who received IOCS blood transfusion during cesarean section in 11 tertiary A hospitals from August 2016 to January 2019 were collected and divided into <1 500 ml group (796 cases) and ≥1 500 ml group (469 cases) according to the amount of blood loss during cesarean section. The general clinical data, ultrasonic imaging data, perinatal and puerperium indicators were analyzed retrospectively. The risk factors of intraoperative blood loss ≥1 500 mL using IOCS transfusion were analyzed by logistic multivariate regression.Results:(1) A total of 848 001 ml of blood was recovered and a total of 418 649 ml of blood was transfused in 1 265 pregnant women who received IOCS transfusions, which was equivalent to 23 258 U red blood cell suspension, greatly saving medical resources. The intraoperative blood loss in <1 500 ml group and ≥1 500 ml group was 800 ml (300-1 453 ml) and 2 335 ml (1 500-20 000 ml), respectively. No amniotic fluid embolism, severe adverse reactions, shock and death occurred in the two groups. (3) Multivariate regression analysis showed that age ≥35 years ( OR=1.5, 95% CI: 1.1-1.9), prenatal hemoglobin level <110 g/L ( OR=1.7, 95% CI: 1.3-2.2), history of uterine surgery ( OR=1.8, 95% CI: 1.3-2.6), placenta previa ( OR=1.9, 95% CI: 1.1-3.1), placenta accreta ( OR=2.6, 95% CI: 1.8-3.9), blood pool in the placenta ( OR=1.6, 95% CI: 1.1-2.3), abnormal posterior placenta muscle wall ( OR=1.8, 95% CI: 1.2-2.6), placenta projecting to the anterior uterine wall ( OR=3.0, 95% CI: 1.3-7.0) were risk factors for blood loss ≥1 500 ml in obstetric transfusion using IOCS technique, with statistical significance (all P<0.05). Conclusion:IOCS is safe and effective in cesarean section, which could save the medical resources and reduces medical expenses, however, it is necessary to strictly master the application indication.
RESUMEN
Objective To explore the efficacy and safety of uterine lower posterior wall breakwater-like suture technique in controlling the intraoperative bleeding of placenta previa. Methods From June 2016 to June 2017,47 patients were diagnosed placenta previa in Union Hospital,Tongji Medical College of Huazhong University of Science and Technology.Posterior wall breakwater-like suture technique was used preferentially,as for cases with poor myometrium layer,lower anterior wall stitch suture was used at the same time.Bilateral descending branches of uterine artery ligation and Cook balloon compression of uterine lower segment was conducted when necessary. The clinic data of the 47 cases were analyzed. Results Thirty cases(63.8, 30/47)were diagnosed placenta inccreta or percreta by ultrasound or MRI preoperatively.Senventeen cases were diagnosed as placenta accreta(36.2%,17/47).Thirty-four cases had the previous history of cesarean section.The average cervical canal length of 47 patients was(2.8±0.9)cm. There were 19 cases(40.4%,19/47)with 1 time posterior wall breakwater-like sutured and 16 cases (34.0%,16/47)with 2 or 3 times posterior wall breakwater-like sutured; 12 cases(25.5%,12/47)were treated with anterior wall stitch suture simultaneously.Ten cases(21.3%, 10/47)underwent uterine artery ligation, 17 cases(36.2%, 17/47)underwent COOK balloon compression on the staxis surface of lower segment. None of them had postpartum hemorrhage or performed internal iliac artery embolization. The median blood loss in the operation was 700 ml,the percentiles 25 was 500 ml,and the percentiles 75 was 1 200 ml.The blood loss≥1 000 ml in 18(38.3%,18/47)patients,and the most serious one was 2 500 ml. The median blood transfusion volume(including allogenetic transfusion and autotransfusion)was 450 ml, the percentiles 25 was 228 ml,and the percentiles 75 was 675 ml.The average vaginal bleeding volume was (150 ± 63)ml first day after operation. The mean hospitalization time was(4.7 ± 1.0)days. The mean gestational weeks of pregnancy termination was(36.1±1.5)weeks,and the mean birth weight of newborns was(2 817±492)g.Apgar score:1-minute 7.8±1.1,5-minute 8.9±0.8.No neonatal death, 16 cases were transferred to neonatal ICU(34.0%, 16/47)mainly for premature delivery and low birth weight. No complication was found in 6 months post-operation. Conclusions Uterine posterior wall breakwater-like suture technique is a simple,safe and effective way in controlling intraoperative bleeding of placental previa. Lower anterior wall stitch suture could effectively stop bleeding and restore the normal uterine shape. Combined application of various methods could significantly reduce the incidence of postpartum hemorrhage and hysterectomy,and improve maternal and fetal prognosis.
RESUMEN
This study investigated the role of netrin-1 in placental vascular development. In vitro rat aortic ring assay and in vivo Matrigel plug assay were conducted to exmaine the effect of netrin-1 on angiogenesis. Human placental microvascular endothelial cells (HPMECs) were isolated and cultured and their viability, migration and tubular formation were studied, in order to examine the effects of netrin-1. The results showed that netrin-1 potently stimulated neovascularization in a mouse Matrigel plug in vivo and the sprouting of endothelial cells in rat aortic rings in vitro. In addition, netrin-1 enhanced the viability, migration and tube formation of HPMECs. Our study suggested that netrin-1 could significantly promote the formation of blood vessels of human placenta and may be a potential target for developing new therapeutic strategies for placental vasculature-related diseases.
RESUMEN
Objective To study influence on angiogenesis of placenta by gene silencing of netrin-1.Methods Netrin-1 gene in human umbilical vein endothelial cells(HUVEC)and placenta of pregnant rats were silenced by RNA interference.The following methods were used in this study,including the phenytetrazoliumromide(MTT)for viability,clone formation for proliferation,transwell for migration,and tube formation for angiogenesis in vitro.The change of fetal growth was recorded.Placental microvessel density in pregnant rats was measured by immunohistochemical CD34 staining in vivo.Results (1)HUVEC:viability and proliferation of HUVEC were remarkably inhibited by gene silencing of netrin-1.which number of clone formation,migration cell,tube formation were from(69±6)%,86±17,37±9 decreased to(46±5)%,46±13 and 17±5(P＜0.05)respectively.(2)Placenta of pregnant rats:after netrin-1gene silenced,fetal weight were decreased from(2.39 ±0.17)g to(2.12±0.10)g(P＜0.05).Placental microvessel density was decreased from(258±38)/mm2 to(197±32)/mm2 in vivo(P＜0.05).Conclusions Gene silencing of netrin-1 could inhibit viability,proliferation,migration,tubal formation of HUVEC and angiogcnesis of placenta.Netrin-1 plays an important role in regulating angiogenesis in placenta.
RESUMEN
Objective To investigate the effects of Netrin-1 on angiogenesis in vitro and in vivo. Methods We performed in vitro rat aortic ring assay and in vivo Matrigel plug assay to determine the effect of Netrin-1 on angiogenesis. Results 10 μg/L, 50 μg/L and 100 μg/L Netrin-1 stimulated microvessel sprouting from the adventitia of aortic rings and the effect reached maximum at 50 μg/L The in vivo Matrigel plug assay showed orange color change if Nestrin-1 was positive; and CD34 immunofluorescent staining showed vascular structures in the Matrigel plug with hemachrome ( 53.4 ± 7. 3 ), which was significantly higher than control ( 5. 8 ± 0. 9 )Conclusions Netrin-1 can induce angiogenesis in vitro and in vivo.