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Objective:To study the effect of knowledge tree combined with problem-based learning (PBL) in the practice teaching of anesthesiology under the concept of multi-disciplinary team (MDT).Methods:A total of 60 students who practiced in the Department of Anesthesiology in Jiangsu Province Hospital from January 2019 to June 2019 were taken as the control group, and the traditional teaching was adopted; another 60 students who practiced from July 2019 to December 2019 were taken as the research group, and the knowledge tree combined with PBL under the MDT concept was conducted for the teaching. The two groups' test scores, clinical abilities and teaching satisfaction were compared between the two groups. SPSS 26.0 was used for t-test, Chi-square test and rank-sum test. Results:After the internship, the test scores of the students in the research group were higher than those in the control group ( P < 0.05); the clinical ability of the two groups were both improved compared to before the training, and the research group was superior to the control group ( P < 0.05); the satisfaction rate of internship students in the research group was 93.33% (56/60), which was higher than 75.00% (45/60) in the control group. Conclusion:The application of knowledge tree and PBL under the MDT concept in the practice teaching of anesthesiology can improve the performance of the intern students, and effectively improve the self-learning ability, communication and expression ability and teamwork ability of the interns, with obvious practice effect.
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Objective@#To assess the relationship between body mass index (BMI) and mortality in adults of Shanxi, China.@*Methods@#Baseline data were from the '2002 China Nutrition and Health Survey’ in Shanxi province. All the death-related investigation and follow-up visits were carried out from December 2015 to March 2016. The follow-up program covered 5 360 people from all the 7 007 participants aged 18 years and over that having complete core information, with a rate as 76.5%. Participants of this study were divided into eight groups, according to the appearance of BMI. Taking the group with the lowest mortality density as the reference group, Cox regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of deaths by the whole population, gender and age groups (≥60 years, <60 years). Results were then adjusted by age, gender, smoking, alcohol use and education level from the baseline survey. Sensitivity analysis was also conducted.@*Results@#Results from the study showed that among the total number of 67 129 person- years from the average period of 12.5 years, there were 615 deaths occurred, with the mortality density as 916 per 100 000 person-years. Taking the BMI range of 26.0-27.9 kg/m2 as the reference, the aHRs of death increased to 1.90 (95%CI: 1.26-2.86), 1.68 (95%CI: 1.15-2.45), 1.49 (95%CI: 1.08-2.06) and 1.72 (95%CI: 1.07-2.76) after the multivariate adjustment, in these four groups (BMI<18.5, 18.5-19.9, 22.0-23.9 and ≥30.0 kg/m2), respectively. Low body weight (BMI<18.5 kg/m2) was associated with higher risks of death in the elderly of ≥60 years, with the aHR of death as 1.94 (95%CI: 1.20-3.15).@*Conclusions@#When BMI appeared as ≤19.9 kg/m2, 22.0-23.9 kg/m2 and ≥30.0 kg/m2, the risks of death would increase. In addition to programs that focusing on obesity, special attention should be paid to the high risk of mortality which was caused by low-weight and malnutrition in the elderly.
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Objective To investigate the factors affecting pulse transit time during anesthesia. Methods Sixty cases of gastrointestinal surgery under general anesthesia were investigated.The pulse transit time (PTT),BP and HR were measured at the time before and after intravenous anes-thesia induction,and at the time before and after the injection of vasoactive drugs,respectively. Results Compared to at the time before injection,HR,SBP and DBP increased significantly,and PTT decreased significantly (P <0.01 )at the time after injection of atropine and ephedrine.Com-pared to at the time before injection,HR and PTT increased significantly,while SBP and DBP de-creased significantly (P < 0.01 )at the time after injection of nicardipine.While HR and PTT de-creased significantly,and SBP,DBP increased significantly (P <0.01 )with the injection of pheny-lephrine.Obvious negative correlation between SBP and PTT was observed before and after induc-tion;meanwhile,only weak correlation between DBP and PTT was observed,and no obvious correla-tion between HR and PTT was detected.SBP and PTT were well negatively correlated with the injec-tion of atropine,ephedrine,nicardipine or phenylephrine.Conclusion All the PTT changes during anesthesia were found to be negatively correlated with the systolic blood pressure.