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Objective:To explore the application effect of standardized patient combined with situational simulation teaching in the course of Intensive and Critical Diseases Care among higher vocational college students.Methods:A total of 66 nursing students in direction of intensive care from Batch 2015 and 60 ones from Batch 2016 were selected as the control group and the experiment group respectively. The control group adopted traditional teaching method, while the experiment group adopted the model of standardized patient combined with situational simulation teaching on the basis of traditional teaching methods. Before teaching, we designed the standard cases of the course, set up and trained the standardized patient team members. Then the standardized patient combined with situational simulation teaching was applied to the experimental teaching of the course. At the end of the course, the comparison of the theoretical examination score and the operational examination score of the two groups of students was made, and the self-designed questionnaire survey for the experimental group was used to evaluate the teaching effect.Results:The theoretical examination score [(82.80±4.17) points] and the operational examination score [(85.90±1.85) points] of students in the experiment group were higher than those of students in the control group [(80.74±3.15) points vs. (83.82±1.91) points], with significant differences ( P<0.01). The results of self-designed questionnaire survey showed that more than 90.0% of the students from the experiment group thought that this teaching mode could improve their interest in learning and subjective initiative; more than 76.7% thought that this teaching mode could improve their own abilities such as observation of disease changes, communication, teamwork and clinical thinking; more than 93.3% recognized the application of this teaching mode. Conclusion:The application of standardized patient combined with situational simulation teaching could improve the theoretical knowledge and operational skills of the students, and could also train the students' comprehensive quality such as clinical thinking, emergency handling ability, communication ability and so on, so as to improve the teaching effect.
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Objective To analyze liver function damage and blood lipid difference in fatty liver patients of different ages.Methods From January 1,2016,to December 31,2017,a total of 15 163 non-alcoholic fatty liver (NAFLD) patients from the Changhai Hospital Medical Center were collected as NAFLD group,and 24 273 normal non-fatty liver patients were used as non-fatty liver group.The two groups were divided into 14 age groups.All age groups were stratified according to normal,abnormal and blood lipids,ideal,marginal and abnormal.The chi-square test was used to analyze the differences in liver function and blood lipids between age groups.Age and analysis of function and dyslipidemia rates and comparison between groups.Results There were differences in alanine aminotransferase (ALT) and aspartic acid aminotransferase (AST) levels between different fatty liver age groups (P＜0.05);x2 was 693.79 and 126.67,respectively.With the increase in age,ALT had a downward trend before the age of 69,and AST had a downward trend before the age of 49.The abnormal rate of ALT was ≥32.3％ in people under 24 years old,10.9％-28.5％ in people 25-54 years old and,≤8.7％ in people over 55 years old.The abnormal rate of AST was ≥30％ in people under 19 years old,10.6％-15.9％ in people 20-29 years old,and ≤7.8％ in people over 30 years old.The levels of high-density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),triacylglycerol (TG),and total cholesterol (TC) in non-alcoholic fatty liver disease of different age groups were statistically significant (x2=181.04,231.35,194.90,203.44,respectively,P＜0.05).The abnormal rates of HDL-C,LDL-C,TG,and TC were 30-34 years old,55-64 years old,45-49 years old,60-64 years old,respectively.The abnormal rate of HDL-C in the NAFLD group and the non-fitty liver group was 28.0％ and 3.4％,respectively,in 30-34 years old,LDL-C was 14.2％ and 4.7％,respectively,in 40-44 years old,and TG was 31.7％ and 4.9％,respectively,in 40-44 years old;the three age groups were the peak of the gap.The marginal rates of TG in the 30-34 age group NAFLD group and non-fitty liver group were 23.5％ and 5.5％,respectively,and it was most obvious in all age groups.Conclusion ALT and AST damage caused by NAFLD is most common in people under 54 years old and 29 years old,with abnormal rates of ≥10.9％ and ≥10.6％,respectively.The abnormal rate of blood lipids in NAFLD patients is higher than that in normal people.The abnormal rate of HDL-C is 30-34 years old,LDL-C is 40-44 years old and,TG is 40-44 years old.The marginal rate difference of TG in the 30-34 age group and the normal group was the most obvious.
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Objective Toinvestigatetheeffectoffolicacidonplasmahomocysteine(Hcy)levels and vascular endothelial function in elderly cerebral infarction patients with hyperhomocysteinemia. Methods Thisstudywasaprospectivecontrolledtrial.Atotalof112elderlylacunarinfarction patients with high hyperhomocysteinemia admitted to the Department of Neurology,Nanjing Municipal Government Hospital from November 2012 to October 2013 were enrolled. The patients were divided into two groups according to the method of random number table. The patients of both groups received the conventional drug treatment of ischemic stroke at the same time. Fifty-six patients were in group A,and they were treated with folic acid 20 mg,once a day;56 patients were in group B,and they did not treat with folic acid. The Hcy levels on admission and after 24 weeks treatment were measured. Brachial artery flow-mediated endothelium-dependent dilation (FMD)was measured by high resolution ultrasound,and nitric oxide (NO), nitricoxidesynthase(NOS),andendothelin(ET)weredetectedatthesametime.Results Twenty-four weeks after treatment,the plasma Hcy level in group A was significantly decreased as compared with prior treatment (12. 2 ± 4. 2 vs. 22. 6 ± 3. 7μmol/L;P<0. 05),moreover,it was lower than the level of group B at the same period (12. 2 ± 4. 2 vs. 21. 8 ± 4. 0μmol/L;P <0. 05 ). The FMD level of group A was significantly higher than that of prior treatment and group B (11. 2 ± 3. 6 vs. 9. 2 ± 3. 3,9. 3 ± 3. 3;P<0. 05). The NO and NOS levels of group A at 24 weeks after treatment were significantly higher than those of prior treatment and group B at the same period (76. 2 ± 9. 4 vs. 49. 2 ± 9. 0,50. 0 ± 9. 1μmol/L,47. 6 ± 9. 5 vs.38. 4 ± 7. 5,37. 8 ± 8. 8 kU/L;P<0.05). The ET level of group A was decreased as compared with that of prior treatment and group B at the same period (81. 3 ± 20. 5 vs. 105. 6 ± 25. 2,105. 3 ± 21. 8 ng/L;P<0.05).NoadversereactionwasfoundduringthetreatmentingroupA.Conclusion Alargerdoseof folic acid can significantly reduce the plasma Hcy level,decrease the FMD level,and ameliorate vascular endothelial function in elderly cerebral infarction patients with hyperhomocysteinemia.
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Objective Studying information disclosure at China' s public hospitals and recommending on information disclosure policies.Methods Collecting and analyzing the websites of 80 public hospitals in five main Chinese cities (Beijing,Shanghai,etc.).Results Information disclosure by these hospitals is found to be identical,with a slight difference in information publicity.By percentage,the information disclosure of hospital profile,department navigation,specialists characteristics,hospital news,health education,and doctor-seeking guidance,is 100.0％,98.3％,95.0％,93.3％,90.0％and 88.3％respectively.The disclosure is found to be lack of general planning,objectivity,timeliness and sufficiency.ConclusionEstablishing the information disclosure system based on mandatory information disclosure,stipulating the content,approach and timing for public hospitals information disclosure.