ABSTRACT
Objective:To explore the feasibility and preliminary effect of improving the comprehensive quality of medical students by introducing the teaching model of cleft lip and palate treatment platform in medical education.Methods:A total of 40 grade two undergraduates of Shantou University medical college were randomly divided into experimental group ( n=20) and control group ( n=20). The students in the experimental group were the volunteers of Cleft lip and palate treatment center, receiving the characteristic idea and methods in clinical teaching. The control group received conventional teaching. The evaluation indicators, including the intellectual quality (60 points), moral quality (15 points), humanistic quality (5 points), physical and mental quality (10 points), social practice (10 points), were quantified by fuzzy evaluation method and a professional evaluation team was set up to evaluate the effect of teaching. SPSS 19.0 was used to perform t test for comparison between the two groups. Results:The average scores of the above items in the experimental group were respectively (51.477±2.381), (10.613±0.169), (4.228±0.124), (8.677±0.296), and (8.565±0.421), and the average total score was (83.559±2.333); the average scores of above items in the control group were respectively (49.746±3.176), (10.268±0.266), (4.008±0.195), (8.207±0.354), and (7.575±0.321), and the average total score was (79.804±3.510). Statistical difference was found in all scores except the intellectual quality score between the two group ( P<0.05). Conclusion:Though no significant difference was found in the intellectual quality, the other qualities have played important roles in improving medical students' comprehensive quality. It is significant to improve the medical students' comprehensive quality by the method of cleft lip and palate treatment platform.
ABSTRACT
Objective To study the effect of dexmedetomidine combined with sufentanil on postoperative analgesia and stress response in laparoscopic gastrectomy .Methods 80 patients with gastric cancer who underwent laparoscopic resection from March 2014 to March 2015 in Yiwu Central Hospital were selected as the subjects . According to draw method ,the patients were divided into the observation group and the control group ,with 40 patients in each group.All patients were treated with laparoscopic resection,midazolam,atropine sulfate,propofol,sufentanil citrate and rocuronium were used for anesthesia .The control group was given sufentanil analgesia after operation ,while the observation group was given dexmedetomidine combined with sufentanil .The awake time ,extubation time ,agitation rate,incidence of postoperative cognitive dysfunction (POCD),epinephrine(E),norepinephrine(NE),cortisol(Cor), oxygen saturation(SpO2),mean arterial pressure(MAP),heart rate(HR),visual analogue scale(VAS) and changes of inflammatory factors in T0(before operation),T1(at the end of surgery),T2(extubation),T3(10 min after extuba-tion),T4(20 min after extubation) of the two groups were compared .Results There was no statistically significant differences between the two groups in awake time and extubation time (all P>0.05).The incidence rates of restless-ness and POCD in the observation group were significantly lower than those in the control group (5.0％vs.25.0％, 7.5％vs.30.0％)(χ2 =6.275,6.646,all P<0.05).At T1,T2,T3 and T4,the E,NE and Cor levels in the two groups were significantly higher than those in T0(all P<0.05),the levels at T2 were the highest,then graduallydeclined ,the rising degree and maximum values of the observation group were significantly lower than those of the control group(all P<0.05).The elevated degree of MAP in the observation group was significantly lower than that in the control group(P<0.05).At T1,T2,T3,HR in the control group significantly increased (all P<0.05),HR at T2 was the highest,at T4 droped.At T1,T2,T3 and T4,HR in the observation group all decreased ,which were lower than those in the control group(all P<0.05).Postoperative 4h,8h,24h,the VAS scores of the observation group were significantly lower than those of the control group [(4.30 ±0.50) points vs.(7.07 ±0.98) points,(4.01 ± 0.46) points vs.(6.28 ±0.90) points,(2.79 ±0.31) points vs.(4.27 ±0.60) points](t =15.924,14.204, 13.860,all P<0.05).The levels of TNF -α,IL-6 and IL-10 in the observation group were significantly lower than those in the control group ( all P <0.05 ).Conclusion Dexmedetomidine combined with sufentanil has significant analgesic effect in laparoscopic gastrectomy for gastric cancer .It can stabilize the hemodynamics , relieve stress reaction and regulate inflammatory factors ,and is beneficial to the recovery of the patients .
ABSTRACT
Objective:To investigate the optimal time of coronary computed tomography angiography (CCTA) after taking nitroglycerine,and to provide basis for improving the image quantity of CCTA .Methods:43 patients underwent CCTA were scanned with coronary artery calcium score (CACS)after taking nitroglycerin 0,3,5 and 10 min.Then the diameters of the same coronary artery from the same anatomic location and the expanding rates were measured,and the change regular was analyzed with single factor analysis of variance of SPSS 17.0 software. Results:The average coronary artery expanding rate was 8% 3 min after taking nitroglycerin, and the difference was significant compared with 0 min (P0.05 ).Conclusion:Taking nitroglycerin can significantly expand the diameter of coronary arteries.It is necessary to perform CCTA during 5-1 0 min after taking nitroglycerine.
ABSTRACT
Objective To observe the early onset breast cancer ( EOBC) sonographic performance character-istics and explore the diagnostic value of ultrasonography in EOBC .Methods 60 cases EOBC patients younger than 35 years old were seclected as the observation group .Older than 35 years of 50 patients with breast cancer were se-clected as the control group .Two groups were underwent breast color Doppler ultrasound .Results 59 cases in 60 pa-tients with preoperative ultrasound diagnosis of breast cancer ,one case was misdiagnosed as mastitis pseudotumor infil-trating ductal carcinoma ,lobular carcinoma ,ductal carcinoma in ultrasound showed more direct signs ,medullary carci-noma showed more indirect signs .Clumps were main types of breast cancer of the observation group and control group , respectively,accounted for 72.9% and 87.5%,the difference was statistically significant (χ2 =6.293,P0.05);Compared with the control group ,heterogeneous internal echo,rear attenuation of observation group had significant differences (P<0.05).Foci were observed group EOBC anteroposterior diameter and aspect ratio were significantly lower than that of the control group ,the difference was statistically significant(t =6.720,9.285,all P <0.05);diameter was significantly higher (t =34.962,P <0.05).Conclusion Early-onset breast cancer at diagnosis with color Doppler ultrasound large diameter aspect ratio is small,and the rear common heterogeneous internal echo attenuation less characteristic features ,screening younger women for breast cancer is important .