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Objective@#To investigate the promotional effect of the new teaching method of goal orientation combined with plan-do-check-act (PDCA) cyclic improvement on specialized medical knowledge and operation skills among physicians in critical care medicine.@*Methods@#A total of 84 physicians who received critical care medicine training in Department of Critical Care Medicine in Foshan Hospital of Traditional Chinese Medicine from January 2013 to December 2015 were selected, and according to the time of admission, they were divided into control group with 41 physicians and experimental group with 43 physicians. The physicians in the experimental group received the new teaching method of goal orientation combined with PDCA cyclic improvement, i.e., the physicians started systematic learning according to the learning goals sent out by the teaching secretary, summarized problems during learning and looked for optimal solutions every week, and then continued learning in the next week through PDCA cyclic improvement. The physicians in the control group received traditional teaching combined with bedside teaching, but no learning goals were set for them. The two groups were compared in terms of theoretical examination scores, clinical operation skills, and results of the questionnaire survey. The t-test and Wilcoxon ranksum test were used for comparison of scores between the two groups by SPSS 18.0.@*Results@#Compared with the control group, the experimental group had significant increases in the scores of theoretical examination (91.50±4.18 vs. 87.80±3.63) and operation skills (88.80±3.34 vs. 85.40±2.88). The questionnaire survey showed that compared with the control group, the experimental group had a significantly higher degree of satisfaction, significantly greater learning interests, and significantly greater improvements in operation skills, clinical thinking ability, and self-confidence.@*Conclusion@#The new teaching method of goal orientation combined with PDCA cyclic improvement can stimulate learning interests, clarify learning goals, help physicians to master important and difficult issues, and thus improve their learning outcomes and scores in Department of Critical Care Medicine.
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Objective To investigate the promotional effect of the new teaching method of goal orientation combined with plan-do-check-act (PDCA) cyclic improvement on specialized medical knowledge and operation skills among physicians in critical care medicine.Methods A total of 84 physicians who received critical care medicine training in Department of Critical Care Medicine in Foshan Hospital of Traditional Chinese Medicine from January 2013 to December 2015 were selected,and according to the time of admission,they were divided into control group with 41 physicians and experimental group with 43 physicians.The physicians in the experimental group received the new teaching method of goal orientation combined with PDCA cyclic improvement,i.e.,the physicians started systematic learning according to the learning goals sent out by the teaching secretary,summarized problems during learning and looked for optimal solutions every week,and then continued learning in the next week through PDCA cyclic improvement.The physicians in the control group received traditional teaching combined with bedside teaching,but no learning goals were set for them.The two groups were compared in terms of theoretical examination scores,clinical operation skills,and results of the questionnaire survey.The t-test and Wilcoxon ranksum test were used for comparison of scores between the two groups by SPSS 18.0.Results Compared with the control group,the experimental group had significant increases in the scores of theoretical examination (91.50 ± 4.18 vs.87.80 ± 3.63) and operation skills (88.80± 3.34 vs.85.40 ± 2.88).The questionnaire survey showed that compared with the control group,the experimental group had a significantly higher degree of satisfaction,significantly greater learning interests,and significantly greater improvements in operation skills,clinical thinking ability,and self-confidence.Conclusion The new teaching method of goal orientation combined with PDCA cyclic improvement can stimulate learning interests,clarify learning goals,help physicians to master important and difficult issues,and thus improve their learning outcomes and scores in Department of Critical Care Medicine.
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Objective To observe the effect and safety of the endovascular hypothermia through hypothermic intravenous infusion device in the treatment of patients with severe craniocerebral injury compared with conventional surface cooling. Methods A total of 66 cases of patients with severe cranio-cerebral injury were randomly divided into the observation group and the control group with 33 cases in each group according to envelop randomization. The control group received surface cooling, and the observation group was given surface cooling plus endovascular hypothermia through hypothermic intravenous infusion device. The target temperature was 35 ℃maintained for 3-5 days, and natural rewarming was applied at the speed of 0.1-0.5℃/h to 36.0-37.3℃. The time to reach target temperature, the constant stability, the incidence rate and severity of complication such as shiver, arrhythmia, skin injury and agitation were recorded and compared between two groups, as well as the heart rate, breathing rate, pulse rate, blood pressure and Glasgow Coma Scale (GCS) scores after 72 h of treatment. Glasgow Outcome Scale scores 30 days after treatment and nursing workload were also calculated and compared. Results The cooling speed, time to reach target temperature and the ability to maintain at 35℃were (1.3±0.2)℃/h, (2.3±0.2) h and (6.5± 1.8)%in the observation group, respectively, compared with (0.5±0.1)℃/h, (3.6±0.6) h and (11.3±2.2)%in the control group, which had significant differences (t=1.862, 2.112, 2.408,P < 0.05). The occurrence rates of shiver, arrhythmia, skin damage and dysphoria and restlessness in the observation group were 33.33%(11/33), 9.09%(3/33), 6.06%(2/33) and 27.27%(9/33), respectively, which were much lower than those in the control group 84.85%(28/33), 15.15%(5/33), 33.33%(11/33), 54.55%(18/33),χ2=1.764-2.733,P<0.05. The heart rate, breathing rate, pulse rate, systolic blood pressure and GCS score after 72 h of treatment were(68.31 ± 3.73)times/min,(16.60 ± 1.52)times/min,(136.35 ± 3.71)mmHg(1 mmHg=0.133 kPa),(34.61 ± 1.05)℃, (9.91±4.05)points in the observation group, while(58.31±3.62)times/min,(19.81±1.83)times/min,(150.66± 2.70)mmHg,(35.65 ± 1.36)℃,(7.63 ± 3.17)points in the control group, and there were significant differences between two groups(t=2.275-3.035, P < 0.05).Besides, the ice-changing ice and turning-over time in the observation group were both remarkably reduced compared with control group, (14.03±3.11) min/h vs (38.12± 2.70) min/h (t=3.356, P<0.05) , (15.08±3.07) min/h vs (26.16±2.54) min/h ( t=3.021, P<0.05). Patients with good recovery, mild disability, severe disability, death in the observation group were 16, 13, 3 and 1 case, while 6, 11, 9, 7 cases in the control group (χ2=2.351,P < 0.05). Conclusions The endovascular hypothermia through hypothermic intravenous infusion device can rapidly reduce and effectively maintain target temperature, reduce the incidence rate of complication, improve the vital signs and decrease the nursing workload in order to improve neurological outcome in the treatment of patients with severe craniocerebral injury.
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Objective To study effect of Xuebijing injection on coagulation function and prevention of deep venous thrombosis in elderly fracture patients with mechanical ventilation.Methods 60 patients were randomly divided into control group(30 cases) and Xuebijing group(30 cases).Xuebijing group received Xuebijing injection, besides physical therapy for prevention of deep venous thrombosis received by control group.Coagulation parameters and Lac at different time points,thrombosis incidence,hemorrhage incidence APACHE II score and 28 -day mortality were compared between the two groups.Results In Xuebijing group,PT,APTT,DD on d3 and Fg 48 on d5 had statistically significant differences compared with before treatment.PT,APTT on d3,d5 and DD on d5 were statistical-ly different compared with the control group(P <0.05).PLT,Lac,hemorrhage incidence and 28 -day mortality had no significant differences between the two groups.Thrombosis incidence in Xuebijing group was significantly lower than the control group(20.00% vs 3.33%) (χ2 =4.043,P =0.044,P <0.05).Both of APACHE II score were lower than before treatment,but the Xuebijing group was significantly decreased(t =5.48,P =0.000,P <0.05). Conclusion Xuebijing injection could improve coagulation function,and decrease thrombosis incidence in elderly fracture patients with mechanical ventilation.
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Objective To study the effect of Xuebijing injection on transfusion and systemic inflammation in traumatic coagulopathy patients. Methods Seventy-nine patients were randomly divided into Xuebijing Group (36 cases) and Control Group (43 cases). Xuebijing group received Xuebijing injection in addition to the regular treatment received by control group. Levels of TNF-α, IL-6, IL-8 and transfusion amount between two groups were compared. Results Coagulation abnormality was almost corrected in all patients after treatment. In Xuebijing Group, transfusion of RBC, FFP and cryoprecipitate were significantly less than that in control group (P<0.05). At 72 h after admission, TNFα, IL-6 and IL-8 were significantly lower in Xuebijing Group (P < 0.05). Conclusion Xuebijing injection could reduce transfusion in traumatic coagulopathy patients , possibly resulting from its antagonism against systemic inflammation.
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To construct, express, purify and identify the Myc-R9-EGFP fusion protein and validate its transduction activity in the cultured porcine embryo fibroblasts. cDNA of pig c-Myc gene was amplified by RT-PCR with specific primers of 9 arginine (R9) from the primordial genital ridges and inserted into prokaryotic expression vector pET-28a-EGFP. After DNA sequencing confirmation, the recombinant plasmid was then transformed into BL21 (Escherichia coli) strain. After IPTG induction, the target fusion protein was efficiently induced to express, successfully purified by Novagen His-Bind kit, identified by SDS-PAGE and Western blotting. Finally, its high transduction activity in the porcine embryo fibroblasts was validated. The purified Myc-R9-EGFP fusion protein and the validation of its transduction activity in fibroblasts have provided an experimental foundation for further studies on the biological characterization of Myc protein, and soundly facilitated the further study of establishing pig induced pluripotent stem cells by recombinant protein.
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Animals , Arginine , Genetics , Metabolism , Cell Line , Cell Membrane Permeability , Escherichia coli , Genetics , Metabolism , Fibroblasts , Cell Biology , Metabolism , Genetic Vectors , Genetics , Green Fluorescent Proteins , Genetics , Metabolism , Proto-Oncogene Proteins c-myc , Genetics , Metabolism , Recombinant Fusion Proteins , Genetics , Metabolism , Pharmacokinetics , SwineABSTRACT
A human fundus transverse microscopic imaging system based on a MEMS deformable membrane mirror was developed. A 37 element small MEMS deformable membrane mirror was used as wave front corrector in this system. Wavefront errors were measured by a Hartman-Shack wave front sensor which contains 127 micro lens lets. After the wavefront error of human eye had been corrected by the deformable membrane mirror under the control of a computer, the imaging illumination light was triggered by a electronic shutter to illuminate the retina, the images were captured by a CCD camera. It has been showed in model eye's test that the system could measure and correct the eye's wavefront aberration efficiently. The fundus image achieved the diffraction limit after aberration correction. It was showed in clinic that except a few patients with turbid eye, most patients could finish the process of measuring and correcting wavefront aberration and then taking fundus image. The examination process could be finished safely, quickly and reliably.
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Humans , Diagnostic Imaging , Methods , Equipment Design , Fundus Oculi , Lighting , Microcomputers , Ophthalmoscopes , Photomicrography , MethodsABSTRACT
BACKGROUND: Inflammatory mediators-induced neurodocitis in the nucleus pulposus is a main factor for backleg pain. Receptor pathway studies confirmed that the nervous system had self-circulation. Administration by receptors has the same effect as targeting drug delivery. OBJECTIVE: To evaluate the therapeutic efficacy of drug injection on synovium of lumbar zygapophyseal joints and muscular attachment point of neural scute in 1 236 patients with discogenic low back pain. DESIGN,TIME AND SETTING: The case analysis experiment was performed at the First People’s Hospital from March 2002 to March 2007. PARTICIPANTS: 1 236 patients with discogenic low back pain were selected at the Department of Pain,including 370 males and 866 females,aged from 20 to 80 years. The patients accompanied with bulging of lumbar intervertebral disc and protrusions less than 1/3 vertebral canal. METHODS: Drugs were injected on bulges of lumbar intervertebral disc,protuberate zygapophysis and neural scute. General pharmaceutical formulation: Betamethason copound injection 5 mg+ levofloxacin 0.1 g+20 g/L lidocaine 5 mL+sacine metered to 20 mL+ sodium hyaluronate 20 mg. The administration was once a week and one course of treatment had three administrations. There was no overweight loading during one month. MAIN OUTCOME MEASURES: Therapeutic efficacy; relapse rate. RESULTS: In 1 236 patients with one course of treatment,there were healing in 1 142 cases (94%),improvement in 89 cases (7.2%),inefficacy in 5 cases (0.4%). In 322 patients with one year consummate data,there were no relapse in 250 cases (77.6%),relapse in 72 cases (22.4%). In 206 patients with two year consummate data,there were no relapse in 155 cases (75.2%),relapse in 51 cases (24.8%). In 91 patients with three year consummate data,there were no relapse in 74 cases (81.3%),relapse in 17 cases (18.7%). In 62 patients with four year consummate data,there were no relapse in 52 cases (83.8%),relapse in 10 cases (16.2%). In 32 patients with five year consummate data,there were no relapse in 27 cases (84.3%) and relapse in 5 cases (15.6%). CONCLUSION: Drug injection on synovium of lumbar zygapophyseal joints and muscular attachment point of neural scute through receptor-mediated pathway is simple and available in patients with discogenic low back pain.
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In the laser ablation refractive surgeries, the corneal ablation model and its realization by laser are difficult to design. They greatly affect the results of those surgeries. This paper firstly presents a mathematical model for corneal ablation to correct the refractive error of spherical myopia, and then gives a technique of planning laser focus positions on cornea to realize the ablation model. Based on the principle of the correction for spherical myopia using small beam laser, our excimer laser corneal surgery system has been able to perform such refractive surgery. Now the corneal surgery system has been applied to clinical practice. Thirty-nine eyes with spherical myopia underwent LASIK using this kind of system. Their refractive states have been greatly improved. Preoperatively, the mean sphere was -5.57+/-2.95 D and the mean uncorrected visual acuity 0.12+/-0.07. One day after surgery, the mean sphere was -0.03+/-0.57 D and the mean uncorrected visual acuity 0.90+/-0.29. One month after surgery, the mean sphere was -0.68+/-0.98 D, and the mean uncorrected visual acuity 1.0+/-0.26.
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Humans , Lasers, Excimer , Models, Biological , Myopia , General Surgery , Photorefractive Keratectomy , Methods , Treatment Outcome , Visual AcuityABSTRACT
The excimer laser diopter correction has proven to be efficient and safe. This paper presents the principle of excimer laser refractive surgery. Based on analyzing the mathematics model of the human eye cornea, the authors have proposed a new model which can be used to proceed the myopia, hyperopia, astigmatism diopter correction. Also studied were the excimer laser's ablation mechanism and the flying-spot scanning technology. The research results have been directly applied to Ophthalmic excimer laser system. The correction of diopter is well improved.
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Humans , Algorithms , Cornea , Keratomileusis, Laser In Situ , Methods , Lasers, Excimer , Models, Theoretical , Photorefractive Keratectomy , Methods , Refractive Surgical ProceduresABSTRACT
Five known compounds have been isolated from the culture of an endophytic fungus Fusarium sp., which was originated in a seagrass Spartina alterniflora. Their structures have elucidated by TLC comparision with standard and spectral methods as ergosterol (Ⅰ), ergosterol peroxide (Ⅱ) cinnamic acid (Ⅲ), para-hydroxyphenylpropionic acid (Ⅳ) and beauvericin (Ⅴ), respectively.
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Objective To investigate the effectiveness of treating postherpetic neuralgia (PHN) by intradermal drug injection.Methods Ten rabbits of both sexes weighing 2.3-2.8 kg were anesthetized with intravenous urethane 1.5 g/kg. In group A (n = 5) 30% horseradish peroxidase(HRP) 500 ?l and in group B (n = 5) 1%-2% fluorescent nuclear yellow (NY) 500?l were injected intradermally at 6-8 points along the both sides of spine in the scapula region. After 48-72 h the animals were sacrificed and C4 -T10 spinal ganglia, cervical and thoracic sympathetic ganglia and celiac ganglia were harvested for identification of labeled neurocytes. Results Labeled neurocytes were found in C4-T10 spinal ganglia, cervical and thoracic sympathetic ganglia and celiac ganglia. There were more labeled neurocytes in the C6-T8 spinal ganglia. There were more labeled neurocytes in the sympathetic ganglia than in the spinal ganglia. The distribution of fluorescent labeled neurocytes corresponded to neurocytes labeled by HRP method. At the same segment there were more fluorescent labeled neurocytes than neurocytes labeled by HRP. Conclusion There is an ascending axoplasma streaming channel from nerver ending to the neurocytes in the ganglion as shown by morphological study and the good therapeutic effect of intradermal drug injection in the treatment of PHN may be related to this channel.