ABSTRACT
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 The objective of this study was to investigate the effect of depression on serum levels of C-reactive protein(CRP)and high-sensitivity C-reactive protein(hs-CRP),and prognosis in liver cancer patients. Methods A total of 251 patients with liver cancer undergoing hepatectomy were enrolled. The hospital anxiety and depression scale( HADS-D) and 9-item patients health questionnaire(PHQ9) were assessed for depression before 3 days for surgery. Patients were divided into depression group(n=95)and non-depression group(n=156) according to the scores. Preoperative serum levels of CRP,hs-CRP,ALT and AST were measured and compared between the depression and non-depression groups. Survival analysis Kaplan-Meier method was used to compare the disease-free survival(DFS)and total survival(OS)between the two groups. Results The serum levels of CRP, hs-CRP,ALT and AST in the depression group were significantly higher than those in the non-depression group(P<0. 05). The follow-up of 3. 5-year showed that 164 patients(65 in depression group and 99 in non-depression group)had recurrence or metas-tasis and 47 patients(22 in depression group and 25 in non-depression group) died. The DFS and OS in the depression group were significantly lower than those in the non-depression group(P< 0. 05). Cox multiple regression analysis showed that liver function grading,BCLC staging and depression were independent risk factors for the prognosis of liver cancer. Spearman correlation analysis showed that patients′degree of depression was positively correlated with serum levels of CRP and hs-CRP(P<0. 05),DFS and OS were negatively correlated with serum levels of CRP and hs-CRP(P<0. 05). Conclusion Depression may mediate elevated serum levels of CRP and hs-CRP,maintain inflammatory response in patients,lead to increased liver function damage,elevate levels of ALT and AST,and thus adversely affect the prognosis of patients with liver cancer.
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Objective To investigate abnormal protein expression of matrix metalloproteinase-9 (MMP-9), vascular endothelial growth factor (VEGF) and proliferating cell nuclear antigen (PCNA) in human gastric adenoearcinoma, and further reveal the clinical significance. Method The MMP-9, VEGF and PCNA proteins expression was determined by immunohistochemistry staining in 45 gastric adenocarcinoma tissues, 45 adjacent specimens and 10 normal gastric mucosa tissues via tissue arrays accordingly. The relationship of these protein expression with differentiation degree, development and progression of gastric adenocarcinoma were also analyzed. Results Positive rates of MMP-9, VEGF and PCNA in gastric adenocarcinoma, adjacent specimens and gastric normal mucosa were as follows: MMP-9, 82.2%(37/45), 64.4% (29/45), 30.0% (3/10) (P=0.019); VEGF, 73.3% (33/45), 62.2% (28/45), 30. 0% (3/10) (P=0.029); PCNA,84.4% (38/45), 71.1% (32/45), 10.0% (1/10) ,there were statistically significant difference (P = 0. 001). The positive rates of MMP-9, VEGF and PCNA in well-differentiated adenocarcinoma, moderately differentiated adenocarcinoma and poorly differentiated adenocarcinoma were as follows: MMP-9,70.0%(7/10), 80. 0% (8/10), 88.0%(22/25), there were statistically significant difference (P=0.015);VEGF, 50.0%(5/10), 60.0% (6/10), 88.0% (22/25), there were statistically significant difference (P =0.000);PCNA, 60.0% (6/10) ,90.0% (9/10) ,92.0% (23/25) ,the difference is significant statistically (P = 0.004). The expression of MMP-9, VEGF and PCNA showed positive relationship with each other by rank correlation analysis (P < 0. 05). Conclusion Tissue arrays technology is effective tool to analyze the expression of cancer related proteins in gastric adenocarcinoma. The expression of MMP-9, VEGF and PCNA proteins participates in the tumorigenesis and development process of gastric adenocarcinoma, and these can be used as indexes to evaluate prognosis in clinical.