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Objective:To explore the value of competency-oriented training mode in the training of professional postgraduate students of thoracic surgery.Methods:A total of 71 professional postgraduate students, who entered thoracic surgery department for rotation training, were divided into experimental group and control group. Among them, 33 students in experimental group accepted competency-oriented training, including medical theoretical knowledge, clinical skills, clinical thinking, scientific information and interpersonal communication, while 38 students in control group received traditional training. Before leaving the department, the two groups of students had a unified assessment, and their results were compared and analyzed. SPSS 19.0 was used to make statistical analysis on the students' assessment results, and the comparison of the two groups of students' results was made by two independent samples t test. Results:The experimental group performed better in theoretical knowledge, clinical skills, clinical thinking and total scores than control group [(14.21±2.03) points vs. (12.97±2.06) points, (24.30±2.35) points vs. (22.37±3.10) points, (24.00±1.85) points vs. (22.71±3.17) points, (78.09±3.53) points vs. (73.34±5.25) points], with significant differences (all P<0.05). Conclusion:Competency-oriented training model can significantly enhance the training quality of professional postgraduates of thoracic surgery. We should make rational use of new media means and various teaching platforms, and give full play to the characteristics and advantages of the discipline, which facilitates to improving the clinical post competence of trainees.
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@#Objective To compare the pain relief and rehabilitation effect of intercostal nerve block and conventional postoperative analgesia in patients undergoing thoracoscopic surgery. Methods China National Repository, Wanfang Database, VIP, China Biomedical Literature Database, Web of Science, Clinicaltrials.gov, Cochrane Library, EMbase and PubMed were searched from establishment of each database to 10 Febraray, 2022. Relevant randomized controlled trials (RCTs) of intercostal nerve block in thoracoscopic surgery were collected, and meta-analysis was conducted after data extraction and quality evaluation of the studies meeting the inclusion criteria. Results A total of 21 RCTs and one semi-randomized study were identified, including 1 542 patients. Performance bias was the main bias risk. Intercostal nerve block had a significant effect on postoperative analgesia in patients undergoing thoracoscopic surgery. The visual analogue scale (VAS) score at 12 h after surgery (MD=–1.45, 95%CI –1.88 to –1.02, P<0.000 01), VAS score at 24 h after surgery (MD=–1.28, 95%CI –1.67 to –0.89, P<0.000 01), and VAS score at 48 h after surgery significantly decreased (MD=–0.90, 95%CI –1.22 to –0.58, P<0.000 01). In exercise or cough state, VAS score at 24 h after surgery (MD=–2.40, 95%CI –2.66 to –2.14, P<0.000 01) and at 48 h after surgery decreased significantly (MD=–1.89, 95%CI –2.09 to –1.69, P<0.000 01). In the intercostal nerve block group, the number of compression of the intravenous analgesic automatic pump on the second day after surgery significantly reduced (SMD=–0.78, 95%CI –1.29 to –0.27, P=0.003). In addition to the analgesic pump, the amount of additional opioids significantly reduced (SMD=–2.05, 95%CI –3.65 to –0.45, P=0.01). Postoperative patient-controlled intravenous analgesia was reduced (SMD=–3.23, 95%CI –6.44 to –0.01, P=0.05). Patient satisfaction was significantly improved (RR=1.31, 95%CI 1.17 to 1.46, P<0.01). Chest tube indwelling time was significantly shortened (SMD=–0.64, 95%CI –0.84 to –0.45, P<0.001). The incidence of analgesia-related adverse reactions was significantly reduced (RR=0.43, 95%CI 0.33 to 0.56, P<0.000 01). Postoperative complications were significantly reduced (RR=0.28, 95%CI 0.18 to 0.44, P<0.000 01). Two studies showed that the length of hospital stay was significantly shortened in the intercostal nerve block group, which was statistically different (P≤0.05), and there was no statistical difference in one report. Conclusion The relief of acute postoperative pain and pain in the movement state is more prominent after intercostal nerve block. Intercostal nerve block is relatively safe and conforms to the concept of enhanced recovery after surgery, which can be extensively utilized in clinical practice.
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Objective:To investigate the application value of standard operation procedure (SOP) of thoracentesis in clinical skills training for undergraduates.Methods:In this study, 63 undergraduates were randomized into two groups, with 29 students in experimental group receiving SOP training, and 34 students in control group trained by traditional teaching methods. The performance of the two groups at different stages of thoracentesis were compared after the training. SPSS 19.0 was used to analyze the assessment data.Results:The experimental group was significantly superior to the control group in the stages of "puncture operation" and "post-puncture operation" [(33.76±2.46) points vs. (31.91±3.60) points, P=0.02; (7.93±1.53) points vs. (6.79±1.84) points, P=0.01], as well as the total scores [(82.59±4.14) points vs. (79.26±4.94) points, P=0.01]. Conclusion:It's suggested that application of SOP may improve the effectiveness of thoracentesis training, and organized teaching methods are essential for clinical skills training.
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Objective:To explore the characteristics of prevailing factors and their influence on esophageal cancer in Xinjiang. Meth-ods:Patients diagnosed with esophageal cancer from January 2010 to January 2016 were selected from the Xinjiang Medical Universi-ty First Affiliated Hospital and categorized as the patient group. Patients without cancer admitted to the same period were classified as the control group. Case control study and correlation analysis between esophageal cancer and type 2 diabetes were performed. Re-sults:Type 2 diabetes (≥2 years), as a risk factor, is associated with esophageal cancer. The use of insulin (≥2 years) can increase the risk of esophageal cancer. Smoking, drinking, hyperlipidemia, body mass index≥24, and esophageal diverticulum esophageal cancer are also risk factors. Conclusion:The risk factors for esophageal cancer are prevalent among patients with type 2 diabetes patients. In-sulin use is also correlated with the occurrence of esophageal cancer. Further studies must be performed to develop secondary preven-tion for diabetic patients susceptible to esophageal cancer in high-risk subgroups.
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Objective To probe into application of clinical pathway on clinical practice teach-ing in thoracic surgery , and evaluate its effect . Methods 76 students were randomized into two groups: 35 students who accepted clinical pathway teaching were the experimental group, they were asked to carry out clinical practice in accordance with the teaching pathway;and the other 41 students were control group. The final examination included four parts: ①theoretical examination account for 20%of the total score. The test paper was randomly combined from the standardized question bank of Xinjiang Medical University, and this test included single choice questions and fill-in questions; ②clinical operational skills test account for 30%of the total score. This part included pleural puncture, dressing change, stitches remove, incision disinfection and surgical draping, and all of these opera-tions were carried out on medical patient simulators; ③clinical case analysis account for 50% of the total score. This part involved history collection, physical examination, humanistic care, case writing, diagnosis and treatment planning for new admission patients. T-test of independent samples was used to analyze all the scores of the two groups. Results The clinical case analysis score and the total score in experimental group [(42.26 ±3.93) points and (81.69 ±6.16) points, respectively]were obviously higher than that in control group[(38.88±4.76) points and(77.39±6.83) points, respectively];There were significant differences between the two groups(P values was 0.001 and 0.006, respectively). Conclusion Application of clinical pathway in clinical practice teaching may improve the effect of clinical teaching. The pathway contents and evaluation methods should be constantly improved accord-ing to teaching practice.