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As a unit of medical science practice, the teaching hospitals shoulder the great responsibility of carrying out medical science popularization. With the development of network media, the model of medical science popularization has also been enriched. In order to make better use of the intelligence and convenience of emerging media, medical students′ science popularization ability and network media literacy urgently need to be improved. This article analyzes the current status of medical students′ science popularization ability and network literacy and analyzes its importance. It discusses the ways and means of training medical students′ science popularization ability and network literacy in teaching work, so as to continuously create a new situation in the development of teaching hospitals.
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Objective:To investigate the effects with perioperative indicators of different irrigation methods (automatic irrigation pump and gravity-based irrigation) on ureteroscopic lithotripsy.Methods:A retrospective analysis was used to select 150 patients with ureteral calculi in the Second Affiliated Hospital of Ningxia Medical University from January 2018 to September 2018. The patients included 86 males and 64 females, and the median age was 47 years, ranged 23 to 75 years. The patients were divided into two groups: automatic irrigation pump and gravity-based irrigation group, with 75 cases in each group. The time of operation, the rate of stone moving up, the rate of stone remaining, the change of leukocyte and serum creatinine before and after operation, and the incidence of operation complications were compared between the two groups. The measurement data was expressed as Mean±standard deviation ( Mean± SD), and the t-test was used for comparison between groups; the Chi-square test was used for comparison between count data. Results:The operative time of automatic irrigation pump was shorter than that of gravity-based irrigation group [(42.20±17.61) min vs (45.23±16.40) min]. The increase of leukocyte count [(3.83±3.01)×10 9/L vs (4.36±2.97)×10 9/L] and serum creatinine of first day [(63.26±12.46) μmol/L vs (65.64±11.10) μmol/L] in gravity-based irrigation group was significantly higher than that in automatic irrigation pump ( P=0.034, 0.011, 0.002, respectively). There was no significant difference between the two groups in the stone migration rate (5.3% vs 9.3%), stone residual rate (2.7% vs 4.0%), the incidence of intraoperative complications-mucosa injury of ureter (12.0% vs 10.7%), and postoperative complications (urinary tract infection: 4.0% vs 5.3%, mild hydronephrosis: 5.3% vs 6.7%) ( P=0.347, 0.649, 0.797, 0.868, respectively). Conclusions:The automatic irrigation pump can shorten the operation time, and reduce the increase of blood routine leukocyte count and serum creatinine compared with the gravity-based irrigation. There was no difference between the two methods in the rate of stone migration, stone residue, ureter injury, hydronephrosis and urinary tract infection.
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Objective:To explore the risk factors of tumor recurrence after radical nephroureterectomy combined with Gemcitabine and Cisplatin(GC) systemic intravenous chemotherapy for upper tract urothelial carcinoma (UTUC), establish a recurrence risk prediction model, and conduct preliminary verification.Methods:One hundred and one cases of UTUC were analyzed from January 2013 to October 2019 in Beijing Friendship Hospital, Capital Medical University retrospectively. All patients underwent radical nephroureterectomy+ bladder cuff resection, and were treated with GC intravenous adjuvant chemotherapy, among which 19 underwent preoperative neoadjuvant chemotherapy. The study collected general information and clinical characteristics of the patients, and follow up the patient's recurrence. Tumor recurrence and relapse free survival (RFS) were the main observation indexes. The patients were divided into the recurrent group and the non-recurrent group according to their recurrence. Kaplan-Meier and Log-rank methods were used to estimate and compare the RFS rates of the two groups. Univariate difference analysis was used to identify the indicators that were significantly different between patients in the recurrence group and the non-recurrence group, and the COX proportional hazard model was further used to explore the correlation between each factor and the tumor recurrence. According to the weights of relevant risk factors, an individual prognostic index (PI) equation was established, a recurrence prediction model was constructed, and the receiver operating characteristic (ROC) curve was used for verification.Results:One hundred and one patients were followed up for 2-82 months, with median 22 months. 40 patients had recurrence, including 32 in the bladder and 8 in the contralateral upper urinary. One-year RFS was 82.10%, two-year RFS was 68.90% and 5-year RFS was 42.10%. COX proportional risk model results showed that tumor hydronephrosis (X1), lymphovascular invasion (X2) and tumor T stage (X3) were independent risk factors, while neoadjuvant chemotherapy (X4) and chemotherapy cycle (X5) were independent protective factors. Individual PI equation =0.964X1+ 0.688X2+ 0.508X3-1.566 X4-0.675X5. The ROC curve was drawn to show that the optimal pointcut value was 179.5 when the Youden index was 0.537, the sensitivity of the model was 0.750, the specificity was 0.787, and the area under the curve (AUC) was 0.838(95% CI: 0.758-0.918). Conclusions:Hydronephrosis, tumor T stage, lymphovascular invasion, neoadjuvant chemotherapy and chemotherapy cycle are independent factors affecting the recurrence of UTUC patients. The multi-factor risk prediction model is suitable for evaluating the possibility of tumor recurrence after radical surgery combined with GC chemotherapy in UTUC patients, which can provide scientific evidence for the prognosis assessment of patients.
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Objective:To investigate the prognostic significance of the lymphovascular invasion (LVI) in patients with upper tract urothelial carcinoma(UTUC) after radical nephoureterectomy (RNU) and Gemcitabine and Cisplatin combination Chemotherapy (GC).Methods:The clinical data of 95 patients with UTUC admitted to Beijing Friendship Hospital, Capital Medical University from March 2013 to March 2019 were analyzed retrospectively. There were 50 males and 45 females; the average age was 63 years, ranged from 36 to 81 years. According to the situation of LVI, they were divided into LVI positive group ( n=25) and LVI negative group ( n=70). Chi-square test was used to analyze the clinicopathological parameters of the two groups of patients. Kaplan-Meier method was used to draw the survival curves of the overall survival (OS) time and recurrence-free survival (RFS) time of the two groups of patients. The difference between the two groups was used Log-Rank test. The risk factors related to OS and RFS were evaluated using univariate and multivariate Cox regression models. Results:All patients were followed up for 2-82 months, with an average follow-up time of 36 months. Among them, 20(21.1%) died and 36(37.9%) relapsed. There were significant differences in T stage ( P=0.046), lymph node metastasis ( P=0.032), and tumor location ( P=0.019) between LVI negative group and LVI negative group. Univariate analysis showed that hydronephrosis ( P=0.026), lymph node metastasis( P=0.001), LVI ( P=0.001), chemotherapy cycle ( P=0.045) were correlated with OS; hydronephrosis ( P=0.031), tumor T stage ( P=0.013), lymph node metastasis ( P=0.004), LVI ( P=0.001) were significantly correlated with RFS. Multivariate analysis showed that hydronephrosis ( P=0.016), lymph node metastasis ( P=0.016), and LVI( P=0.003) were significantly correlated with OS. Lymph node metastasis ( P=0.018), LVI ( P=0.003) were significantly correlated with RFS. In conclusion, LVI was an independent risk factor for OS and RFS. The OS [(40.7±6.5) months for LVI positive group, (68.5±3.2) months for LVI negative group, χ2=15.750, P<0.001] and RFS [(31.0±5.7) months for LVI positive group, (58.0±8.8) months for LVI negative group, χ2=10.986, P=0.001] of patients with LVI positive group were worse than those with LVI negative group, the differences were statistically significant. Conclusions:LVI is more likely to be possitive in patients with high T stage, lymph node metastasis and single renal pelvis cancer, which provides a basis for risk stratification of patients with UTUC. After radical resection and adjuvant chemotherapy, the benefit of OS and RFS in patients with positive LVI was significantly worse than that in patients with negative LVI.