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Objective:To explore the effect of the "organ system-based learning (OBL)" digestive system teaching model in the clinical internship teaching of undergraduate nursing students.Methods:A total of 84 nursing undergraduates who practiced in the digestive system department of a third-grade Class-A general hospital from July 2020 to May 2022 were selected as the research objects. According to the historical control study, they were divided into control group ( n=42) and experimental group ( n=42). The control group adopted traditional practice teaching, and the experimental group adopted OBL teaching. The admission theory scores of the two groups of nursing students in the department, graduation theory scores and technical scores, nursing students' core competency and clinical teaching satisfaction were compared. SPSS 24.0 was used for t-test and chi-square test. Results:There was no significant difference between the experimental group and the control group in admission theory scores. The graduation theory scores of the experimental group (93.27±1.47) and the control group (90.91±1.32) were statistically significant ( t=7.72, P<0.001). The graduation technical scores of the experimental group (94.51±1.81) and the control group (94.00±2.35) were not significantly different ( t=1.12, P=0.268). The core competency of nursing students in the experimental group (164.21±20.81) and the control group (152.79±15.76) was statistically significant ( t=2.84, P=0.006). Clinical teaching satisfaction of the experimental group (173.33±17.58) and the control group (152.67±19.74) was statistically significant ( t=5.07, P<0.001). Conclusion:The application of the OBL practice teaching model in the digestive system department is conducive to improving the theoretical knowledge of nursing students, and improving the core competence and clinical teaching satisfaction.
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Objective:To evaluate the clinical value of endoscopic release therapy for fecal impaction in the colorectal diverticulum.Methods:Data of patients with fecal impaction in the colorectal diverticulum who received endoscopy in Shantou Central Hospital from January 2018 to September 2020 were included in this study. Among them, 85 patients treated with endoscopic release therapy were assigned to the observation group (2 patients were excluded from the observation group due to acute appendicitis), and 43 patients receiving no treatment were assigned to the control group. The relief of abdominal symptoms was used as an index to evaluate the clinical value of endoscopic release therapy for fecal impaction in the colorectal diverticulum.Results:In the observation group, 42.2% (35/83) were successfully released at one time. The successful comprehensive measures accounted for 25.0% (12/48) of the first release failure, and the total success rate was 56.6% (47/83). There were no complications related to endoscopy in the observation group. One week after the treatment, patients in the observation group were followed up by telephone. Among the 45 patients who were successfully released, positive symptoms of 30 patients disappeared or significantly improved with the effective rate of 90.9% (30/33). Among the 38 patients who failed to release the fecal impaction, 19 had positive symptoms and 16 improved in varying degrees with the effective rate of 55.2% (16/29). The overall effective rate of the observation group was higher than that of the control group [55.4% (46/83) VS 7.0% (3/43)], showing significant difference( χ2=23.354, P<0.01). The effective rate were significant differences in the successful release group [65.2% (30/46)], unsuccessful release group [29.7% (11/37)] and the control group [7.0% (3/43), χ2=33.792, P<0.01]. By pairwise comparison, the effective rate of the successful release group was the highest, followed by the unsuccessful release group, and that of the control group was the lowest with significant difference ( P<0.017). Conclusion:The endoscopic release therapy for fecal impaction in the colorectal diverticulum is relatively simple, which can relieve and reduce related symptoms, avoid complications, missed diagnosis and misdiagnosis, and show definite curative effects. When colorectal diverticulum with fecal impaction is found in the process of endoscopy, it is of great practical significance to release the incarcerated feces by means of different methods.
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Objective:To investigate the effect of sarcopenia on physical performance and nutritional status in elderly patients with gastrointestinal tumors.Methods:a total of 120 eligible in-patients were enrolled from gastrointestinal surgery department of a Grade A tertiary hospital in Ningbo city from September 2021 to January 2022. General clinical data were collected, nutritional risk was screened using Nutritional Risk Screening 2002 (NRS 2002), physical performance was assessed by Short Physical Performance Battery (SPPB), skeletal muscle index at the third lumbar vertebra level (L3 SMI) was calculated using abdominal CT scan, and grip strength/muscle strength, gait speed by 6 Meter Timed Walk Test and calf circumference were measured. Subjects were divided into sarcopenia and non-sarcopenia group according to the diagnostic criteria of the Asian Working Group for Sarcopenia (AWGS). Impacting factors of sarcopenia and the correlation between muscle mass and physical performance in elderly patients with gastrointestinal tumors were analyzed.Results:The overall prevalence rate of sarcopenia in elderly patients with gastrointestinal tumors was 28.3% (34/120) and it was 28.9% (22/76) and 27.3% (12/44) in males and females respectively. There were statistically significant differences in age, tumor stage, nutritional risk, body mass index, calf circumference, L3 SMI, grip strength/muscle strength, gait speed and SPPB score between patients with and without sarcopenia (P<0.05). Muscle strength/grip strength, L3 SMI and gait speed were closely correlated with the occurrence of sarcopenia in elderly patients with gastrointestinal tumors (P<0.05). The L3 SMI was positively correlated with physical performance as assessed with SPPB in both groups.Conclusions:Sarcopenia is a common complication in elderly patients with gastrointestinal tumors with multiple influencing factors. Timely nutritional intervention and exercise intervention should be incorporated into the treatment of elderly gastrointestinal tumor patients with sarcopenia in order to improve nutrition status.
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Myelodysplastic syndrome (MDS) is a heterogeneous group of myeloid clonal disease deriving from hematopoietic stem cells, which is mainly characterized with bone marrow failure and abnormal cloning. Trisomy 8 is the most common chromosomal abnormality in MDS. Current studies have found that gene amplification, gene mutation, abnormal expression of microRNA, high expression of Wilms tumor 1 protein, Survivin and miR-661 are related to trisomy 8, which play roles in the abnormality of clone and apoptosis of MDS. This article summarizes the molecular biology transformation and clinical treatment progress of MDS with trisomy 8.
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Objective To compare the safety and efficacy of different methods for nasal jejunum tube placement in patients with mechanical ventilation.Methods From March 1,2015 to August 31,2017,patients with mechanical ventilation needed nasal jejunum tube placement were randomly divided into three groups,and three groups were provided with supine position(Group A),head forward flexion (Group B) and head back position(Group C),and nasal jejunum tubes were inserted by the same person.Time of reaching stomach,time of stomach to jejunum,and number of successful cases were recorded.Results In Group C,time of reaching stomach was significantly shorter than that in Group A and Group B(P＜0.01),time of stomach to jejunum in Group B was significantly shorter than that in Group A and Group C(P＜0.01).There were no statistically significant differences among three groups in number of successful cases in stomach and in jejunum(P＞O.05).Conclusion The method of head elevation and head back position is easy for nasal jejunum tube to pass through the throat with spiral movement;right lateral position together with uniform continuous advancing of nasal jejunum tube can have higher successful rate,which is conducive to the establishment of early enteral nutrition in patients with mechanical ventilation.
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Myelodysplastic syndromes (MDS) is a group of malignant clonal hematopoietic stem cell disorders. With the application of molecular biology techniques in a wide range of scientific research and clinical practice, studies have shown that gene mutation is one of the key factors in the occurrence and progression of MDS. Great clinical heterogeneity of MDS is associated with diversity of genes mutation, and genes research will play an increasingly important role in the diagnosis, classification and prognosis of MDS. In this review, the recent advances on these common genes will be summarized.
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Objective To establish an aortic transplantation model in the rat. Methods A thoracic aorta to abdominal aorta interposition transplant model in the rat was established. The male Lewis rats were used as donors and the female Brown Norway(BN) rats were used as recipients.Intercepted the thoracic aorta of lewis rats about one and a half centimeter. Transplanted it on the abdominal aorta of BN rats. The activity and weight change of BN rats were observed everyday until 1 week after transplantation. Then observed these index one time a week. The transplanted aortas were harvested at 8 weeks after transplantation. The intimal thickening were observed by pathological. The expression of CD3,CD68 and α-actin on transplanted aorta were observed by immunohistochemistry. Resuts All operations were finished within 2 hours. No recipients died during operation. All recipients could survival more than 8 weeks. The symptoms of bowing back, hair shedding and weight loss was appeared after transplantation. The weight of the rats were upturn at 4 or 5 days after transplantation. About 1 week after transplantation, all situations of the rats were recovery to the lever before transplantation. 8 weeks after transplantation the intimal thickening of the transplanted aortas were observed obviously by pathological. And the expressions of CD3, CD68 and α-actin on aortic allograft were observed. Conclusion The intimal thickening and the expressions of CD3, CD68 and α-actin on aortic allograft were typical expressions of chronic rejection. So this aortic transplantation model is feasible and reliable for studying chronic rejection.
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Mesenchymal stem cell(MSC) is a kind of tissue stem cell having a characteristics of high self-renewal and multipotency. It is tended to be separated in vitro and play an important role in hematopoietic stem cell transplantation and transplantation of other systems. This article described mesenchymal stem cell's function and mechanism on supporting hematopoiesis, enhancing implantation,adjusting immunity and alleviating graft versus host disease (GVHD) in transplantation and also give some advices and experties about its further application.
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Objective To investigate the efficacy of micafungin sodium for injection in the treatment of invasive fungal infections in patients with hematologic malignancy.Methods The therapeutic effect,action time and adverse effect were analyzed in 12 cases of invasive fungal infections in patients with hematologic malignancy who underwent intravenous injection of micafungin sodium 100 mg qd in Research Center of Hemotology,Union Hospital affiliated to Fujian Medical University,from February 2007 to October 2007.Results The total effective rate was 66.7%.The effective rates of the patients with clinical diagnosis and with recommended diagnosis were 57.14% and 80% respectively ;there was no significant difference between them.The mean action time was 1~5 days.Conclusion Micafungin sodium for injection is effective and safe in treatment of invasive fungal infections in patients with hematological malignancy.
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AIM and METHOD: The relationship between the evolution of the reticulin fibres(RF) or the collagen fibres(CF) and the growing of hematopoietic cells in long-term bone marrow culture (LTBMC) from 15 paticnts with acute myeloid leukemia (AML) and form 6 normal subjects was observed by inverted microscope, Gomoris staining and Massons staining were used. RESULTS: (1)The amount of RF contents of 8 AMLs,with self- maintained(AMLsm) in the 1～8 weeks-old-culture was significant less than that of normal control and 7 AMLs,without self-maintained(AMLnsm) ( P