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According to the high failure rate and high maintenance cost of SIF-Q260 enteroscope in Endoscopy Center of Zhongnan Hospital of Wuhan University,the causes for the failure of SIF-Q260 enteroscope were analyzed by the Reason model from four aspects of environmental impact,unsafe supervision,unsafe behavior precursor and unsafe behavior.In view of the analyzed causes of failures at all levels,measures should be proposed from three aspects of regular training to standardize the decontamination and use of endoscopes,appointment of special personnel to manage endoscopes,regular supervision and evaluation of the standardization of endoscopic decontamination,and improvement of the supervision system of endoscopes to block the"loopholes"in the system and provide a basis for the formulation of endoscopic quality control measures,which can prevent and reduce the occurrence of endoscopic failures.
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@#Objective To explore the timing and safety of limited-period lung cancer surgery in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods Clinical data of of patients infected with COVID-19 undergoing lung cancer surgery (an observation group) in the Department of Thoracic Surgery of Guangdong Provincial People's Hospital, the Department of Thoracic Surgery of General Hospital of Southern Theater Command of PLA, and the Department of Cardiothoracic Surgery of the First Affiliated Hospital of Guangdong Pharmaceutical University from December 2022 to January 2023 were retrospectively analyzed and compared with patients who underwent surgery during the same period but were not infected with COVID-19 (a control group), to explore the impact of COVID-19 infection on lung cancer surgery. Results We finally included 110 patients with 73 patients in the observation group (28 males and 45 females at age of 52.62±12.80 years) and 37 patients in the control group (22 males and 15 females at age of 56.84±11.14 years). The average operation time of the observation group was longer than that of the control group, and the incidence of anhelation was higher than that of the control group (P<0.05). There were no statistcal differences in blood loss, length of hospital stay, moderate or above fever rate, degree of cough and chest pain, or blood routine between the two groups. Conclusion It is safe and feasible to perform lung cancer surgery early after recovery for COVID-19 patients with lung cancer.
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Objective:To evaluate the efficacy and safety of a China-made disposable peroral cholangioscope in animal cholangioscopy.Methods:Six healthy Bama minipigs underwent the domestic disposable peroral cholangioscopy after anesthesia. The operation performance and image quality of the products were evaluated, and intraoperative and postoperative complications were recorded.Results:All 6 animals received the domestic disposable peroral cholangioscopy. The cholangioscope showed good operating performance and could smoothly enter the biliary tract through the duodenoscope. The water injection, suction and instrument channels were unobstructed. The cholangioscopic image was clear, the color resolution was good, and there was no image distortion. The lumen and the mucosal surface could be accurately assessed. During the examination, there was no operative injuries such as bleeding, perforation, or adverse events such as respiratory depression or cardiac arrest. All pigs survived the operation with no adverse reaction.Conclusion:The China-made disposable peroral cholangioscope is safe, with good operability and high-quality image.
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Objective:To construct an evaluation index system of teaching quality in medical schools.Methods:The text entry analysis was used to construct the index entry pool. The thematic group discussions were used to determine the preliminary index system. The Delphi method was used to further select the index. Finally, the analytic hierarchy process was used to determine the index weight and perform consistency test. EpiData 3.2 was used to build database, and MATLAB was used for statistical analysis and solving judgment matrix.Results:The index framework was established by attitude, content, method and effect, which was refined into 10 secondary indicators and 20 tertiary indicators such as passing on knowledge, knowledge mastering, and so on. The consistency test coefficients of each layer was less than 0.1.Conclusion:The method of constructing the indicator system is scientific, and the selection of indicators is in line with the current medical education reform, which has certain feasibility and guiding significance.
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Objective:To solve the difficult problem of experimental teaching of MRI equipment by independently designing a virtual simulation teaching system for performance testing of medical magnetic resonance imaging (MRI) equipment.Methods:A total of 202 students of Batch 2016 majoring in 4-year medical imaging technology and 5-year medical imaging of Binzhou Medical University. According to the teaching requirements of MRI equipment in Medical Imaging Equipment Science, a 3D experimental simulation model and experimental scenes were established based on Unity3D engine by using Unity3D, 3D Studio Max, Maya and Visual Studio technology to design experimental learning content and assessment content, develop the teaching system software and perform Web-based online learning. Then, the satisfaction survey on experimental learning was conducted, the statistics of the experimental results of the teaching system on the national virtual simulation experiment teaching platform was collected and the learning effects were evaluated in multiple dimensions. Results:The virtual simulation teaching system was a comprehensive experiment with 12 knowledge points, 12 experimental items and a total of 81 interactive contents and steps. The overall satisfaction rate of 202 students in our school was 96.82%(2 347/2 424). Among the 499 subjects who participated in the learning of the teaching system on the national virtual simulation experiment teaching platform and submitted the experimental report, the average score of the experiment was 78.07 points (the full score of online learning assessment was 90 points), and the overall passing rate was 96.79%(483/499). The average learning time of the 18 students who got 90 points was 54 min.Conclusion:This virtual simulation teaching system possesses comprehensive experimental contents with high fidelity of experimental scenes and strong interactivity of experimental operation, prospecting great learning effects and promotion value.
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ObjectiveTo investigate the clinical significance of highly sensitive nucleic acid detection in precise antiviral therapy for patients with liver cirrhosis and its association with aminotransferase level. MethodsA total of 377 patients with hepatitis B cirrhosis who were hospitalized or attended the outpatient service from May 2013 to April 2019 were enrolled and tested by both domestic HBV DNA detection and highly sensitive Cobas HBV DNA detection. All patients underwent biochemical examination, four blood coagulation tests, routine blood test, and upper abdominal computed tomography or ultrasound. Sensitivity of different HBV DNA detection reagents was compared in liver cirrhosis patients with a low viral load, and the correlation between alanine aminotransferase (ALT) level and viral load was analyzed. The paired t-test was used for comparison of continuous data before and after treatment. The receiver operating characteristic (ROC) curve was used to screen out the optimal predictive values of ALT at different cut-off values of HBV DNA. ResultsAmong the 377 patients with hepatitis B cirrhosis, 215 tested positive and 162 tested negative by domestic HBV DNA, and among these 162 patients, 104 (64.2%) tested positive by Cobas HBV DNA detection, with a mean level of 267.5±42.3 IU/ml. After 24 weeks of antiviral therapy, the 104 patients with hepatitis B cirrhosis had significant improvements in viral replication level, ALT, and Child-Pugh score for liver function; HBV DNA decreased from 267.5±32.2 IU/ml before treatment to 59.6±7.7 IU/ml after treatment (t=3.486, P=0.002), ALT decreased from 871±10.8 U/L before treatment to 36.5±7.6 U/L after treatment (t=3.235, P=0.020), and the Child-Pugh score decreased from 6.5±0.7 before treatment to 5.7±0.5 after treatment (t=2.928, P=0.041). The ROC curve analysis of ALT in predicting HBV DNA decision point showed that an ALT level of 29 IU/L was the most sensitive cut-off value for predicting HBV DNA <20 IU/ml, with an area under the ROC curve of 0.904, a sensitivity of 1.0, and a specificity of 0.237. ConclusionPrecise detection helps to guarantee the precise clinical treatment of patients with hepatitis B cirrhosis and improve their treatment outcome and prognosis. An ALT level of 29 IU/L is a sensitive indicator for predicting patients with negative Cobas HBV DNA, so as to achieve individualized precise screening and treatment.
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OBJECTIVE@#To evaluate the effectiveness of the Frog appliance in three dimensions by using cone-beam computed tomography (CBCT) images.@*METHODS@#Forty patients (21 boys and 19 girls), averaged 11.7 years old, with an Angle Class II division 1 malocclusion were included in our study. They had either late mixed dentition or early permanent dentition, and the maxillary second molars had not yet erupted. All patients underwent CBCT before and after the treatment for measuring changes in the maxillary first molars, second premolars, central incisors, and profile. Paired-samples t-test was used to compare the mean difference in each variable before treatment and after the first phase of treatment.@*RESULTS@#The maxillary first molars were effectively distalized by 4.25 mm (p < 0.001) and 3.53 mm (p < 0.05) in the dental crown and root apex, respectively. The tipping increased by 2.25°, but the difference was not significant. Moreover the teeth moved buccally by 0.84 mm (p < 0.05) and 2.87 mm (p < 0.01) in the mesiobuccal and distobuccal cusps, respectively, whereas no significant changes occurred in the root apex. Regarding the anchorage parts, the angle of the maxillary central incisor's long axis to the sella-nasion plane increased by 2.76° (p < 0.05) and the distance from the upper lip to the esthetic plane decreased by 0.52 mm (p = 0.01).@*CONCLUSIONS@#The Frog appliance effectively distalized the maxillary molars with an acceptable degree of tipping, distobuccal rotation, and buccal crown torque, with only slight anchorage loss. Furthermore, CBCT image demonstrated that it is a simple and reliable method for three-dimensional analysis.
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Clinical novitiate is not only a significant part in the training of basic comprehensive ability of clinical medicine students,but also a weak link in current teaching practice link. This research is guided by the educational reform of the"5+3"talent training mode and it carries out reforms by constructing three-stage novitiate mode, realizing curriculum integration and PBL teaching as well as multi-dimensional performance appraisal etc.It is student-centered and lays emphasis on developing students' autonomous learning ability,basic clinical skills and thinking ability,so as to improve the training quality of the medical professionals and provide a referable novitiate teaching mode for the training of medicine professionals under the new situation.
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Aiming at the existing problem of inequality and being unscientific in the evaluation of comprehensive quality of medical students, through literature research and expert opinion method, and from multi angles , the author constructed the evaluation index system of comprehensive quality of scientific medicine, using AHP to determine the weights of evaluation indexes, and established a fuzzy evaluation model of the comprehensive quality of medical students, and on this basis, improved the calculation method of fuzzy evaluation and the maximal subjection degree of the evaluation result. The specific examples of the evaluation results showed that the method was effective and could reflect the comprehensive quality of med-ical students in a comprehensive and objective way, and it had great significance to the comprehensive quality evaluation of medical students.
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Objective:To evaluate the effects of Sander Ⅱ appliance in the orthodontic treatment of adolescent ClassⅡmalocclusion. Methods:15 cases (6 male and 9 female)of adolescent ClassⅡ malocclusion with mandibular retrution were treated with Sander Ⅱappliance.Pre-treatment and post-treatment Lateral cephalogram measurements were traced and analyzed in terms of 28 indicators. SPSS 19.0 software package was used for paired t test.Results:After treatment,15 patients achieved remarkable improvement in the maxillofacial profile and normal overjet of teeth.The cephalometric analysis showed that ANB,OJ,H°and U1-E decreased(P <0. 05),SNB,B-OLP,Pg-OLP(mm),Ii-OLP,Ms-OLP(mm),Mi-OLP(mm),N-Me,ANS-Me,S-Go,Go-Gn,N'-Pg'/FH,Cm-Sn-Ls and Pg-Pg'increased(P <0.05).There was no significant change in SN-MP,SN-OL and Y-axis before and after treatment. Conclusion:Sander Ⅱ appliance is effective in the treatment of adolescent early Class Ⅱmalocclusion.
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Objective To let students grasp comprehensive applied knowledge and the new development.Methods A special website was set up based on the traditional teaching.Results The special website could provide students with a quick,convenient and modern technology resource library.Conclusion The website can effectively help students consolidate and deepen the study of basic theory and technology of medical imaging equipment,and broaden their knowledge.
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Objective To design a set of long bone and bone-mode auto-matching system which is based on computer image processing technology.Methods Through the analysis on clinical pictures and image data,we got the exact data.Based on these data,the system searched out the bone-mode from the bone-mode database which matched with the skeletal.Results It can find a suitable bone-mode which can match with the bone in a very short time.Conclusion The system improves the efficiency of matching,as well as the success rate.It reduces the surgery time and the suffering of patents.