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Objective To evaluate the effect of 3D printed skeletal model in orthopedic clinical in-ternship teaching . Methods From October 2015 to October 2016 , 30 undergraduate clinical medical internship students were divided into traditional teaching group and 3D model teaching group randomly. 1 teaching ward round was conducted for each student. Teaching rounds were conducted according to routine procedures in traditional teaching group, while the 3D model teaching group used the patient's 3D print skeletal model to assist in teaching rounds and perform simulated surgery. All students were tested in theory and practice, and the teaching evaluation was carried out by questionnaire. Data were imputed into SPSS 19.0 for comparison between the two groups using t-test. Results Students in 3D model teaching group significantly outperformed than those in traditional teaching group in theoretical achievement [(92.27±4.56) vs. (86.87±5.30)] and practical achievement [(90.07±4.61) vs. (82.53±5.03)] (P<0.01). In respects of pro-moting theoretical knowledge, enhancing surgical participation, hands-on ability exercise, teaching attraction and overall satisfaction, students in 3D model teaching group gave a better evaluation of teaching they had received than those in the traditional teaching group (P<0.01). Conclusion 3D printed skeletal model is an effective teaching tool, and its application in clinical internship teaching at basic-level hospital can signifi-cantly improve teaching effectiveness and satisfaction. It is worth further exploration and promotion.
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Objective To analyze the anticoagulation in patients with atrial fibrillation.Methods A retrospective analysis of anticoagulant therapy situation in 926 patients with atrial fibrillation was conducted,in order to sum up experience and improve the understanding of atrial fibrillation.Results In 926 patients with atrial fibrillation,there were no anticoagulant therapy in 675 patients,accounting for 72.89%,while only 251 cases received the treatment of anticoagulation,accounting for 27.11%.Only 66 patients aged>75 years were treated with anticoagulant therapy,accounting for 33.17%.The patients with coronary heart disease,in 17.60% and with anticoagulation treatment,the patients with diabetes in 28.37% and received anticoagulation therapy,28.32% patients with anticoagulation therapy in patients with hypertension,30.77% patients with cardiac insufficiency with anticoagulant therapy.Choice of treatment of aged>75,hypertension,coronary heart disease,clinical treatment strategies and patients were the main factors that affected the use of warfarin,but only>75 years of age,coronary heart disease,choice of treatment factors with statistical significance of three factors(OR=7.02,12.73,4.79,all P<0.05).675 cases without anticoagulant therapy in 101 patients with non warfarin treatment indications without the use of warfarin anticoagulation treatment,accounted for 14.96%.In addition,there were 574 AF patients with warfarin treatment indications and treatment with warfarin,analysis of its causes:63 cases had anticoagulant contraindications,172 cases for the doctor too much about bleeding complications,440 patients were not in accordance with the requirements of the detection of INR.Conclusion The positive effect of warfarin in prevention of ischemic stroke,but in basic hospital application of warfarin anticoagulation in patients with severe AF deficiency,should raise the awareness of risk of grassroots medical staff and patients of atrial fibrillation complicating embolism,do a good job of educating patients,to reduce the incidence of embolic events in patients with atrial fibrillation.
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Objective To explore the approaches to improve the detection of early gastric and precancerous lesions for basic level hospi-tals. Methods The 72 patients with abnormal gastric mucosa observed by gastroscope arranged with pathology after acetic acid-indigo car-mine dyeing were considered as the dyeing group, and 68 patients with abnormal gastric mucosa observed by gastroscope directly arranged with pathology were considered as the control group. The dyeing conditions of gastric mucosa were observed and compared to pathology detec-tion. The detection rate of early gastric cancer and precancerous lesions in the two groups were compared. Results After acetic acid-indigo carmine dyeing, there were 16. 7% of demonstrated discoloration, 63. 9% of poor dyeing, and 14. 3% of even dyeing. The detection rate of early gastric cancer and high grade intraepithelial neoplasia in patients with mucosa discoloration (91. 7%) was obviously higher than that in patients with poor dyeing (8. 6%) or even dyeing (0. 0%). The detection rate of low grade intraepithelial neoplasia or intestinal metaplasia in patients with poor dyeing (82. 6%) was obviously higher than that in patients with mucosa discoloration (8. 3%) or even dyeing (14. 3%). The detection rate of early gastric cancer and precancerous lesions in dyeing group (13. 9%,63. 9%) was obviously higher than that in control group (2. 9%,29. 4%). Conclusion The acid-indigo carmine dyeing could increase the diagnosis of early gastric cancer and precancerous lesions in basic level hospital. It is adaptable to extend approach in basic level hospital for its low cost and simple operation.
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Objective To investigate the influence of participation of healthcare-associated infection (HAI)man-agement department in ward round presided over by hospital director on hand hygiene compliance of health care workers (HCWs)in a basic-level hospital.Methods Implementation of hand hygiene in January-June 2012 (control group :HAI management department didn’t participate ward round)and January-June 2013 (trial group :HAI management department participated ward round)were investigated,the compliance of hand hygiene of two groups of HCWs and consumption of hand hygiene products of each department were compared.Results HAI case rate in trail group was significantly lower than control group (1.49% vs 2.01% )(χ2= 4.31,P<0.05);HCWs’hand hy-giene compliance rate was significantly higher than control group (71 . 56% [3 249/4 540 ]vs 44. 00% [1 914/4 350]),hand hygiene compliance rates in nurses were higher than doctors of both groups(χ2= 151.30,179.92, respectively,bothP<0.001),hand hygiene compliance rate in trial group from high to low was department of pedi-atrics,obstetrics and gynecology,surgery,and internal medicine. The consumption of rapid hand disinfectant of trail group and control group was 5.38mL/bed-day and 1.88 mL/bed-day respectively,the consumption of hand sanitizer was 11.51 mL/bed-day and 7.03 mL/bed-day respectively.Conclusion Hand hygiene checked during the ward round presided over by hospital director can improve HCWs’hand hygiene compliance,reduce the incidence of HAI,and ensure medical safety.
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Objective:To experimentally intervene safe injection by medical staff in basic-level hospitals and observe the recent and long-term effect atfer the intervention and to provide practical measures to improve safe injection. Methods:We used random sampling methods to set up groups in county hospitals and township hospitals of Hunan Province, and offered lectures, delivered safe injection guide, brochure and on-site guidance in the experimental group. We surveyed the 2 groups atfer the intervention at 1 month and 6 months to compare the effect of unsafe injection behaviors and safe injection behaviors. Results:One month after the intervention, the unsafe injection rate in the experimental group decreased from 27.8%to 21.7%, while in the control group injection the unsafe injection rate rose from 26.0%to 27.9%, with signiifcant difference (P<0.01). Six months atfer the intervention, the unsafe injection rate in the experimental group declined to 18.4%while the unsafe injection rate in the control group also dropped to 22.4%, with signiifcant difference (P<0.01). Unsafe injection rate was decreased in the experimental group at different intervention points, with signiifcant difference (P<0.01). The safe injection behavior scores in the experimental group were higher than those in the control group after the intervention of 1 month and 6 month intervention (P<0.01);the experimental group got higher scores atfer the intervention (P<0.01). Conclusion:Training of safe injection, distribution of safe injection guide, and comprehensive intervention model can significantly change the primary care practitioners’ behaviors in unsafe injections and it is worth promoting.