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Objective:To analyze the effect of problem-based learning (PBL) combined with case-based learning (CBL) and clinical pathway (CP) teaching methods in standardized residency training in department of hepatobiliary surgery.Methods:A total of 64 residents who received the standardized residency training in the Department of Hepatobiliary Surgery in Shaanxi Provincial People's Hospital from July 2018 to July 2019 were selected and divided into the observation group and the control group. The control group used PBL + CBL teaching methods, while the observation group adopted PBL + CBL + CP teaching methods. The after-department examination scores and the teaching cognition scores of the two groups were compared. SPSS 15.0 was used for t-test and Chi-square test. Results:The after-department examination scores of the two groups were compared. Compared with the control group, the examination scores of professional theories, case analysis and operation skills in the observation group were significantly higher, and the difference was statistically significant ( t = 6.98, 7.85, 7.01, P < 0.05). In terms of recognition of teaching, the observation group was significantly higher than the control group, and the difference was statistically significant ( t = 9.14, P < 0.05). Conclusion:The PBL + CBL + CP teaching is conducive to the comprehensive and systematic mastery of knowledge and the rapid establishment of scientific clinical thinking. It has a strong scientific and systematic nature and is worthy of promotion.
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Objective:To investigate the clinical efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on therapy-related leukemia (TRL).Methods:The clinical data of 14 patients with TRL who received allo-HSCT in Aerospace Central Hospital from April 2012 to February 2020 were retrospectively analyzed, and the therapeutic efficacy and survival status were also analyzed.Results:Of the 14 patients, 5 were males and 9 were females; the median age was 35 years old (12-59 years old). There were 12 patients with acute myeloid leukemia, 1 patient with chronic lymphocytic leukemia/small cell lymphoma, and 1 patient with acute lymphoblastic leukemia. At the time of transplantation, 4 patients achieved bone marrow complete remission, 3 patients achieved bone marrow partial remission, and the remaining 7 patients had no remission. Five patients received HLA-matched sibling transplantation, 9 patients received haplotype transplantation, and they all received myeloablative pretreatment schemes. All 14 patients were successfully implanted; the median engraftment time of granulocyte was 16 d (10-24 d), and the median engraftment time of platelet was 13 d (10-34 d). Grade Ⅰ-Ⅱ acute graft-versus-host disease (GVHD) occurred in 7 patients, chronic GVHD occurred in 6 patients, and grade Ⅲ intestinal GVHD occurred in 2 patients. The median follow-up time was 32 months (4-97 months). Among 14 patients, 5 patients died.Conclusion:The allo-HSCT can improve the prognosis and long-term survival rate of TRL patients.
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Objectives To explore the difference of heart rate deceleration capacity (DC), heart rate acceleration capacity (AC), and heart rate variability (HRV) among overweight children, obesity children, and metabolic syndrome (MS) children. The correlation between body mass index (BMI) and the indexes of DC, AC, and HRV was analyzed. Methods One hundred three overweight and obesity children over 10 years old were selected. The levels of DC, AC, and HRV were detected in these children. Results The level of DC (5.97±1.77 ms) in MS group was lower than that in non-MS group (7.93±1.56 ms); the level of AC (?6.78±1.56 ms) in MS group was higher than that in non-MS group (?8.17±1.61 ms2); the level of HF [335.2(157.03~659.33) ms2] in MS group was lower than that in non-MS group [497.5(345.6~767.1) ms2]; BMI (29.64±2.83 kg/m2) was higher than that in non-MS group (26.79±1.83 kg/m2) and the differences were statistically significant (P all < 0.05). The BMI in overweight and obesity children was negatively correlated with DC (r= ?0.241, P=0.014), and was positively correlated with AC (r=0.199, P=0.044). Conclusions The autonomic nervous function of MS patients is impaired, and the vagus nerve tension is decreased. The protective force on the heart was weaker in the higher degree of overweight, obesity and lower vagus nerve tension, and thus it was the more likely to cause cardiovascular disease.
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Objectives To explore the difference of heart rate deceleration capacity (DC), heart rate acceleration capacity (AC), and heart rate variability (HRV) among overweight children, obesity children, and metabolic syndrome (MS) children. The correlation between body mass index (BMI) and the indexes of DC, AC, and HRV was analyzed. Methods One hundred three overweight and obesity children over 10 years old were selected. The levels of DC, AC, and HRV were detected in these children. Results The level of DC (5.97±1.77 ms) in MS group was lower than that in non-MS group (7.93±1.56 ms); the level of AC (?6.78±1.56 ms) in MS group was higher than that in non-MS group (?8.17±1.61 ms2); the level of HF [335.2(157.03~659.33) ms2] in MS group was lower than that in non-MS group [497.5(345.6~767.1) ms2]; BMI (29.64±2.83 kg/m2) was higher than that in non-MS group (26.79±1.83 kg/m2) and the differences were statistically significant (P all < 0.05). The BMI in overweight and obesity children was negatively correlated with DC (r= ?0.241, P=0.014), and was positively correlated with AC (r=0.199, P=0.044). Conclusions The autonomic nervous function of MS patients is impaired, and the vagus nerve tension is decreased. The protective force on the heart was weaker in the higher degree of overweight, obesity and lower vagus nerve tension, and thus it was the more likely to cause cardiovascular disease.
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Cognitive dysfunction is one of the complications of chronic obstructive pulmonary disease(COPD),often affecting the patient's daily life ability and reducing the quality of life.COPD associated cognitive dysfunction includes five areas of primary cognitive domain of awareness,attention,learning and memory ability,execution ability and language skills.The decreased cognitive dysfunction may be correlated with the age,education background,smoking,malnutrition,as well as hypoxemia,hypercapnemia,COPD duration and length of hospitalization stay,inflammatory and other factors.Early screening and assessment of COPD cognitive dysfunction,long-term oxygen therapy and other measures for interfering risk factors and improving the quality of life of patients have a positive significance.
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Objective To explore the relationship between heart rate variability (HRV) and deceleration capacity (DC) in children with idiopathic ventricular premature contraction of different origins. Methods The clinical data from 155 children with idiopathic ventricular premature contraction were retrospectively analyzed. According to the age, the children were divided into young children group (
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Objectives To explore the clinical application of deceleration capacity of rate (DC), acceleration capacity of rate (AC) and heart rate variability (HRV) in children with precardial distress of unknown origin. Methods A total of 56 children with precardial distress of unknown origin and 63 healthy children aged 6 to 17 years were examined by 24 h dynamic elec-trocardiogram, and the indexes of DC and HRV were compared between these two groups. Results DC value of children with precardial distress is less than that of the control group (P<0.05), AC value is greater than that of the control group (P<0.05), and heat rate (HR) is greater than that of the control group (P<0.05). No statistical differences were observed in the indexes of HRV between the two groups. The indexes of DC show a signiifcant positive correlation with HRV in children with precardial distress(r=0.27~0.40, P<0.05), while appear a negative relation with HR (r=-0.46, P=0.000). In contrast, the indexes of AC show a signiifcant negative correlation with HRV (r=-0.57~-0.34, P<0.05), and appears a positive relation with HR(r=0.61, P=0.000). HR value is higher in male children less than 12 years old with precardial distress than that of age-matched males in control group, and RMSSD is lower than the latter. DC value of male children more than 12 years with precardial distress is lower than that of age-matched males in control group, while AC value is higher than that of the latter;DC value is signiifcant lower in fe-male children more than 12 yeares with precardial distress than that of age-matched females in the control group (P<0.05). Con-clusions The activity of vagus nerve in children with precardial distress of unknown origin is decreased. DC value is signiifcantly lower than that of control group, and shows correlation with indexes of HRV. There is no signiifcant difference in DC and HRV value between male and female children with precardial distress. DC value is lower in children aged 12 or older with precardial distress than that of age-matched children in the control group, which indicates adolescents are vulnerable to autonomic nerve functional disorder.
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Objective To evaluate the effect of azithromycin on Pseudomonas aeruginosa PAO1 biofilm formation and virulence factors production. Methods Detect the minimum inhibitory concentration of azithromycin against PAO1 by 2-fold dilution method. Crystal violet staining assay was used for initial adhesion assays. The PAO1 biofilm was established in vitro and observed by scanning electron microscope. Viable bacterial counts were determined by serial dilution. LasB elastolytic activity was determined by using Elastin-Congo Red. Protease activity was determined by Azo-casein. Chloroform extraction method was used for pyoverdine assay . The orcinol assay was used to directly assess the amount of rhamnolipids . Results Scanning electron microscope biofilm and viable bacterial counts of PAO1 adhered to the surface of catheter in PAO1 azithromycin group were less than the PAO1 control group after incubated for 3 d and 7 d ( P ＜0.05), and the initial adhesion was weaker ( P ＜ 0. 05 ). The virulence factors production were obviously decreased (P ＜0.01 ). LasB elastolytic activity and pyoverdine were even reduced to the same as with the PA-JP3 group ( P ＞ 0.05 ), but the protease activity and the rhamnolipids concentration were higher than the PA-JP3 group ( P ＜ 0.05 ). Conclusion Azithromycin can inhibit PAO1 bioflim formation in vitro and virulence factors production.
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Objective To explore the role and significance of standardized scheme for diagnosis and treatment of pulmonary thromboembolism(PTE).Methods The clinical data of 163 consecutive PTE patients who were treated in our hospital from Jan.1972 to Dec.2006 were retrospectively reviewed.The patients were divided into group A and group B based on the time of application of standardized treatment and diagnosis for PTE.The clinical data of the two groups were analyzed and compared.Results The main risk factors included deep vein thrombus,operation,injury,fracture and tumors,etc.Dyspnea was the most important clinical symptoms.The incidences of dyspnea in group A and B were 92.5% and 84.6%,respectively.The diagnostic case and the ratio of final diagnosis in group B was increased compared to those in group A on an annual basis.The median time for diagnosis was shortened(P