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Objective:To explore the effect of fishbone diagram combined with PDCA(plan, do, check, action) closed-loop management in the teaching of orthopedic interns in operating room.Methods:The 60 interns received by the Department of Orthopedics in our hospital from January 2019 to August 2020 were randomly divided into the conventional group and the observation group in average. The conventional group used traditional methods, and the observation group introduced fishbone diagram combined with PDCA closed-loop management. The theoretical and practical assessment scores and the evaluation of satisfaction with the teaching were compared between the two groups before and after the teaching in the operating room. SPSS 22.0 was used for t-test and Chi-square test. Results:The scores of each theoretical assessment, the total scores of theoretical assessments, and the scores of practical assessments, in the observation group were higher than those of the conventional group ( P<0.05). The satisfaction rates of interest, effectiveness, rationality, and popularization with teaching in the observation group were 100.00%, 100.00%, 96.67%, and 100.00% respectively, which were higher than those (80.00%, 83.33%, 80.00%, and 83.33% respectively) in the conventional group. Conclusion:The application of fishbone diagram combined with PDCA closed-loop management in orthopedic operating room teaching can improve the performance of interns in the assessment, and can also achieve better teaching satisfaction.
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Objective:To explore the application of reflective circulation fusion link teaching in operating room nursing teaching.Methods:A total of 60 nursing students of operating room accepted by our unit from October 2019 to October 2020 were divided into the control group (30 cases, using routine nursing instruction of operating room) and the experimental group (30 cases, taking reflective circulation fusion link teaching). The assessment results, self-directed learning ability and satisfaction with the teaching before and after the teaching were compared between the two groups. SPSS 26.0 was used for t test and chi-square test. Results:The scores of theoretical knowledge and nursing skills assessment in the two groups were improved, and the scores of the experimental group after teaching were higher than those of the control group[(92.84±5.91) vs. (87.25±7.29); (91.68±7.14) vs. (85.96±8.62)] ( P<0.05); the two groups were both improved in terms of learning awareness, learning behaviors, learning strategies, and learning evaluation and interpersonal skills dimensions, and the scores of the above-mentioned dimensions of the test group after teaching were higher than those of the control group ( P<0.05); the satisfaction scores of improving learning initiative, deepening the understanding and mastery of theoretical knowledge, and enhancing operational skills were higher than those of the control group ( P<0.05). Conclusion:The application of reflective circulation fusion link teaching in nursing students of the operating room can not only enhance the students' assessment results and self-directed learning ability, but also improve their satisfaction of the teaching.
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Objective:To explore the teaching effect of micro class combined with situational exercise for operating room interns.Methods:A total of 42 interns in the operating room of Mianyang Hospital from May 2019 to February 2020 were divided into the control group taking the traditional teaching mode, while 45 interns from March 2020 to December 2020 in the same operating room were divided into the observation group taking the teaching mode of micro class combined with situational exercise. The examination results (theoretical knowledge and practical operation skills) at the time of graduation were compared, and the ability of clinical case analysis and teaching satisfaction were also comparatively analyzed. T-test and chi-square test were performed by SPSS 24.0 software. Results:The scores of theoretical knowledge and practical operation skills in the observation group at the time of graduation were (90.56±4.27) and (93.48±3.59) points respectively, which were higher than those in the control group ( P<0.05). The scores of clinical case analysis ability of the two groups at the time of graduation were higher than those entering the department, and the clinical case analysis ability scores of the observation group [(86.12±6.04) points] were higher than those in the control group [(79.23±5.65) points] at the time of graduation, with statistically significant differences were ( P<0.05). The satisfaction of interns with the improvement of self-study ability and enthusiasm, team cooperation ability, clinical practical operation ability, language expression ability, analyzing and solving problem ability, clinical thinking and knowledge point mastery in the observation group was higher than those in the control group, and the differences were statistically significant ( P<0.05). Conclusion:In the clinical teaching of the operating room interns, the teaching mode of micro class combined with situational exercise can significantly improve the actual teaching effect and enhance the interns' satisfaction to teaching, which has the value of popularization and application.
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Objective To compare the different methods for treating aerobic vaginitis and mixed clinical effects of infection.Methods A randomized controlled method was used,298 cases of aerobic vaginitis and mixed infections were randomly divided into control group(149 cases):the use of combination anti -infective therapy,the treatment group(149 cases):the use of combination anti -infective at the same treatment plus lactobacillus vaginal medication.And the therapeutic effect was evaluated.Results The difference of the clinical efficacy of aerobic vagi-nitis treatment of mixed infections was not statistically significant (total effective rate of 95.3% in the treatment group,92.6% in the control group).With the time of treatment extended,the effective rate increased,the use of com-bination anti -infective therapy at the same time plus lactobacillus vaginal administration group of aerobic bacteria vaginosis and recurrence rate was significantly reduced in patients with mixed infection (recurrence rate was 6.0% in the treatment group and 12.8% was in the control group,χ2 =3.941 3,P <0.05).Conclusion The combination of anti -infective therapy at the same time plus lactobacillus vaginal drug treatment aerobic mixed infections and vagini-tis has slightly higher effective rate than the use of combination anti -infective treatment,the former relapse rate was significantly reduced.
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Objective To investigate the diagnosis and treatment of the patients with lung cancer hospital-ized in affiliated hospital of Hainan Medical College.Methods A retrospective study was performed from January 1st 2005 to December 31th 2009 in the Hospital.201 patients were enrolled in this study.Results The average onset age of patients with lung cancer was 66 years old.No difference in different gender.The incidence of male was 72.1%, which was higher than of female(27.9%).Male to female ratio was 2.6:1.70.3% of male patients with lung cancer had a history of smoking.146 cases(72.6%)were diagnosed by clinical data,only 55 cases(27.4%)were diagnosed by histopathology.134 cases(66.7%)hadn′t indications for surgery.only 17 cases(25.4%)agreed to have surgery among 67 cases (33.3%)with indications for surgery,50 cases(74.6%)didn't agree to have surgery.34 cases (16.9%)had no indications for chemotherapy.40 cases(24.0%)agreed to have chemotherapy among 167 cases (83.1%)with indications for chemotherapy,but only 14 cases(35.0%)had completed 4 to 6 cycles of chemotherapy, and 26 cases(65.0%)hadn't completed 4 to 6 cycles.8 cases(4.0%)agreed to have radiotherapy.3 cases(1.5%) agreed to have targeted therapy.3 cases (1.5%)transfered to other hospital.Conclusion The ratio of lung cancer patients in male is higher than female in the hospital.smoking is closely related to male patients.Clinical diagnosis rate of patients is high,whereas histopathologic diagnosis rate is low.The rate of the intervention that patients accepted is low and many patients give up available management after the diagnosis is made.
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Objective To analyze the clinical characteristics of gravidas with HBV in Nanfang Hospital from 2008 to 2014. Methods 22 906 gravidas were retrospectively investigated. Results The HBsAg positive rates were 11.64% and 6.16% when the gravidas were divided into Cantonese and non-Cantonese groups (χ2 =193.370, P < 0.005). The ALT abnormal rates in HBeAg positive and HBeAg negative gravidas were 17.96% and 6.68% (χ2=62.594, P<0.005). Conclusion The HBsAg positive rate of gravidas in Guangdong and the ALT abnormal rate of HBeAg positive gravidas are higher.
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Objective: To explore the effect of caveolin-1 ( Cav-1 ) on lipopolysaccharide ( LPS )-induced airway mucous hypersecretion.Methods:16HBE human airway epithelial cells with Toll-like receptor 4(TLR4) inhibitor,nuclear factor-kappa B(NF-κB) inhibitor,Cav-1 siRNA or plasmid pr-treated,further stimulated with LPS.The cells were divided into 8 groups:the control group, the LPS group,the LPS+Cav-1 expression group,the LPS+Cav-1 siRNA group,the LPS +negative siRNA group,the LPS +empty vector group,the LPS +E5564 group, the LPS +PDTC group.Cell survival rate was detected by MTT assay.Transcription level of mucin(MUC)5AC was evaluated with RT-PCR.The level of MUC5AC protein was measured by ELISA.The expression of TLR4,Cav-1 and phosphorylated IκBα( p-IκBα) were measured by Western blot.MUC5AC protein changes were observed by immunofluorescence and confocal laser technology.Results:LPS remarkably increased MUC5AC,as well as TLR4,p-IκBα(P<0.05).These effects were prevented by E5564 and PDTC.We found that the overexpression of Cav-1 further enhanced the expression of TLR4, p-IκBαand MUC5AC.However,downregulation of Cav-1 inhibited the expression of TLR4,p-IκBα,MUC5AC.Conclusion: Cav-1 enhances LPS-induced MUC5AC hypersecretion through TLR4/NF-κB signaling pathway.
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<p><b>OBJECTIVE</b>To investigate the role of miR-21 in airway immunologic dysfunction induced by cold air irritation.</p><p><b>METHODS</b>Immortalized human airway epithelial cell lines BEAS-2B and 16HBE cells were cultured in air-liquid phases. The differential expressions of endogenous miR-21, miR-164, and miR-155 in the cells induced by cold air exposure for different time were detected by real-time PCR. The reporter plasmid containing wild-type or mutated 3'UTR of TLR-4 were constructed and co-transfected into BEAS-2B cells or 16HBE cells together with miR-21 mimic, miR-21 mimic control, miR-21 inhibitor, or miR-21 inhibitor control. Following the transfection, dual luciferase reporter assay was performed to verify the action of miR-21 on TLR-4. miR-21 mimic, miR-21 mimic control, miR-21 inhibitor, and miR-21 inhibitor control were transfected via lipofectamine 2000 in BEAS-2B or 16HBE cells that were subsequently exposed to a temperature at 37 degrees celsius; or cold irritation (30 degrees celsius;), and the protein levels of TLR-4/MyD88 were detected by Western blotting.</p><p><b>RESULTS</b>Cold irritation caused a time- dependent up-regulation of miR-21 in both BEAS-2B and 16HBE cells (P<0.05) without obviously affecting the expressions of miR-164 and miR-155. Dual luciferase reporter assay demonstrated a direct combination of miR-21 and its target protein TLR-4. The synthesis levels of TLR-4/MyD88 protein were decreased in miR-21 mimic group even at a routine culture temperature (P<0.05), as also seen in cells with cold irritation (P<0.05). Treatment with the miR-21 inhibitor partially attenuated cold irritation-induced down-regulation of TLR-4/MyD88 protein (P<0.05).</p><p><b>CONCLUSION</b>Cold air irritation-induced airway immunologic dysfunction is probably associated with TLR-4/MyD88 down-regulation by an increased endogenic miR-21.</p>
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Humanos , Regiões 3' não Traduzidas , Western Blotting , Linhagem Celular , Temperatura Baixa , Regulação para Baixo , Células Epiteliais , Alergia e Imunologia , Metabolismo , Luciferases , MicroRNAs , Metabolismo , Fator 88 de Diferenciação Mieloide , Metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Transdução de Sinais , Receptor 4 Toll-Like , Metabolismo , Transfecção , Regulação para CimaRESUMO
Objective:To observe the dynamic changes in serum gastroanteric hormones in patients with stroke complicating stress upper gastrointestinal hemorrhage in acute stage,the changes in acidity,and the changes in gastric empty and to investigate the pathogenetic link of stress pathological change of gastric mucous membrane in patients with stroke(Zhongzangfu,ZZF,中脏腑).Methods:In 20 cases with acute ZZF (Glasgow coma score 6-12 scores) who were all complicating upper gastroenteric bleeding within 24 hours of attack,the levels of motilin(MTL),somatostation(SS),and gastruins(GAS) were measured by radioimmunoassay at the first day (within 24 hours) and the fourth day (within 72-96 hours) respectively meanwhile the gastratube was plased and kept within 24 hours of attack to dynamically observe the pH of gastric juice and the condition of gastric emptying.Results:In comparison with control group the MTL level was significantly increased in patients at the first day of attack (P<0.05),the SS level significantly decreased (P<0.01),and the GSA level had not significant difference (P>0.05).Otherwise the pH (2.87±0.90） of gastric juice in comparison with control group has not significant difference (P>0.05).Among patients in 17 cases the gastric emptying time was prolonged.Even at the fourth day in patients the MTL level was still significantly increased (P<0.01),SS level decreased (P<0.05),and GAS level increased (P<0.01).Conclusions:The upper gastrointestinal hemorrhage in patients with acute ZZF is tightly associated with the changes in MTL and SS but the changes in GAS and gastric pH are not main factor.