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Objective:To investigate the application effect of CBL teaching based on mind mapping combined with know-want-learned (KWL) chart in standardized nursing training for neonatal infection.Methods:A total of 58 students who participated in standardized training in Department of Neonatology, Children's Hospital, Capital Institute of Pediatrics, were included in the study and were divided into control group and observation group using a simple random number table, with 29 students in each group. The students in the control group were given traditional teaching, and those in the observation group were given CBL teaching based on mind mapping combined with KWL chart. Assessment score was compared between the two groups, and the two groups were compared in terms of self-directed learning ability, critical thinking ability, and evaluation of teaching effectiveness. SPSS 22.0 was used to perform the chi-square test and the t-test. Results:Both groups had significant increases in the scores of theoretical knowledge (91.65±5.17 vs. 84.58±9.14), clinical skills (89.16±6.24 vs. 83.34±7.40), Self-Rating Scale of Self-Directed Learning (257.23±25.79 vs. 241.56±22.74), and Critical Thinking Disposition Inventory-Chinese Version (317.14±38.50 vs. 285.78±34.71) after training, and the observation group had significantly higher scores than the control group ( P<0.05). The observation group had a significantly higher evaluation of teaching effectiveness than the control group ( P<0.05). Conclusion:CBL teaching based on mind mapping combined with KWL chart can improve the assessment scores of students and improve their self-directed learning ability and critical thinking ability, and students have a high evaluation of teaching effectiveness.
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Objective:To investigate the diagnostic value of contrast-enhanced ultrasonography (CEUS) in evaluating the severity of renal artery stenosis.Methods:Eighty six patients with suspected renal artery stenosis admitted to Shanxi Provincial People′s Hospital from January 2018 to July 2021 were enrolled in the study. All patients underwent digital subtraction angiography (DSA), Doppler ultrasonography (DUS) and CEUS examinations. With DSA results as gold standard the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of CEUS and DUS in the diagnosis of renal artery stenosis were analyzed. The consistency between CEUS and DSA in the diagnosis of renal artery stenosis was evaluated. The accuracy of DUS and CEUS in diagnosis of renal artery stenosis was assessed by the area under receiver operating characteristic (ROC) curve (AUC) and compared between groups.Results:Among 153 renal arteries from 86 patients examined by DSA, 101 showed the stenosis ≥30% (49 left and 52 right renal arteries), and there were 31, 45, 20 and 5 renal arteries with grade I, II, III and IV stenosis. The sensitivity and specificity of DUS in the diagnosis of renal artery stenosis were 74.3% (75/101) and 76.9% (40/52),respectively. DUS showed 21, 42, 20 and 4 renal arteries with grade Ⅰ, Ⅱ, Ⅲ and Ⅳ stenosis, respectively. The sensitivity and specificity of CEUS in the diagnosis of renal artery stenosis were 88.1% (89/101) and 86.5%(45/52), respectively. CEUS showed 26, 43, 23 and 4 renal arteries with grade Ⅰ, Ⅱ, Ⅲ and Ⅳ stenosis, respectively. There was a significant difference between DUS and DSA in grading of renal artery stenosis (χ2=4.447, P=0.03),and there was a moderate consistency between DUS and DSA ( Kappa=0.480). There was no significant difference between CEUS and DSA in grading renal artery stenosis (χ2=0.842, P=0.36) with a good consistency ( Kappa=0.730). The AUC of CEUS in diagnosis of renal artery stenosis was higher than that of DUS [0.873 (95% CI: 0.808-0.938) vs. 0.756 (95% CI:0.673-0.839); Z=4.361, P<0.01]. Conclusion:The study suggests that contrast-enhanced ultrasonography may be used as a diagnostic method for grading renal artery stenosis.
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Objective: To evaluate the impact of acute carbon monoxide poisoning on left ventricular systolic function with three-dimensional speckle tracking imaging (3D-STI). Methods: Totally 109 patients with acute carbon monoxide poisoning (study group) were enrolled and divided into mild (n=36), moderate (n=40) and severe (n=33) subgroups. And 105 healthy volunteers were selected as control group. 3D-STI was performed 1 hour and 1 week after poisoning, respectively. The levels of carboxyhemoglobin (HbCO) and serum cardiac troponin I (cTnI) were measured. The difference and correlation of the indexes were analyzed between the study group and the control group. Results: One hour after acute carbon monoxide poisoning, no significant difference of global longitudinal strain (GLS), global area strain (GAS), global circumferential strain (GCS), global radial strain (GRS) nor left ventricular ejection fraction (LVEF) was found between mild subgroup and control group (all P>0.05), while HbCO and cTnI in mild subgroup were higher than those in control group (both P0.05); GAS in severe subgroup was lower than that in control group (P<0.05), cTnI was higher than that in control group (P<0.05). One hour after acute carbon monoxide poisoning, serum cTnI was negatively correlated with GLS and GAS in the study group (r=-0.626, -0.640, both P<0.05). Conclusion: 3D-STI can early diagnose damage of left ventricular systolic dysfunction caused by acute carbon monoxide poisoning. GAS decreases with the increase of serum cTnI content, which is a good indicator of left ventricular dysfunction in patients with acute carbon monoxide poisoning.
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Objective To analyze the normal reference values of the right ventricular volumes and ejection fraction of healthy adults measured by single-beat real-time three-dimensional echocardiography (sRT-3DE).Methods The subjects of this study included three hundred and thirty-four healthy adults,and were divided into 2 groups by gender and 6 groups by age.The sRT-3DE was chosen to measure their right ventricular volumes and ejection fraction.The parameters of right ventricular volumes were standardized by body surface area (BSA)and lean body mass (LBM)to calculate the ranges of their normal value.The correlation between these parameters and genders as well as the physical characteristics (height,weight, body mass index,BSA and LBM)was also clarified.Results Three hundred and thirty-four (96%)of the 348 subjects had been tested.Before standardizing,men had larger right ventricular volumes compared with women,and the differences of the right ventricular end diastolic volume (RVEDV),right ventricular end systolic volume (RVESV)and right ventricle stroke volume (RVSV)were statistically significant(P 0.05 ).After standardizing by LBM,the RVEDV,RVESV and RVSV in male group were significantly lower than those in women group (P < 0.001 ).In different age groups,the difference of RVEDV,RVESV,RVSV ,but no RVEF were statistically significant (P < 0.05 ).Positive correlations between the RVEDV,RVESV,RVSV and the BSA,height,weight,body mass index and LBM had been detected,and it showed a negative relation between RVEDV,RVESV,RVSV with age.Noticeably,RVEF had no correlation with them.Conclusions sRT-3DE can provide a preliminary range for normal reference values of right ventricular volumes and RVEF in healthy adults according to gender and age and finds that LBM has certain impact on adult cardiac structure,which offers valuable evidence for the diagnosis of right heart diseases in clinical practices.