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To evaluate the association between serum anti-tissue transglutaminase antibody (anti-tTG) titers and the severity of histological damage to the duodenal mucosa and to predict a possible anti-tTG cutoff value for diagnosing celiac disease (CD) and villous atrophy in the domestic population. Clinical and pathological data from 76 adult CD patients with positive anti-tTG titers and duodenal biopsy results who were treated at the People′s Hospital of Xinjiang Uygur Autonomous Region from July 2017 to January 2022 were retrospectively analyzed. The correlation between anti-tTG titers and the severity of duodenal mucosal damage was statistically assessed to predict the optimal anti-tTG titer cut-off value for diagnosing CD and villous atrophy. Of the 76 patients, 10 had underlying CD, and of the 66 patients with duodenal histopathology, four were Marsh Ⅰ, six were Marsh Ⅱ, and 56 were Marsh Ⅲa-c grade. In adults with CD, anti-tTG titers were shown to be associated with the severity of histological damage to the duodenal mucosa. When the anti-tTG level was ≥5 times the upper limit of normal (ULN), the sensitivity and specificity for diagnosing CD were 83.9% and 92.9%, respectively. When the anti-tTG titer was ≥8 times the ULN, the sensitivity and specificity for diagnosing villous atrophy were 67.9% and 90.0%, respectively. Anti-tTG levels had a strong predictive value for diagnosing CD in adults when titers exceeded 10 times the ULN. Thus, the anti-tTG cut-off value can be combined with clinical judgment to diagnose CD, limiting the use of invasive endoscopy.
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Objective:To explore the effect of applying scaffolding teaching to infectious disease teaching.Methods:The study selected 259 undergraduate nursing students of Batch 2017 as the research objects, and they were randomly divided into an experimental group (126 students) and a control group (133 students) according to the odd and even numbers of their student numbers. The experimental group carried out scaffolding teaching, and the control group adopted traditional teaching. After the teaching, the two groups of students were assessed on the theory of infectious diseases and scenario simulation excercises. The teaching satisfaction of the two groups was assessed through questionnaire surveys. SPSS was used for t test and chi-square test. Results:The experimental group's theoretical assessment and scenario simulation excercises scores were both higher than those of the control group, and the difference was statistically significant ( P<0.05). The results of the questionnaire survey showed that the experimental group students were more satisfied with the scaffolding teaching model [80.2% (101/126)], which was higher than that of the control group [54.1% (72/133)], with statistically significant differences ( P<0.001). Conclusion:Scaffolding teaching is helpful to improve teaching quality and satisfaction in infectious disease teaching, and it is worthy of further promotion and application in educational practice.
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Objective:To explore the effect of CDIO (conceive, design, implement, operate) model workshop training on the training of new nurses in the operating room.Methods:Forty-two nurses with standardized training were selected as the research objects, and they were randomly divided into two groups: observation group ( n=21) and control group ( n=21). The control group used the traditional training method in the operating room, and the observation group used the workshop training based on the CDIO model. SPSS 17.0 was used to statistically analyze the operation skill scores and case scores after training. The measurement data is expressed by (mean±standard deviation), the independent sample t test is used for comparison between the two groups, and the chi-square test is used for the comparison of counting data. Results:After the training, the scores of operating room knowledge assessment of the two groups were (72.31±2.16) points and (73.61±2.18) points respectively, with statistical significance ( P<0.05); the operation skill scores of observation group were (7.42±0.13) points, which were higher than those of the control group (6.62±0.11) points, and the disposal scores of observation group after operation were (7.12±0.20) points, which were higher than those of the control group (6.27±0.16) points, with statistical significance ( P<0.05); the professional quality scores of observation group were (7.41±0.25) points, which were higher than those of the control group (6.55±0.22) points; the adaptability scores of observation group were (7.06±0.22), which were higher than those of control group (6.35±0.21) points, with statistical significance ( P<0.05). Conclusion:The workshop training based on the CDIO model is effective for the training of nurses in the operating room, and the combined application effect is better than the effect of the traditional teaching model, especially for the improvement of practical skills.
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Objective:To investigate the clinical manifestations and pathological features of adult celiac disease in Xinjiang Uygur Autonomous Region.Methods:From January 2016 to December 2019, the clinical data of 943 patients with gastrointestinal symptoms such as chronic diarrhea, abdominal pain, abdominal distension and visited the People′s Hospital of Xinjiang Uygur Autonomous Region were collected. All patients tested for serum anti-tissue transglutaminase antibody inmunoglobulin A (tTG-IgA). And patients with positive serum tTG-IgA underwent gastroscopy and colonoscopy examination. To observe whether duodenal and ileal mucosal villi atrophy and histopathological examination was performed. Body mass index (BMI), hemoglobin, serum calcium, serum albumin level were compared between patients with and without celiac disease. T test and chi-square test were used for statistical analysis. Results:Serum tTG-IgA was positive in 30 patients, and 28 cases were finally diagnosed as celiac disease. The detection rate of celiac disease of Kazakh patients was higher than that of Uygur and Han patients (17.3%, 9/52 vs. 3.2%, 12/375 and 1.4%, 6/427), the detection rate of celiac disease of Uygur was higher than that of Han, and the differences were statistically significant ( χ2=7.65, 5.42 and 5.98, all P<0.05). The main clinical manifestations of 28 patients with celiac disease were weight loss or marasmus (71.4%, 20/28), iron deficiency anemia (67.9%, 19/28), persistent fatigue (57.1%, 16/28) and chronic diarrhea (53.6%, 15/28). The serum tTG-IgA level of patients with celiac disease was higher than that of patients without celiac disease ((131.97±64.58) CU vs. (7.58±1.92) CU), while the levels of BMI, hemoglobin, serum calcium and serum albumin were all lower than those of patients without celiac disease ((15.4±2.9) kg/m 2 vs. (23.8±3.4) kg/m 2, (110±28) g/L vs. (138±12) g/L, (1.70±0.20) mmol/L vs. (2.52±0.15) mmol/L, and (31.5±11.6) g/L vs. (48.2±7.3) g/L, respectively), and the differences were statistically significant ( t=2.473, 2.521, 2.641, 2.734 and 2.512, all P<0.05). Under gastroscopy all patients with celiac disease had atrophy of duodenal mucosal villi, which mainly appeared as nodular mucosal atrophy, grooves and fissure like changes, and villous atrophy was confirmed by histopathology. Conclusions:The detection rates of celiac disease in Kazakh and Uyghur in Xinjiang Uygur Antonomous Region are significantly higher than that of Han nationality. Celiac disease screening has a certain clinical significance.
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Objective To investigate the self-care agency level and analysis the relationship between the self-care ability level and the prognosis of the patients with upper gastrointestinal bleeding caused by liver cirrhosis.Methods In the first stage,78 cases of liver cirrhosis patients complicated with first eruption of upper gastrointestinal bleeding were selected,the Exercise of Self Care Agency Scale (ESCA)was adopted to assess the self care ability of patients,the results underwent analysis.In the second stage,according to the results that the proportion of scores accounted for total score ratio,the patients were divided into low,medium and high level groups.By prospective studies,through telephone follow-up and clinic follow-up,the evaluation items of patients were collected,and the survival status of patients within 3 months after discharge was compared.Results For patients with upper digestive tract bleeding caused by liver cirrhosis,the self-care scored (84.07±17.38) totally,among 78 patients selected,15.4％ (12/78) was in the low level,75.6％ (59/78) was in the medium level,9.0％ (7/78) was in the high level.The self-care ability increased in conjunction with decreased mortality rate.The mortality rate in the lower level group was 8/12,33.9％ (20/59) in the medium level group,1/7 in the higher level group,there was statistically significant difference,x2=6.3,P＜0.05.The MELD-Na scores in the lower,medium and higher level groups wererespectively 34.03±4.62,22.57±3.05,12.87±1.36,F=6.0,P＜0.05.Likewise,complication incidence rates were negatively correlated with self-care ability,r =-(0.525-0.189).Conclusions The self-care ability of patients with gastrointestinal bleeding caused by liver cirrhosis is in the medium level,and it exercises certain influence on prognosis of patients.Attention should be paid to cultivation of self-care ability of patients in clinic.
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Background:It has been demonstrated that serum perinuclear antineutrophil cytoplasmic antibody( pANCA)occurred significantly more often in ulcerative colitis( UC ) than in Crohn ’s disease( CD ),so it is of great importance for differential diagnosis of UC and CD. Aims:To study the correlation of serum pANCA with efficacy of aminosalicylic acids ( ASA)on UC. Methods:A retrospective study was conducted in 70 mild to moderate active UC patients admitted between Jan. 2007 and Dec. 2013 at People’s Hospital of Xinjiang Uygur Autonomous Region,all of them received oral mesalazine therapy,35 were positive and 35 were negative for serum pANCA. The efficacy was compared between the two groups. Results:After a four-week oral mesalazine therapy,the remission rate and overall efficacy were significantly higher in pANCA-positive group than in pANCA-negative group( remission rate:80. 0% us. 54. 3%,P﹤0. 05;overall efficacy:94. 3% us. 77. 1%,P﹤0. 05). Conclusions:Mesalazine is more effective in serum pANCA-positive UC patients. Being a specific immunological biomarker of UC,pANCA might be an indicator for predicting the therapeutic efficacy of ASA in UC patients.