Objective: To evaluate the effectiveness of the Demin Circle in on-site first-aid training among fishermen, so as to provide insights into improving the on-site first-aid knowledge and skills among fishermen. Methods : Deep-sea male fishermen were sampled from Putuo District of Zhoushan City, Zhejiang Province and randomly assigned to the intervention and control groups. Participants in the control group received training pertaining to conventional first-aid knowledge, while participants in the intervention group were given the Deming Circle. The knowledge, awareness and skills of on-site first-aid, and satisfaction with the first-aid training were evaluated among fishermen before and after the training using questionnaire surveys and on-site first-aid skill operations. Results: A total of 327 questionnaires were allocated, and 273 valid questionnaires were recovered, with an effective recovery rate of 83.49%. There were 132 respondents in the control group and 141 in the intervention group, and there were no significant differences between the two groups in terms of age or educational level ( P>0.05 ). The increase of the score of on-site first-aid knowledge, proportion of active learning of on-site first-aid knowledge, proportion of active elimination of potential dangers and proportion of active implementation of on-site first-aid, and seizing the skills of cardiopulmonary resuscitation, trauma first-aid, airway foreign body disposal and calling the police were all higher in the intervention group than in the control group ( P<0.05 ). Following training, the score of satisfaction with the training was significantly higher in the intervention group than in the control group [( 9.13±0.49 ) vs. ( 7.08±0.72 ) points, P<0.05 ], and the score of willingness to continue the enrollment in the Deming Circle was significantly greater in the intervention group than in the control group [( 65.13±3.11 ) vs. ( 43.62±3.79 ) points, P<0.05 ]. Conclusion Deming Circle is superior to conventional first-aid training for improving the effectiveness of on-site first-aid training among fishermen.

Objective To summarize the experience of surgical treatment of ascending aortic aneurysms and aortic dissections. Methods From February 2001 to October 2005, 31 patients including 26 male, 5 female, aged 41.3 years old (range 14-72) received surgical management. Twenty cases were diagnosed as ascending aortic aneurysm and aortic root aneurysm, 8 as Standford A dissection, 3 as Stanford B dissection. Twenty-one patients underwent classic Bentall procedure in which VSD repair was carried out in 1 case, mitral valvoplasty in 2 and mitral valve replacement in 2; Four patients underwent modified Bentall procedure (coronary button technique); Three patients underwent Wheat procedure; The remaining 3 patients with Stanford B dissection underwent graft replacement of descending aorta. Results There was no death during hospital stay that lasted 13-46 d with an average of 16.4 d after operation. The mean clinical follow-up was (21?18.5) months (range 1-63 months). One patient died without describable cause two years later. One patient had ascending aorta-pulmonary artery fistula at color Doppler examination half a year later. One patient was detected rupture of distal anastomoses half a year after operation and underwent stent-graft, SG. Conclusion The surgical treatment of aortic aneurysms and aortic dissections could be carried out safely based on the accurate diagnosis, specific surgical strategy and fine technique.