Objective To understand the effect of the general practitioners training in northern An-hui province, so as to provide a scientific basis for improving training strategies and measures. Methods In accordance with the requirements of Implementation of General Practitioners Training Program in Anhui Province, the training courses was designed, which includes the differences between general medicine and special medicine, general medicine service psychology, ethics related skills, general teaching skills, general clinical skills, and general practice policies, with a total of 32 credit hours. Participants were examined through the self-designed electronic questionnaire before and after the training. A total of 118 participants were involved in the training, and 109 of them were examined before the training, with a recovery rate of 92.4％. After the training, they were examined again, and the recovery rate was 100％. All data were analyzed by SPSS 17.0 software, and P<0.05 was considered statistically significant. Results Scores of the general medicine knowledge and skills after the training were higher than that before the training, and the difference was statistically significant (P<0.05). As for the course evaluation, the average score was over 4 in organiza-tion and management, training facilities, teacher knowledge, training materials, training methods and skills, while the average score was no more than 4 in training content and helping teaching. Conclusion The training achieves good results, and in the future, we should strengthen the training of teaching ability, thus further improving the effect of general practitioners training. Also, we should design the training content reasonably and pay attention to improve the quality and effectiveness of individual courses accordingly. What's more, we can use diversified teaching methods to further improve the teaching ability of general practitioners.

Objective The aim of the study was to develop a kind of new fluoride composite resin .We explored the practica-bility of preparing fluorinated filler by using hollow silica microsphere as a carrier of sodium fluoride (NaF) as well as its fluoride-re-lease properties in composite resin . Methods Hollow silica microspheres with mesoporous shells were prepared by the sacrificial template method.NaF was loaded into hollow silica microspheres by the impregnation method .Scanning electron microscopy ( SEM) was used to determine the morphologies of hollow silica microspheres before and after NaF loading .Hollow nanosilica microsphere con-taining NaF and NaF powder were respectively mixed with resin at the same intial NaF concentration of 13.9, 27.8 and 55.6 mg/mL for comparison, which were taken as the experiment group and the control group .The samples were put into 100 mL artificial saliva at 37℃to caculate the cumulative fluoride release quantities from 1 d to 47 d.Results The morphology of hollow microsphere did not chang significantly before and after NaF loading .In the experiment group ,the cumulative quantities of fluoride release were 0.026, 0.105, 0.21 mg/cm 2on 1 d and increased to 0.088, 0.239, 0.484 mg/cm 2on 47 d according to respective initial NaF concentration . While in the control group, the corresponding figures were 0.006, 0.025, 0.04 mg/cm2on 1 d and 0.022, 0.045, 0.056 mg/cm2on 47 d.The difference between these two groups was of great statistical significance . Conclusion Hollow silica microsphere could be used as a carrier of NaF .Fluorinated nanosilica filler using hollow microsphere promotes the fluoride release in composite resin .

Objective To systematically review the effects of different delivery routes of oxytocin in preventing hemorrhage after cesarean section.Methods Databases including PubMed,Medline,Embase,Cochrane library,Wanfang Medical Database,China National Knowledge Internet (CNKI),VIP Database for Chinese Technical Periodicals were searched by computers and Conference papers were manually searched.The randomized,controlled clinical trials of oxytocin given by intramuscular injection,intravenous injection or intravenous infusion were included in elective cesarean section under spinal anesthesia.The quality of included literatures was evaluated by Cochrane systematic evaluation.The primary outcome measure was intraoperative amount of blood loss or change in Hb before and after operation.The secondary outcome measures were changes in blood pressure and heart rate,electrocardiogram,uterine contraction and other adverse reactions after using oxytocin.Results Seven studies involving 2 325 patients were included in this meta-analysis.Among the 2 325 patients,oxytocin was given through intramuscular injection in 79 cases,by intravenous injection in 1 147 cases and in the way of intravenous infusion in 1 099 cases.Compared with intramuscular injection group or intravenous infusion group,no significant change was found in the amount of blood loss during operation in intravenous injection group (P＞0.05).There was no statistically significant difference in the amount of blood loss during operation between intravenous injection group and intravenous infusion group (P＞0.05).Intravenously infusing oxytocin produced less effect on the mean arterial pressure and heart rate than intravenously injecting oxytocin (P＜0.01).Conclusion Intravenous infusion is a suitable route for oxytocin delivery in cesarean section with spinal anesthesia.

In this study, ivabradine hydrochloride (IVB) was prepared as elementary osmotic pump tablets whose administration frequency was reduced to once daily. The dissolution method was developed, and effects on drug release profiles were evaluated by single factor analysis involving suspending agents, osmotic active agents and aging process. Orthogonal test was carried out at 3 levels on 3 factors including the amount of polyoxyethylene (PEO) in the core, polyethylene glycol (PEG) percentage and weight increase of controlled-release film coatings. The final formulation consisted of IVB (16.25 mg), PEO N80 (60 mg), hypromellose E5 (10 mg), lactose (111.75 mg), magnesium stearate (2 mg); and the film coatings consisted of PEG (15%), cellulose acetate (85%), with a weight increase of 7.5%. In vitro drug release behaviors were investigated. Prepared tablets exhibited similar release profiles in different pH dissolution media, with no risk of dose dumping in 40% ethanol solutions. The osmotic pressure differences inside and outside the membrane drove drug release. IVB osmotic pump tablets could reduce the frequency of administration and improve patients'' compliance, thus with better application values.

Objective:To understand the current situation and demand of intracavity electrocardiographic positioning technique training for PICC specialist nurses in Shandong Province, and provide a reference for further improving and improving the training of PICC specialist nurses.Methods:From July 7-23, 2019, a total of 903 PICC specialist nurses in Shandong Province were selected by the convenience sampling method. The nurses were investigated by the self-made general information questionnaire of PICC specialist nurses in Shandong Province and the training demand questionnaire of intracavity electrocardiographic positioning technique.Results:40.75% (368/903) PICC specialist nurses had participated in intracavity electrocardiographic positioning technique training; 84.27% (761/903) PICC specialist nurses thought it necessary to conduct intracavity electrocardiographic positioning technique training. PICC specialist nurses had various training on intracavity electrocardiographic positioning technique, the average content requirements were all above 4.67 points. The highest score of theoretical training content was the judgment of the relationship between catheter tip position and electrocardiogram P wave (4.80 ± 0.47), and the highest score of operation training content was the intracavitary electrocardiography guided PICC catheterization (4.74 ± 0.55). 94.24%(851/903) PICC specialist nurses hoped to achieve the goal of improving clinical nursing practice ability through intracavity electrocardiographic positioning technique training. Intravenous therapy specialist academic conference was the main hoped training form(76.85%, 694/903). Multiple regression analysis showed that the number of years of catheterization, job position and understanding of the technology were the influencing factors of PICC specialist nurses′ training needs for intracavity electrocardiographic positioning technique ( t = -3.73,3.12, -3.63, all P<0.05). Conclusions:The training rate of intracavity electrocardiographic positioning technique was low, but PICC specialist nurses had higher training requirements for intracavity electrocardiographic positioning technique. Managers should pay attention to the training of intracavity electrocardiographic positioning technique, and develop targeted training programs to further improve the clinical practice capabilities of the PICC specialist nursing team.

Objective:To construct a virtual simulation training platform for peripheral inserted central catheter (PICC) catheterization and discuss its application in clinical training.Methods:A total of 118 nurses who attended the PICC professional and technical advanced training courses in a province in 2020 and 2021 were enrolled in this study. In 2020, the training was conducted in the form of theoretical teaching combined with practical training ( n=51), and in 2021, virtual simulation platform was introduced as a supplement on the basis of the original training ( n=67). SPSS 23.0 was used for independent-samples t-test to compare the theoretical and operational assessment results of the two years and evaluate the application effect of the platform. Through the satisfaction survey and learning log, the nurses' experience of using the platform was understood. Results:The theoretical performance and the operational performance of nurses who participated in the training in 2021 were (96.56±3.17) and (94.06±2.16) respectively, and the operational performance was better than that of nurses who participated in the training in 2020 ( t=-11.37, P<0.001), and the difference in theoretical performance was not statistically significant ( t=0.17, P=0.853). In 2021, 63 nurses (94.0%) who used the virtual simulation platform believed that the platform could assist to improve the training effect; 61 nurses (91.0%) expected the application of virtual simulation technology in the teaching and training of other knowledges. Conclusion:As a new teaching form, virtual simulation technology can significantly improve the training effect and satisfaction, and provide reference for the development of relevant teaching and training.

Animals ; Copper ; toxicity ; Disulfiram ; toxicity ; Humans ; Leukemia, Myeloid, Acute ; Mice ; Mice, Inbred NOD ; Mice, SCID