Objective To evaluate the value of bypass graft in the treatment of critical lower limb ischemia with distal single outflow artery.Methods Forty-nine lower limbs in 42 patients with single outflow artery were collected and underwent arterial bypass graft.The operation methods included femoropopliteal artificial graft to single outflow artery with autograftand popliteal artery to calf vessel and so on.The results were analyzed finally.Results All of 42 patients,postoperative grafts occlusion occured in 1 case,the occlusion rate was 2.4％(1/42) and the success rate was 97.6％(41/42),1 case died of respiratory failure 4 d postoperatively,the mortality was 2.4％(1/42).The patency rate of graft was 100.0％(41/41) on discharge.Healing rate of foot ulcer was 33.3％ (11/33).Conclusions It's difficult to reconstruct blood flow for critical ischemic limb with single outflow artery,but good result is still expected by distal lower limb bypass graft.Distal bypass can provide a better nutritional support for the healing of foot ulcer and result in a lower limb salvage or lowering of amputation level.

Objective:To construct a model of nursing teaching rounds in dental clinics, and to provide a reference for the implementation of nursing teaching activities in dental clinics.Methods:Using the constructivism learning theory framework, we developed a preliminary draft of a teaching rounds model for dental outpatient nursing according to literature review, cross-sectional survey, and brainstorming results. Two rounds of Delphi consultation with 21 experts from across China were conducted to determine the teaching rounds model for dental outpatient nursing. Data entry and statistical analysis were performed with Excel 2016 and SPSS 26.0 software.Results:In the two rounds of expert consultation, the questionnaire response rates were both 100%; the expert authority coefficients were 0.865 and 0.873, respectively; and the Kendall's coefficients of concordance were 0.116 and 0.164, respectively. The established dental outpatient nursing teaching rounds model included 7 first-level items and 22 second-level items.Conclusions:The dental outpatient nursing teaching rounds model constructed in this study is scientific, reliable, and practical, which can provide guidance for conducting nursing teaching rounds in dental clinics.

Objective:To develop an inquiry learning community centered on learning experience in the course of Nursing Clinical Comprehensive Experiment to verify the influence of this teaching mode on the learning gains and practical ability of nursing students. Methods:A total of 132 undergraduate nursing students form grade 3 in Chongqing Medical University were enrolled. The participants were randomly assigned to a learning community group ( n = 69) and a control group ( n = 63) using Minitab 14.0 software. The students in the learning community group adopted the inquiry learning community mode in accordance with the curriculum map for online self-learning, group discussion and skills practice, while the control group received the teacher-led teaching mode for offline theory teaching, operation teaching and skills practice. After the teaching intervention, both groups of students received the assessment questionnaire of learning gains and the comprehensive experimental ability evaluation. Chi-square test or paired t-test was performed using SPSS 23.0. Results:Compared with the control group, students in the learning community group reported that their sense of learning gain was enhanced ( P<0.001, Cohen d=0.97); sub-items showed that the effect size for the understanding of learning content ( P<0.001, Cohen d=1.22), the overall course situation ( P<0.001, Cohen d=0.90), the course activities ( P=0.000, Cohen d=0.83), and the information obtained ( P<0.001, Cohen d=1.16) was significantly different. The total score of practical ability of comprehensive experiment was significantly improved ( P = 0.005, Cohen d=0.51), in which the experimental situation displays ( P=0.002, Cohen d=0.55) and experimental effect ( P=0.006, Cohen d=0.49) were better than the control group. There was no significant difference in the performance of experimental preparation and case analysis between the two groups. Conclusion:Developing an inquiry learning community in nursing clinical comprehensive experiment can effectively enhance student' sense of learning gains and promote the improvement of clinical practical ability.