Objective:To systematically review the teaching effects of flipped classroom (FC) in undergraduate medical education in China.Methods:Such databases as CNKI, VIP Data, and WanFang, were electronically searched for literature of randomized controlled trials (RCTs) on FC versus lecture-based learning (LBL) applied in medical education in China up to March, 2018. The included literature were evaluated for the quality, and RevMan5.3 software was used for Meta-analysis.Results:A total of 26 RCTs were included in the study, including 4 249 students, of whom the FC group had 2 135 cases, while LBL group had 2 114 cases. The students in FC group got significantly higher scores than those of the students in LBL group in the theoretical scores (WMD = 7.81, 95%CI = 5.18 -10.43, P < 0.05), skills tests (WMD = 4.69, 95%CI = 0.65 -8.73, P < 0.05). Conclusion:The FC can significantly improve the teaching results in undergraduate medical education.

Objective:To explore the application effect of Roy adaptation model combined situational teaching method in pediatric nursing teaching.Methods:A total of 108 nursing students interned in our hospital in 2019 were selected and randomly divided into two groups, among which, 54 nurses who accepted the traditional teaching method were taken as the control group, and 54 ones who adopted Roy adaptation model combined situational teaching method were taken as the research group. The scores of theory and operation skills of the two groups were evaluated before and after teaching, at the same time, the comprehensive ability was assessed and the satisfaction survey was conducted among the students after the teaching. SPSS 20.0 was used for data processing, the scores of theory and operation skills comprehensive ability and nursing students' satisfaction with teaching were described with ( ± s) and t test was performed. Results:After the teaching, the theoretical knowledge and operational skills scores of the two groups were significantly improved than those before the teaching ( P<0.05), and those of all students in the research group were significantly higher than those in the control group ( P<0.05). The scores of ability to integrate theory with practice, self-learning ability, communication ability, teamwork ability, independent thinking and problem solving ability, clinical thinking ability in the research group were higher than those in the control group, with statistical differences ( P<0.05). And students in research group had significantly higher overall satisfaction scores on the teaching than those in control group had ( P<0.05). Conclusion:Application of Roy adaptation model combined situational teaching method in pediatric practice teaching can improve the theoretical knowledge and operational level of nursing students, enhance their communication ability and other abilities, and help to improve their satisfaction with teaching.

The factors affecting cerebral ischemia model of rat established by middle cerebral artery occlusion include animal selection, drugs of anesthesia, surgical site, thread affect building, and etc. To find and manufacture an appropriate thread is the key to success. It includes the species, length, diameter, hardness, and placing method of the thread. The improvement of these factors greatly increases the successful rate in the establishment of focal cerebra ischemia model of rat caused by middle cerebral artery occlusion.

In the post-genomic era, gene function analysis has attracted much attention. Transformation is often needed to investigate gene function. In this study, an easy, rapid, reliable, and cost-effective colony polymerase chain reaction (PCR) method for screening mushroom transformants was developed: picking up a suitable amount of transformant's tissue (1–10 μg) to 20 μl 0.25% Lywallzyme solution, and vortexing for 10 s followed by incubation at 34 °C for 15 min. Finally, 2 μl of the suspension was used as templates to perform PCR and single target bands were successfully amplified from respective transformants of Tremella fuciformis, Pleurotus ostreatus, and Pleurotus tuber-regium. This procedure could be widely employed for screening transformants in mushroom transformation experiments.

Objective:To explore the improvement effect of positive emotional support combined with education mode based on animation demonstration on treatment compliance in children with bronchial asthma (BA) so as to provide guidance for clinical nursing of BA children.Methods:The quasi-experiment research scheme was adopted. The children with BA admitted to the First Affiliated Hospital of Xinjiang Medical University were enrolled as the research objects by convenience sampling method. Grouped according to admission time, 52 children with BA were treated as the control group from January 2020 to June 2021, and 52 children with BA were treated as the experimental group from July 2021 to June 2022. The control group received routine nursing care, while the experimental group received positive emotional support in addition to routine nursing care, combined with an animated demonstration health education model for intervention.According to 6 months of follow-up, changes of treatment compatibility, asthma control, psychological state and quality of life after intervention in the two groups were observed.Results:In control group, there were 31 boys and 21 girls, with age of (9.95 ± 1.57) years. In experimental group, there were 35 boys and 17 girls, with age of (9.46 ± 1.02) years. After intervention, the treatment compatibility of the experimental group was 96.15% (50/52), which was higher than 80.77% (42/52) of the control group, and the difference was statistically significant ( χ2=6.03, P<0.05); the asthma control rate in the experimental group was 94.23% (49/52), which was higher than the control group′s 75.00% (39/52), and the difference was statistically significant ( χ2=7.39, P<0.05); the scores of psychological state (psychoticism, neuroticism, dissembling or lying) in experimental group were 42.18 ± 4.21, 49.23 ± 4.66 and 48.63 ± 4.26, higher than those in control group 38.22 ± 4.32, 46.36 ± 4.87, 44.33 ± 3.47, the differences were statistically significant ( t=4.73, 3.07, 5.64, all P<0.05), The score of introversion-extroversion of the observation group was 56.86 ± 5.58, lower than the control group′s 59.66 ± 5.17, and the difference was statistically significant ( t=2.65, P<0.05). The total score of the scale and the scores of symptoms, activities and emotions in experimental group were 114.71 ± 18.33, 51.36 ± 7.88, 24.66 ± 4.36 and 38.69 ± 5.29, higher than those in control group 96.42 ± 14.34, 43.26 ± 7.21, 22.28 ± 4.27, 30.88 ± 5.84, the difference was statistically significant ( t values were 2.81-7.15, all P<0.05). Conclusions:The application of positive emotional support combined with education mode based on animation demonstration in the clinical nursing of BA children can improve treatment compliance and asthma control rate, effectively improve quality of life and psychological state.

Objective:To study the clinical application and complications of umbilical arterial catheterization (UAC) in premature infants.Methods:From January 2021 to December 2022, premature infants with UAC successfully inserted in NICU of our hospital were enrolled. According to birth weight (BW), the infants were assigned into three groups: <1 000 g, 1 000~1 499 g and ≥1 500 g. The perinatal data, UAC usage, UAC-related complications and risk factors of UAC-related complications were retrospectively analyzed.Results:A total of 39 premature infants received UAC, with gestational age 29.3(27.3, 30.4) weeks and BW 1 100 (900, 1 310) g. The insertion length (IL) of UAC was calculated using the average value of two formulas: a, IL (cm) =4×BW (kg) +7; and b, IL(cm) =3×BW (kg)+9. The accuracy of tube end position was determined using chest/abdomen radiography. 30(76.9%) cases had accurate position, 6(15.4%) had higher position and 3(7.7%) had lower position. The proportion of appropriately positioned tube end in <1 000 g, 1 000~1 499 g and ≥1 500 g groups were 80.0%, 76.5% and 71.4%, respectively, without statistically significant differences ( P>0.05) .No significant differences existed among the three groups in UAC duration and UAC routinely removal rate ( P>0.05). 9 cases (23.1%) of UAC were removed for specific reasons, including 4 cases of arterial spasm, 2 cases of withdrawal of treatment, 1 case of tube end displacement, 1 case of abdominal distension and 1 case of death. 21 cases received 1 U/ml heparin (0.9%NaCl solution) 0.5~1 ml/h arterial infusion. 23.8% (5/21) had hypernatremia and the level of sodium became normal after reducing the concentration of NaCl solution. Arterial vasospasm occurred in 4 patients with skin color changes of one side of the lower extremities. After UAC removal, the skin color returned to normal. Conclusions:UAC is helpful and safe for preterm infants, however, its complications should be alerted to.

Objective:To construct and validate a prediction model for the risk of intermediate cesarean delivery for primiparous women with failed vaginal trial of labor.Methods:Clinical data of 6 128 pregnant women who gave birth in the Affiliated Hospital of Jining Medical College from January 2019 to December 2020 were collected. The puerpera was randomly divided into train set ( n=4 290) and validation set ( n=1 838). The factors influencing the conversion to cesarean section in primiparous women with failed vaginal trial of labor were analyzed with univariate and binary multivariate logistic regression, and a risk prediction model was established based on the influencing factors. The predictive power of the model was assessed by receiver operating characteristic (ROC) curve and the Hosmer-Lemeshow goodness-of-fit test in train set and validation set. Results:Among 6 128 pregnant women 1 042 cases failed in vaginal trial of labor and were transferred to cesarean section. Univariate analysis showed age, occupation, gestational weight gain, days of gestation, body temperature before delivery, fetal heart condition at delivery, fetal abdominal circumference, Bishop score, premature rupture of membranes, gestational illness, mode of induction of labor, labor analgesia, and fetal orientation were significantly associated with converting to cesarean delivery (all P<0.05). The multivariate binary logistic regression analysis showed that the age, gestational weight gain, body temperature, gestational co-morbidities, days of gestation, premature rupture of membranes, amniotic fluid contamination, induction of labor, and abnormal occipital position were independent risk factors for intermediate cesarean delivery ( OR=1.03-8.06, all P<0.05); while height, occupation, Bishop score, and labor analgesia were protective factors for intermediate cesarean delivery ( OR=0.17-0.96, all P<0.05). A risk prediction model was constructed based on the risk factors and protective factors. In train set, the area under the ROC curve(AUC) of the model was 0.902 (95% CI: 0.89-0.92, P<0.001), with the best cutoff value of 0.138, the sensitivity and specificity were 0.837 and 0.825, respectively; and the Hosmer-Lemeshow goodness-of-fit test showed P=0.192. In validation set the AUC of the model was 0.917 (95% CI: 0.90-0.93, P<0.001), and the sensitivity and specificity were 0.826 and 0.851, respectively; the total correct rate of the model was 87.21% (1 603/1 838). Conclusion:The risk prediction model of failed vaginal trial of labor in primiparous women for intermediate cesarean delivery constructed in this study has good clinical prediction efficacy and high correctness rate.

Objective:To recognize the overall situation of the core competency of medical professional postgraduate, analyze the advantages and disadvantages of the training process, and provide basis for better optimization and revision of training objectives and training plans.Methods:An anonymous online questionnaire was conducted among 264 postgraduates majoring in clinical medicine to recognize the cognition and self-evaluation of core competence, and analyze the differences in scores of different grades and types. SPSS 23.0 was used for independent-samples t test; and one-way analysis of variance to analyze categorical variables. Results:The doctoral degree students' core competency results were higher than those of master degree students, and those of the senior students were higher than junior students ( P<0.05). "System Improvement Ability" [master degree students (2.94±1.07), first-year students (2.82±0.97)], "Patient Management" [(first-year students (2.77±1.22)], "Academic Research" [first-year students (2.90±1.03)], and 4 other indicators were the weakness of students (all less than 3 scores). Conclusion:The students have a good sense of professional identity for doctors. The different depth of the clinical practice education is the possible cause which brings about the differences among students with different degrees. We should focus on strengthening the training for the "shortcomings" in the core competence of students.