Objective To investigate the effects of a novel scientific research practice model on medical undergraduates'!cognition and behavior. Method Totally, 60 medical undergraduates took part in the research. All of them accepted scientific research training by using improved tutorial system + team-based learning (TBL) combat training models. Before and after training, students completed the same ques-tionnaires respectively. The content included the purpose of participating in scientific research activities, the interest of scientific research, and the confidence and satisfaction of publishing scientific research papers, etc.. SPSS 16.0 was used to conduct non parametric Mann-Whitney test or Wilcoxon non parametric test to the pre and post survey data. Results Fifty-seven students (95.0%) were satisfied with the novel teaching model. Before and after training, the liking scores for scientific research practice rose from 1.12 (95%CI=0.65 to 1.59) to 5.87 (95%CI=5.34 to 6.39), P=0.001. Fifty-three students (88.3%) proactively participated in research work after training compared with 21 students (35.0%) before training, P=0.000. More students had confidence in publishing academic papers on Chinese core journals or Science Citation Index journals after training (P=0.000, P=0.003 respectively). 57 students (95%) said they were very satisfied or satisfied with the training of scientific research and practice. Conclusion Improved tutorial system+TBL research combat training model can stimulate students'!interest in scientific research and make them have more pos-itive cognition and behavior on scientific research work.

Objective: To compare the effects of various interventions on the incidence of central line-associated bloodstream infection (CLABSI) . Methods: The clinical data of 218 patients with central venous catheterization were retrospectively analyzed. Infected patients were treated as CLABSI group and non-infected patients as control group. Results: Of the 218 patients, 24 patients were developed CLABSI. There was no significant difference in sex, age, primary infection status and puncture site between CLABSI group and control group. Univariate analysis showed that axillary vein puncture could significantly reduce the incidence of CLABSI (P=0.028), and the infection rate of axillary vein puncture per 1000 days under B-ultrasound was significantly reduced by 0.93‰. The average indwelling days of deep venous catheter in patients with pulse puncture were significantly longer than those in other groups (47.32 days vs 19.90 days). The average indwelling days in patients with axillary vein puncture positioned by B ultrasound were longer than those in patients with other parts of vein puncture positioned by B ultrasound (P < 0.05). Logistic multiple regression analysis showed that the main risk factors for CLABSI were anatomically located puncture (P = 0.031) and non-axillary venous catheterization (P = 0.068). Conclusions Choosing axillary vein as the position of deep venous catheterization and using ultrasound-guided central venous puncture can reduce the incidence of CLABSI and prolong the average catheterization time.

Objective To observe the value of ovarian-adnexal reporting and data system ultrasound 2022 version(O-RADS US v2022)and it combined with risk of malignancy index 4(RMI4)for differential diagnosis of benign and malignant adnexal tumors.Methods Data of 126 patients with adnexal tumors confirmed by surgical pathology were retrospectively analyzed.O-RADS US v2022 was used to classify:1-3 as benign lesion and 4-5 as malignant lesion.RMI4 classification took 450 as the critical value.And classification was performed based on the two combination.Taking pathological results as gold standard,receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of O-RADS US v2022 and RMI4 alone or combination for the differential diagnosis of benign and malignant adnexal tumors.Results Among 126 cases,94 were benign and 32 were malignant tumors.The sensitivity,specificity,accuracy and area under the curve(AUC)of O-RADS US v2022 were 78.13％,80.85％,80.16％and 0.795,respectively.The diagnostic results of RMI4 were 71.88％,84.04％,80.95％and 0.780,respectively.The specificity and accuracy of the combination of the two(93.62％,92.06％)were higher than those of O-RADS US v2022(x2=7.322,5.967,P=0.007,0.015)or RMI4(x2=4.625,5.331,P=0.032,0.021),while no significant difference in sensitivity and AUC(87.50％,0.906)was found with O-RADS US v2022 or RMI4(all P＞0.05).Conclusion O-RADS US v2022 could effectively differentiate benign and malignant adnexal tumors,and combined with RMI4 could improve the diagnostic specificity and accuracy.

Objective: To explore the success rate and safety of axillary venipuncture catheterization with ultrasound localization and homologous surface localization (Magney). Method: A total of 80 patients were enrolled in the EICU from January 2017 to September 2018. They were randomly assigned to the Magney method (n=35) and the ultrasound-guided method (n=45). The number of successful punctures, success rate and complications were recorded. Results: Compared with ultrasound-guided method, the one-time success rate (25.7% vs 68.9%, P<0.01), puncture greater than 2 times (34.3% vs 11.1%, P=0.012), and total success rate (82.9% vs 100%, P=0.004) in Magney method were significantly different. Both of the two puncture methods were mis-invasive, and the difference was not statistically significant. In Magney method 2 patients occurred hematoma and 1 patient brachial plexus injury, but no infection occurred within 48 h. While no such occurrence was found in ultrasound-guided method. Conclusion Ultrasound-guided method axillary venipuncture is a safe and effective method of central venous catheterization, which has higher success rate and safety than Magney method.