Objective:To explore the learning patterns of resident physicians in anesthesiology when performing tracheal intubation guided by Shikani laryngoscope, and provide a reference for the skill training of clinical anesthesiologists.Methods:From August 2023 to December 2024, a total of 19 resident physicians specializing in anesthesiology participated in this study at Peking University Third Hospital. All resident physicians received standardized training on clinical skills. None of them had received specialized training in Shikani laryngoscope-guided tracheal intubation. The relevant theoretical teaching and practical guidance were provided by the same senior attending physician throughout the study. A flipped-classroom teaching model was adopted, and each student was instructed by the teaching physician to perform the procedure on 15 cases in chronological order, resulting in a total of 285 cases. The cumulative sum (CUSUM) value for each tracheal intubation was calculated, and the learning curve was plotted using R software. A fourth-order polynomial nonlinear regression model was used to fit the curve and estimate the 95% confidence interval of the learning curve. The first-order derivative function of the regression model was further analyzed to reveal the dynamic changes in proficiency with the number of training sessions. The CUSUM curve was segmented using the maximum statistics test to identify the optimal breakpoint.Results:The maximum selection test revealed that the breakpoint for the increase in CUSUM level was at the eighth attempt.Conclusions:Resident physicians in anesthesiology can master Shikani laryngoscope-guided tracheal intubation after eight standardized training sessions. Moreover, the participants showed high satisfaction with the flipped-classroom teaching model.

Objective:To explore the learning patterns of resident physicians in anesthesiology when performing tracheal intubation guided by Shikani laryngoscope, and provide a reference for the skill training of clinical anesthesiologists.Methods:From August 2023 to December 2024, a total of 19 resident physicians specializing in anesthesiology participated in this study at Peking University Third Hospital. All resident physicians received standardized training on clinical skills. None of them had received specialized training in Shikani laryngoscope-guided tracheal intubation. The relevant theoretical teaching and practical guidance were provided by the same senior attending physician throughout the study. A flipped-classroom teaching model was adopted, and each student was instructed by the teaching physician to perform the procedure on 15 cases in chronological order, resulting in a total of 285 cases. The cumulative sum (CUSUM) value for each tracheal intubation was calculated, and the learning curve was plotted using R software. A fourth-order polynomial nonlinear regression model was used to fit the curve and estimate the 95% confidence interval of the learning curve. The first-order derivative function of the regression model was further analyzed to reveal the dynamic changes in proficiency with the number of training sessions. The CUSUM curve was segmented using the maximum statistics test to identify the optimal breakpoint.Results:The maximum selection test revealed that the breakpoint for the increase in CUSUM level was at the eighth attempt.Conclusions:Resident physicians in anesthesiology can master Shikani laryngoscope-guided tracheal intubation after eight standardized training sessions. Moreover, the participants showed high satisfaction with the flipped-classroom teaching model.

Objective: To analyze the maternal and fetal outcomes of pregnancies complicated by aplastic anemia (AA) and to investigate the underlying risk factors. Methods: In this retrospective case control study, we retrieved medical records of 85 singleton gravidas with AA (AA group) who were admitted to Peking University People's Hospital from January 2003 to January 2016, and another 340 singleton gravidas (case∶control=1∶4) without blood system or immune system diseases who gave birth at the same period were selected as the control group. Differences in general condition and the incidence of maternal and neonatal complications were compared between the two groups. AA group were further divided into adverse outcome subgroup (n=33) and non-adverse outcome subgroup (n=52), and relevant factors were also analyzed. Statistical analysis was performed using t-test, Chi-square test and logistic regression. Results: No maternal deaths occurred in all 85 cases of AA group, 81 of them gave live birth [one neonate died and the others survived with a mean gestational age of 36⁺⁵ weeks (30⁺²-40⁺⁵ weeks)], and 45 developed maternal or fetal adverse outcomes. Compared with the control group, AA group had higher incidences of hypertensive disorders of pregnancy [20.0% (17/85) vs 6.2% (21/340)], acute heart failure [7.1% (6/85) vs 0.0% (0/340)], postpartum hemorrhage [5.9% (5/85) vs 0.9% (3/340)], puerperal infection [2.4% (2/85) vs 0.0% (0/340)], preterm birth [22.3% (19/85) vs 5.6% (19/340)], small for gestational age [11.7% (10/85) vs 0.9% (3/340)], fetal growth restriction [8.2% (7/85) vs 1.2% (4/340)], intrauterine fetal death [4.7% (4/85) vs 0.0% (0/340)] and neonatal death [1.2% (1/85) vs 0.0% (0/340)] (all P<0.05). After adjusting for age, pregnancy history and the time of diagnosis, we found that low median (OR=0.88, 95%CI: 0.83-0.95), mean (OR=0.85, 95%CI: 0.79-0.93) and minimal (OR=0.87, 95%CI: 0.82-0.93) values of hemoglobin concentration during pregnancy, and low median (OR=0.96, 95%CI: 0.92-1.00), mean (OR=0.96, 95%CI: 0.92-1.00) and minimal (OR=0.95, 95%CI: 0.90-0.99) values of platelet counts during pregnancy were risk factors for adverse maternal and fetal outcomes of gravidas with AA (all P<0.05). Conclusions Maternal and fetal complications are more common in pregnant women with AA and maintain hemoglobin and platelet counts at a certain level may improve the outcomes.

Objective To conduct intensive clinical skill training for non-mainland medicine interns and to explore the effects of training.Methods Twenty-six new clinical interns in the first affiliated hospital of Jinan university from June 2019 to June 2011 were enrolled and the 96 hours of intensive training was conducted.Results The scores of theoretical examination,puncture operation,physical examination and complete medical records of the 26 non-mainland interns were improved after training ( P ＜ 0.05 ) and were higher than those of mainland interns ( P ＜ 0.05 ).The enhancement in complete medical recording skills was the greatest and in puncture operation was the smallest among the four techniques.Conclusions The intensive training can effectively improve the clinical skills of nonmainland medical interns and the improvement of clinical skills in non-mainland interns is greater than that in mainland students.

The clinical practice on real patients is more and more difficult in the present condition of the hospitals.The application of the simulating teaching system in clinical cardiovascular teaching can improve the study-activity,and develop studnets'ability to practice.

To explore the teaching model and effect of emergency care simulator(ECS) teaching in "Shock"during clinical bed side teaching,fifty-six students were randomly divided into two groups, receiving model and traditional teaching model respectively. After one semester,the students’examination results and general effect were evaluated. The students’ex-amination results,clinical theory and clinical skills in ECS teaching group were significantly better than traditional teaching group.

This paper dealt with the influences of different media, temperature, light and pH to the amount of oospore formation. The results showed that millet agar, bai yun beau agar and soybean agar provided the favorable condition for oospore formation, the number of oospores was 131.6~149.6 /cm2, but a few oospores was formation on frozen pea agar. The results also suggested that the optimal conditions for oospore formation were 18℃, pH7 and darkness. The oospores failed to be formed tinder fluorescent or black light.