1.Research on the effect of curriculum ideological and political teaching model of Fundamentals of Nursing based on outcome based education concept
Rong WANG ; Jingzhi FANG ; Hong ZHAO ; Cong LIANG ; Meichun WU ; Yanping WAN
Chinese Journal of Modern Nursing 2023;29(31):4216-4220
Objective:To explore the teaching effectiveness of curriculum ideological and political teaching model for Fundamentals of Nursing based on outcome based education concept.Methods:Using the convenient sampling method, a total of 194 undergraduates of grade 2019 from School of Nursing at University of South China were selected as the control group from February to December 2021, and 146 undergraduates from 2020 were selected as the experimental group from February to December 2022. The control group was taught in accordance with the conventional teaching methods, and the experimental group was taught in the ideological and political teaching model of Fundamentals of Nursing based on outcome based education concept. After the intervention, the total course scores of nursing undergraduates in the two groups were compared, and the cognitive attitude, implementation effect and teaching satisfaction of the experimental group students on "ideological and political curriculum" were compared.Results:After the intervention, the total course score of nursing undergraduates in the experimental group was (85.65±7.31), and that in the control group was (77.71±7.28), and the difference between the two groups was statistically significant ( P<0.01). The cognitive attitude score of undergraduate nursing students in the experimental group towards "ideological and political curriculum" was (32.62±2.15), and the implementation effect score of "ideological and political curriculum" was (22.78±1.78). The satisfactory form of ideological and political cases for undergraduate nursing students in the experimental group was news reports and hot events, and the satisfactory ideological and political teaching method was experiential teaching method and case-based teaching method. Conclusions:The curriculum ideological and political teaching model of Fundamentals of Nursing based on outcome based education concept can improve the academic performance of nursing undergraduate students and provide reference for the construction of ideological and political teaching courses in nursing basic courses. In the future, this teaching model can be applied to the teaching reform of other nursing courses in order to accelerate the progress of ideological and political construction of professional courses.
2.Application of preoperative serum CYFRA 21-1 level in the prognosis of colorectal cancer.
Wen Qi HU ; Hui CONG ; Rong Hua FANG ; Wen Tao YUAN ; Chun Yan MAO ; Jie Rong WANG ; Ying WANG ; Xiu Ying SHI
Chinese Journal of Preventive Medicine 2023;57(10):1613-1619
To explore the predictive value of preoperative serum CYFRA 21-1 in colorectal cancer (CRC) resection patients. In this retrospective study, 456 patients with CRC who received surgical treatment in the Department of General Surgery, Affiliated Hospital of Nantong University from January 2016 to February 2018 were analyzed. Preoperative CYFRA 21-1, CEA, CA19-9 and pathological data of the study subjects were collected. Determine the cut-off value of CYFRA 21-1 based on the X-tile. Chi-square test or Fisher exact probability test were used to compare clinicopathological features in different CYFRA 21-1 level groups. Univariate and multivariate regression analysis of factors affecting 5-year overall survival (OS) and disease-free survival (DFS). Kaplan-Meier survival curves were used to analyze 5-year differences in OS and DFS in CRC patients with different levels of CYFRA 21-1, CEA and CA19-9. Receiver operating characteristic(ROC) was adopted. ROC curves were used to analyze the prognostic efficacy of CYFRA21-1 for CRC, and nomogram maps were used to predict 1, 3, and 5-year survival rates. The results showed that the optimal cut-off values of serum CYFRA 21-1, CEA and CA19-9 were 4.9 ng/ml, 29.2 ng/ml and 72.8 U/ml, respectively. Different gender, tumor size, location, degree of differentiation, depth of invasion, lymph node metastasis and tumor node metastasis (TNM) classification stage were significantly different between the two groups with high and low CYFRA 21-1, the P-values were 0.018,<0.001,<0.001,<0.001, 0.002, 0.001, 0.003, respectively. CYFRA 21-1 (≥4.9 ng/ml) was an independent risk factor for 5-year OS (HR: 4.008, 95%CI: 2.309-6.958, P<0.001) and DFS (HR: 3.75, 95%CI: 2.227-6.314, P<0.001) in CRC patients. CYFRA 21-1 predicts a 5-year AUC of 0.725 and 0.720 for OS and DFS, respectively, and 0.804 and 0.827 for the combination of CEA and CA19-9. Based on the results of multivariate Cox regression analysis, nomogram graphs of OS and DFS were established, the C-indexes were 0.799 and 0.803, respectively. In conclusion, preoperative serum CYFRA 21-1 level may be an independent risk factor affecting the prognosis of patients with colorectal cancer. The prognostic model established by CYFRA 21-1 combined with CEA, CA19-9 and TNM stages may provide references for the prevention of CRC recurrence and clinical decision-making.
Humans
;
Colorectal Neoplasms/pathology*
;
CA-19-9 Antigen
;
Retrospective Studies
;
Neoplasm Staging
;
Neoplasm Recurrence, Local/pathology*
;
Biomarkers, Tumor
3.Uterine POLE mutant endometrioid carcinoma combined with human papilloma virus-associated cervical adenocarcinoma: A case report and literature review.
Fang CAO ; Ming ZHONG ; Cong Rong LIU
Journal of Peking University(Health Sciences) 2023;55(2):370-374
Independent primary uterine and cervical adenocarcinoma are rare and difficult to identify their origins, which makes treatment decision difficult. A 46-year-old female with endometrioid carcinoma and adenocarcinoma, human papilloma virus (HPV)-associated of the uterine cervix was reported. The patient presented with increased menstrual flow, contact bleeding and watery leucorrhea for more than one year, and the imaging findings showed abnormal uterine morphology, irregular margins, and multiple abnormal signals in uterine cavity and myometrium, which suggested multiple leiomyomas of the uterus. The signal intensity in the right muscle layer was markedly enhanced, suggesting a smooth muscle tumor of uncertain malignant potential. A large number of cystic hypointensity was seen in the cervix, and multiple cysts were considered. The initial preoperative diagnosis was multiple leiomyoma of the uterus, and a hysterectomy operation was planned. During the operation, the uterus was sent for frozen sections. There was a mass in the endometrium of the fundus, with a soft grayish-red cut surface and a clear border with the myometrium, and there was a grayish-white nodule in the cervix with a hard grayish-white cut surface. The two masses were well demarcated from each other, and the distance between them was 30 mm. The result of the frozen sections indicated the malignant tumor of the endometrium, and the extended hysterectomy+pelvic lymphadenectomy+partial resection of the greater omentum was performed. After the operation, the paraffin sections were sent to the Department of Pathology of the Peking University Third Hospital for histochemistry, POLE gene sequencing and HPV RNAscope tests, and the final diagnosis was a synchronous endometrioid carcinoma (POLE-mutant according to the WHO classification) and an adenocarcinoma, HPV-associated of the uterine cervix. Now the patient had been treated with 2 cycles of chemotherapy and her condition was fine. Through the analysis of the histological, immunohistochemical and molecular detection results of this case, the importance of applying HPV RNAscope and TCGA molecular typing in the diagnosis of cervical adenocarcinomas and endometrial carcinomas was emphasized. At the same time, gynecologists should not blindly rely on intraoperative frozen sections, and should pay attention to preoperative pathological examination, and make appropriate operation methods according to the results in order to prevent passivity in the surgery.
Humans
;
Female
;
Middle Aged
;
Carcinoma, Endometrioid/pathology*
;
Uterine Cervical Neoplasms/pathology*
;
Human Papillomavirus Viruses
;
Papillomavirus Infections/pathology*
;
Uterus/pathology*
;
Adenocarcinoma/diagnosis*
4.Application of preoperative serum CYFRA 21-1 level in the prognosis of colorectal cancer.
Wen Qi HU ; Hui CONG ; Rong Hua FANG ; Wen Tao YUAN ; Chun Yan MAO ; Jie Rong WANG ; Ying WANG ; Xiu Ying SHI
Chinese Journal of Preventive Medicine 2023;57(10):1613-1619
To explore the predictive value of preoperative serum CYFRA 21-1 in colorectal cancer (CRC) resection patients. In this retrospective study, 456 patients with CRC who received surgical treatment in the Department of General Surgery, Affiliated Hospital of Nantong University from January 2016 to February 2018 were analyzed. Preoperative CYFRA 21-1, CEA, CA19-9 and pathological data of the study subjects were collected. Determine the cut-off value of CYFRA 21-1 based on the X-tile. Chi-square test or Fisher exact probability test were used to compare clinicopathological features in different CYFRA 21-1 level groups. Univariate and multivariate regression analysis of factors affecting 5-year overall survival (OS) and disease-free survival (DFS). Kaplan-Meier survival curves were used to analyze 5-year differences in OS and DFS in CRC patients with different levels of CYFRA 21-1, CEA and CA19-9. Receiver operating characteristic(ROC) was adopted. ROC curves were used to analyze the prognostic efficacy of CYFRA21-1 for CRC, and nomogram maps were used to predict 1, 3, and 5-year survival rates. The results showed that the optimal cut-off values of serum CYFRA 21-1, CEA and CA19-9 were 4.9 ng/ml, 29.2 ng/ml and 72.8 U/ml, respectively. Different gender, tumor size, location, degree of differentiation, depth of invasion, lymph node metastasis and tumor node metastasis (TNM) classification stage were significantly different between the two groups with high and low CYFRA 21-1, the P-values were 0.018,<0.001,<0.001,<0.001, 0.002, 0.001, 0.003, respectively. CYFRA 21-1 (≥4.9 ng/ml) was an independent risk factor for 5-year OS (HR: 4.008, 95%CI: 2.309-6.958, P<0.001) and DFS (HR: 3.75, 95%CI: 2.227-6.314, P<0.001) in CRC patients. CYFRA 21-1 predicts a 5-year AUC of 0.725 and 0.720 for OS and DFS, respectively, and 0.804 and 0.827 for the combination of CEA and CA19-9. Based on the results of multivariate Cox regression analysis, nomogram graphs of OS and DFS were established, the C-indexes were 0.799 and 0.803, respectively. In conclusion, preoperative serum CYFRA 21-1 level may be an independent risk factor affecting the prognosis of patients with colorectal cancer. The prognostic model established by CYFRA 21-1 combined with CEA, CA19-9 and TNM stages may provide references for the prevention of CRC recurrence and clinical decision-making.
Humans
;
Colorectal Neoplasms/pathology*
;
CA-19-9 Antigen
;
Retrospective Studies
;
Neoplasm Staging
;
Neoplasm Recurrence, Local/pathology*
;
Biomarkers, Tumor
5.Effect of Chuanxiong Rhizoma on the absorption and clearance of four coumarins in Angelicae Dahuricae Radix
Li-rong LIU ; Zhi-xin JIA ; Xiao-ning YAN ; Mei-xia ZHU ; Cong FANG ; Meng-han FENG ; Bei-bei HUANG ; Jie LIU ; Qian LI ; Hong-bin XIAO
Acta Pharmaceutica Sinica 2021;56(7):1804-1810
To study the changes in the pharmacokinetic behavior of four coumarins (bergapten, oxypeucedanin, imperatorin and isoimperatorin) in rats before and after combinating Angelicae Dahuricae Radix with Chuanxiong Rhizoma. The plasma concentrations of the drugs were determined by ultra performance liquid chromatography-fluorescence detection (UPLC-FLD) for dose response and time dependent curves. The pharmacokinetic parameters were calculated by DAS 3.2.8, and SPSS 20.0 was used to analyze the differences of main pharmacokinetic parameters between the two groups. The result showed: comparing with Angelicae Dahuricae Radix group, the area under drug time curve (AUC0-24 h) of bergapten, oxypeucedanin and imperatorin increased by 177.2%, 97.14% and 54.43% respectively, AUC0-∞ increased by 282.3%, 104.2%, and 75.40% respectively, and clearance rate (CLZ/
6.Effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia: a multicenter study in Hubei Province, China.
Chun-Hua LIU ; Hui WANG ; Si-Cong PENG ; Wen-Xiang WANG ; Rong JIAO ; Sha PAN ; Tian-Jiao ZHU ; Xiao-Ying LUAN ; Xiao-Fang ZHU ; Su-Ying WU ; De-Guo WEI ; Bing-Feng FU ; Rui-Hong YAN ; Shu-Jie YANG ; Ya-Hui LUO ; Gui-Ping LI ; Min YANG ; De-Zhao JIA ; Chuang GAO ; Xiong-Fei XIAO ; Li XIONG ; Jie SUN ; Jia-Peng XIAO ; Bo-Wen LI ; Yan-Ni LI ; Lian-Hong ZHANG ; Tian-Guo LI ; Min CHENG ; Jian-Xin XIA ; Shi-Wen XIA
Chinese Journal of Contemporary Pediatrics 2021;23(12):1208-1213
OBJECTIVES:
To study the effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia.
METHODS:
A retrospective analysis was performed on the medical data of the neonates with asphyxia who were admitted to 52 hospitals in Hubei Province of China from January to December, 2018 and had blood glucose data within 12 hours after birth. Their blood glucose data at 1, 2, 6, and 12 hours after birth (with an allowable time error of 0.5 hour) were recorded. According to the presence or absence of brain injury and/or death during hospitalization, the neonates were divided into a poor prognosis group with 693 neonates and a good prognosis group with 779 neonates. The two groups were compared in the incidence of glucose metabolism disorders within 12 hours after birth and short-term prognosis.
RESULTS:
Compared with the good prognosis group, the poor prognosis group had a significantly higher proportion of neonates from secondary hospitals (48.5% vs 42.6%,
CONCLUSIONS
Recurrent hyperglycemia in neonates with asphyxia may suggest poor short-term prognosis, and it is necessary to strengthen the early monitoring and management of the nervous system in such neonates.
Asphyxia
;
Asphyxia Neonatorum/epidemiology*
;
Humans
;
Hyperglycemia
;
Infant, Newborn
;
Prognosis
;
Retrospective Studies
7.Prescription Law of New Coronavirus Pneumonia in Different Stages
Lu-hua XU ; Yan-rong LI ; Dan-ru ZHENG ; Zong-fang SHAO ; Si-qi WEN ; Feng-xia LIN ; Zi-cong ZENG ; Yin-zhi SONG
Chinese Journal of Experimental Traditional Medical Formulae 2020;26(13):8-16
Objective:To study the clinical medication regulation for the prevention and treatment of new coronavirus pneumonia with traditional Chinese medicine(TCM),especially prescriptions,on the basis of "treatment in accordance with seasonal conditions". Method:The guidelines and suggestions on novel coronavirus pneumonia formulated and published by national,provincial and municipal governments and experts before February 17,2020, were retrieved and summarized. Data was recorded in stages according to "prevention period,clinical observation period,pre-clinical period,middle clinical period,late clinical period and recovery period". The frequency analysis of TCM and its efficacy,prescription and proprietary Chinese medicine was carried out,and then the factor analysis and cluster analysis of TCM were carried out to obtain rational drug combinations. Result:Totally 172 suggestions on combined structure of drugs,50 suggestions on prescriptions and 31 suggestions on proprietary Chinese medicine were involved in the study,and provided by 24 official agencies and 24 medical experts, 147 kinds of herbs,44 prescriptions and 16 proprietary Chinese medicines were collected. No matter for the drug category or for the specific drug selection,the law of drug use in different stages was not the same. Huoxiang Zhengqi capsule,Shufeng Jiedu capsule,Lianhua Qingwen capsule and Jinhua Qinggan capsule can be used in the observation period. Xuanbai Chengqitang can be used in the middle of the disease. Angong Niuhuangwan,Suhexiangwan or Zixuedan, and Angong Niuhuangwan can be selected in the middle of the disease. And Qingfei Paidu decoction can be used in all stages of the disease. Conclusion:Doctors need to adjust their prescriptions along with the progress of the disease,because the law of medication in each stage of the new coronavirus pneumonia is different.
8.A clinical epidemiological investigation of neonatal acute respiratory distress syndrome in southwest Hubei, China.
Yong-Fang ZHANG ; Xin-Qiao YU ; Jian-Hua LIAO ; Feng YANG ; Cong-Rong TAN ; Su-Ying WU ; Shi-Qing DENG ; Jun-Yuan FENG ; Jia-Yan HUANG ; Zuo-Fen YUAN ; Kai-Dian LIU ; Zhen-Ju HUANG ; Li-Fang ZHANG ; Zheng-Guo CHEN ; Hong XIA ; Lin-Lin LUO ; Yan HU ; Hua-Sheng WU ; Hong-Ling XIE ; Bao-Min FEI ; Qing-Wei PANG ; Song-Hua ZHANG ; Bi-Xia CHENG ; Lang JIANG ; Chang-Tao SHEN ; Qiong YI ; Xiao-Guang ZHOU
Chinese Journal of Contemporary Pediatrics 2020;22(9):942-947
OBJECTIVE:
To investigate the clinical features and outcome of neonatal acute respiratory distress syndrome (ARDS) in southwest Hubei, China.
METHODS:
According to the Montreux definition of neonatal ARDS, a retrospective clinical epidemiological investigation was performed on the medical data of neonates with ARDS who were admitted to Department of Neonatology/Pediatrics in 17 level 2 or level 3 hospitals in southwest Hubei from January to December, 2017.
RESULTS:
A total of 7 150 neonates were admitted to the 17 hospitals in southwest Hubei during 2017 and 66 (0.92%) were diagnosed with ARDS. Among the 66 neonates with ARDS, 23 (35%) had mild ARDS, 28 (42%) had moderate ARDS, and 15 (23%) had severe ARDS. The main primary diseases for neonatal ARDS were perinatal asphyxia in 23 neonates (35%), pneumonia in 18 neonates (27%), sepsis in 12 neonates (18%), and meconium aspiration syndrome in 10 neonates (15%). Among the 66 neonates with ARDS, 10 neonates (15%) were born to the mothers with an age of ≥35 years, 30 neonates (45%) suffered from intrauterine distress, 32 neonates (49%) had a 1-minute Apgar score of 0 to 7 points, 24 neonates (36%) had abnormal fetal heart monitoring results, and 21 neonates (32%) experienced meconium staining of amniotic fluid. Intraventricular hemorrhage was the most common comorbidity (12 neonates), followed by neonatal shock (9 neonates) and patent ductus arteriosus (8 neonates). All 66 neonates with ARDS were treated with mechanical ventilation in addition to the treatment for primary diseases. Among the 66 neonates with ARDS, 10 died, with a mortality rate of 15% (10/66), and 56 neonates were improved or cured, with a survival rate of 85% (56/66).
CONCLUSIONS
Neonatal ARDS in southwest Hubei is mostly mild or moderate. Perinatal asphyxia and infection may be the main causes of neonatal ARDS in this area. Intraventricular hemorrhage is the most common comorbidity. Neonates with ARDS tend to have a high survival rate after multimodality treatment.
China
;
Female
;
Humans
;
Infant, Newborn
;
Meconium Aspiration Syndrome
;
Pregnancy
;
Respiratory Distress Syndrome, Newborn
;
Retrospective Studies
9.Combined detection of urine specific gravity and BK viruria on prediction of BK polyomavirus nephropathy in kidney transplant recipients
Chen XU-TAO ; Wang ZE-YUAN ; Huang YANG ; Wang JIN-YUAN ; Yang SHI-CONG ; Chen WEN-FANG ; Chen PEI-SONG ; Li JUN ; Deng RONG-HAI ; Huang GANG
Chinese Medical Journal 2020;133(1):33-40
Background:BK polyomavirus (BKPyV)-associated nephropathy (BKPyVAN) is an important cause of dysfunction and failure of renal transplants.This study aimed to assess the diagnostic performance of morning urine specific gravity (MUSG) in diagnosing BKPyVAN in kidney transplant recipients.Methods:A total of 87 patients,including 27 with BKPyVAN,22 with isolated BKPyV viruria,18 with T cell-mediated rejection (TCMR),and 20 with stable graft function,were enrolled in the First Affiliated Hospital of Sun Yat-Sen University from March 2015 to February 2017.MUSG at biopsy and during a follow-up period of 24 months after biopsy was collected and analyzed.Receiver operating characteristic (ROC) curve analysis was used to determine the ability of MUSG to discriminate BKPyVAN.Results:At biopsy,the MUSG of BKPyVAN group (1.008 ± 0.003) was significantly lower than that of isolated BK viruria group (1.013 ± 0.004,P < 0.001),TCMR group (1.011 ± 0.003,P =0.027),and control group (1.014 ± 0.006,P < 0.001).There was no significant difference in MUSG among the isolated BK viruria group,TCMR group,and control group (P =0.253).In BKPyVAN group,the timing and trend of MUSG elevate were consistent with the timing and trend of the decline of viral load in urine and plasma,reaching a statistical difference at 3 months after treatment (1.012 ± 0.003,P < 0.001) compared with values at diagnosis.ROC analysis indicated that the optimal cut-off value of MUSG for diagnosis of BKPyVAN was 1.009,with an area under the ROC curve (AUC) of 0.803 (95% confidence interval [CI]:0.721-0.937).For differentiating BKPyVAN and TCMR,the optimal MUSG cut-off value was 1.010,with an AUC of 0.811 (95% CI:0.687-0.934).Condusion:Combined detection of MUSG and BKPyV viruria is valuable for predicting BKPyVAN and distinguishing BKPyVAN from TCMR in renal transplant recipients.
10.Prognosis of BK polyomavirus nephropathy: 10-year analysis of 133 renal transplant recipients at a single center.
Xu-Tao CHEN ; Shi-Cong YANG ; Jun LI ; Rong-Hai DENG ; Wen-Fang CHEN ; Jiang QIU ; Li-Zhong CHEN ; Chang-Xi WANG ; Gang HUANG
Chinese Medical Journal 2019;132(4):388-394
BACKGROUND:
BK virus-associated nephropathy (BKVN) is an important cause of chronic allograft dysfunction. The objective of our study was to evaluate the prognosis of BKVN.
METHODS:
We retrospectively reviewed the data of 133 renal transplant recipients with BKVN treated at the First Affiliated Hospital of Sun Yat-Sen University between July 2007 and July 2017. BK viral loads, graft function, and pathologic indexes were compared between initial diagnosis and last follow-up.
RESULTS:
After a mean follow-up period of 14.4 (range, 0.3-109.6) months after diagnosis of BKVN, BK viruria, and BK viremia become negative in 19.5% and 90.2% of patients, respectively. The mean estimated glomerular filtration rate (eGFR) at last follow-up was lower than at diagnosis of BKVN (18.3 ± 9.2 vs. 32.8 ± 20.6 mL·min·1.73 m, t = 7.426, P < 0.001). Eight (6.0%) patients developed acute rejection after reducing immunosuppression. At last follow-up, the eGFR was significantly lower in patients with subsequent rejection than those without (21.6 ± 9.8 vs. 33.5 ± 20.9 mL·min·1.73 m, t = 3.034, P = 0.011). In 65 repeat biopsies, SV40-T antigen staining remained positive in 40 patients and became negative in the other 20 patients. The eGFR (42.6 ± 14.3 vs. 26.5 ± 12.3 mL·min·1.73 m), urine viral loads (median, 1.3 × 10vs. 1.4 × 10 copies/mL), and plasma viral load (median, 0 vs. 0 copies/mL) were all significantly lower in patients with negative SV40-T antigen staining than those with persistent BK involvement (all, P < 0.05). Five (3.8%) recipients lost their graft at diagnosis of BKVN, and 13 (9.8%) lost their graft during the follow-up period. The 1-, 3-, and 5-year graft survival rates after diagnosis of BKVN were 99.2%, 90.7%, and 85.7%, respectively. Higher pathologic stage correlated with lower allograft survival rate (χ = 6.341, P = 0.042).
CONCLUSION
Secondary rejection and persistent histologic infection in BKVN lead to poor prognosis.
Adolescent
;
Adult
;
Aged
;
BK Virus
;
Child
;
Female
;
Glomerular Filtration Rate
;
Graft Rejection
;
Graft Survival
;
Humans
;
Kidney Diseases
;
complications
;
Kidney Transplantation
;
adverse effects
;
Male
;
Middle Aged
;
Polyomavirus Infections
;
complications
;
Retrospective Studies
;
Viral Load
;
Viremia
;
complications
;
Young Adult

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