Objective:To investigate the application of virtual simulation-based teaching-examination linkage mode based on aneSIM anesthesia simulation system and NW13 difficult airway management model in improving the ability of anesthesia crisis resource management among trainees receiving standardized residency training.Methods:A total of 236 trainees (189 trainees with non-anesthesia majors and 47 with anesthesia majors) who received standardized residency training in Department of Anesthesiology in 2021 were selected as control group, and 234 resident trainees (184 trainees with non-anesthesia majors and 50 with anesthesia majors) in 2022 were selected as observation group. The trainees in the control group received traditional theoretical teaching, and those in the observation group received teaching with the aneSIM system. The trainees in both groups received two sessions of online theoretical assessment through the QR code in Bangboss Application, as well as situational simulation training and assessment using the NW13 difficult airway management model. SPSS 26.0 was used to perform the t-test and the chi-square test. Results:Compared with the control group, the observation group had a significantly higher score of the second theoretical assessment, significantly better degree of anxiety and score of simulation assessment, and significantly better knowledge mastery and ability improvement ( t=7.15, 14.31, 3.90, 6.22, 4.23, 3.04, all P<0.05). Compared with the control group in terms of the resident trainees with non-anesthesia majors, the observation group had a significantly higher score of the second theoretical assessment, significantly better degree of anxiety and score of simulation assessment, a significantly higher degree of satisfaction with teaching, and significantly better knowledge mastery and ability improvement ( t=7.77, 5.43, 3.09, 5.26, 3.82, 2.19, all P<0.05). Compared with the control group in terms of the resident trainees with anesthesia majors, the observation group had a significantly higher score of simulation assessment, a significantly higher degree of satisfaction with teaching, and significantly better knowledge mastery and ability improvement ( t=2.60, 3.56, 2.01, 2.48, P=0.011, 0.001, 0.047, 0.015). Conclusions:The mode of virtual simulation-based teaching-examination linkage based on the aneSIM anesthesia simulation system and NW13 difficult airway management model can examine and improve the abilities for difficult airway management and operation among resident trainees, especially those with non-anesthesia majors, thereby showing its application value in the teaching of anesthesia crisis resource management.

Objective:To investigate the application of virtual simulation-based teaching-examination linkage mode based on aneSIM anesthesia simulation system and NW13 difficult airway management model in improving the ability of anesthesia crisis resource management among trainees receiving standardized residency training.Methods:A total of 236 trainees (189 trainees with non-anesthesia majors and 47 with anesthesia majors) who received standardized residency training in Department of Anesthesiology in 2021 were selected as control group, and 234 resident trainees (184 trainees with non-anesthesia majors and 50 with anesthesia majors) in 2022 were selected as observation group. The trainees in the control group received traditional theoretical teaching, and those in the observation group received teaching with the aneSIM system. The trainees in both groups received two sessions of online theoretical assessment through the QR code in Bangboss Application, as well as situational simulation training and assessment using the NW13 difficult airway management model. SPSS 26.0 was used to perform the t-test and the chi-square test. Results:Compared with the control group, the observation group had a significantly higher score of the second theoretical assessment, significantly better degree of anxiety and score of simulation assessment, and significantly better knowledge mastery and ability improvement ( t=7.15, 14.31, 3.90, 6.22, 4.23, 3.04, all P<0.05). Compared with the control group in terms of the resident trainees with non-anesthesia majors, the observation group had a significantly higher score of the second theoretical assessment, significantly better degree of anxiety and score of simulation assessment, a significantly higher degree of satisfaction with teaching, and significantly better knowledge mastery and ability improvement ( t=7.77, 5.43, 3.09, 5.26, 3.82, 2.19, all P<0.05). Compared with the control group in terms of the resident trainees with anesthesia majors, the observation group had a significantly higher score of simulation assessment, a significantly higher degree of satisfaction with teaching, and significantly better knowledge mastery and ability improvement ( t=2.60, 3.56, 2.01, 2.48, P=0.011, 0.001, 0.047, 0.015). Conclusions:The mode of virtual simulation-based teaching-examination linkage based on the aneSIM anesthesia simulation system and NW13 difficult airway management model can examine and improve the abilities for difficult airway management and operation among resident trainees, especially those with non-anesthesia majors, thereby showing its application value in the teaching of anesthesia crisis resource management.

Objective:To explore the short-term efficacy and safety of intra-arterial thrombolysis (IAT) in the treatment of retinal artery occlusion (RAO) with the assistance of the rescue green channel in the eye stroke center.Methods:A prospective, interventional, single-center study. Thirty-eight eyes from 38 RAO patients who received IAT treatment in Guangdong Provincial People’s Hospital were enrolled. All the patients were rescued via the green channel in our eye stroke center. Data from comprehensive ocular examinations including best-corrected visual acuity (BCVA) and optical coherence tomography angiography (OCTA) were collected. BCVA was measured with Snellen chart and converted to the logarithmic minimum angle of resolution (logMAR) unit for statistical analysis. RTVue XR OCTA was used to measure vascular densities (VD) of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and radial peripapillary capillary (RPC), and central retinal thickness (CRT). All RAO eyes attempted IAT treatment and 34 eyes were successful. Four eyes failed to complete IAT because of the occlusion of internal or common carotid arteries on the same side with the RAO eyes. Ocular examinations in post-operative 1-3 days were performed with the same devices and methods as those before surgery. Parameters measured before and after surgery include BCVA, VD of SCP, DCP, RPC, and CRT. Data of the green channel collected include the time intervals from onset of RAO to first presentation in local hospitals, and from onset of RAO to our eye stroke center. Comparisons of VD and CRT between the RAO eyes and contralateral healthy eyes were performed with independent samples Mann-Whitney U test; comparisons of VD and CRT in RAO eyes before and after IAT surgery were performed with paired samples Wilcoxon Rank Sum test. Results:Among the 34 RAO patients who had successful IAT surgery, 18 (52.9%, 18/34) were males and 16 (47.1%, 16/34) were females; the mean age was (51.0±12.9) years old. There were 30 and 4 eyes diagnosed as central RAO and branch RAO respectively. The logMAR BCVA before and after IAT surgery was 2.52±0.61 and 2.18±0.85 respectively, and the difference was statistically significant ( Z=-3.453, P=0.002). Before surgery, VD of SCP, DCP and RPC were significantly decreased and CRT was significantly increased in the affected eye compared with the contralateral healthy eyes, with the statistical significance ( P<0.001). Compared with those before surgery, the VD of SCP and DCP were significantly improved after surgery ( Z=-2.523, -2.427; P=0.010, 0.014), while there was no difference in VD of RPC and CRT ( Z=-1.448, -1.454; P=0.150, 0.159). The time interval between onset of RAO and first visit to the hospital was (6.56±6.73) hours; the time interval between onset of RAO and the arrival at our hospital was (24.11±19.90) hours. No cerebral stroke was observed in the early postoperative period and no cerebrocardiovascular events were observed later. he time interval between onset of RAO and the arrival at our hospital was (24.11±19.90) hours. No cerebral stroke was observed in the early postoperative period and no cerebrocardiovascular events were observed later. Conclusions:The short-term efficacy and safety of IAT in the treatment of RAO were satisfactory. The rescue time window might be prolonged.

Purpose:To study the clinical characteristics and therapy of acquired fungemia in acute leukemia patients. Methods:Retrospective analysis of the clinical characteristics and therapy of 34 acquired fungemia patients from 127 acute leukemia patients was done. Results:52 fungus strains were isolated from the blood culture of 34 acquired fungemia patients. Monilia was the main pathogen (92.4%). 24 fungemia patients also had bacteremia and the percentage was (70.6%). The overall mortality rate was 55.7% .The mortality rate of fungemia and fungemia together with bacteremia were (23.5%) and 76.4% respectively. The effective rates were 70.8% for diflucan treated group, 66.7% for the liposome treated group, and 75% for the combined treatment group respectively. Conclusions:Fungus infection has been one of the main causes of death in acute leukemia patients. So timely monitoring of the fungus infection and appropriate antifungal therapy have become the principle management to reduce the incidence rate and mortality rate of fungemia in acute leukemia patients. Diflucan and liposome are still effective antifungal drugs.

Objective To investigate the relationship between the root diameter of Angelica sinensis and its early bolting rate, and to decrease the bolting rate. Methods The seedling transplanting of A. sinensis with various root diameters was used to study the bolting rate and yield. Results Bolting plants can be observed in the field at June and the period from June to July is the bolting heyday. The bolting rate was the highest, up to 94.65%, in the treatment of root diameter ≥ 0.86 cm. However, it was only 1.63% in the treatment of root diameter ≤ 0.35 cm on Oct. 2nd. In the treatment of root diameter ≤ 0.35 cm, the seedling rate was only 33.62%, while in the treatment of root diameter ≥ 0.86 cm, the seedling rate was the highest, up to 95.75%, but the harvest seedling number was only 6 395 plant/hm2. In the treatment of root diameter of 0.46—0.55 cm, the harvest seedling number was 68 398 plant/hm2, which was significantly higher than other treatments. The highest yield appeared in the treatment of root diameter in 0.46—0.55 cm of transplanting seedling, the fresh and dry yields of A. sinensis were 5 717.58 kg/hm2 and 1 554.98 kg/hm2, respectively. Conclusion The seedlings with root diameter in the range of 0.46—0.65 cm should be selected to transplant in practice.