1.Research on the application of woven mesh unit method in teaching nursing students in clinical internship in operating room
Yunqing GUO ; Xiaojing XIA ; Rui DIAO ; Juan SHU ; Jialin DENG
Chinese Journal of Medical Education Research 2024;23(12):1702-1707
Objective:To explore the application effect of woven mesh unit method in teaching nursing students in clinical internship.Methods:The 300 nursing interns in Chongqing University Jiangjin Hospital who interned in 2022 were included in the traditional group, and the 300 nursing interns who interned in 2023 were included in the reform group. The traditional group received traditional teaching, while the reform group received woven mesh unit teaching. The two groups of nursing students were compared for the assessment scores (theoretical assessment scores and practical operation scores), emergency response abilities (warning ability, emergency response ability, and recovery and summary ability), and evaluation of clinical teaching quality. The t-tests, chi-square test, and rank-sum test were conducted using SPSS 26.0. Results:The theoretical assessment scores and practical operation scores of the reform group were significantly higher than those of the traditional group [(79.15±9.27) vs. (74.58±9.16), (81.25±8.35) vs. (76.04±8.25)]. The scores and total scores of the early warning ability, emergency response ability, and recovery and summary ability of the reform group were significantly higher than those of the traditional group [(15.28±2.36) vs. (12.91±2.42), (38.76±7.37) vs. (34.15±7.29), (21.25±5.14) vs. (18.73±5.07), (75.29±9.86) vs. (65.79±9.76)]. The clinical teaching quality grade of teachers in the reform group was significantly higher than that of the traditional group [high quality (88.67% vs. 79.00%)/medium quality (11.33% vs. 16.67%)/low quality (0.00% vs. 4.33%)].Conclusions:The application of woven mesh unit method in teaching nursing students in clinical internship can effectively improve their theoretical assessment scores, practical operation level, and emergency response ability, as well as the quality of clinical teaching.
2.Advances in the genetics of venous thromboembolic disease
Yunqing XIA ; Liang TANG ; Yu HU
Chinese Journal of Hematology 2024;45(12):1144-1147
Venous thromboembolism (VTE) is clinically manifested as deep vein thrombosis (DVT) and pulmonary embolism (PE). VTE is the third most prevalent vascular disease after coronary artery and cerebrovascular diseases. VTE is a multifactorial disease caused by the interaction of genetic and acquired risk factors. Genetic heritability is estimated to be 40%-60% based on studies of families, twins, and siblings. The accumulation of information linking genetic variations to VTE risk has rapidly expanded with the continuous advancement of sequencing technology. Currently, mutations in key genes of the coagulation system, anticoagulation system, and fibrinolysis system are constantly being updated, and the functional mechanisms of new genes are receiving gaining attention. This review summarizes the research progress and prospects of key genetic variations associated with venous thromboembolism.
3.Research on the application of woven mesh unit method in teaching nursing students in clinical internship in operating room
Yunqing GUO ; Xiaojing XIA ; Rui DIAO ; Juan SHU ; Jialin DENG
Chinese Journal of Medical Education Research 2024;23(12):1702-1707
Objective:To explore the application effect of woven mesh unit method in teaching nursing students in clinical internship.Methods:The 300 nursing interns in Chongqing University Jiangjin Hospital who interned in 2022 were included in the traditional group, and the 300 nursing interns who interned in 2023 were included in the reform group. The traditional group received traditional teaching, while the reform group received woven mesh unit teaching. The two groups of nursing students were compared for the assessment scores (theoretical assessment scores and practical operation scores), emergency response abilities (warning ability, emergency response ability, and recovery and summary ability), and evaluation of clinical teaching quality. The t-tests, chi-square test, and rank-sum test were conducted using SPSS 26.0. Results:The theoretical assessment scores and practical operation scores of the reform group were significantly higher than those of the traditional group [(79.15±9.27) vs. (74.58±9.16), (81.25±8.35) vs. (76.04±8.25)]. The scores and total scores of the early warning ability, emergency response ability, and recovery and summary ability of the reform group were significantly higher than those of the traditional group [(15.28±2.36) vs. (12.91±2.42), (38.76±7.37) vs. (34.15±7.29), (21.25±5.14) vs. (18.73±5.07), (75.29±9.86) vs. (65.79±9.76)]. The clinical teaching quality grade of teachers in the reform group was significantly higher than that of the traditional group [high quality (88.67% vs. 79.00%)/medium quality (11.33% vs. 16.67%)/low quality (0.00% vs. 4.33%)].Conclusions:The application of woven mesh unit method in teaching nursing students in clinical internship can effectively improve their theoretical assessment scores, practical operation level, and emergency response ability, as well as the quality of clinical teaching.
4.Advances in the genetics of venous thromboembolic disease
Yunqing XIA ; Liang TANG ; Yu HU
Chinese Journal of Hematology 2024;45(12):1144-1147
Venous thromboembolism (VTE) is clinically manifested as deep vein thrombosis (DVT) and pulmonary embolism (PE). VTE is the third most prevalent vascular disease after coronary artery and cerebrovascular diseases. VTE is a multifactorial disease caused by the interaction of genetic and acquired risk factors. Genetic heritability is estimated to be 40%-60% based on studies of families, twins, and siblings. The accumulation of information linking genetic variations to VTE risk has rapidly expanded with the continuous advancement of sequencing technology. Currently, mutations in key genes of the coagulation system, anticoagulation system, and fibrinolysis system are constantly being updated, and the functional mechanisms of new genes are receiving gaining attention. This review summarizes the research progress and prospects of key genetic variations associated with venous thromboembolism.
5.Application of the two-step sentinel lymph node biopsy with double-tracer in early staged endometrial cancer
Yaning WANG ; Yufang XIA ; Yunqing CHEN ; Huiyang QI ; Yanhui LOU
Chinese Journal of Obstetrics and Gynecology 2022;57(11):812-820
Objective:To explore the feasibility and clinical value of sentinel lymph node (SLN) biopsy through cervix-uterine combined two-step injection with two tracers in patients with early stage endometrial cancer.Methods:From July 2019 to April 2021, a total of 73 patients, aged (54.2±3.3) year, who were preoperatively diagnosed as stage Ⅰ-Ⅱ endometrial cancer (including 56 low-risk patients and 17 medium-high risk patients) in Affiliated Hospital of Qingdao University were selected. According to the different sites of tracer injection, the patients were randomly divided into three groups: cervical injection group (25 cases): 1 ml of nano-carbon was used to inject at 3 and 9 o'clock in the cervix; uterine injection group (21 cases): the magnetic resonance imaging examination was performed to determine the location of the lesion, and 4 ml of methylene blue was injected into the uterine body at 2 sites where the lesion was located; combined injection group (27 cases): cervical injection of nano-carbon (1 ml) combined with uterine injection of methylene blue (4 ml). The SLN in all patients were identified under laparoscopy, removed, and followed by frozen pathological examination. Pathological ultra-staging was performed if the postoperative pathological outcome of SLN was negative. The total detection rate of SLN, bilateral pelvic SLN detection rate, sensitivity, negative predictive value, and location of SLN in each group were calculated and compared.Results:(1) In 73 patients with endometrial cancer, the overall detection rate of SLN was 88% (64/73), the detection rate of bilateral pelvic SLN was 67% (49/73), and the detection rate of para-aortic SLN was 49% (36/73). The overall detection rate of SLN (71%, 15/21) and bilateral pelvic SLN (43%, 9/21) in the intrauterine injection group were significantly lower than those in the cervical injection group [92% (23/25), 76% (19/25), respectively] and the combined injection group [96% (26/27), 78% (21/27), respectively; all P<0.05]; the detection rate of para-aortic SLN in the cervical injection group (28%, 7/25) was significantly lower than those in the intrauterine injection group and combined injection group [52% (11/21) and 67% (18/27), respectively; both P<0.05]. Among 73 cases with endometrial cancer, 9 had lymph node metastasis confirmed by postoperative pathological examination, 8 of them had lymph node metastasis detected by SLN and 1 had no lymph node metastasis detected by SLN, with a total sensitivity of 89% and a negative predictive value of 98%. The sensitivity and negative predictive value of cervical injection group and combined injection group were 100%, while the sensitivity and negative predictive value of intrauterine injection group were 67% and 95%. Among 56 low-risk patients, only one patient with lymph node metastasis was confirmed by postoperative pathology by SLN detection, and the metastasis rate was 2% (1/56), and the sensitivity and negative predictive value were 100%. Lymph node metastasis was confirmed in 8 of 17 patients (8/17) with a sensitivity of 88% and a negative predictive value of 90%. (2) A total of 459 SLN were detected in 73 endometrial cancer patients, with the highest proportion of external iliac (33.3%, 153/459).The obturator foramen was 25.3% (116/459), para-aortic 19.6% (90/459), iliac 12.0% (55/459), and presacral 9.8% (45/459). The proportion of para-aortic SLN in the cervical injection group was 12.4% (21/169), which were significantly lower than that in the intrauterine injection group and the combined injection group [27.4% (26/95) and 22.1% (43/195), respectively; both P<0.05]. (3) Pathological super-staging results: among 64 patients with negative SLN routine paraffin pathology, 4 cases of lymph node micro-metastases and 1 case of isolated tumor cell metastasis were detected, and the SLN micro-metastases rate was 8% (5/64), including 2 cases of low-risk patients and 3 cases of medium-high risk patients. Conclusions:SLN biopsy has high sensitivity and negative predictive value in patients with early endometrial cancer and could be used as an alternative to systematic lymph node dissection in low-risk patients. The SLN mapping through cervical-uterine combined injection could further improve the detection rate effectively and avoid the missed detection of positive para-aortic lymph node, especially for high-risk patients or patients with fundal tumor involvement.
6.Clinical prognosis of staged coronary artery bypass grafting and carotid stent implantation in patients with preoperative stroke
Qi XIA ; Chentao LUO ; Yi LIN ; Yunqing SHI ; Runhua MA ; Wenjun DING
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2022;29(05):565-571
Objective To analyze the short-term and long-term efficacy of staged coronary artery bypass grafting (CABG) and carotid artery stenting (CAS) compared with CABG alone in patients with coronary heart disease with preoperative history of stroke and carotid stenosis. Methods We reviewed the clinical data of 55 patients (48 males, 7 females, aged 67.62±7.06 years) with coronary heart disease and carotid stenosis who had a history of stroke and underwent CABG+CAS or CABG alone in Zhongshan Hospital from 2008 to 2017. There were 13 patients in the staged CABG+CAS group and 42 patients in the CABG alone group. The differences in the incidence of perioperative adverse events and long-term survival between the two groups were studied, and univariate and multivariate analyses were carried out to determine the independent risk factors of long-term adverse events. Results Perioperative adverse events occurred in 1 (7.69%) patient of the staged CABG+CAS group, and 4 (9.52%) patients of the CABG alone group (P=0.84). During the follow-up period (67.84±37.99 months), the long-term survival rate of patients in the staged CABG+CAS group was significantly higher than that in the CABG alone group (P=0.02). The risk of long-term adverse events in the staged CABG+CAS group was 0.22 times higher than that in the CABG alone group (95%CI 0.05-0.92, P=0.04). Conclusion Staged CABG+CAS can significantly improve the long-term survival prognosis without increasing the perioperative risk. It is a safe and effective treatment, but prospective randomized studies are still needed to further confirm this finding.

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