Objective:To explore the application of short video situational teaching based on clinical pathway management cases in cardiology internship teaching.Methods:30 medical students who were interned in the Department of Cardiology of Xiangya Hospital of Central Souty University from June 2020 to May 2021 were selected as the control group, using traditional clinical teaching mode, and another 30 medical students from June 2021 to May 2022 were selected as the observation group. Short video situational teaching based on clinical pathway management cases was used to compare the performance evaluation results, satisfaction evaluation results, teaching effectiveness, improvement of critical thinking ability, and teaching method evaluation results of the two groups of students. Perform chi square test and t-test using SPSS 20.0. Results:The results showed that the performance of the observation group students in the entrance examination [theoretical: (88.25±5.14) vs. (80.23±5.34); operational: (90.36±5.23) vs. (86.58 ± 5.12)] was better than that of the control group, and the difference was statistically significant; The observation group showed statistically significant differences in teaching effectiveness compared to the control group ( P<0.05); The critical thinking ability score of the observation group students was better than that of the control group ( P<0.05); The observation group students rated the teaching methods higher ( P<0.05). Conclusions:The use of situational teaching in cardiology internships can enhance the critical thinking ability of medical students, meet clinical needs, and is worth promoting in diagnostic teaching.

Objective To study the effects of integrated orthopedic rehabilitation pathway on motor function in six months after total knee arthroplasty (TKA), including pain, stiffness, range of motion and muscle strength, etc. Methods From March, 2016 to March, 2019, 180 patients who underwent TKA and treated with integrated orthopedic rehabilitation pathway were enrolled. Age, gender, operation time, time of follow-up, the scores of Hospital for Special Surgery-Knee Scale (HSS-KS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC) at preoperative/postoperative/one-month after operation/three-month after operation/six-month after operation time points were collected. The sub items, such as muscle strength, range of motion, flexion deformity, pain, stiffness, functional difficulty were primarily focused on. Results A total of 42 patients were followed up for three months and 22 patients were followed up for six months. There was no significant difference in the scores of HSS-KS and WOMAC before and after operation (P > 0.05). Within three months after operation, the HSS-KS scores gradually increased (P < 0.05) and the WOMAC scores gradually decreased (P < 0.05). The active knee flexion range of motion and knee extensor muscle strength scores of HSS-KS significantly decreased after operation (P < 0.05), and gradually recovered one month and three months after operation (P < 0.05). The flexion deformity scores of HSS-KS increased after operation (P < 0.05), decreased one month after operation (P < 0.05), and got a trend of incensement again three months after operation. The pain score of WOMAC decreased continuously within three months after operation (P < 0.05); the stiffness score of WOMAC did not change after operation (P > 0.05), decreased significantly one month after operation (P < 0.05), and did not change three months after operation (P > 0.05). The degree of functional difficulty of WOMAC decreased after operation (P < 0.05), and improved continuously within six months after operation (P < 0.05). Conclusion The overall function after TKA shows a trend of improvement within three months, and there is no obvious improvement from three to six months after operation. The flexion deformity score showed a downward trend in one month after operation, and it could be improved again after strengthening rehabilitation, which needs more attention in the postoperative rehabilitation.

Objective:To explore the application effect of 6S and PDCA cycle lean management in nursing management of orthopaedic trauma surgery.Methods:A retrospective cohort study was conducted to analyze the clinical data of 80 patients with orthopedic trauma admitted to University-Town Hospital of Chongqing Medical University from January 2020 to November 2021, including 51 males and 29 females; aged 23-68 years [(44.5±9.2)years]. According to the order of operation date, 40 patients from January 2021 to November 2021 received routine management plus 6S and PDCA cycle lean management (lean management group), and 40 patients from January 2020 to December 2020 received routine surgical nursing management (routine management group). The nursing quality score in operating room (instrument and equipment management, surgical instrument preparation, surgical coordination, disinfection and isolation), qualified rate of infection monitoring in operating room (air in operating room, hand hygiene of medical staffs and sterile articles in operating room), surgeons′ satisfaction with operating nurses (circulating nurses and scrub nurses), self- rating anxiety scale (SAS) of patients before operation, incidence of complications at postoperative 12 days and patients′ satisfaction with nurses in operating room at postoperative 2-3 days.Results:The four dimensions of the nursing quality score in operating room in lean management group were (27.8±1.5)points, (18.1±1.1)points, (26.6±1.5)points and (18.1±0.8)points, significantly higher than (23.7±2.3)points, (14.6±1.1)points, (22.4±1.8)points and (13.7±1.1)points in routine management group (all P<0.01). The three dimensions of qualified rate of infection monitoring in operating room in lean management group were all 100%, showing no significant differences in routine management group (75%, 100%, 100%) (all P>0.05). Surgeons′ satisfaction with circulating nurses and scrub nurses in lean management group was 90% and 85%, higher than 73% and 65% in routine management group (all P<0.05). Preoperative SAS in lean management group was (32.5±8.2)points, significantly lower than (54.6±10.7)points in routine management group ( P<0.01). The incidence of postoperative complications in lean management group was 0, significantly lower than 15%(6/40) in routine management group ( P<0.05). Patients′ satisfaction with nurses in operating room in lean management group was 95% (38/40), significantly higher than 78%(31/40) in routine management group ( P<0.05). Conclusion:6S and PDCA cycle lean management can effectively improve the nursing quality of orthopedic trauma surgery, reduce patients′ anxiety and postoperative complications, and improve surgeons′ and patients′ satisfaction, which is worthy of further clinical application.

Objective To observe the serum γ-glutamyltransferase (γ-GGT) levels in patients with chronic hepatitis B virus (HBV) infection in different immune status and investigate their relationship with HBV DNA loads and ALT levels. Methods Blood samples were collected from 191 patients with chronic HBV infection in different immune status, including inactive HBV carrier state (group B,n = 55), immune tolerance phase (group C, n=47), HBeAg-negative CHB (group D, n =17), immune-reactive phase (group E, n=72) and 61 healthy individuals ( group A) for the detection of the serum γ-GGT, ALT level and HBV DNA loads. Results γ-GGT level were obviously higher in groups D and E than those in groups of A, B and C (P<0.01). Correlation analysis showed that the γ-GGT levels were positively correlated with serum ALT , AST levels in HBeAg-negative CHB and immune-reactive phase , but not correlated with HBV DNA loads. Conclusions The levels of γ-GGT are different during different immune status in patients with chronic HBV infection. The increased serum γ-GGT level may be an indicator for patients with chronic HBV infection entering immune active phase. The liver inflammation is the major impact factor to the γ-GGT levels.

OBJECTIVETo evaluate the effect of rapid teeth movement through reducing resistance and distraction using cone-beam computed tomography (CBCT).

METHODSThe left or right side of the mandible of 10 beagles (5 males and 5 females) was randomly selected as the control side (for the conventional distraction with a force of about 85 g) and the other side as the experimental side (subjected to reducing resistance and distraction). CBCT images were taken at 5, 10, and 15 days and also after retaining for 10 and 90 days after distraction for 15 days. The distance of teeth transportation, degree of inclination, alveolar bone density of the compressive area and root resorption were evaluated based on the CBCT images and Ez3D2009 visualization software.

RESULTSNo significant difference was found between CBCT-based measurement and direct measurement of teeth transportation distance within the mouths (P>0.05). Teeth inclination on the experimental side was slightly greater than that on the control side (P<0.05). The root resorption on the experimental side was minimal, and the bone density increased gradually along with the teeth migration. The experimental side showed a comparable newly formed alveolar bone density and similar X-ray features of the compressive area with the control side.

CONCLUSIONSCBCT three-dimensional imaging can resolve the problems of overlapping and deformation of the two-dimensional images and is especially useful for measurement of teeth inclination and alveolar bone density in the process of reducing resistance and distraction.

Animals ; Bone Density ; Cone-Beam Computed Tomography ; Dogs ; Female ; Male ; Mandible ; diagnostic imaging ; Tooth ; diagnostic imaging ; Tooth Movement Techniques ; methods

Objective To evaluate the effect of rapid teeth movement through reducing resistance and distraction using cone-beam computed tomography (CBCT). Methods The left or right side of the mandible of 10 beagles (5 males and 5 females) was randomly selected as the control side (for the conventional distraction with a force of about 85 g) and the other side as the experimental side (subjected to reducing resistance and distraction). CBCT images were taken at 5, 10, and 15 days and also after retaining for 10 and 90 days after distraction for 15 days. The distance of teeth transportation, degree of inclination, alveolar bone density of the compressive area and root resorption were evaluated based on the CBCT images and Ez3D2009 visualization software. Results No significant difference was found between CBCT-based measurement and direct measurement of teeth transportation distance within the mouths (P>0.05). Teeth inclination on the experimental side was slightly greater than that on the control side (P<0.05). The root resorption on the experimental side was minimal, and the bone density increased gradually along with the teeth migration. The experimental side showed a comparable newly formed alveolar bone density and similar X-ray features of the compressive area with the control side. Conclusions CBCT three-dimensional imaging can resolve the problems of overlapping and deformation of the two-dimensional images and is especially useful for measurement of teeth inclination and alveolar bone density in the process of reducing resistance and distraction.

Objective To evaluate the effect of rapid teeth movement through reducing resistance and distraction using cone-beam computed tomography (CBCT). Methods The left or right side of the mandible of 10 beagles (5 males and 5 females) was randomly selected as the control side (for the conventional distraction with a force of about 85 g) and the other side as the experimental side (subjected to reducing resistance and distraction). CBCT images were taken at 5, 10, and 15 days and also after retaining for 10 and 90 days after distraction for 15 days. The distance of teeth transportation, degree of inclination, alveolar bone density of the compressive area and root resorption were evaluated based on the CBCT images and Ez3D2009 visualization software. Results No significant difference was found between CBCT-based measurement and direct measurement of teeth transportation distance within the mouths (P>0.05). Teeth inclination on the experimental side was slightly greater than that on the control side (P<0.05). The root resorption on the experimental side was minimal, and the bone density increased gradually along with the teeth migration. The experimental side showed a comparable newly formed alveolar bone density and similar X-ray features of the compressive area with the control side. Conclusions CBCT three-dimensional imaging can resolve the problems of overlapping and deformation of the two-dimensional images and is especially useful for measurement of teeth inclination and alveolar bone density in the process of reducing resistance and distraction.