Objective To explore a new teaching mode relying on the new media platform, aiming to stimulate residency standardized trainees’ interest in learning theories related to gynecology outpatient surgery, improve practical operation skills, and achieve better teaching effects. Methods The residency standardized trainees who rotate in the gynecology outpatient of West China Second University Hospital, Sichuan University between July 2021 and June 2022 were selected. According to the random number table method, the trainees were divided into the control group (using the traditional teaching mode) and the intervention group (using the teaching mode of combining the flipped classroom and simulated teaching relying on the new media platform). The assessment results, teacher evaluation, trainees self-evaluation and teaching satisfaction of the two groups were compared and analyzed. Results A total of 118 trainees were enrolled, 59 in each group. There was no significant difference in gender, age, years of training and education level between the two groups (P>0.05). The total scores of evaluation scores (87.59±4.54 vs. 85.17±3.70), teachers’ evaluation (87.05±3.79 vs. 85.14±3.75), and trainees’ self-evaluation (87.81±4.41 vs. 85.54±3.96) of trainees in the intervention group were better than those in the control group, and the differences were statistically significant (P<0.05). The clinical thinking ability [teachers’ evaluation (24.49±1.62 vs. 23.22±2.05), trainees’ self-evaluation (25.25±1.99 vs. 23.97±2.27) and operation skills [teachers’ evaluation (37.05±1.58 vs. 36.10±1.99), trainees’ self-evaluation (36.75±2.73 vs. 35.66±2.56)] of trainees in the intervention group were better than those in the control group, and the differences were statistically significant (P<0.05). The satisfaction rate of the trainees in the intervention group was 98.3%, and that of the trainees in the control group was 93.2%. The teaching satisfaction of the intervention group was better than that of the control group (P<0.05). Conclusion The teaching mode of combining flipped classroom and simulated teaching relying on the new media platform has effectively stimulated residency standardized trainees’ learning interest in gynecological outpatient surgery, improved trainees’ clinical practice ability, improved teaching satisfaction, achieved good teaching results, and can be promoted as a new teaching mode.
Objective To explore the clinical effect and complications of lumbar plexus block through different approaches on perioperative analgesia in aged proximal femur surgery, and find the best method for analgesia in these patients. Methods From January to December 2015, 150 elderly patients scheduled for proximal femur surgery were randomly divided into three groups: psoas compartment block (PCB group, n=50), Winnie " 3 in 1” block (Winnie group, n=50), and fascia iliaca compartment block (FICB group, n=50). Twelve hours before surgery, guided by ultrasound and nerve stimulator, lumbar plexus blocks were performed in all the patients, then patient-controlled analgesia (the formula and the usage were the same) was done. All patients received epidural anesthesia, and were maintained postoperative analgesia for 72 hours. If Rest Visual Analogue Scale>3 or Initiative Movement Visual Analogue Scale>4, sufentanyl 10 μgi.m. was given. Muscle strength grades and complications were recorded. Anesthetic effect of sensory block of femoral, lateral femoral cutaneous, and obturator nerves were measured and recorded too. Results There were two cases of epidural block, and one case of puncture point bleeding in group PCB; no complication in the other groups was found. There was no remedy for inadequate analgesia in the three groups. Compared with group PCB, the muscle strength grades during postoperative 24–72 hours in group FICB were higher (P<0.05). The successful rate of the block of lateral femoral cutaneous nerves was 64%, 91% and 96% in group Winnie, group PCB and group FICB, respectively, and the differences between the three groups were all statistically significant (P<0.05). The successful rate of the block of obturator nerves in group FICB (62%) was lower than that in group PCB (89%) and Winnie group (84%) (P<0.05). Conclusion Continuous fascia iliaca compartment block on perioperative analgesia in aged proximal femur surgery, with exact effect, less complications and simple operation, is better than the psoas compartment block and Winne " 3 in 1” nerve block.
ObjectiveTo systematically review the quality of evidence-based guidelines (EBGs) on medication therapy for children with vitamin D deficiency, and to compare differences and similarities of the drugs recommended, in order to provide guidance for clinical practice. MethodsDatabases such as the TRIP, PubMed, EMbase, CNKI, VIP, WanFang Data, CBM, National Guideline Clearinghouse and Guidelines International Network were searched to collect EBGs on medication therapy for children with vitamin D deficiency. The methodological quality of the guideline was evaluated according to the AGREE Ⅱ instrument, and the differences between recommendations were compared. ResultsA total of 9 EBGs were included. Among them, 3 guidelines were developed by America, 1 by Europe, 1 by France, 1 by China, 1 by Poland, 1 by Canadian and 1 guideline was by Australia and New Zealand. Seven guidelines were developed specially for children, while others were for people of different ages. According to the AGREE Ⅱ instrument, only "Scope and purpose" and "clarity and presentation" were scored more than 60%. The recommendations of different guidelines were of large different. ConclusionThe quality of included guidelines concerning children with vitamin D deficiency is vary. Although only the America 2011 guideline is of high quality, the strength of recommendation is not high. Thus, the development of national guidelines is urgently needed.