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2024 Vol. 54, No. 1 Published: 2024-01-25   1 The effects of transcutaneous electrical acupoint stimulation on perioperative neurocognitive disorders and clinical prognosis in elderly patients with open spine surgery YU Lu, QIAN Xuwen, LI Guoyan,TANG Wenqian, LI Chuntian, LIU Guokai DOI: 10.3969/j.issn.2095-9400.2024.01.001 Objective: To explore the effects of TEAS points Hegu and Neiguan assisted general anesthesia on perioperative neurocognitive impairment in elderly patients with open spine surgery, as well as the depth of intraoperative anesthesia and postoperative complications. Methods: The study adopted the principle of randomized control and single-blind design. Totally 64 elderly patients with open spine surgery who met the criteria were included as the research subjects. Using the random number table, 64 patients were divided as the control group (only general anesthesia group) and the experimental group (acupoint electrical stimulation combined with general anesthesia group), with 32 cases in each group. The patients of the experimental group were performed with percutaneous acupoint electrical stimulation in bilateral Hegu and Neiguan points from 30 minutes before anesthesia induction to the end of surgery. We observed the incidence of postoperative delirium (POD) on the 7th day after surgery, the incidence of delayed neurocognitive recovery (DNR) on the 30th day when POD was excluded, changes in the patient’s BIS value before anesthesia, during tracheal intubation, during skin incision, pedicle screw placement, as well as the impact of postoperative complications (incision infection, nausea and vomiting) within 30 days after surgery, incidence of secondary hospitalization, and all-cause mortality within 30 days. Results: The surgery turned out successful in all 64 patients, with no statistical difference in the baseline value. However, at the end of the surgery, the BIS value of the experimental group was higher than the control group, with significant difference (P<0.05). The incidence of DNR within 30 days after the operation in the experimental group was lower than that of the control group, with significant difference (P<0.05). There was statistical difference between the two groups in the number of vomiting cases within 30 days after operation (P<0.05). Conclusion: Compared with simple general anesthesia, acupoint electrical stimulation combined with intravenous general anesthesia used in the open spine surgery for the elderly can reduce the incidence of PND, effectively reduce the incidence of postoperative vomiting and improve the prognosis of patients. 2024 Vol. 54 (1): 1-6 [Abstract] ( 269 ) HTML (1 KB)  PDF (1478 KB)  ( 767 ) 7 Low-dose CT radiomics nomogram differentiates pure ground-glass microinvasive adenocarcinoma from invasive adenocarcinoma WANG Hailin, LIN Guihan, CHEN Weiyue, YING Haifeng, WENG Yaqin, FU Weidong, WENG Qiaoyou, LU Chenying, JI Jiansong DOI: 10.3969/j.issn.2095-9400.2024.01.002 Objective: To evaluate the value of low-dose CT image nomogram in the differential diagnosis of pulmonary microinvasive adenocarcinoma (MIA) and pulmonary invasive adenocarcinoma (IAC) in pure ground-glass nodule (pGGN). Methods: A retrospective analysis of the clinical and CT imaging data of 239 lung adenocarcinoma patients with pGGN confirmed by surgery and pathology at the Fifth Affiliated Hospital of Wenzhou Medical University from January 2018 to April 2023, including 93 cases of MIA and 146 cases of IAC.Patients were divided into a training set (n=167) and a validation set (n=72) at a 7:3 ratio using the complete randomization method. The radiomics features of the lesions in low-dose CT images were extracted using Radcloud platform, and the best features were preserved by dimensionality reduction. Subsequently, three machine learning classifiers, including Logistic regression (LR), support vector machine support vector machine (SVM),and random forest (RF), were established to validate the classifier with the highest area under the concentration curve (AUC) as the best radiomics model, with the output results as Rad-score. The clinical and CT features with P<0.05 were included in the multivariate logistic regression analysis to screen out the independent risk factors and establish the clinical model. Finally, a joint model was constructed based on Rad-score and clinical risk factors,and a nomogram was drawn. The area under the receiver operating characteristic (ROC) curve (AUC), sensitivity,specificity and accuracy were used to evaluate the diagnostic performance of the model. Results: Fifteen radiomics features significantly related to the differential diagnosis of MIA and IAC were obtained by dimensionality reduction. Among the three machine learning classifiers, RF had the best diagnostic performance, with AUC being 0.837 in training set and 0.788 in verification set. Multivariate logistic regression analysis showed that the long largest diameter, irregular shape and spiculate sign were independent risk factors for the identification of MIA and IAC. The results of ROC showed that the linear graph had a good diagnostic performance. The AUC, sensitivity,specificity and accuracy in the training set were 0.913, 87.25%, 81.54% and 84.94%, respectively, while those in the validation set were 0.862, 88.63%, 75.01% and 82.78%, respectively. Conclusion: Low-dose CT radiomics nomogram can distinguish MIA and IAC with pGGN, which can be used to guide clinical operation planning. 2024 Vol. 54 (1): 7-13,19 [Abstract] ( 256 ) HTML (1 KB)  PDF (1853 KB)  ( 582 ) 14 Clinical effect of endoscopic inlay butterfly cartilage and underlay tragus perichondriummyringoplasty for moderate tympanic membrane perforation ZHANG Lu, ZHANG Xiangbao, YANG Huanhuan, PAN Fangfang, WU Shiyuan, XU Chao, YU Xiao, WANG Kai. DOI: 10.3969/j.issn.2095-9400.2024.01.003 Objective: To investigate the clinical effect of inlay butterfly cartilage and underlay tragus perichondriummyringoplasty on moderate tympanic membrane perforation under endoscope and the differences between them. Methods: The clinical data of patients from the department of Otolaryngology of Ningbo No.2 Hospital with moderate tympanic membrane perforation form June to December 2021, who underwent endoscopic tympanoplasty without tympanomeatal flap elevation, were retrospectively analyzed. According to the operation method, the patients were dividedinto two groups: the observation group used inlay butterfly cartilage myringoplasty,and the control group used underlay tragus perichondrium myringoplasty. The two groups were followed up regularly at 6, 12 and 18 months postoperatively, with otoscopy and pure tone audiometry (PTA) performed. The graft success rate, hearing outcomes, complications, ear fullness and operation time were compared between the two groups.Results: Of 56 cases included in the study, 32 cases were in the observation group and 24 cases in the control group. There was no significant difference in sex, age, cause and location of tympanic membrane perforation,calcified spot and dry and wet ears between the two groups (P>0.05). The graft success rate in both groups was 100.00% at 6 and 12 months postoperatively. At 18 months postoperatively, graft success rate was 93.75%(30/32) in the observation group and 91.67% (22/24) in the control group. There was no significant difference between two groups (P>0.05). In the observation group, the mean PTA decreased from (35.29±7.25) dB HL preoperatively to (19.06±4.96) dB HL at 18 months postoperatively, and the mean air-bone gaps (ABG) decreased from (16.72± 4.95) dB HL preoperatively to (7.66±3.37) dB HL at 18 months postoperatively. In the control group, the mean PTA decreased from (33.23±5.71) dB HL preoperatively to (17.76±2.55) dB HL at 18 months postoperatively, and the mean ABG from (15.36±4.73) dB HL preoperatively to (7.45±2.67) dB HL at 18 months postoperatively. There was no significant difference in the decreasing degree of mean PTA and ABG between two groups (P>0.05). The operation time of the observation group was significantly shorter than that of the control group [(27.72±3.03) vs. (31.71±3.95) min]. The VAS score of postoperative ear fullness in the observation group was significantly lower than that of the control group (P<0.01). Conclusion: Endoscopic inlay butterfly cartilage myringoplasty and underlay tragus perichondrium myringoplasty both have good clinical effect on moderate tympanic membrane perforation with high success rate and less complications, however, the former takes less time and leads to less postoperative fullness. 2024 Vol. 54 (1): 14-19 [Abstract] ( 203 ) HTML (1 KB)  PDF (1789 KB)  ( 559 ) 20 The effect of Notch3/DLL4 signal pathway on the lymphatic development after cystic hygroma WANG Rongyue, QIU Haifan, DAI Fen, LOU Wenwen, GONG Jian, XIE Ailan DOI: 10.3969/j.issn.2095-9400.2024.01.004 Objective: To investigate the effect of Notch3 signaling pathway on the maturation and development of fetal lymphatic vessels after cystic hygroma (CH). Methods: C57BL/6 mice and C57BL/6 background Notch3 gene knock-in mice were divided into a normal control group and a mutation group. Cervical lymph nodes were collected from F2 generation mice for HE staining, Masson staining, RT-qPCR, Western blot, and immunohistochemical analysis. Results: Compared with the control group. the results of HE and Masson staining showed that the cervical lymph nodes of the mutant mice were significantly disrupted and cellular fibrosis was severe; RT-qPCR results showed that the mRNA expression of DLL4, Hes1, and VEGFR3 in lymphatic nodes of Notch3 mutant mice was significantly decreased, which had statistical difference (P<0.05);Western blot analysis showed that the expression of DLL4, Hes1, and VEGFR3 proteins in the lymphoid nodes of Notch3 mutant mice was remarkably decreased, indicating significant difference (P<0.05);immunohistochemical analysis showed that the expression of DLL4, Hes1, Ang2, VEGFA, and VEGFR3 in the lymphoid nodes of Notch3 mutant mice was decreased, with significant difference (P<0.05). Conclusion:Notch3 regulates cystic hygroma in mice, and its mechanism is likely to be through lymphatic vessel neogenesis. 2024 Vol. 54 (1): 20-24,30 [Abstract] ( 182 ) HTML (1 KB)  PDF (2801 KB)  ( 774 ) 25 Serum obestatin and nesfatin-1 levels in patients with first episode schizophrenia and their clinical significance LE Yajuan, SHEN Yue, CAI Lili, WANG Zhenhua. DOI: 10.3969/j.issn.2095-9400.2024.01.005 Objective: To explore the relationship between serum obestatin and nesfatin-1 levels with cognitive function in patients with first-episode schizophrenia. Methods: A total of 98 patients diagnosed with first-episode schizophrenia who were admitted to Huzhou Third People’s Hospital from June 2018 to June 2021 were assigned as the patient group, and 102 healthy volunteers in the same period were selected as the control group. The serum levels of Obestatin and nesfatin-1 in patients with first-episode schizophrenia were detected by enzyme-linked immunosorbent assay (ELISA). Clinical symptoms were assessed using the positive and negative syndrome scale (PANSS), the trail-making test (TMT), brief visuospatial memory test-revised (BVMT-R),Hopkins verbal learning test-revised (HVLT-R), brief assessment of cognition in schizophrenia-symbol coding (BACS SC), neuropsychological assessment battery (NAB), continuous performance test-identical pairs (CPT-IP) in the MATRICS consensus cognitive battery (MCCB) were used to evaluate the cognitive function of patients. Results: The serum nesfatin-1 level and TMT score in the patient group were obviously higher than those in the control group, the obestatin level, BVMT-R, HVLT-R, BACS SC, NAB and CPT-IP scores were obviously lower than those in the control group (P<0.05). Pearson’s correlation analysis showed that the expression of nesfatin-1 in the serum of patients with first-episode schizophrenia was obviously positively correlated with the total score of PANSS (r=0.486, P<0.05); the expression of obestatin was obviously negatively correlated with the total score of PANSS (r=-0.422, P<0.05); the level of serum nesfatin-1 was negatively correlated with HVLTR and NAB scores (r=-0.501, -0.545, P<0.05), and the level of obestatin was positively correlated with HVLTR and NAB scores (r=0.435, 0.491, P<0.05). Multivariate logistic regression analysis showed that NAB score (OR=1.541, 95%CI=1.131-2.100, P=0.006), obestatin (OR=1.713, 95%CI=1.247-2.353, P=0.001) and nesfatin-1 levels (OR=1.647, 95%CI=1.213-2.236, P=0.001) were the factors affecting the occurrence of first-episode schizophrenia. Conclusion: The serum levels of obestatin expression was significantly decreased and nesfatin-1 expression was significantly increased in patients with first-episode schizophrenia, which was closely related to the cognitive functions of the patients. 2024 Vol. 54 (1): 25-30 [Abstract] ( 174 ) HTML (1 KB)  PDF (1495 KB)  ( 625 ) 31 Extracorporeal shock wave lithotripsy with Piezolith 3000 plus in the management of single ureteral stone:An analysis of its safety, efficacy and failure factors CHEN Weiying, CHEN Jiya, HAN Zihua, LI Feiping,YU Hongyuan. DOI: 10.3969/j.issn.2095-9400.2024.01.006 Objective: To investigate the safety, efficacy and failure factors of the latest generation Piezolith 3000 plus extracorporeal shock wave lithotripsy (SWL) in the treatment of single ureteral stone. Methods: A total of 3 515 patients underwent Piezolith 3000 plus SWL for single ureteral stone from February 2019 to July 2022.There were 2 167 males and 1 348 females with a mean age of (41.2±9.3) years (range, 10 months to 76 years),in which there were 9 children (0.25%) including 4 males and 5 females. The single stone was located in the upper ureter in 1 620 (46.1%), the mid-ureter in 489 (13.9%), and the lower ureter in 1 406 (40.0%). The diameter of stone was 0.7-2.0 (0.94±0.16) cm. The stone-free rate, auxiliary treatment rate, re-treatment rate and related complications were recorded and evaluated. Results: Of 3 515 patients, 2 897 (82.42%) were successfully treated with SWL at once, with the stone-free rate at 3mo being 91.04%, the re-treatment rate 8.62%, and the overall efficiency quotient (EQ) 81.7. Hematuria was the most common postoperative complication and no serious complications were found. In univariate analysis, calculous location, size, and grade of hydronephrosis between two groups showed significant differences (all P<0.05). The predictive factors of SWL failure were BMI>25 kg/m2 (OR=1.795, 95%CI=1.127-3.157), calculous size≥1.0 cm (OR=2.157, 95%CI=1.413-5.647), calculous location(upper ureter, OR=3.155, 95%CI=1.399-11.765; mid-ureter, OR=6.098, 95%CI=1.569-52.632) and severe grade of hydronephrosis (mild, OR=1.244, 95%CI=1.054-1.686; Moderate, OR=1.335, 95%CI=1.088-1.569). Conclusion: The double-layer Piezolith 3000 plus lithotripter is safe and effective in the treatment of single ureteral stone with the advantages of fine gravel particles, high overall stone-free rate and being relatively painless and non-invasive.BMI>25 kg/m2, calculous size≥1 cm, location and severe hydronephrosis are importment independnt predictors of SWL failure. 2024 Vol. 54 (1): 31-35 [Abstract] ( 175 ) HTML (1 KB)  PDF (1471 KB)  ( 748 ) 36 Efficacy analysis of deuterium oxide-assisted vitrectomy combined with external scleral drainage for massive sub-macular hemorrhage in polypoidal choroidal vasculopathy JIANG Heng, LUO Hongbo,ZHENG Qingqing, LI Xiaoxia, LIU Hui. DOI: 10.3969/j.issn.2095-9400.2024.01.007 Objective: To investigate the clinical efficacy of deuterium oxide -assisted vitrectomy combined with external scleral drainage for massive sub-macular hemorrhage caused by polypoidal choroidal vasculopathy (PCV). Methods: Retrospective analysis was performed in the hemorrhagic PCV patients with vitrectomy from Zhejiang Provincial People’s Hospital between January 2017 and 2022. Patients were divided into two groups:vitrectomy alone (28 eyes) and deuterium oxide-assisted vitrectomy combined with external scleral drainage surgery (28 eyes). The best-corrected visual acuity (BCVA), centre macular thickness (CMT), regression of polypoid vascular lesions and complications were observed pre- and post-operation in both groups. Results: The BCVA of the combined group improved after treatment compared with the baseline at the 1st, 3rd, 6th and 12th months (P<0.05), while the BCVA of the single vitrectomy group decreased compared with pre-operation at the 1st and 3rd months post-operation (P<0.05), and it increased significantly at the 6th and 12th months post-operation (P<0.05). The BCVA of the combined group was all better than that of the single vitrectomy group at the 1st,3rd, 6th and 12th months post-operation (P<0.05). CMT of the combined group and the single vitrectomy group all decreased significantly compared with the pre-operation at the 1st, 3rd, 6th and 12th months post-operation (P<0.05). And the CMT of the combined group were all lower than that of the single vitrectomy group at every follow-up point (P< 0.05). At 6th months post-operation, polypoid vascular lesion had basically regressed in 4 patients in the combined group, only one polypoid vascular lesion in the single vitrectomy group had regressed significantly, and no statistical difference existed between the two groups (P=0.349). At 12th months postoperation,polypoid vascular lesion had completely regressed in 8 patients in the combined group, 4 polypoid vascular lesions had regressed in the single vitrectomy group, and had no statistical difference between the two groups (P=0.193). Anterior chamber hemorrhage and secondary glaucoma complications didn’t occurred in the combined group during the treatment period; 10 eyes in the single vitrectomy group developed significant anterior chamber hemorrhage and secondary glaucoma after the operation, which turned better after anterior chamber irrigation and IOP-lowering medication. Conclusion: Compared with the single vitrectomy, deuterium oxideassisted vitrectomy combined with external scleral drainage is more effective in improving patients’ visual acuity and reducing CMT in patients with hemorrhagic PCV, more complete hemorrhage drainage, less postoperative sub-macular blood accumulation, and decreased postoperative complications. 2024 Vol. 54 (1): 36-41 [Abstract] ( 166 ) HTML (1 KB)  PDF (1713 KB)  ( 715 ) 42 Application value of whole genome sequencing in the diagnosis of drug-resistant tuberculosis WU Lianpeng, XIA Dandan, XU Ke DOI: 10.3969/j.issn.2095-9400.2024.01.008 Objective: To evaluate the whole genome sequencing (WGS) in the diagnosis of drug resistant tuberculosis. Methods: The strains of 65 tuberculosis patients treated in Wenzhou Central Hospital from January 2021 to September 2022 were collected. MGIT960 liquid drug sensitivity test and WGS were used to detect the drug resistance of streptomycin, rifampicin, isoniazid and ethambutol. The result of MGIT960 liquid drug sensitivity test was used as reference criteria to evaluate the diagnostic efficacy of WGS in drug-resistant tuberculosis. Results: After WGS detection, it was found that the main mutation types of streptomycin resistance gene were rpsL_K43R (62.07%, 18/29) and rpsL_K43R+rrs_A1401G (13.79%, 4/29), while those of rifampicin resistance gene were rpoB_S450L (48.15%, 26/54) and rpoB_D435V (9.26%, 5/54). The main mutation types of isoniazid resistance gene were katG_S315T (78.72%, 37/47) and fabG1_C-15T (8.51%, 4/47). The main mutation types of ethambutol resistance gene were embB_M306V (52.38%, 11/21) and embB_M306I (14.29%, 3/21). Taking the MGIT960 test results as the reference standard, the sensitivity of WGS to streptomycin, rifampicin, isoniazid and ethambutol resistance was 93.10%, 98.11%, 95.92% and 81.25%, respectively and the specificity was 94.44%, 83.33%, 100.00% and 83.67%, respectively; and the kappa values were 0.875, 0.842, 0.920 and 0.578,respectively. The sensitivity of WGS in the diagnosis of multidrug resistant tuberculosis (MDR-TB) was 93.10%,the specificity was 100.00%, and the Kappa value was 0.887. Conclusion: WGS has high sensitivity, specificity and consistency in the diagnosis of streptomycin, rifampicin and isoniazid resistance, and effective in the diagnosis of MDR-TB, which can serve as reference for the early diagnosis of drug resistant tuberculosis. 2024 Vol. 54 (1): 42-46,52 [Abstract] ( 206 ) HTML (1 KB)  PDF (1466 KB)  ( 862 ) 47 Regulatory effect of metformin on oxidative stress response in mouse hepatic ischemia/reperfusion injury WANG Xinyu, XU Junpeng, WANG Xiaoting, LIU Xiujie, HUANG Qinghao, CHEN Sian, WANG Wantie DOI: 10.3969/j.issn.2095-9400.2024.01.009 Objective: To explore the effect of metformin on oxidative stress response in hepatic ischemia/reperfusion injury (HI/RI) in mouse. Methods: Fifteen SPF grade male C67BL/6 mice were randomly divided into three groups with 5 mice in each: the control group, the hepatic ischemia/reperfusion injury group (HI/RI group) and the hepatic ischemia/reperfusion injury+metformin group (MET group). The morphology of liver tissue was observed under the ordinary light microscopy; the degree of liver damage was evaluated with HE staining and PAS stain; the levels of ALT, AST, malondialdehyde (MDA) and Glutathione (GSH) were determined with a chemical kit. Results: Compared with the control group, the overall morphology, HE staining, and PAS staining of the HI/RI group showed an increase in the degree of liver tissue damage; The concentrations of ALT and AST in serum had a significant increase (P<0.01), so did the level of MAD in liver tissue (P<0.01), while the level of GSH significantly decreased (P<0.01); The red fluorescence intensity results in DHE staining showed a cumulative increase in ROS. Compared with the HI/RI group, the gross morphology, HE staining, and PAS staining of MET showed a significant reduction in liver tissue damage; The levels of ALT and AST in serum were significantly reduced (P<0.01), so did the MDA level in liver tissue (P<0.01), while the GSH level significantly increased (P<0.05); The DHE results showed a decrease in ROS accumulation. Conclusion: Metformin alleviates liver injury caused by ischemia/reperfusion, and it inhibits the oxidative stress response induced by liver ischemia/reperfusion. 2024 Vol. 54 (1): 47-52 [Abstract] ( 252 ) HTML (1 KB)  PDF (1995 KB)  ( 710 ) 53 Application of Acostream thrombus suction device in the treatment of acute lower limb arterial embolism WU Senyan, CHENG Guobing, WU Jiawen, XU Youyao, LU Wei. DOI: 10.3969/j.issn.2095-9400.2024.01.010 Objective: To investigate the safety and effectiveness of Acostream thrombus aspiration device in the treatment of acute lower limb arterial embolism (ALAE). Methods: A retrospective analysis was conducted on the clinical data of 11 patients with ALAE treated with Acostream thrombus suction device in the vascular department of Quzhou People’s Hospital from January 2022 to January 2023. Clinical observation indicators such as target vessel lesion length, intraoperative blood loss, balloon and stent use, complications (target vessel perforation, dissection, bleeding events, etc.), and symptom relief were recorded. Treatment effectiveness was evaluated through changes in lower limb ischemia WIFi grading and Cooley efficacy score. Outpatient follow-up was conducted at the 1st, 3rd, and 6th months after surgery to evaluate lower limb pain and target vessel patency.Results: All patients underwent surgery using the Acostream thrombus suction device, with intraoperative blood loss of 50-300 [190 (145, 245)] mL. Seven patients underwent balloon dilation without stent implantation. No target vessel flow limiting dissection or perforation occurred during the surgery. After the surgery, all patients had significantly reduced limb pain symptoms in a resting state, with no lower limb movement or sensory disorders in 9 cases, 1 left foot numbness, and 1 foot drop. The postoperative creatine kinase level, NRS pain score, ABI,and lower limb ischemia WIFi grading were significantly improved compared with those before surgery, showing significant differences (P<0.05). According to postoperative Cooley efficacy score, 9 cases were cured and 2 cases were good. During the follow-up period, 11 patients did not experience lower limb pain or intermittent claudication, and follow-up ultrasound showed smooth blood flow at the original occluded vessel. Conclusion:The Acostream thrombus suction device is safe, effective, and has high clinical application value in the treatment of ALAE. 2024 Vol. 54 (1): 53-56,60 [Abstract] ( 257 ) HTML (1 KB)  PDF (1570 KB)  ( 734 ) 67 A Meta-analysis of platelet-rich fibrin combined with hydroxyapatite in the treatment of periodontal bone defects XU Chuchu, DENG Hui DOI: 10.3969/j.issn.2095-9400.2024.01.014 Objective: To evaluate from the perspective of clinical indicators the therapeutic effect of platelet-rich fibrin (PRF) combined with hydroxyapatite (HA) in the treatment of periodontal intrabony defects.Methods: Database such as PubMed, the Cochrane Library and Web of Science, VIP, Wanfang database, and China National Knowledge Infrastructure were searched until June 2023 for randomized control trials (RCTs) related to the combined treatment of PRF and HA and the treatment of periodontal intrabony defects with PRF or HA alone. Results: Altogether 9 RCTs and 354 periodontal intrabony defect sites were ultimately included.The Meta analysis showed that there were statistically significant differences in the probing depth (PD), clinical attachment loss (CAL), plaque index (PI), and gingival index (GI) changes between the PRF and HA combination group and the PRF or HA group. Conclusion: Current research evidence suggests that the combination of PRF and HA is superior to PRF or HA alone in the treatment of periodontal intrabony defects. However, more highquality literature is urgently needed to prove this due to limitations in the number and quality of the included studies. 2024 Vol. 54 (1): 67-73 [Abstract] ( 166 ) HTML (1 KB)  PDF (2475 KB)  ( 577 ) 74 Analysis of effective approaches for discipline construction of local medical universities in the context of the new round of “Double First-Class” construction WANG Jiaozhi, ZHANG Yi, XIAO Jian, ZHANG Yi. DOI: 10.3969/j.issn.2095-9400.2024.01.015 In the context of the new round of “Double First-Class” construction, identifying effective approaches to enhance the disciplinary development of local medical colleges and universities is a key research focus and challenge. This paper summarizes the current situation and features of local medical colleges and universities, such as the shortage of educational resources, difficulties in talent introduction, single disciplinary development, insufficient advantages and characteristics and imperfect institutional mechanism. Combining with the national “Double First-Class” policy guidance, it studies the basic ideas of disciplines building in local medical colleges and universities, and proposes to focus on highlighting the first-mover advantage of developing the advantageous and characteristic disciplines, building high-level talent hubs, promoting the interdisciplinary integration of medical disciplines, integrating into the development of local medical and health, deepening the reform and innovation of institutional mechanism, which can guide medical colleges and universities in achieving “Double First-Class” construction in their advantageous and characteristic disciplines. 2024 Vol. 54 (1): 74-80 [Abstract] ( 216 ) HTML (1 KB)  PDF (1480 KB)  ( 902 ) 81 The effect of implementation time of online and offline blended teaching on the learning outcome of Pediatrics course ZHANG Hu, SUN Yan, LIU Qi, CHEN Yiping, ZHANG Hailin DOI: 10.3969/j.issn.2095-9400.2024.01.016 Objective: To explore the influence of the duration of online and offline blended teaching mode on the learning effect of Pediatrics course. Methods: The undergraduate senior students of Wenzhou Medical University were selected as the research subjects, who were divided into the study group and the control group.Students in the study group received traditional instruction in the first year and a combination of online and offline instruction in the following three years. The control group received traditional instruction in the first three years and a combination of online and offline instruction in the fourth year. Data were collected in the form of questionnaire survey, including their interest in class form, memorizing ability, thinking ability, etc., to compare between the two groups of students the differences in self-evaluation of ability improvement, and in in-class answer scores. Results: In the control group, students liked the blended teaching form more (Z=2.152, P<0.05), and more students were more interested in medical knowledge (Z=2.117, P<0.05). Compared with the control group, the study group had more students gathering information ability (Z=2.258, P<0.05), and the research team get higher score [60(50, 70) vs. 60(40, 60), P=0.001]. There is no statistical significance of the knowledge point understanding depth, memory ability, thinking ability, solution case ability, communication and cooperation ability,and classroom speech ability to improve these aspects. Conclusion: In pediatric teaching, most students believe that the combination of online and offline teaching can improve students’ learning ability. The longer the students were exposed to the teaching pattern, the ability to gather information was more enhanced and the scores were higher. 2024 Vol. 54 (1): 81-86 [Abstract] ( 237 ) HTML (1 KB)  PDF (1479 KB)  ( 770 )

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