ObjectiveTo preliminarily explore application and effectiveness of stimulation learning based on a live demonstration system in hepatobiliary surgical training, using laparoscopic cholecystectomy (LC) as an example. MethodsFrom March 2023 to February 2024, 60 surgical residents undergoing a 4-month standardized residency training at the Liver Transplant Center of West China Hospital, Sichuan University, were randomly assigned into an observation group (n=30) and a control group (n=30) using a random number table. The observation group received stimulation learning based on the live demonstration system, while the control group received traditional teaching methods. At the end of the training, both groups underwent an operative assessment on LC and completed a resident satisfaction questionnaire. Operative assessment used critical view of safety (CVS) scoring to evaluate surgical safety. Resident satisfaction was assessed using a self-designed questionnaire covering five domains: stimulating the learning atmosphere, increasing learning engagement, improving surgical proficiency, enhancing the understanding of surgical complications, and recognition of the teaching model. The final results were categorized as positive or negative evaluations. ResultsThe observation group had significantly higher CVS score than the control group (4.2±1.3 vs. 2.8±1.7, t=3.57, P=0.001). All 60 questionnaires were collected, and the observation group reported significantly higher positive evaluations in improving surgical proficiency, enhancing the understanding of surgical complications, and recognition of the teaching model compared to the control group (P<0.05). There were no statistically significant differences between the two groups regarding positive evaluations for stimulating the learning atmosphere and increasing learning engagement (P>0.05). ConclusionThe results of this study suggest that the stimulation learning model based on a live demonstration system demonstrates good effectiveness in hepatobiliary surgical training and can improve the quality of surgical teaching during standardized residency training for surgical residents.
Objective To assess clinical efficacy and safety of Oxaliplatin plus Vinorelbine in the treatment of advanced non-small cell lung cancer (NSCLC). Methods We used the methods of Cochrane reviews, electronically searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 3, 2008), MEDLINE (1966 to April 2008), EMbase (1984 to Dec. 2006), Cancerlit (1996 to Dec. 2005), CBM (1978 to April 2008), CNKI (1994 to April 2008), VIP (1989 to April 2008), and handsearched 15 Chinese medical core journals, to collect randomized controlled trials (RCTs) of Oxaliplatin combined with Vinorelbine in the treatment of advanced NSCLC. RCTs were included according to the inclusion and exclusion criteria, the quality of included trials was evaluated and RevMan 4.2.8 software was used for metaanalyses after the extraction of the data. Results Seventeen RCTs involving 1 399 patients with advanced NSCLC were included. All of them reported the use of a random method, but with no detailed reports of allocation concealment and whether the blind method was used. The results of meta-analyses showed that NO program (vinorelbine + oxaliplatin) and NP program (vinorelbine + cisplatin) were similar in efficient rate (RR=0.97, 95%CI 0.85 to 1.10) and 1-year survival rate (RR=0.82, 95%CI 0.66 to 1.03). Compared with NP program, NO program induced lower III-IV degree of nausea and vomiting response (RR=0.20, 95%CI 0.14 to 0.28), III-IV degree of leukopenia reaction (RR=0.64, 95%CI 0.52 to 0.79), and I-II degree of renal damage RR=0.27, 95%CI 0.11 to 0.60) after chemotherapy. No study reported treatmentrelated death. Conclusion Oxaliplatin and Cisplatin plus Vinorelbine are similar in efficacy in the treatment of advanced NSCLC. Oxaliplatin plus Vinorelbine could be used as a chemotherapy of advanced NSCLC because of its better tolerance and more liability to be accepted by patients. However, highly-potential selection bias and measurement bias would affect the demonstration level of the outcome, so more high-quality double-blind RCTs are needed.
Chronic obstructive pulmonary disease (COPD) is one of the major chronic diseases that seriously endanger the health of residents in our country. Exercise is one of the effective interventions to improve the cardiopulmonary function and quality of life of COPD patients. An exercise prescription specifies the frequency, intensity, duration, mode, total exercise volume, and progression of exercise, forming a clear - purpose and systematic exercise guidance plan. Clinical pathways standardize and proceduralize the patient's diagnosis and treatment process. Developing an exercise prescription for the entire process of issuing and implementing exercise prescriptions for COPD patients helps to promote the application of exercise prescriptions and assist in the implementation of related work in primary - level medical institutions. Therefore, we invited a number of COPD experts and sports medicine experts to develop this clinical pathway in combination with domestic and international guidelines, consensuses, and personal experience. Its aims are to simplify the exercise prescription development process, reduce the required level of expertise, enhance the capacity of primary healthcare institutions, and facilitate the application of exercise prescriptions within these settings.