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The Effectiveness of Student-Led Ward Round Training on Knowledge Acquisition, Critical Thinking Ability, and Self-Confidence of Acute Upper Gastrointestinal Bleeding for Nursing Students
Liu N, Zheng Z, Liao J, Li J, Yang Z, Lai X
Advances in medical education and practice. 2023;14:21-30
Abstract
INTRODUCTION Nursing knowledge, critical thinking ability, and self-perceived confidence are imperative to nursing skills in professional nursing practice. Therefore, nurse educators are required to use teaching strategies that will help promote their knowledge, critical thinking, and self-confidence in complex contents such as the nursing of acute upper gastrointestinal bleeding (AUGIB). PURPOSE This study compares the effect of student-led and instructor-led ward-round training methods on knowledge acquisition, critical thinking ability, and self-perceived confidence during AUGIB sessions. METHODS Forty nursing students in the first year of the Emergency Nursing Residency Program were randomly divided into a student-led ward round training group (SG) and an instructor-led ward round training group (IG) with a ratio of 1:1. A knowledge quiz, critical thinking ability test, and self-perceived confidence questionnaire were performed before and after the ward round training to assess both groups of students for their knowledge acquisition, critical thinking ability, and self-perceived confidence improvement. Feedback questionnaires were conducted after the training to evaluate students' perspectives and interests concerning the teaching module. RESULTS The scores of the post-training quiz were significantly higher than that of the pre-training quiz in both the SG (44.10±2.92 vs 31.10±4.27, p<0.001) and IG (32.35±2.21 vs 30.55±2.24, p=0.01). In the post-training quiz, scores achieved by the students from the SG (44.10±2.92) were significantly higher than those achieved by the students from the IG (32.35±2.21, p< 0.001). The level of self-perceived confidence improved significantly after ward round training in the SG (p< 0.001). However, there was no statistically significant difference in the IG with respect to the change from pre- to post-training (p=0.43).The students' critical thinking ability improved significantly in the SG (14.95±2.58 vs 7.10±1.79, p<0.001), while no significant improvement was found in the IG (7.91±2.28 vs 6.52±2.21, p=0.07) after ward round training. CONCLUSION The teaching method of SWRT improves nursing students' knowledge acquisition, critical thinking ability, and self-perceived confidence in AUGIB.
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Clinical Use of Platelet-Rich Plasma to Promote Tendon-Bone Healing and Graft Maturation in Anterior Cruciate Ligament Reconstruction-A Randomized Controlled Study
Gong H, Huang B, Zheng Z, Fu L, Chen L
Indian journal of orthopaedics. 2022;:1-7
Abstract
BACKGROUND We investigated the effect of platelet-rich plasma (PRP) on tendon-bone healing and intra-articular graft (IAG) maturation after anterior cruciate ligament (ACL) reconstruction. METHODS In this prospective randomized controlled study, 60 patients with ruptured ACLs were divided one-to-one into two groups (study and control). Patients were treated using single-bundle autologous hamstring autografts. Only patients in the study group were administered PRP. Knee function (pre-operative and three-, six-, and 12-month post-operative Lysholm activity, Tegner and International Knee Documentation Committee scores, femoral tunnel (FT) and tibial tunnel (TT) diameters measured with computed tomography (post-operative follow-up at 4 days and at 12 months), and magnetic resonance imaging signal/noise quotients of the IAG and graft in the FT (at 12 months) were used to evaluate tendon-bone healing and graft maturation. RESULTS Patients' knee function scores improved after ACL reconstruction, but there were no significant differences between groups. At 12 months, FT (study, 8.88 ± 1.46 mm; control, 8.42 ± 2.75 mm) and TT (study, 9.50 ± 1.07 mm; control, 9.99 ± 1.91 mm) diameters were larger than FT (study, 6.91 ± 0.74 mm; control, 7.30 ± 1.17 mm) and TT (study, 9.31 ± 0.83 mm; control, 9.36 ± 0.88 mm) diameters at 4 days; however, differences between groups were not significant (FT, P = 0.67; TT, P = 0.52). There were no significant differences between groups for signal/noise quotients of the IAG (study, 1.38 ± 0.70; control, 2.01 ± 0.62; P = 0.06) and FT-portion of the graft (study, 2.39 ± 1.22; control, 2.46 ± 0.83; P = 0.89). CONCLUSION PRP had no significant effect on reducing bone tunnel widening, accelerating tendon-bone healing, or improving knee function; however, PRP may improve IAG maturation. TRIAL REGISTRATION Our study was first registered at Clinicaltrials.gov with registration No. NCT04659447 on 12/09/2020.
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Therapeutic efficacy of autologous platelet-rich plasma and polydeoxyribonucleotide on female pattern hair loss
Lee SH, Zheng Z, Kang JS, Kim DY, Oh SH, Cho SB
Wound Repair & Regeneration. 2015;23((1)):30-6.
Abstract
Autologous platelet-rich plasma (PRP) exerts positive therapeutic effects on hair thickness and density in patients with pattern hair loss. The aim of our study was to evaluate the efficacy of intra-perifollicular autologous PRP and polydeoxyribonucleotide (PDRN) injections in treating female pattern hair loss (FPHL). Twenty FPHL patients were treated with a single session of PRP injection, followed by 12 sessions of PDRN intra-perifollicular injection, along the scalp at weekly intervals. Additionally, another 20 FPHL patients were treated with 12 sessions of PDRN injection only. Meanwhile, one half of the backs of two rabbits was injected with the PRP preparation, while the other half was injected with phosphate buffered saline as a control. Tissue samples from the rabbits were analyzed by real-time polymerase chain reaction and Western blotting. Compared with baseline values, patients treated with PRP and PDRN injections exhibited clinical improvement in mean hair counts (23.2+/-15.5%; p<0.001) and mean hair thickness (16.8+/-10.8%; p<0.001). In addition, patients treated with the 12 sessions of intra-perifollicular PDRN injection alone also showed clinical improvement in mean hair counts (17.9+/-13.2%; p<0.001) and mean hair thickness (13.5+/-10.7%; p<0.001). Comparison analyses between the two groups revealed that combined therapy with PRP and PDRN induces greater improvement in hair thickness than treatment with PDRN therapy alone (p=0.031), but not in hair counts (p>0.05). The pilot animal study revealed significant up-regulation of WNT, platelet-derived growth factor, and fibroblast growth factor expression in rabbit skin treated with the PRP preparation, compared with control skin. In conclusion, intra-perifollicular injections of autologous PRP and/or PDRN generate improvements in hair thickness and density in FPHL patients. Copyright © 2014 by the Wound Healing Society.
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Comparison of two tranexamic acid dose regimens in patients undergoing cardiac valve surgery
Du Y, Xu J, Wang G, Shi J, Yang L, Shi S, Lu H, Wang Y, Ji B, Zheng Z
Journal of Cardiothoracic & Vascular Anesthesia. 2014;28((5):):1233-7.
Abstract
OBJECTIVE Tranexamic acid (TA), a synthetic antifibrinolytic drug, has been shown to reduce postoperative bleeding and the need for allogeneic blood transfusion in cardiac surgery. However, the optimal dose regimen of TA is still under debate. The aim of this study was to evaluate whether a lower-dose TA regimen produced equivalent efficacy to its higher-dose counterpart in reducing postoperative bleeding and transfusion needs. DESIGN A prospective, randomized, double-blind trial. SETTING National Center for Cardiovascular Diseases & University Hospital, Beijing, People's Republic of China. PARTICIPANTS One hundred seventy-five patients undergoing cardiac valve surgery were enrolled in the study. INTERVENTIONS All patients were divided randomly into 2 groups. The lower-dose TA group received a loading dose of 10 mg/kg, maintenance dose of 2 mg/kg/h, and a cardiopulmonary bypass pump prime dose of 40 mg; the higher-dose TA group received a loading dose of 30 mg/kg, maintenance dose of 16 mg/kg/h, and a pump prime dose of 2 mg/kg. MEASUREMENTS AND MAIN RESULTS The amount of postoperative bleeding, the amount and frequency of allogeneic transfusion, mortality, and morbidities were recorded. There was no significant difference in the volume of 24-hour postoperative bleeding between the lower-dose group and the higher-dose group. Other measurements also showed no statistical difference between the 2 groups, including the amount and frequency of allogeneic transfusion, mortality, and morbidities. CONCLUSION Lower-dose TA regimen was as effective as the higher-dose regimen in reducing postoperative bleeding and transfusion needs in patients undergoing cardiac valve surgery. 2014 Elsevier Inc. All rights reserved.
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Effects of retrograde autologous priming on blood transfusion and clinical outcomes in adults: a meta-analysis
Sun P, Ji B, Sun Y, Zhu X, Liu J, Long C, Zheng Z
Perfusion. 2013;28((3):):238-43.
Abstract
OBJECTIVE Reducing the priming volume is an effective means of decreasing hemodilution and blood transfusion during cardiopulmonary bypass (CPB). The patient's own blood was used to replace the crystalloid in the CPB circuit by retrograde autologous priming (RAP) in order to decrease the priming volume. Therefore, we performed a meta-analysis to investigate whether RAP could reduce blood transfusion and improve clinical outcomes. Materials and METHODS A comprehensive search was conducted for randomized, controlled trials (RCTs) exploring RAP in PubMed, Embase, The Cochrane Library, Google Scholar and Chinese literature databases (WanFang, WeiPu and CNKI). Clinical parameters and outcomes were focused on the lowest hematocrit (Hct) during CPB, the number of patients transfused blood intraoperatively, the number of patients transfused blood perioperatively, the number of blood units transfused, 24-hour chest tube drainage, hours to extubation, length of ICU stay, and length of hospital stay. RESULTS Ten trials, with a total of 1123 patients, were included. The number of patients transfused blood intraoperatively (RR = 0.39, 95% CI = [0.29, 0.53], p<0.00001, I(2) = 40%) and perioperatively (RR = 0.53, 95% CI = [0.43, 0.66], p<0.00001, I(2) = 0%) and the number of blood units transfused (SMD = -0.53, 95% CI = [-0.73, -0.33], p<0.00001, I(2) = 14%) were all significantly reduced in the RAP group. No differences in the hours to extubation (SMD = -0.11, 95% CI = [-0.33, 0.12], p=0.37, I(2) = 0%) and the length of ICU stay (SMD = -0.17, 95% CI = [-0.41, 0.08], p=0.18, I(2) = 0%) were observed between the two groups. CONCLUSION Compared to conventional priming, RAP could reduce transfusion in adults significantly, but had no effect on clinical outcomes, comparing to conventional priming. Further studies involving RAP are expected to investigate if this technique is beneficial to the patient.
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Comparison of the effects of three cell saver devices on erythrocyte function during cardiopulmonary bypass procedure--a pilot study
Wang X, Ji B, Zhang Y, Zhu X, Liu J, Long C, Zheng Z
Artificial Organs. 2012;36((10):):931-5.
Abstract
Cell salvage devices are routinely used to process red blood cells (RBCs) shed during cardiac surgery. The purpose of this study was to evaluate three commercially available cell saver (CS) devices in terms of erythrocyte function and the quality of washed RBCs during cardiopulmonary bypass (CPB). Thirty patients undergoing CPB were randomly allocated to three CS devices: Group C (Cell Saver 5+; Haemonetics, n = 10), Group M (autolog; Medtronic, n = 10), and Group F (CATS; Fresenius HemoCare, n = 10). Blood samples were collected from reservoirs and transfusion bags. Reservoirs and washed RBCs were analyzed for erythrocyte aggregation index, deformation index (DI) and hematocrit viscosity, 2,3-diphosphoglycerate (2,3-DPG), hematocrit (Hct), hemoglobin (Hb), free Hb removal (fHb), glucose (Glu), lactate (Lac), and blood urea nitrogen. After processing, Groups C (P = 0.026) and M (P = 0.032) had relatively higher erythrocyte DI compared with Group F. Group C had lower 2,3-DPG compared with Groups M (P = 0.001) and F (P = 0.001). Group F provided the maximum concentration of Hct (P = 0.021; 0.046) and Hb (P = 0.008; 0.013). In addition, Groups C (P = 0.035) and M (P = 0.038) had a higher removal of fHb (fHb), differing significantly with Group F. In conclusion, CS devices use the same theory of centrifugation; however, based on different designs, the function of the washed erythrocyte and undesirable content removal efficiency differs widely from one device to another. 2012, Copyright the Authors. Artificial Organs 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.