Cardiovascular Internal Medicine Research Articles

A study on the Application of PDCA Cycle Combined with PBL Teaching Method in Teaching Cardiovascular Medicine Interns

To study the application effect of PDCA cycle combined with PBL teaching method in the teaching of cardiovascular internal medicine trainees. Sixty intern trainee doctors were selected as the research subjects, and were divided into the observation group and the control group using the random number table method, with 30 in each group. The observation group implemented the PDCA cycle combined with the PBL method of teaching, and the control group implemented the traditional method of teaching, observing and comparing the teaching effect of the two groups of doctors. The observation group was better than the control group in all assessment scores, teaching satisfaction and teaching effect indicators after teaching (P<0.05). Therefore, the PDCA cycle combined with the PBL teaching mode is conducive to improving the trainee doctors' learning initiative, cultivating clinical thinking ability, and improving the quality of teaching.

Analysis of The Use of Implicit Nursing Knowledge in The Teaching of Cardiovascular Internal Medicine Nursing

Objective: To explore the utilization of implicit nursing knowledge in the teaching of cardiovascular internal medicine nursing and to provide a reference for improving the quality and efficiency of cardiovascular internal medicine nursing work. Methods: Thirty-six trainee nurses working in the cardiovascular internal medicine department of our hospital from September 2022 to September 2023 were selected and randomly divided into a control group and an observation group of 18 trainees each. The control adopted the traditional teaching methods while the observation group adopted the implicit nursing knowledge in their clinical practice work. The assessment scores and teamwork ability of the two groups were analyzed and compared. Results: The performance of the observation group was better than that of the control group, and the difference between the two groups was statistically significant (P < 0.05). The teamwork ability of the observation group was significantly better than that of the control group in teamwork ability (P < 0.05). Conclusion: Implicit nursing knowledge teaching is conducive to the cultivation of high-quality nursing talents and meets the development needs of hospitals. Therefore, the importance of implicit nursing knowledge should be strengthened in the teaching of cardiovascular internal medicine nursing and it should be comprehensively organized to improve the quality of nursing services.

Analysis of The Impact of The Healthcare Roundtable Model on the Major Disease Perceptions and Competencies of Cardiovascular Medicine Nursing Staff

Objective: To analyze the impact of the healthcare roundtable model on the major disease perceptions and competencies of cardiovascular nursing staff. Methods: Forty female nursing staff working in the hospital from April to June 2023 were selected and were randomly divided into a control group and an observation group, with 20 in each group. For 60 days, the control group used the conventional learning and communication model and the observation group used the medical and nursing roundtable model. The cognitive scores of cardiovascular disease-related knowledge, competency scores, and satisfaction with the learning and communication model before and after the implementation of the model in both groups were compared. Results: After the implementation, the cognitive scores related to cardiovascular disease- related knowledge, competency scores, and satisfaction with the learning and communication model in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion: The healthcare roundtable model improved the knowledge and competence of cardiovascular internal medicine nursing staff in major diseases, and it is worth popularizing.

Significance of pharmacist intervention to oral antithrombotic therapy in the pharmaceutical outpatient clinic of cardiovascular internal medicine: a retrospective cohort study

BackgroundOptimised antithrombotic therapy requires clinical experience and an understanding of the current guidelines. This retrospective study aimed to evaluate whether pharmacist interviews and interventions with patients taking oral antithrombotic drugs in the pharmaceutical outpatient cardiology clinic had favourable clinical outcomes including decreased bleeding.MethodsThe participants included patients visiting the outpatient clinic of cardiovascular internal medicine at the Kobe University Hospital from January–December 2017, and were taking oral antithrombotic medication. The observation period was from the first visit to the outpatient clinic to October 2021 or death. Patients who received pharmacist intervention more than twice were defined as the pharmacist intervention group. Two control patients per one pharmacist intervention group individual were selected from the non-intervention pool matched for age, gender and antithrombotic medication type.ResultsOf the 895 eligible patients, 132 were in the pharmacist intervention group and 264 were selected for the matched non-intervention group. Bleeding events according to the Bleeding Academic Research Consortium criteria over type 2 were significantly lower in the pharmacist intervention group compared with the non-intervention group (17.4% versus 28.4%, P = 0.019). There were no significant differences in mortality and heart failure hospitalisation frequency, stroke, or cardiovascular events between the groups. Multivariate analysis identified age (≥ 65 years) and pharmacist intervention as factors associated with bleeding (odds ratio = 2.29 and 0.51, respectively).ConclusionPharmacist intervention in the outpatient clinic of cardiovascular internal medicine was effective in reducing the risk of bleeding in patients undergoing antithrombotic therapy.

Epipericardial Fat Necrosis: A Retrospective Analysis in Japan.

Objective Epipericardial fat necrosis (EFN) has been considered to be a rare cause of acute chest pain, and especially important for emergency physicians. Chest computed tomography (CT) is often used for the diagnosis of EFN after excluding life-threatening states, such as acute coronary syndrome and pulmonary embolism. While the proportion of EFN patients who underwent chest CT in emergency departments is being clarified, little is still known about other departments in Japan. To investigate the proportion of EFN patients who underwent chest CT for acute chest pain in various departments. Methods Chest CT performed from January 2015 to July 2020 in Asahikawa Medical University Hospital in Japan was retrospectively analyzed in this study. All images were reviewed by two radiologists. Results There were 373 outpatients identified by a search using the word ‘chest pain’ who underwent chest CT. Eight patients satisfying the imaging criteria were diagnosed with EFN. The proportions of patients diagnosed with EFN were 10.7%, 4.8%, 2.8%, 0.9% and 0% in the departments of general medicine, cardiovascular surgery, emergency medicine, cardiovascular internal medicine and respiratory medicine, respectively. Only 12.5% of the patients were correctly diagnosed with EFN, and the other patients were treated for musculoskeletal symptoms, acute pericarditis or hypochondriasis. Conclusion EFN is not rare and is often overlooked in various departments. All physicians as well as emergency physicians should consider the possibility of EFN as the cause of pleuritic chest pain.

Application of High Quality Nursing in Cardiovascular Internal Medicine Nursing

Application of High Quality Nursing in Cardiovascular Internal Medicine Nursing

Discussion on Application of Health Education in Cardiovascular Internal Medicine Care for Elderly

Discussion on Application of Health Education in Cardiovascular Internal Medicine Care for Elderly

Research Process in Modern Application and Diseases Control of Shengyu Decoction

Shengyu Decoction was initially mentioned in "the Secret of Orchid House" written by Li Dongyuan. It is one of the first 100 classic recipes in the list of ancient classic recipes (the first batch) released by the State Administration of Traditional Chinese Medicine in 2018. The soup is beneficial to qi and blood circulation, nourishing blood, and tonifying deficiency. It is mainly used for various diseases caused by qi and blood deficiency in gynecology. Moreover, it is found that the application of shengyu decoction has been expanded in modern clinical practice. All patients with deficiency of qi and blood or excessive blood loss can apply shengyu decoction to mitigate these symptoms. The theory from traditional chinese medicine believes that qi and blood are the basis of life activities, and replenishing qi and blood makes healthy good and diseases difficult to invade. So the shengyu decoction performs a great effect in treating some diseases, including gynecological disease, bone disease, oncology, cardiovascular internal medicine disease, nerve internal medicine diseases, and skin diseases. The study found that more soups could promote blood cells proliferation, improve arterial blood flow velocity, restore nerve function, reduce inflammation and edema reaction and improve the immune function. With the increase of modern working pressure and the aggravation of aging, Shengyu Decoction has great potential in treating deficiency, and its mechanism and curative effect are worth further studied.

Exploration on the Application Effect of High Quality Nursing Service in Cardiovascular Internal Medicine Nursing

Exploration on the Application Effect of High Quality Nursing Service in Cardiovascular Internal Medicine Nursing

Exploration on the Application of High Quality Nursing Mode in Cardiovascular Internal Medicine Nursing Work

Exploration on the Application of High Quality Nursing Mode in Cardiovascular Internal Medicine Nursing Work

P1713 A case of quadricuspid aortic valve complicated with infective endocarditis diagnosed by 3D transesophageal echocardiography

Abstract Background Quadricuspid aortic valve (QAV) is a rare congenital heart disease with an estimated incidence of 0.008% to 1.46%. The functional status of QAV is predominantly a pure aortic regurgitation. The extensive use of echocardiography has allowed an early and accurate diagnosis of this malformation. In many cases, the transthoracic echocardiography (TTE) is suitable for the diagnosis but, transesophageal echocardiography (TEE), especially 3-dimensional (3D) TEE, is a tool for the accurate definition of the valve anatomy. Clinical case A 60-year-old female underwent a head CT for intermittent headaches for one month ago. She was admitted to neurosurgery in our hospital diagnosed of subarachnoid hemorrhage. Four mm aneurysm was found on the periphery of the right middle cerebral artery on CT examination, and a cerebral aneurysm coil embolization was performed with a catheter in emergency. The possibility of infectious cerebral aneurysm was pointed out, and we examined in cardiovascular internal medicine. TTE revealed moderate aortic regurgitation. The ventricular septum exhibits sigmoid septum. A mobile mass was found near the left ventricular outflow tract in the sigmoid septum. TEE revealed a hypoplasia cusp (accessory cusp) is found between non coronary cusp and right coronary cusp. Aortic valve leaflets have become thickened and regurgitation from the central part of the cusps. 3DTEE was able to more accurately visualize that only the accessory cusp was hypoplastic, and the size of the other three leaflets appears almost the same. Similarly, vegetation on the left ventricular outflow tract were clearly revealed by 3DTEE. Based on the above, it was diagnosed that quadricuspid aortic valve complicated with infective endocarditis (IE) with aortic valve regurgitation. After treatment with antibiotics according to IE, surgical treatment was scheduled. Discussion QAV is a rare congenital heart disease, and TTE is an important imaging tool for accurate diagnosis. Furthermore, TEE, especially 3DTEE, was a more appropriate diagnostic method in QAV and IE. Abstract P1713 Figure. 3DTEE

History of catheter ablation

After His bundle electrography was established in 1967, the step from invasive electrophysiologic diagnosis of arrhythmias to interventional treatment by catheter ablation was imminent. The time interval of 15 years between the diagnosis and treatment of arrhythmias was even shorter than the 19 years between the first selective coronary angiography in 1958 at the Cleveland Clinic in the USA and the first percutaneous coronary intervention in 1977 in Zurich. During each time period, a great amount of knowledge was gained in cardiac surgery, which proved to be very helpful for the development of the interventional treatment. The history of endovascular treatment is an impressive reminder that the preparation and support of cardiovascular surgeons and their handling of complications played a decisive role in the further development of cardiovascular internal medicine. The history of catheter ablation teaches us that the joint work of cardiologists and cardiovascular surgeons is of great importance for the choice and further development of the best possible treatment as for future development of the techniques of therapy.

Application of microlecture in clinical practice teaching of cardiovascular internal medicine

Objective To investigate the application of microlecture in clinical practice teaching of cardiovascular internal medicine. Methods A total of 98 students who received practice teaching in Department of Cardiology, the Second Affiliated Hospital of Xi’an Jiaotong University, from January to September, 2016, were randomly divided into control group and observation group. The students in the control group received traditional practice teaching, and those in the observation group received microlecture combined with the traditional practice teaching. The two groups were compared in terms of the scores of theoretical and skill examinations, and the degree of satisfaction with practice teaching was surveyed. Results The observation group had a significantly higher score of clinical skill examination than the control group (P<0.05). The observation group had a significantly higher degree of satisfaction with the teaching methods of cardiovascular internal medicine than the control group (P<0.05). Conclusion The introduction of microlecture into the clinical practice teaching of cardiovascular internal medicine can significantly enhance students' mastery of clinical operation skills and improve their satisfaction with practice teaching of cardiovascular internal medicine. Key words: Microlecture; Cardiovascular internal medicine; Clinical practice teaching

Application of "Dual-mentor System" in the standardized residency training in cardiovascular inter-nal medicine

Objective To explore the application effect of the dual-mentor system in the standardized training in cardiovascular internal medicine. Methods 40 physicians received from January to December in 2016 and 40 from January to December in 2017 were selected as the control group and the observation group respectively. The control group was administrated with the traditional training mode, while the obser-vation group was administrated with the dual-mentor training model, namely a theoretical mentor and a skill mentor. The training was carried out in accordance with the training plan formulated by the teaching group. The training effect was investigated by questionnaire survey and compared with that of the traditional train-ing mode. Results Under the dual-mentor system, the physicians acquired more theoretical knowledge and clinical skills and their ability of doctor-patient communication was improved significantly. The complete mastery rate of the theoretical knowledge and clinical skills in the observation group was 42.5% and 35.0% respectively, significantly greater than that in the control group (15.0% and 12.5%, respectively, P<0.05). The ability of doctor-patient communication improved more significantly in the observation group than in the control group (92.5% vs. 77.5%, P<0.05), and the satisfaction with the teachers and the training arrangement was higher in the observation group than in the control group (82.5% vs. 60.0%, 82.5% vs. 52.5%, P<0.05). Conclusions The dual-mentor system has a definite effect on the standardized residency training of cardiovascular internal medicine, The dual-mentor system facilitates the mastery of professional knowledge and skills in residents, improves the ability of doctor-patient communication, and increases residents' satisfaction with the mentors and the training program, thereby worthy of widespread promotion and application. Key words: Dual-mentor system; Cardiovascular internal medicine; Standardized residency train-ing

Association of mild cognitive impairment with coronary artery disease in elderly patients

Objective To investigate the relationship between coronary artery disease, other vascular risk factors and mild cognitive impairment in elderly patients. Methods A total of 196 inpatients were collected from the departments of cardiovascular internal medicine from April to September 2015.The unified questionnaires of cognitive status and standardized survey were developed. The patients were divided into 133 cases of mild cognitive impairment and 63 cases of cognitively normal by Montreal Cognitive Assessment Scale. The patients were divided into 79 cases of coronary heart disease and 117 cases of negative control by coronary angiography. Coronary artery disease and other vascular risk factors for mild cognitive impairment were analyzed. Results The levels of education and proportion of coronary heart disease were (9.23±4.34) years and 45.9%(61/133) in mild cognitive impairment patients, and (12.27±3.79) years and 28.6% (18/63) in cognitively normal patients. There were significant differences between the two(t = 4.77, P< 0.05, χ2=5.31, P< 0.05). Multivariate Logistic regression analysis showed that degree of education was a protective factor for mild cognitive impairment with odds ratio (OR) 0.86, 95% confidence interval (CI) 0.77 to 0.91 and P = 0.00. Coronary heart disease was an independent risk factor for mild cognitive impairment (OR=2.02, 95%CI 1.03 to 4.00; P = 0.04) . The total scores of Montreal Cognitive Assessment Scale and delayed memory were (20.9±4.8), (22.4±5.6) points and (2.1±1.6), (2.6±1.8) points in coronary heart disease and negative control patients. There were significant differences between the two (t=1.98, 4.77, all P<0.05). Conclusions The degree of education is a protective factor for mild cognitive impairment. Coronary heart disease is an independent risk factor for mild cognitive impairment, and it mainly impairs delayed memory ability. Key words: Coronary artery disease; Cognition disorders; Risk factors; Neuropsychological tests; Aged

Efforts and effects of additional medical coverage to maintain or improve activities of daily living in an acute cardiovascular internal medicine ward

Kono Y, Aoyagi Y, Kayukawa T, Mori E, Ishikawa A, Yatsuya K, Mizokoshi E, Izawa H, Saitoh E. Efforts and effects of additional medical coverage to maintain or improve activities of daily living in an acute cardiovascular internal medicine ward. Jpn J Compr Rehabil Sci 2017; 8; 104-108.

Hospital pharmacist intervention improves the quality indicator of warfarin control: A retrospective cohort study.

Background/Aims Our previous study showed that time in therapeutic range (TTR) control of warfarin therapy was negatively affected in non-valvular atrial fibrillation (NVAF) patients with heart failure. This study assesses the effect of intervention by hospital pharmacists on TTR control in Japanese NVAF patients with heart failure. Method This retrospective cohort study included NVAF patients with heart failure admitted and discharged from the cardiovascular internal medicine ward between March 2011 and July 2013. Participants were classified into two groups according to the instructions by hospital pharmacists and physicians (Intervention group) and by physicians only (Usual care group). The primary outcome was TTR. Secondary outcomes were major bleeding and minor bleeding. Results In total, 57 participants (35 males, 22 females; mean age: 69.7 years) were classified into the Intervention (n = 25) and Usual care (n = 32) groups. TTR within-therapeutic range was significantly higher and within sub-therapeutic range was significantly lower in the Intervention than the Usual care group. Major bleeding and minor bleeding were not significantly different between the two groups. Conclusion The intervention of hospital pharmacists with anticoagulation therapy can lead to proper use of warfarin, which can be useful when physicians prescribe warfarin. J. Med. Invest. 64: 266-271, August, 2017.

The Publishing and Influencing Factors of Medical Papers in Hospitals

Objective To promote the level of scientific research management in hospitals and provide a scientific basis for publishing high level papers. Methods Use bibliometric method to analyze the papers published in our hospital from 2010 to 2014; use Logistic model to analyze the related factors that influence publication; use SE-DEA model to analyze input and output efficiency. Results During past five years, our hospital has published 758 papers, most of them published in general journals and focusing on neurology, cardiovascular internal medicine, and clinical laboratory. Most authors were with senior and intermediate professional titles (75.59%) and about 26.65% of the total core journals were published by them. The most important determinants were author’s title and educational level. Authors’ age and working time were also important. Compared with output efficiency from 2010 to 2012, the efficiency from 2013 to 2014 was lower. The input redundancy was higher for authors with high-titled researchers and also higher supported by municipal than by Provincial finance. Conclusions The general quality of our hospital’s medical papers was not high. The scientific research capability of medical staff, especially high-titled staff, was insufficient. The hospital should aim at strengthening its guidance, evaluation, and motivation in terms of technical staff’s research capability. Besides, the staffs, who were responsible for the provincial research projects, could take the role as research leaders to improve scientific research level of medical personnel. Key words: Medical papers; Bibliometric analysis; Logistic regression model; SE-DEA model

ASSECSSING MOCA TEST IN SUBACUTE STROKE PATIENTS AND COMPARE MOCA VERSUS MMSE

Background: Dementia after stroke, particularly subacute period is often overlooked. Today the quality of human life is increasingly high, finding scales that have high value for detection of dementia in patients with stroke is increasingly interested. MoCA test is high sensitivity with mild dementia and identify more abnormalities of awareness caused by vascular, but MoCA have not been studied much in Vietnam. Objective: Assessing MoCA test in subacute stroke patients and compare MoCA versus MMSE in these patients. Subjects: 90 patients with subacute stroke period, these people are being treated at Department of cardiovascular internal medicine at Hue Central Hospital, from 7/2014 - 7/2015. Methods: cross-sectional description and analysis. Results: The mean age is 65.57 ± 13.38, accounting for 54.4% male and 45.6% female. Age, duration of illness has weak correlation with MoCA. The risk factors: hypertension, stroke ischemic transient, alcoholism, smoking, heart disease, diabetes, dyslipidemia related no statistical significance with MoCA. The proportion of dementia in subacute stroke according MoCA is 82.2%. The concordance between MoCA and MMSE was good (kappa = 0.684). Using DSM-IV criteria as the gold standard we found MoCA more valuable in the dementia diagnosis than MMSE (AUC 0.864 versus 0.774, p &lt;0.05). Conclusion: The rate of dementia in stroke subacute period according MoCA is quite high. MoCA is valuable than MMSE in detecting dementia in patients with stroke subacute period, this scale is short, easy to implement so should put into using widely in clinical practice. Key words: MoCA test, subacute stroke, dementia

Enhanced corrosion resistance and biocompatibility of Mg-Zn-Y-Nd alloy achieved with APTES pre-treatment for drug-eluting vascular stent application

Event Abstract Back to Event Enhanced corrosion resistance and biocompatibility of Mg−Zn−Y−Nd alloy achieved with APTES pre-treatment for drug-eluting vascular stent application Jing Liu1, Tingfei Xi1 and Ming Chen2 1 Peking University, Academy for Advanced Interdisciplinary Studies, China 2 Peking University First Hospital, Cardiovascular Internal Medicine Department, China Bioabsorbable magnesium alloys (Mg) are advantageous in temporary functional implant applications, as they avoid the risks posed by permanent metallic implants. Nevertheless, the over-fast corrosion of Mg alloys under physiological conditions hinders its wider use as medical implants. Here we introduce a convenient one-step process to introduce a cross-linked 3-amino-propyltrimethoxysilane (APTES) silane physical barrier layer on the surface of Mg-Zn-Y-Nd alloys before coating with drug-eluting poly (glycolide-co-lactide) (PLGA) layer loaded with rapamycin. Surface microstructure was characterized by scanning electron microscope (SEM), Fourier transform infrared spectroscopy (FT-IR), X-ray photoelectron spectroscopy (XPS). Nano-scratch test verifies the adhesion strength of the PLGA pre-treated with APTES is superior to direct PLGA coating. Electrochemical testing combined with long-term immersion results indicate that the APTES coating results in preferable in vitro anti-corrosion behaviour. Cell morphology and proliferation tests demonstrate that APTES pre-treated Mg-Zn-Y-Nd substrate shows markedly preferable effects for both human umbilical vein endothelial cells (EA. hy926) and vascular smooth muscle cells (VSMC). Furthermore, the in vivo test via implanting APTES pre-treated Mg-Zn-Y-Nd stent to porcine coronary arteries for 6 months confirms benign tissue compatibility with the well re-endothelialized vessel with no sign of obvious thrombogenesis and restenosis. National Basic Research Program of China (Grant No. 2012CB619102); Shenzhen Science and Technology Funding Projects (CXZZ20140730091722497); Shenzhen Special Funds for Development of Strategic Emerging Industries(Project No. JCYJ20130402172)