Objective To identify the potential associations of patient-, treatment-, and central venous access device (CVAD)-related factors with the CVAD-related thrombosis (CRT) risk in hospitalized children. Methods A systematic search of PubMed, EMBASE, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, Wanfang, and VIP database was conducted. RevMan 5.3 and Stata 12.0 statistical software were employed for data analysis. Results In terms of patient-related factors, the patient history of thrombosis (odds ratio [OR] = 3.88, 95% confidence interval [CI]: 2.57–5.85), gastrointestinal/liver disease (OR = 1.85, 95% CI: 0.99–3.46), hematologic disease (OR = 1.45, 95% CI: 1.06–1.99), and cancer (OR = 1.58, 95% CI: 1.01–2.48) were correlated with an increased risk of CRT. In terms of treatment-related factors, parenteral nutrition (PN)/total PN (OR = 1.70, 95% CI: 1.21–2.39), hemodialysis (OR = 2.17, 95% CI: 1.34–3.51), extracorporeal membrane oxygenation (OR = 1.51, 95% CI: 1.31–1.71), and cardiac catheterization (OR = 3.92, 95% CI: 1.06–14.44) were associated with an increased CRT risk, while antibiotics (OR = 0.46, 95% CI: 0.32–0.68) was associated with a reduced CRT risk. In terms of the CVAD-related factors, CRT risk was more significantly increased by peripherally inserted central catheter than tunneled lines (OR = 1.81, 95% CI: 1.15–2.85) or totally implantable venous access port (OR = 2.81, 95% CI: 1.41–5.60). And subclavian vein catheterization significantly contributed to a lower CRT risk than femoral vein catheterization (OR = 0.36, 95% CI: 0.14–0.88). Besides, multiple catheter lines (OR = 4.06, 95% CI: 3.01–5.47), multiple catheter lumens (OR = 3.71, 95% CI: 1.99–6.92), central line-associated bloodstream infection (OR = 2.66, 95% CI: 1.15–6.16), and catheter malfunction (OR = 1.65, 95% CI: 1.07–2.54) were associated with an increased CRT risk. Conclusion The exact identification of the effect of risk factors can boost the development of risk assessment tools with stratifying risks. L.T. was responsible for the design of retrieval strategies, the selection of articles, the extraction of data, the evaluation of evidence quality, the analysis and interpretation of data, the writing of the initial draft and the revision of the manuscript. W.L., Y.S., H.G., Q.Y., P.L., L.W., and J.Z. assisted in the selection of articles, data extraction, the evaluation of evidence quality, the interpretation of data, and the revision of the manuscript. Y.L. conceptualized and designed the systematic review, coordinated and supervised the review, and revised the manuscript. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work. Received: 05 July 2020 Accepted: 23 September 2020 Publication Date: 13 November 2020 (online) © 2020. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Developing a nursing undergraduate blended teaching quality evaluation tool based on the Context, Input, Process and Product model and evaluating its reliability and validity. Blended teaching is a commonly used teaching method in medical education, but there are limited tools available to effectively measure the quality of blended teaching. A Delphi study and cross-sectional study. Using the Context, Input, Process and Product model as the theoretical framework, a questionnaire was developed through literature review, expert consultation and pre-survey. From April to July 2023, 448 students from a certain university were selected as the research subjects and the questionnaire was examined for reliability and validity through a survey method. The blended teaching quality evaluation scale with 35 items includes four dimensions Context, Input, Process and Product. The content validity and reliability of the blended teaching quality evaluation scale are both good, with a content validity index of 0.934 for the total scale and a content validity index of 0.750-1.00 for each item. The SEM shows that χ2/df = 6.89, RMSEA = 0.115, CFI = 0.882, NFI=0.865, RFI= 0.855, IFI = 0.882, TLI = 0.873. The Cronbach's α coefficient of the total scale is 0.991 and the Cronbach's α coefficient for each dimension is 0.944-0.984. The scale is based on the characteristics of blended learning and quality evaluation covers all aspects of teaching. It can accurately evaluate the quality of teaching, evaluate the problems in the teaching process based on the teaching quality score and propose reasonable teaching improvement suggestions based on the weak links in the teaching process.

Application of dexmedetomidine combined with sufentanil in colon cancer resection and its effect on immune and coagulation function of patients was studied. Colon cancer cases (n=176) admitted to Xiangya Hospital Central South University were selected into the study. They were divided into group A (n=92) and group B (n=84). In group A, patients underwent surgery anesthesia with dexmedetomidine combined with sufentanil. In group B, patients underwent surgery anesthesia only with sufentanil. The anesthesia induced intubation, operation time and incidence of postoperative adverse reaction of patients were compared between the two groups. Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were observed and recorded before induction, before intubation and after intubation. Blood coagulation analyzer was used to detect four items of coagulation before and after operation. FACSCalibur flow cytometry was used to detect T lymphocyte subsets in peripheral blood of patients in the two groups. The pain scores (VAS) of patients in the two groups were measured and recorded after surgery at 4, 24 and 48 h. There was a difference in anesthesia induced intubation and operation time of patients in both groups (P<0.05). There were differences in HR, SBP and DBP of patients in both groups after intubation (P<0.05), in postoperative coagulation function (P<0.05), and in postoperative immune function of patients in both groups (P<0.05). The VAS scores of patients in both groups were different at different time-points after operation (P<0.05). There were differences in postoperative adverse reactions of patients in both groups (P<0.05). Dexmedetomidine combined with sufentanil is a viable anesthetic regimen for colon cancer resection. The coagulation function and immune function have certain improvement effect for patients.