Objective To investiget the necessity of carrying out the education of Tobacco Hazards and Prevention and Control in Chinese universities, and explore the teaching mode of Tobacco Hazards and Prevention and Control suitable for college students, so as to improve the teaching quality and the awareness level of Chinese college students on tobacco hazards. Methods A public elective course on Tobacco Hazards and Prevention and Control was set up in Sichuan University with the teaching mode of scientific popularization education, combining theory and practice. The 43 college students who had completed the public elective course on Tobacco Hazards and Prevention and Control in the autumn semester of 2022 were retrospectively included as the research group (the elective group), and 43 college students who did not take this course in the same period were included as the control group (the non-elective group) by the method of quota sampling. Questionnaire survey was adopted to investigate the basic information, personal and family smoking situation of the two groups of students, evaluate the purpose of taking this course, satisfaction with the course, and mastery of knowledge related to tobacco epidemiology of the students who had completed the course, and compare the awareness of tobacco hazards and the attitude toward tobacco prevention and control between the two groups. Results There was no significant difference in age, gender, education level, place of student source, personal smoking situation, family smoking situation, or secondhand smoking exposure between the two groups (P>0.05). In the elective group, 58.1% of the students chose the course due to their personal interests, and 74.4% of the students were very satisfied with the course. The awareness rates of smoking causing myocardial infarction (97.7% vs. 72.1%) and stroke (97.7% vs. 81.4%), secondhand smoking causing heart disease in adults (97.7% vs. 76.7%), and “low tar not equaling to low hazard” (86.0% vs. 37.2%) in the elective group were significantly higher than those in the non-elective group (P<0.05). The rates of awareness of E-cigarettes being harmful to health and supportive attitude toward smoking being forbidden in public places were high in both groups (P>0.05). Conclusion Carrying out the public elective course on Tobacco Hazards and Prevention and Control in comprehensive universities with the teaching mode of popularizing science education and combining theory and practice can improve the theoretical knowledge and awareness level of college students related to tobacco, which is of great significance to improving the tobacco prevention and control awareness of college students.
ObjectiveTo investigate the anticoagulant drug treatment decision for patients with renal contusion and acute pulmonary embolism, and to enhance the level of treatment for this disease. MethodsA retrospective analysis of the clinical data of a patient with renal contusion and acute pulmonary embolism treated at the West China Hospital of Sichuan University, along with a relevant literature review. Databases including PubMed, Ovid Medline, Embase, VIP, Wanfang and Chinese National Knowledge infrastructure were searched using the keywords as “Pulmonary embolism” AND “Hemorrhage”from January 1983 to December 2023. ResultThe patient was a 21-year-old male who presented with right kidney contusion for 5 days and dyspnea for 1 day. The abdominal CT scan revealed a ruptured right kidney accompanied by hemorrhage and hematoma in the surrounding tissue. Abdomen ultrasound: a low echogenic area measuring approximately 10.6 cm×2.8 cm is noted around the right kidney. The CT pulmonary angiography (CTPA) demonstrated filling defects at the bifurcation of the pulmonary trunk, as well as within the upper and lower lobes of both lungs and their respective branches. The blood gas analysis of patient indicated (face mask oxygen therapy at 10 L/min, oxygenation index of 120): pH 7.456, PCO2 24.9 mm Hg, PO2 73.2 mm Hg. His myocardial markers were Myoglobin: 79.21 ng/ml, Troponin T: 58.7 ng/L, BNP: 2062 ng/L. The patient was diagnosed with renal contusion and pulmonary embolism, and was treated with subcutaneous heparin（initial dose is given as an 80 IU/kg intravenous bolus, followed by a continuous infusion of 12-18 IU/kg/h） and low-molecular-weight heparin at a dose of 0.8 ml every 12 hours one after another for anticoagulation, along with symptomatic treatment. Following the intervention, the patient's respiratory distress showed significant improvement, and subsequent arterial blood gas analysis indicated enhanced oxygenation. Then, the anticoagulant medication was adjusted to oral rivaroxaban anticoagulation for 6 months, follow-up CTPA scan revealed complete resolution of the pulmonary embolism and the abdominal CT scan indicated a reduction in the extent of patchy low-density shadows surrounding the right kidney, leading to the discontinuation of anticoagulation therapy. After searching the above-mentioned databases, total of 26 articles were identified that reported on 30 patients diagnosed with high-risk bleeding and acute pulmonary embolism; among these, 3 patients succumbed while 27 exhibited clinical improvement. ConclusionsPatients with renal contusion and acute pulmonary embolism can be safely and effectively treated with low-dose heparin anticoagulation under close monitoring. High-risk bleeding patients with acute pulmonary embolism present a significant challenge in clinical practice. After weighing the risks of bleeding disorders and the adverse outcomes of pulmonary embolism, it is necessary to find the optimal balance between anticoagulation and bleeding. Consequently, the formulation of personalized treatment strategies in accordance with established guidelines can enhance patient outcomes.