After-department examination palys an important role in clinical teaching.The level of clinical teaching is one of the most important markers to evaluate the whole quality of the hospital.To improve the ability of teaching and teaching concept,we summarized the problem of after-department examination and put forward a series of reformation methods.

The connotation development of industry and education is the road to advance the development of connotation and the quality of higher vocational and technical education.Based on this and bringing into play the advantages of running a vocational school and combined with cultivating the applied personnel needed by enterprises and professions,the college perfects the personnel cultivation model.carries out the "225" education model,accelerate the development of the teacher,promote its service capacity to enhance constantly the quality of higher vocational and technical education.

This article summarized the application of Quality of Life in Parkinson's disease such as in therapy or nurse assessment, and discussed how it can be used to assess the effect of Traditional Chinese Medicine on Parkinson's disease, which suggest that a Sinicized Patient Reported Outcome (PRO) measure should be advanced.

Background Posterior capsular opacification (PCO) following cataract extracapsular extraction is a major cause of the reduction of visual acuity.Topical administration of eye drops is a research hotspot for the prevention of PCO.Objective This study was to evaluate the release of cyclosporine A-loaded chitosan nanoparticles (CyA-CS-NP) by ionic gelation in vitro and its feasibility of modification of the surface of polymethylmethacrylate intraocular lens (PMMA IOL) with CyA-CS-NP.Methods The CS-NP and CyA-CS-NP were prepared by ionic gelation of CS with sodium tripolyphosphate.The characteristics of CS-NP,such as the appearance and mean size,and drug entrapment efficient (EE),loading capacity (LC),and the drug release were studied ; the CyA content on the IOL surface was detected by high performance liquid chromatography (HPLC).The IOL surface modified with CyA-CS-NP was observed by scanning electron microscope and X-ray photoelectron spectroscopy technique (XPS),the changes of elements and chemical bond types between simple plasma processed IOL and CyA-CS-NP modified IOL were analyzed.The transmittance at the wavelength of 360-490 nm and refraction of IOL were detected using back focal length method and spectrophotometer,and the effective resolution of IOL was evaluated according to the instruction of ISO/CD 11979-2.Loops anti fatigue test of IOL referred to the criteria of ISO/CD 11979-3.Results The CS-NP and CyA-CS-NP showed monodisperse,uniform appearance similar to spherical shape with a mean size of (158±18) nm and (219±29) nm,respectively.The CyA-CS-NP had high CyA association efficiency and loading capacity (64.2％ and 7.6％).In vitro release study revealed a fast release on the first day followed by a increased drug release during an 11-day following up.The sustained release was approximately 46.6％ at day 1 and 77.7％ at day 12,respectively.The surface of IOLs with cling film was smooth without CS-NP;while the edge of IOLs appeared a layer of CyA-CS-NP after modification.XPS analysis displayed some elements such as phosphonium,CNH2 and O =CN that appeared on the modified surface,indicating that CyA-CS-NP existed on the surface of IOLs edge.The mean quality of CyA on three IOLs surface after modification was 171.88 μg.The diopter,distinguishing ability and transmittance of modified IOL were (16.64±0.23) D,(90.28 ± 0.25) ％ and (73.57 ±0.62) ％,and those of unmodified IOL were (16.62±0.29) D,(90.28±0.21) ％,(73.61±0.60)％,without significant differences between them (t =0.381,0.078,2.291,all at P ＞ 0.05).The antifatigue ability of loops complied with the criteria of ISO/CD 11979-3.Conclusions The optical property and antifatigue ability of loops of the edge-modified IOLs by CyA-CS-NP reach the normal standard and meet the requirement of clinic application.The edge-modified IOLs by CyA-CS-NP can be a delivery system for intraocular drug release.

Adult ; Cerebrospinal Fluid Rhinorrhea ; Female ; Humans ; Sphenoid Sinus ; pathology

Introduction of clinical cases to experiment teaching of pharmacology is an effective method,which combines basic theory with clinical medicine.It can stimulate students' interest in pharmacology,enhance their go-aheadism in study and also improve teaching effects.Moreover,it plays an important role in improving the students qualities such as the reasoning ability,the verbal capacity and the ability to analve and resolve problems,etc..In this article,we explored the teaching method in experiment teaching of pharmacology,and evaluated the effect by questionnaire.

ObjectiveDiabetes is an independent risk factor for coronary artery bypasss grafting(CABG). Off pump coronary artery bypasss (OPCAB) experience in 251 cases was reviewed to determine whether diabetes wou ld be applicable in OPCAB procedures.MethodsConsecutive 251 patients underwent OPCAB over 12 month period. This study included 71 diebetic patients (DM group) and 180 nondiabetic patients (NDM group). Preoperative v ariables were compared between the two groups by univariate analysis.R esultsNo differences were found regarding the length of stay in cardio intensive care unit [DM group(2.4?0.3)d; NDM group (2.4?0.3) d;P=0. 386], and sternal complication (DM group: 5.7%;NDM group: 3.9%;P=0.511) . In hospital complications were as follows: death rate(DM group: 2.8%; NDM gr oup: 1.1%; P=0.680); stroke (DM group: 2 8%; NDM group: 1 7%; P=0 623 ); hemofiltratioin renal failure (DM group: 2.8%; NDM group: 0.5%; P=0.194); myocardial infarction(DM group: 0%; NDM group: 0.5%;P=1.000); blood using were more frequent in DM group comparied with NDM group (P=0.111). ConclusionOPCAB in diabetic patients is as safe as in non diabetic patients.

Objective To census the preoperative prevalence rate of deep venous thrombosis (DVT) and to evaluate the risk factors of DVT in senile osteoporotic hip fractured patients.Methods The object of study were patients aged 60 and above, and osteoporotic hip fracture by low energy injury in 2013.Based on medical records, all the patients with osteoporotic hip fracture were evaluated the signs and symptoms of DVT in 24 h, D-dimer test and underwent Doppler ultrasound screening of bilateral venous system in lower extremity after admission, and all the patients received preoperative prophylactic anticoagulation.Patients with popliteal and proximal level thrombus or floating thrombus underwent inferior vena cava (IVC) filter insertion.Outcome measures: age, gender, fracture type, D-dimer value in 24 h preoperatively, occurrence time of DVT and region, grade of preoperative American Society of Anesthesiologists, preoperative medical diseases.Results 702 of 946 hip fracture inpatients were comprised in this retrospective study.All were not founded any symptom or signs of DVT.All patients were took preoperative Doppler ultrasound screening and the results as follows: 36 of 302 patients (11.9％) with femoral neck fracture were proved preoperative thrombosis(13 male, 23 female), the average age was 72.7 year-old(range from 62-90 year-old), on the same side as the fractured hip in 31 patients, bilateral thrombosis in 5 patients.74 of 400 patients (18.5％) with intertrochanteric fracture were proved preoperative thrombosis(38 male, 36 female), the average age was 76 year-old (range from 60-95 year-old), on the same side as the fractured hip in 68 patients, bilateral thrombosis in 6 patients.The most prevalence rate of DVT were in the first day after osteoporotic hip fracture, 15 patients (41.7％) with femoral neck fracture and 38 patients (51.40％) with intertrochanteric fracture.There were more proximal level and multiple level involment thrombosis over 5 days after injury.The most thrombosis were proven at calf and popliteal vein.Conclusion The prophylaxis of DVT should be started even in the emergency department in senile patient with osteoporotic hip fracture.To avoid the risk factors, early surgery and early postoperative mobilization will be effective.

AlM: To evaluate the application of phacoemulsification of different nucleus density using ozil and traditional mode.METHODS: A total of 89 eyes (72 patients ) ( visual acuity was of 0. 6 and above after 1mo follow - up) of different nucleus density level (LOCS Ⅱ criteria grade Ⅲ 46 eyes, grade Ⅳ and more 43 eyes ) were randomly assigned into 2 groups: ozil group (group A), grade Ⅲ 22 eyes (torsional energy 80% lP on);grade Ⅳ and more 17 eyes (torsional energy 100% lP on); Traditional mode group(group B), grade Ⅲ 24 eyes (energy 50% ), grade Ⅳ and more 26 eyes (energy 60% ~ 70% ) . All surgeries were performed by the same experienced surgeon,who use the chop to split the nucleus in the application of phacoemulsification. lntraoperative parameters were total equivalent pawer ( TEP ), cumulative dissipated energy ( CDE ) and effective phaco time ( EPT ) and surgical complications. The effectiveness of the two modes in dealing with hard - core cataract phacoemulsification were compared.RESULTS: GradeⅢ nucleus dealing: TEP of ozil group was significantly higher than that of the traditional mode group [(24.58±7.78)% vs (13.84±1.97) %]and EPT of ozil group was significantly lower than that of the traditional mode group (50. 59±14. 73 s vs 60. 19±9. 04 s, P<0. 05). CDE showed no difference between two groups [(13.12±6.03)% vs (13.38±2.85)]. Grade Ⅳ and more nucleus dealing: CDE [( 34. 10 ± 13. 48 )%] and EPT (104. 64±32. 4s) of the ozil group was higher than CDE [(30. 31 ± 13. 48)%] and EPT (93. 01 ± 41. 01s) of the traditional mode group, but there were no difference between two groups. Obstacles in the needle of phacoemulsification surgery: ozil group 4/17, traditional mode group 2/26 (χ2=2. 16, P=0. 14).CONCLUSlON: Bothozil and traditional mode can deal with all kinds of nucleus effectively and safely. Ozil mode is more efficacy and quick deal in gradeⅢnucleus. With the increase of nucleus hardness, the traditional mode still have the advantage of high efficiency and no obstacle to dealing patients with grade Ⅳ and more nucleus. Choose according to different nuclear hardness ultrasonic model can improve the operation efficiency and security.