Objective:To investigate the understanding of microsurgery education for clinical medical students, and the education methods for microsurgery courses in 8 schools.Methods:The questionnaire was designed around four aspects: the learning status of Chinese medical students in microsurgery learning, the impact of microsurgery learning on future career choices, the current situation of opening microsurgery courses in 8 medical schools, and the opinions and suggestions on improving microsurgery learning in China. Electronic and paper questionnaires were combined to evaluate the condition of understanding microsurgery among 1 000 medical students from Peking University Health Science Center and other 7 schools. Then, the validity of the collected questionnaires was reviewed. SPSS 19.0 were applied for data analysis.Results:A total of 808 valid questionnaires were collected (recovery rate=80.8%). Respondents' understanding of microsurgery remained at the level of "just heard" (2.18±2.83), and 98.41% (795/808) of the students believed that microsurgery related disciplines would bring certain help to their future careers. Male students more recognized the impact of microsurgery learning on future career than female students [(6.19±2.36) vs. (5.76±2.09), P< 0.05)]. In these 8 investigated universities, only Shanghai Jiao Tong University School of Medicine and Zhongshan School of Medicine of Sun Yat-sen University conducted a microsurgery course, while 80.01% (531/663) of the students in the other 6 universities wanted to set microsurgery courses. Microsurgery operation observation (86.82%, 701/808), animal models for microsurgery practical training (82.95%, 670/808), and online theory courses (43.18%, 349/808) were able to increase the interest in microsurgery learning for students. Conclusion:Microsurgery course can bring many benefits to medical students, and it is urgent for domestic medical colleges to carry out microsurgery related courses.

The pharmacokinetics and absolute bioavailability of 1-hexyl-carbamoyl-5-fluorouracil ( HCFU ) (10 mg/kg ) after oral and intravenous administration were studied in 5 dogs with cross-over design. The concentration of HCFU in serum was determined by reversed-phase high performanee liquid chromatography. After intravenous administration, the curve of serum HCFU concentration vs time was fit to a two-compartment opened model and the phar-macokinetic parameters were. T1/2?=1 .67 min, T1/2? = 34.55 min, Vc= 0.2525L/kg,C1 = 0.3205 L/kg?h~-1 & AUCiv =1.9375 mmol/min?L~-1. When HCFU tablets were tiken orally, the curve of concentration vs time was fit to an one-compartment opened model and its pharmacokinetie parameters were: T1/2ke=12.13 min, T1/2ke=38.51 min, Tmax=23.46 min,Cmax=8.140?10~-3mmol/L & AUCpo=1.5856 mmol/min?L~-1 . The absolute bioavailability calculated from AUCpo and AUCiv was 0.8214.

Heart Atria ; Humans ; Lung Neoplasms ; Sarcoma ; Skull Neoplasms

Objective To summarize the characteristics and clinical value of multi-slice spiral computed tomography (MSCT) examination in the biliary gallbladder-duodenal fistula.Methods The imaging data of 28 patients with gallbladder-duodenal fistula who were admitted to the Wuxi No.2 Hospital of Nanjing Medical University between June 2012 and March 2015 were retrospectively analyzed.All the 28 patients received MSCT examinations,and the imaging changes were observed and analyzed,including the location of lesions,figures of fistulous tract,shrinking or enlarging gallbladder,pneumotosis and stones of gallbladder or bile duct.Results Of the 28 patients,fistula located at the duodenal bulb were detected in 14 patients,junction of the bulb and the descending part of the duodenum in 2 patients,ascending duodenum in 7 patients,horizontal part in 5 patients.Indirect signs of biliary gallbladder-duodenal fistula included that gallbladder volume in 28 patients was significantly reduced,cross sectional area of gallbladder was 2 cm × 1 cm-6 cm × 2 cm,and gallbladder wall was thickened with an average thickness of 5 mm (range,4-9 mm).Adhesion of gallbladder and duodenum,unclear boundary,structure disorder and visible effusion surrounding gallbladder were detected.Among 21 patients with biliary gas,19 patients had pneumotosis of gallbladder and 17 had biliary pneumatosis.Biliary stones were detected in 23 patients including cholecystolithiasis in 19 patients,gallbladder neck stones in 6 patients,common bile duct stones in 13 patients and intra-and extra-hepatic cholangiolithiasis in 1 patient.The diverticulum signs appeared in the duodenum of 11 patients.The direct signs of MSCT in the biliary gallbladder-duodenal fistula included that fistulous tract of 13 patients clearly showed and some were dumbbell-shaped.Two and 2 patients were complicated with gallstone ileus and multiple liver abscesses,respectively.The diagnostic results of MSCT in 28 patients were compared with the results of operative exploration,with an diagnostic concordance rate of 78.6％ (22/28),and the diagnostic concordance rate of gallbladder stones was 82.1％ (23/28).Conclusions The indirect signs of MSCT in patients with biliary gallbladder-duodenal fistula include pneumotosis of gallbladder or/ and biliary gas,gallbladder neck stones or common bile duct stones,gallbladder shrank,adhesion of gallbladder and duodenum,unclear boundary,diverticulum signs in the adhesions of duodenum and gallbladder,and clear orificium fistulae of gallbladder-duodenum is a direct sign of MSCT.

Objective To investigate the influence of the pain management path on the postherpetic neuralgia patients. Methods Ninety patients with postherpetic neuralgia were divided into two groups by random digits table method:the control group and the experimental group, 45 cases in each group. The patients in the control group accepted conventional nursing care, the patients in the experimental group accepted the pain management path nursing care. The scores of pain and the overall satisfaction were assessed, the incidence of common adverse reactions at 5 and 10 days after the treatment, hospitalization expenses and hospitalization days were recorded. Results The gender, age, course of disease and degree of pain had no significant difference between the experimental group and the control group at admission (P>0.05). After 5 and 10 days treatment, the scores of pain in the experimental group were (3.07±1.34) , (1.09±0.90) points, and these were (4.29±1.74), (2.27±1.32) points in the control group, the differences were statistically significant (t=3.74, 4.94, all P<0.01). After 5 and 10 days treatment, the scores of the overall satisfaction in the experimental group were (5.50 ± 1.71), (7.96 ± 1.30) points, and these were (4.50 ± 1.60), (7.00 ± 1.50) points in the control group, the differences were statistically significant (t=-2.89,-3.37, all P<0.01). After 10 days treatment, the incidence of constipation was 26.67% (12/45) and 53.33% (24/45) in the experimental group and the control group respectively, the difference was statistically significant between the two groups (χ2=6.667, P<0.05). The hospitalization days were (13.71 ± 3.05) d and (15.76 ± 3.54) d in the experimental group and the control group respectively, the difference was statistically significant between the two groups (t=2.934, P<0.01). The hospitalization expenses were (11798.38 ± 3312.33) yuan and (13972.24 ± 3726.66) yuan respectively, there was significant difference between the two groups (t=2.925, P < 0.01). Conclusions The application of the pain management path for the pain management in patients with postherpetic neuralgia, can relieve the pain, reduce the incidence of adverse effects, hospitalization expenses and days, improve the overall satisfaction of the patients.

Objective:To study the reliability and validity of schizophrenia quality of life scale (SQLS)in China.Method:Eighty-eight patients with schizophrenia were assessed with the SQLS.Results:The Cronbach's alpha were in 0.58-0.93.The split-half reliability coefficient were in 0.91-0.94.The test-retest reliability coefficient were in 0.57-0.76.The content validity and construct validity reached psychometrically acceptable level.Conclusion:The SQLS is a simple and reliable scale.

Objective: To investigate the epidemiological characteristics of 45 norovirus clusters in Baoshan District, Shanghai Municipality from 2019 to 2021, so as to provide the evidence for improving the management of norovirus clusters. Methods: The epidemiological characteristics and laboratory testing of 45 norovirus clusters were collected in Baoshan District from 2019 to 2021, and the temporal distribution, population distribution, distribution of places of norovirus clusters, clinical manifestations, laboratory testing results, origin of norovirus infection and transmission routes of norovirus clusters were analyzed using a descriptive epidemiological method. Results: A total of 45 norovirus clusters involving 29 379 individuals were reported in Baoshan District from 2019 to 2021, and 435 cases with norovirus infections were identified, with an average attack rate of 1.48%. Norovirus infection most often occurred from November to April of the following year, and the infection predominantly occurred among students (408 cases, 93.79%). There were 25 norovirus clusters in kindergartens (55.56%), 18 clusters in primary and middle schools (40.00%), one cluster in a social care facility and one cluster in a geriatric ward. Vomiting was the predominant clinical symptom (416 cases, 95.63%). The positive rate of norovirus was 37.35% in 597 samples. There were 40 norovirus clusters caused by the norovirus GⅡ genotype (88.89%), and the median duration of the norovirus cluster was 6 days (interquartile range, 1 day). In addition, 82.22% of the norovirus clusters reported to centers for disease control and prevention within 1 day,and 88.89% of the clusters were transmitted through human to human transmission or vomitus of cases. Conclusion The norovirus clusters predominantly occur in winter/spring and among students in Baoshan District from 2019 to 2021. Kindergartens and primary and middle schools are main places of norovirus infections, and the norovirus GⅡ genotype is the main type of pathogens. Human-to-human transmission and exposure to patients' vomitus are the main routes of transmission.

Objective To develop a rapid detection method of flow cytometry for antifungal susceptibility testing.Methods The experiment conditions of flow cytometry were optimized and the minimum inhibitory concentrations (M1Cs) of 230 strains of Candida spp to flucytosin,fluconazol,itraconazole,amphotericin B were detected.The MIC results obtained by flow cytometry were compared with M27-A2 reference assay.Results The agreement of MIC results between flow cytometry and M27-A2method was 85.0％ - 100％.Conclusion Flow cytometry can be used as a rapid and reliable method for antifungal susceptibility testing.

The developmental origins of health and disease(DOHaD)suggests that a poor maternal developmental environment during pregnancy can significantly increase the risk of chronic metabolic diseases such as obesity,diabetes mellitus(DM),and cardiovascular disease in offspring during adulthood.The adverse environmental factors of the father's generation influence the glucose and lipid metabolism of the offspring.The environmental factors exposed by the father before fertilization,such as over nutrition,obesity,diabetes caused cross generation reprogramming in offspring,and develop glucose and lipid metabolism disorders,which can last for one or more generations.Currently,paternal origin of health and disease(POHaD)has received widespread attention and has important scientific value and social significance.This article reviews the research progress on the impact of parental nutritional environment on offspring glucose metabolism.

Objective To investigate the early diagnosis value of MR by detecting spinal inflammatory lesions in ankylosing spon-dylitis (AS).Methods Forty patients were involved in this study,including 20 cases with short inflammatory back pain (IBP)histo-ry (duration ≤18 months)and 20 cases with long IBP history (duration ≥24 months).MR images were analyzed retrospectively. Results Patients with a short history of IBP had 7 lesions in vertebral bodies (anterior/posterior spondylitis and spondylodiscitis) and 33 lesions in posterior spinal structures (arthritis of costovertebral joints,costotransversal joints,zygapophyseal joints and en-thesitis of spinal ligaments).Patients with a long history of IBP had 27 lesions in vertebral bodies and 24 lesions in posterior spinal structures.Patients with a short history of IBP had significantly more lesions in posterior spinal structures than in vertebral bodies with 82.5% (33/40)vs 1 7.5% (7/40),respectively (P <0.01).In contrast,patients with a long history of IBP had significantly more inflammation in vertebral bodies with 79.4% (27/34)vs 20.6% (7/34),respectively (P <0.01).Conclusion Inflammatory spinal lesions in patients with a short history of IBP are seen more often in the posterior structures.Early detection of inflammatory spinal lesions by MRI is useful for early diagnosis of AS.