Our hospital has set up a relatively complete assessment methods after nearly 10 years of residents/medical specialist training, including the day-to-day assessment, periodic assessment,comprehensive assessment,and completed the corresponding management evaluation.

Residents(medical specialists)programmed education is an important aspect to fulfill the post-graduated medical education. It can remedy the clinical practice of young doctors,which ac-cords with the trend of international medical education .This article is to give advice for the resi-dents (medical specialists)programmed education according to the work and existing problems in our hospital.

We have established the model of English ability training on the residency training project,and have provided the systematic training plan to 29 residents who were employed in 2005.This paper summarizes the effect and points out the further reform perspectives.

Objective To evaluate the clinical efficacy of percutaneous endoscopic lumbar discectomy (PELD) on treatment of far lateral lumbar disc herniation (FLDH). Methods We retrospectively analyzed 27 patients with FLDH underwent percutaneous endoscopic lumbar discectomy from June 2014 to September 2015, age from 41 to 64, average 52.3. The average operation time, intraoperative blood loss and length of hospital stay were collected. The lumbocrural pain perception of patients before and after surgery was assessed by visual analog scale (VAS) and postoperative lumbar functional recovery after surgery by modified MacNab criteria. Results Average operation time was 69 min (58~109 min), intraoperative blood loss was 18 ml (11~40 ml), and length of stay was 5.0 d (3.0 ~ 10.0 d). VAS score from (8.12 ± 1.25) preoperatively improved to (2.80 ± 1.12) at the 3rd d after operation, (1.59 ± 1.06) at 3 months after operation, and (1.31 ± 0.89) at the last follow-up after operation; There was a statistical difference between preoperative scores and postoperative scores (P < 0.05). Modified MacNab criteria was a ratio of 88.9%. Conclusions PELD on the treatment of far lateral lumbar disc herniation have small area of trauma, faster postoperative recovering and several other advantages,which is a safe and effective minimally invasive surgery.

Objective:To analyze and evaluate the teaching effect of the Problem-Based Learning and intelligent simulation training in emergency medicine.Methods:Based on Problem-Based Learning,129 residents of our hospital accepted the cardiopulmonary resuscitation training and test by intelligent simulation training.And their feedback questionnaires were analyzed.Results:After training,their abilities to deal with the cardiac arrest have made a great progress(P

Objective:To investigate the clinical effect of Infix combined with hollow screws for the treatment of pelvic injuries with pubic symphysis separation in middle-aged and elderly patients.Methods:Data of 8 middle-aged and elderly patients with pelvic injuries due to pubic symphysis separation undergone treatment from January 2017 to December 2020 were retrospectively analyzed.Results:The average operating time of 8 patients was (46.0±6.2)min(range: 40-62min); the average intraoperative blood loss was (32.0±5.6)ml(range: 25-50 ml); the average length of incisions at the iliac screw was(2.6±0.4)cm(range: 2.0-3.5 cm); the average length of incisions at the hollow screw was (1.1±0.3)cm(range: 0.8-1.5 cm); and the average times of fluoroscopy were (36.0±6.0)times(range: 28-52 times). Postoperative X-ray and CT examinations showed that the reduction of the pubic symphysis was good, the inserted iliac screws and cannulated screws were positioned accurately, and the incision healed well.Based on Matta's criteria, postoperative radiological outcomes were evaluated, with 7 cases rated as excellent and 1 as good, giving an excellent to good rate of 100%(8/8). The average followed up time for all 8 patients was (15.0±4.2)months(range: 6-24 months). Pelvic X-ray and CT examinations at the last follow-up showed that the fractures healed well and the pubic symphysis reduction did not fail.Infix and cannulated screws in the pubic symphysis were removed 10-12 weeks after surgery[average: (10.5±0.5)weeks]. According to the Majeed Pelvic Score, 5 cases were rated as excellent, 2 cases as good and 1 as fair, with an excellent to good rate of 87.5%(7/8). One patient had symptoms related to the lateral femoral cutaneous nerve that disappeared after 3 months.One patient developed deep venous thrombosis after surgery, and the filter was placed and removed 10 weeks later.Conclusions:Using Infix plus cannulated screws for the treatment of pelvic injuries in middle-aged and elderly patients with pubic symphysis separation has the advantages of limited trauma and intraoperative blood loss, good fixation and few complications.

OBJECTIVETo analyze the clinical feature of early newborn infants with congenital heart disease.

METHODSWe retrospectively analyzed the clinical features of 477 newborn infants with congenital heart disease born within seven days out of 28 050 live births in Shaoxing women and children hospital from October 1, 2009 to September 30, 2012. Infants with congenital heart disease were divided into single malformation group (240 cases), composite deformity group (199 cases) and multiple malformations group (38 cases). Differences of clinical feature were compared between the three groups.

RESULTSAtrial septal defect was the most malformation 91.6% (437/477) .Incidence of preterm birth was higher in newborn inants with congenital heart disease [512.23/10 000(134/2 616)] than infants without without congenital heart disease [134.86/10 000 (343/25 434) , P < 0.01]. Proportion of preterm birth among the three congenital heart disease groups was similar (P > 0.05) . The incidence of small for gestational age in congenital heart disease group (10.90%, 52/477) was also significantly higher than those without congenital heart disease group (5.91%, 1 630/27 573, P < 0.01).Small for gestational age with congenital heart disease of complex malformations, multiple malformations groups was higher than that in the single malformation group (P < 0.01 and P < 0.05).

CONCLUSIONSEarly newborn with atrial septal defect is the most common neonatal congenital heart disease. The incidence of preterm is higher in newborn infants with congenital heart disease. Complex and multiple malformations are linked with small for gestational age birth weight.

Female ; Heart Defects, Congenital ; diagnosis ; Heart Septal Defects, Atrial ; diagnosis ; Humans ; Infant, Newborn ; Infant, Small for Gestational Age ; Male ; Premature Birth ; Retrospective Studies

OBJECTIVE：To estab lish the fingerprint ，analyze the monosaccharide composition and content ，investigate the inhibitory effects of the polysaccharide from Desmodium styracifolium on α-glucosidase in vitro . METHODS ：Polysaccharide from D. styracifolium was prepared by water extraction and ethanol precipitation. After hydrolyzed by TFA and derived by PMP ，HPLC method was adopted to establish the fingerprint （using glucose peak as reference ），and analyze the constituent and content of monosaccharide. The content determination was performed on Phenomenex Luna C 18 column with mobile phase consisted of acetonitrile-0.05 mol/L potassium phosphate （pH adjusted to 6.8 with sodium hydroxide ）in gradient elution at the flow rate of 0.8 mL/min. The detection wavelength was set at 250 nm，and column temperature was set at 30 ℃. The sample size was 10 μL. Using acarbose as control ，PNPG assay was used to investigate the α-glucosidase inhibitory activity of polysaccharide from D. styracifolium. RESULTS ：There were 9 common peaks in HPLC fingerprints of 18 batches of samples ，and the similarity of 15 batches of samples was higher than 0.90. Totally 7 peaks were identified as mannose ，rhamnose，galacturonic acid ，glucose， galactose，xylose and arabinose. The contents of rhamnose ，galacturonic acid ，glucose，galactose and arabinose were 0.471-2.092， 1.379-8.919，2.560-35.679，1.194-6.905，0.566-4.158 mg/g，respectively. Based on rhamnose ，the molar ratios of the other four monosaccharides were 1.58-4.07，2.26-19.95，2.20-4.21 and 1.31-2.86，respectively. The inhibitory activity of polysaccharide from D. styracifolium on α-glucosidase increased with the increase of dose ，and the half inhibitory concentrations of it was 0.70 mg/mL， lower than 7.76 mg/mL of acarbose （positive control ）. CONCLUSIONS ：Glucose is the main component of D. styracifolium polysaccharide in different batches ，and the contents of monosaccharides are different. The polysaccharide from D. styracifolium have significant inhibitory activity on α-glucosidase，which is better than that of acarbose.