Medicine is a practicing and experiencing subject.The most important study method for medical students is to practice during clinic.With the development of society,patients' consciousness of sticking up for their rights is stronger and stronger.During their receiving medical treatment,they are not satisfied with the teaching behavior provided by physician,and even to make medical conflicts.To resolve these conflicts,it is necessary to rule the clinical practicing teaching,harmonize the relationship between clinical teachers,medical practicing students,and patients.Medical education should be based on humanity and should be behaved by law.

The author reviewed papers on Evaluation on Teaching Hospitals in China from 1997 to now.Teaching hospitals were evaluated by educational and health administrator of local government since 1997.The methods the roles of evaluation,advantage and disadvantage of evaluation on teaching hospitals were described in this paper.

Objective To study and observe the application effect of debridement adhesive combined with comfeel silver ion dressing in the treatment of wound after the total cystectomy.Methods 90 patients with total cystectomy in Cixi People's Hospital from July 2014 to June 2016 were selected as the research object, and all the patients were randomly divided into control group 45 cases and observation group 45 cases, the control group were treated with conventional treatment of postoperative wound, the observation group were treated with debridement adhesive combined with comfeel silver ion dressing on the treatment of control group, then the infection rates, degree of edema and local comfort, life quality and local microcirculation state before and after the intervention of two groups were respectively analyzed and compared .Results The infection rates of observation group were higher than those of control group, the degree of edema and local comfort, life quality and local microcirculation state after the intervention were all significantly better than those of control group, the difference was all statistically significant ( P <0.05 ).Conclusion The application effect of debridement adhesive combined with comfeel silver ion dressing in the treatment of wound after the total cystectomy is better , and it has active role for the improvement of discomfortableness and microcirculation state.

Objective To discuss the influence of respiratory training and prompting effective discharging of sputum for chronic obstructive pulmonary disease (COPD) patients in acute aggravation period. Methods 50 patients were randomized into the intervention group and the control group with 25 cases in each group.The intervention group received respiratory training and prompting effective discharging of sputum while the control was only given routine treatment and nursing.The ratio of first second expiration volume to forced vital capacity, oxygen partial pressure (PaO2),carben dioxide partial pressure (PaCO2) ,blood oxygen saturation (SpO2)and the in-hospital days were compared between the two groups. Results The clinical effect in the intervention group was superior to that of the control group with shorter in-hospital days (P<0.01).Conclusion Better results could be obtained by application of respiratory training and prompting effective discharging of sputum for COPD patients in acute aggravation period.

ObjectiveTo study the mastery, acquiring ways and need of studying the knowl-edge and skill of emergency treatment in non- medical junior college and technical secondary school students. MethodsThe survey was carried out in 600 non-medical junior college and technical sec-ondary school students to investigate their mastery and need of emergency knowledge, the results underwent analysis. ResultsThe mastery of the emergency knowledge was uneven in non- medical junior college and technical secondary school students. 100.0% of them can call 120 correcdy, 58.5% of them mastered the e-mergency treatment of carbon monoxide poisoning, and 25.0% mastered cardiac pulmonary resuscitation. All the students desired to hold the knowledge and skill of emergency treatment. Television, broadcast and internet were the main ways for them to master emergency knowledge. ConclusionsThe mastery of the knowledge and skill of emergency treatment is not good. It is urgent to educate and train them with the knowledge and skill of emergency treatment, and to improve knowledge and skill of emergency treatment.

Objective To summarize the nursing experience in prehospital first-aid of patients with cardiac traumas in order to improve the cooperation capability of prehospital first-aid. Methods The nursing cooperation of prehospital first-aid of 33 patients with cardiac trauma was analyzed retrospec-tively. Results 24 cases of them were rescued successfully, and were completely recovered without se-quelas. 4 cases complicated with severe multiple trauma, died after arriving at hospital, and 3 cases com-plicated with multiple trauma died of complications, while 2 cases with injury of thoracic aorta died during the surgery. Conclusions Early emergency treatment and judgment of traumatic condition could pro-vide valuable chance for inhospital first-aid.

[Objective] To explore the clinical effect of Buyang Huangwu Decoction and Guipi Decoction together on BTS. [Method] Select 48 cases of BTS in accordance of diagnosis standard, divide them into treatment group 48 cases(take revised Buyang Huangwu Decoction and Guipi Decoction ) and control one 20(routine western medicine), judge their cure effect after 2~4 courses. [Result] The cure rate and total effective rate were respectively 60.42%and 87.50% for treament group, for control one, they were respectively 30.00% and 65.00%; with χ2 test, their differences were respectively of marked statistical meaning and statistical meaning. [Conclusion] Buyang Huangwu Decoction and Guipi Decoction together had definite cure effect on BTS.

Human resource,as the core resource of hospitals,plays a key role in maintaining the competitive advantage of the hospitals.From the perspective of system engineering,this paper closely combined the present situation of human resource management under the background of medical staff shortage with the systematic theory,and systematically analyzed the problems of medical staff shortage and human resource management in public hospitals on the basis of literature research and investigation.It constructedand analyzed the archetype of “growth upper limit” that the over load of medical staff in hibited their mental health,“growth and investment insufficiency” archetype of medical staff's human capital investment,and the “trifles” archetype of medical personnel shortage.As well,it put forward the problem-solving management strategy using the theory of systematic thinking.

BACKGROUND: Routine methods of chromosome G-bending are complicated, time-consuming and worse in effect, which is not suitable for clinical examination and teaching investigation of chromosomal disorder.OBJECTIVE: To seek for proper method of improving the effect of chromosome G-banding.DESIGN: Observation experiment.SETTING: Xinxiang Medical University.MATERIALS: The experiment was conducted in the Laboratory of Morphous, Xinxiang Medical University between January 2001 and January 2005. 376 blood samples were obtained from patients with infertility and sterility or those had abnormal childbearing history, who came from the Clinic of Gynecology and Obstetrics, Third Hospital Affiliated to Xinxiang Medical College between 2001 and 2004. Main agents: RPMI1640 culture fluid (GIBCO Co., Ltd), 20% calf serum (CS), colchicines, 0.075 mol/L KCL, methanol, glacial acetic acid, trypase (SIGMA Co., Ltd) and Giemsa staining solution.METHODS: Modified method of human peripheral chromosomal preparation and G-banding: The procedures were the same as routine methods, while partial influential factors were regulated, for example, the action time of colchicines was set at 2 hours before the ending; 1 mL of fixation fluid (the ratio of methanol and glacial acetic acid was 2:1) was added for pre-fixation, and samples were mixed and centrifuged at 1 500 r/minute for 10 minutes. After re-centrifugalization,fresh fixation fluid was added to prepare for cell suspension and glass slide by according to the amount of cells.Above-mentioned glass samples were baked at 50 ℃ for 1-2 hours, naturally cooled to 37 ℃, digested for 3-5 minutes by immersing into trypase, rapidly stained for 10 minutes with Giemsa staining solution, and counted by the test under microscope to observe 3 000 metaphases, and the percentages; The percentage of 400-600 metaphases and well-dispersion rate were calculated. Well-dispersion rate of chromosome referred to the overlapping after dispersion with complete numbers. The trabant and kinetic body were obvious and in bright color with clear shape. Moreover, all chromosomes were on the same plane. The percentage of metaphase = the number of metaphase cells (400-600)/number of cells under observation×100%.MAIN OUTCOME MEASURES: The percentage of 400-600 pieces of metaphases in samples and good integration chromosome.RESULTS: 400-600 metaphases obtained with routine methods accounted for 52% with a well-dispersion rate of 68%,while 400-600 metaphases obtained with modified methods accounted for 75% with a well-dispersion rate of 86%, and there were significant differences between the two groups (P ＜ 0.05).the stripes are chear.CONCLUSION:Chromoseme metaphases obtained with modified methods are more in number and good in dispersion with proper size. Giemsa shows that the stripes art chear.

OBJECTIVE: To investigate the preservation of the structure and function of the trachea and larynx, the management of laryngotracheal defect when trachea and larynx was involved. METHOD: To review the management and clinical results of 13 cases of thyroid papillary carcinoma with larynx and trachea involvement, the preservation of laryngotracheal structure and relative defect reconstruction of our department from 2007-2014. Those patients being performed total laryngectomy was excluded. 3 males and 10 females, aged from 46 to 67 years old with median age of 53 were included. Among them 8 cases were recurrent. The extent of the tumor foci was estimated with the help of computed tomography and laryngofiberoscope before surgery. Selective neck dissection, total thyroidectomy and related laryngotracheal resection was performed for the first time operation patient, while selective neck dissection, recurrent foci and related larynx and trachea resection was performed for those recurrent patients. Three kinds of modalities were applied to manage the laryngotracheal defect including to reconstruct with pedicled sternocleidomastoid clavicular periosteocutaneous flap, pedicled trapizius muscular flap and to preserve the remaining larynx and trachea and perform a stoma of larynx and trachea which repaired by a second-stage procedure. The patients were followed-up from half an year to 3 years. RESULT: Ten patients out of 13 decannulated while another 3 cases, 2 of which were performed local flap to reduce the stoma, wore tracheal tubes all time. CONCLUSION Either flap transfer or laryngotracheal stoma before second stage repair might preserve partial laryngotacheal anatomy and function in selected cases thus improve the life quality of the patients.
Aged ; Carcinoma ; surgery ; Carcinoma, Papillary ; surgery ; Female ; Humans ; Laryngectomy ; Larynx ; surgery ; Male ; Middle Aged ; Neck Dissection ; Reconstructive Surgical Procedures ; Surgical Flaps ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; Trachea ; surgery