Objective By taking cardiopulmonary resuscitation (CPR) resident standardization training skills practice as an example,to explore how to improve the ability of resident operating on the clinical skills.Methods 58 resident physicians in the hospital standardized training were selected,and through training and assessment of cardiopulmonary resuscitation skill training,the result was compared,and statistical analysis was made on the overall pass rate,the performance after the training,and the pass rate of operation.Result Comparison of the data was done by the t test,and pass rate by chi square result 48 people passed the training and examination,and the pass rate was 82.76％.The operation scores before and after training were:General (78.5 ± 6.44) vs.(89.2 ± 6.12),Department of gynecology and Obstetrics (74.3 ± 6.54) vs.(87.0 ± 6.34) of (70.6 ± 6.78) vs.(87.3 ± 6.31),rehabilitation medicine (70.2 ± 6.81) vs.(85.6 ± 6.77),Department of Stomatology (69.80 ± 7.07) vs.(82.80 ± 6.89),psychiatric (69.4 ± 7.19) vs.(80.4 ± 6.91),Department of medical imaging (69.30 ± 7.20) vs.(78.80 ± 6.94),(64.00 ± 7.25 test vs.) (76.5 ± 6.99),and the differences were statistically significant.After the training,the average score of the general professional training was 89.2,the highest score,while the average score of students trained in professional inspection department was 76.5 points,the lowest score.Chest compressions and artificial respiration,electrode plate installation project operation were the worst.Students pressed 80 times/min before but now increased to 90 seconds;as for artificial respiration,students often extended more than 30 seconds;the electrode plate installation project operation,extended more than 25 seconds.Conclusion The pass rate of different professional training and the performance before and after professional training have differences,so theory and practice need to be combined to carry out scientific and reasonable training so as to improve the train-ing residents' clinical skills.

It has been over two decades from the discovery of extracorporeal shock wave(ESW).The therapy of ESW has been proved effective in improving fracture healing,and has been developed quickly both in the choice of indications and in the medical equipments research.The status quo of ESW research,application in orthpedic trauma and treatment mechanism are summarized in this paper.Successful cases are reviewd in treating post-traumatic nonunion,renovation of artificial joints,and traumatic osteonecrosis of the femoral head.Common complications and its preventive measures are given.Detailed description of ESW operating principles and selection of working parameters are also described,with the expectation of wider range of clinical applications of ESW.

Objective To investigate the effect of Mahong decoction on serum VEGF and b-FGF of rat model bronchus asthma airway remolding. Method Forty SD rats randomly divided into four groups: blank group, asthma group, hormone group, Chinese medicine group. The asthmatic model was established by sensitization and challenge with ovalbumin, and the rats in the hormone group and Chinese medicine group conferred hormone and Chinese medicine before the challenge. ELISA was used to measure the level of serum VEGF and b-FGF. Results The serum VEGF and b-FGF in asthma group was higher than in other groups (P0.05). Conclusion Mahong decoction may control the level of serum VEGF and b-FGF of rat model of bronchus asthma airway remolding, which has the similar result with hormone.

OBJECTIVE: To investigate the intestinal absorption behaviors of Diospyros kaki L.f. extract (PLE) in self-microemulsifying drug delivery system (SMEDDS). METHODS: The concentration of quercetin, kaempferol and phenol red in rat intestinal perfusion solution was determined by HPLC. Rat single-pass intestinal perfusion technique was employed to assay the effects of concentrations of PLE in perfusion solution, intestinal segments and different formulations on the drug percentage absorbed (P) and the absorption rate constant (Ka). RESULTS: No significant changes of Ka and P were observed in different PLE concentrations. The main absorption segments of SMEDDS in rat intestines were the duodenum and ileum. The values of Ka and P of SMEDDS were significantly higher than the PLE solution (P<0.05). CONCLUSION: The absorption mechanism of PLE conforms to passive diffusion. The PLE SMEDDS presented the high absorption rate than conventional solution in rat intestine, which illustrates the potential use of SMEDDS for the delivery o f PLE by the oral route.

Objective:To explore the clinical value of chest multi-slice computed tomography angiography (MSCTA) as a preoper-ative examination for lung cancer patients undergoing pulmonary lobectomy. Methods: Sixty lung cancer patients formed the study population and were randomly divided into 2 groups of 30 cases each. In the experimental group, CTA images of the tumors and pulmo-nary artery, bronchial artery, pulmonary vein were acquired, analyzed, and post-processed using VR to determine the anatomical rela-tionship between vessels and tumors. Pulmonary lobectomy followed. Cases in the control group underwent pulmonary lobectomy with-out guidance by chest MSCTA. Operation times and amounts of operative blood loss were compared between the two groups. Results:Significant differences between groups in terms of operation time (study group vs. control group, 199±55.7 vs. 231.5±51.2(min);P=0.02) and amount of operative blood loss (study group vs. control group, 318.33±99.6 vs. 431.7±89.5(mL), P<0.01) were observed. Val-ues of operation time and amount of contrast agents in the study group were consistently lower than those in the control group. Conclu-sion:Chest MSCTA can shorten the operation time and reduce the amount of operative blood loss during pulmonary lobectomy. Thus, the technique has significant clinical value.

Objective To explore the diagnosis and treatment of iatrogenic bile duct injury during choledochocystectomy. Methods Clinical data of 24 cases of iatrogenic bile duct injury were analyzed retrospectively from 2005 to 2009. Results Eight patients underwent early repair of bile duct within 4 days after the injury. 14 patients with later recognized bile duct injury underwent selective operations, and two patients were discharged after their jaundice were relieved without any surgical treatment. Supporting T tubes were left in place in 22 patients for 8 to 14 months after operations, without any biliary obstruction found after one year and six months to five year follow-up. Conclusions Early bile duct injury within 4 days was easily treated, but later bile duct injury should have selective operation. The patients with jaundice could be diagnosed with PTCD and ERCP to observe the bile duct injury. During operation membrane-to-membrane wide hepatojejunostomy helps prevent later anastomotic stenosis. The left in drainage tube in anastomotic stoma for more than 8 months improves success rate in the process of injuried bile duct repair.

ObjectiveTo study the mechanism of infection-related reactive thrombocytosis.MethodsSeventy-five infectious disease patients were selected including 42 cases with acute infections phase thrombocytosis (acute infectious phase thrombocytosis group),18 cases with acute infectious phase normal platelet count (acute infectious phase normal platelet count group),15 cases with recovered phase (infectious recovered phase group) and 16 cases with healthy controls(control group).The serum thrombopoietin (TPO),intefleukin-6 (IL-6),white blood cell,platelet was determined and compared among 4 groups.Results The serum TPO in acute infectious phase thrombocytosis group [( 159.1 ± 65.9) ng/L]was higher than that in acute infectious phase normal platelet count group,infectious recovered phase group,and control group [(43.5 ± 14.4),(40.3 ± 15.2),(41.8 ± 18.9) ng/L](P＜ 0.05).There was no significant difference in the serum IL-6 between acute infectious phase thrombocytosis group [(542.7 ± 247.0) ng/L]and acute infectious phase normal platelet count group [(598.5 ± 250.4) ng/L] (P ＞ 0.05 ),but which was higher than that in infectious recovered phase group [(43.5 ± 20.7 ) ng/L] and control group [( 38.3 ± 17.6 )ng/L] respectively (P ＜ 0.05 ).The serum IL-6,TPO was positively correlated with platelet,white blood cell.The serum TPO was positively correlated with IL-6.ConclusionElevated TPO leads to the thrombocytosis,which is the possible mechanism of infection-related reactive thrombocytosis.

Objective To observe the effects of electroacupuncture on expression of caspase-3 in the is- chemic penumbra in the early stage of cerebral ischemia in rats. Methods 100 Wistar rats were randomly divid- ed into a sham-operated group, a model group and an electroacupuncture group. The middle cerebral artery was ex- perimentally occluded in the rats in the model and electroacupuncture groups, while a sham operation without cere- bral artery occlusion was carried out on the rats in the sham-operated group. Immunocytochemistry was employed to detect the expression of caspase-3 in the ischemic penumbra at 24 h, 48 h and 72 h after cerebral ischemia. Re- suits There was almost no positive expression of caspase-3 in the sham-operated rats. Numerous caspase 3-posi- tive cells were found in the ischemic penumbra in the model and electroacupuncture groups. The peak of expression was reached 24 hours after cerebral ischemia. The number of caspase 3-positive cells was significantly greater in the model group than in the electroacupuncture group at 24 h and 48 h. Conclusion The increase of caspase 3-posi- tive cells in the ischemic penumbra is time-dependent. Electroacupuncture can significantly decrease the expression of caspase-3.

Objective: To observe influence of different risk factors on prognosis of patients with coronary heart disease (CHD) and normal myocardial perfusion imaging outcome.Methods: A total of 99 CHD patients with normal myocardial perfusion imaging outcome were selected.Left ventricular function indexes were measured by gated resting myocardial imaging in resting and stress state.All patients received telephone follow-up until natural death (died of other causes) or fatal or non-fatal heart attacks, or the termination of the experiment after 45 months.Cox proportion risk regression model was used to analyze risk factors of fatal and non-fatal heart attacks.Results: A total of 15 cases died during the 45-month follow-up.Mean all-cause mortality per year was 5.05%.Fatal heart attacks occurred in nine cases (9.09%), and non-fatal heart attacks occurred in 21 cases (21.21%).Cox proportion risk regression analysis indicated that smoking and left ventricular ejection fraction (LVEF) <50% were risk factors for fatal heart attacks (HR=4.887, 3.365, P=0.043, 0.002), while diabetes mellitus, dyslipidemia, smoking and LVEF<50% were risk factors for non-fatal heart attacks (HR=2.215~4.544, P<0.05 all).Conclusion: Incidence rate of cardiovascular events is higher in CHD patients with normal myocardial perfusion imaging.Smoking and impaired heart function suggest poor prognosis in these patients.

BACKGROUND: Studies have found that chondroitin sulfate proteoglycans degradation with chondroitinase canpromote the migration of Müller cells on the retina, but whether it could promote the migration of adipose-derivedmesenchymal stem cells in retinal degeneration rats is unclear.OBJECTIVE: To investigate the effect of chondroitin sulfate proteoglycans degradation with chondroitinase on adipose-derived mesenchymal stem cell treatment for retinal degeneration in rats.METHODS: Human adipose-derived mesenchymal stem cells were isolated and cultured. A retinal degeneration ratmodel was established followed by administration of adipose-derived mesenchymal stem cells+chondroitinase into thesubretinal space. The migration of adipose-derived mesenchymal stem cells and retinal cell apoptosis in rats aftertransplantation were observed.RESULTS AND CONCLUSION: The human adipose-derived mesenchymal stem cells could be successfully cultured.The labeling rate of BrdU to the human adipose-derived mesenchymal stem cells was more than 90.0%. At 7 days aftermodeling, the outer nuclear layer of the retina was collapsed, and a large amount of photoreceptor cells were dissected.The outer nuclear layer was attached to the Bruch''s membrane, and the retina was arched. The central retina andperipheral retina were damaged. In normal rats, the retinal layers were clear, and the photoreceptor cells arrangedregularly; and the retinal pigment epithelium was complete. The migration rate of adipose-derived mesenchymal stemcells in adipose-derived mesenchymal stem cells+chondroitinase group was higher than that in adipose-derivedmesenchymal stem cells group (P < 0.05). There was no significant difference in the apoptotic rate of retinal cellsbetween the two groups (P > 0.05). These experimental findings show that chondroitin sulfate proteoglycans degradationwith chondroitinase can enhance the migration ability of human adipose-derived mesenchymal stem cells on the retina.