The postgraduate education of specialized degree in clinical medicine, which was set up in 1998 in China,is an important measure in the reform of qualified personnel training. Therefore, some views about the role of theimprovement of work circumstances, the renewal of medical knowledge, the evaluation of clinic ability, and the devel-opment of clinical research in postgraduate training, are advanced to enhance their ability in clinical practice.

Cardiovascular Diseases ; complications ; prevention & control ; Diabetes Mellitus, Type 2 ; complications ; prevention & control ; Humans ; Metabolic Syndrome ; complications ; prevention & control

AlM:To evaluate the long-term efficiency and safety of overnight orthokeratology in myopia correction and control in adolescents.METHODS: Sixty-five myopia adolescents treated in our hospital from August 2011 to February 2012 were retrospectively analyzed and followed up to 2a. Among them, 35 cases ( 67 eyes ) wearing overnight orthokeatology were included as trial group, and 30 cases ( 60 eyes ) wearing spectacles were included as control group. The trial group were divided into 2 subgroup according the myopic grading in the initial visit:subgroup A(35 eyes,≤-3. 00D), B subgroup (32 eyes,>-3. 00D and ≤-6. 00D). ln the trial group, slit lamp, visual acuity, refraction, intraocular pressure, corneal tomography were collected before wearing overnight orthokeratology, 1d, 1wk, 1month, 3mo, and every 6mo after wearing overnight orthokeratology , with axial length, corneal thickness, anterior chamber depth, corneal endothelial cell count, abjective refraction and tear film were also collected before and 2a after wearing overnight orthokeratology. ln the control group, slit lamp, visual acuity, refraction and intraocular pressure were collected before wearing and 2a after wearing spectacles. Paired t test were used to compare the intragroup difference. One-way analysis of variance ( ANOVA) was used to compare the differences among the groups. P<0. 05 was considered statistically significant.RESULTS: The uncorrected visual acuity of the trial group was improved obviously after wearing Orthokeratology Lens 1d, the visual acuity of a group patients improved more significantly. The corneal curvature ( including vertical curvature and horizontal curvature ) of the trial group became more flat after wearing Orthokeratology Lens 2a and stopped 2 wk; The length of ocular axis was also increased, the growth rate of B group (0.33±0.31)mm was lower than that of group A (0. 43±0. 25)mm; Subjective refraction of myopia was increased 0.68±0.49D than wearing Orthokeratology Lens before, but compared with the growth (2. 08 ± 0. 57) D of the control, the effect of myopia control was more obviously. Grade of dry eye was more severely than that of wearing Orthokeratology Lens before, but there was no significant difference between groups A and B. Compared with wearing Orthokeratology Lens before, corneal thickness, anterior chamber depth, corneal endothelial cell number and the intraocular pressure were all no significant differences between the trial and control group.CONCLUSlON: Orthokeratology is a safe and effective method for the correction of myopia, and long-term use of Orthokeratology Lens can effectively control the development of myopia. Controlling of moderate myopia is more effective than that of low myopia.

The organic acidemia/aciduria is one of the most common inherited metabolic disorders in clinic,more than 50 species have been found until now.The illness is believed to be caused by gene mutation,leading to the reduction or loss of enzyme activity and the accumulation of carboxylic acid and its metabolites.The manifestations of increased blood organic acids include refractory metabolic acidosis,paroxysmal vomiting,feeding difficulties,hypotonia,convulsions and disturbance of consciousness.Most of the organic acidemia begins in neonatal period or infancy,accompanied by progressive neurological damages at most of the time.There are little specific clinical features can be found in this kind of diseases,therefore,early diagnosis and treatment must be initiated in order to decrease risk of neurological induries and damages or acute deaths.So application of the gas chromatography-mass spectrometry and tandem mass spectrometry is important to the early diagnosis,helpful for improving the outcomes and reducing child mortality.

Urea cycle disorder is a common inherited metabolic disorder,and it is the most common genetic cause of hyperammoniema in children.The illness is believed to be caused by gene mutation of six main enzymes in urea cycle,leading to ammonia,which is produced by amino acid catabolism,can't conver to urea through the urea cycle and be discharged through the urine.The manifestations of hyperammonemia turn out to be disorders of brain function (refusing to milk,vomiting,drowsiness,coma,convulsions,ataxia,aggressive behaviors).The incidence of this disease is 1/30 000.At the same time,the severity of the clinical symptoms is connected with the extent of the enzymes defects.More serious the enzymes defected,the earlier and worse the disease onsets.Some children with mild enzyme defects may intermittently attack or have a delay onset.Serious nervous system injuries can be found in hyperammonernia,therefore,early diagnosis and treatment must be ensured in order to decrease risk of mental injuries and damages or acute deaths.

OBJECTIVE:To introduce how to use the automated drug dispensing machine to prepare drugs in single dose and to introduce our experience in the application of this machine. METHODS:The working principe, application context, and the functional advantage of the machine were introduced, and the problems encountered in the use of the machine was analyzed based on our experience, and the prospect of the machine was discussed. RESULTS: The machine enjoys the advantages of raising work efficiency, lowering dispensing error rate and bringing about convenience for patient to use, but it has its limitation in that it proposes higher requirement for software and hardware environment. CONCLUSION: The application of this automatic system will be more widespread with people’s increasing demand on medical care.

Neurocognitive impairment frequently occurs in epilepsy patients,especially in children,which has been considered to interfere the development of mind and body and cause mental retardation.Now it has attracted wide attention from doctors home and abroad.The mechanisms are complicated,and may be influenced by several factors.Different locations of epileptiform focuses cause different cognitive impairment.This review aims to illustrate the major cognitive impairment in relation to the epileptogenic zone in brain,with a more detailed interest for temporal lobe epilepsy,frontal lobe epilepsy,occipital lobe epilepsy and parietal lobe epilepsy.

Adenoviruses, Human ; Child ; Humans ; Orthomyxoviridae ; Respiratory Syncytial Viruses ; Respiratory Tract Infections ; virology

Objective To assess the safety and effectiveness of prenatal multiple and single course glucocorticoids treatment on preterm birth infants. Method Seven researches on the treatment of preterm birth infants with glucocorticids were meta analyzed. Results Multiple courses of glucocorticoids treatment before labor may lower the incidence of patent ductus arteriosus (PDA) of preterm babies (OR=0.51,95% CI 0.49~0.54),and so did the respiratory distress syndrome (RDS), (OR=0.72,95% CI 0.49~1.07).But it may increase the septicemia of preterm infants (OR=1.62, 95%CI 1.07~2.44),and could not decrease the morbidity and mortality of intracranial hemorrhage (ICH)(OR=0.65, 95% CI 0.37~1.15)? necrosis enterocolonitis (NEC)(OR=1.30, 95% CI 0.79~2.12)and chronic lung disease (CLD)(OR=0.94,95%IC 0.59~1.49)? It cound not decrease the use of pulmonary surfactant after the birth of preterm infants. (OR=0.86,95% CI 0.48~1.55). Conclusions It suggests that multiple courses treatment with glucocorticoids is not safer and more effective than single course before labor.

Background The measurement of the extraocular muscle is critical for the diagnosis of extraocular muscle diseases,but conventional medical imaging techniques present some shortcomings because of the contact pattern.The anterior segment optical coherence tomography (OCT) is thought to be an in vivo noninvasive optical diagnostic imaging method.Objective This clinical study attempted to seek an available approach to the evaluation of the anatomic structure of human horizontal rectus insertion with Visante OCT.Methods One hundred and fourteen eyes of 58 subjects were included in this study and were divided into the low refractive power group (≤-3.00 D) with 43 eyes,moderate refractive power group(＞-3.00 D-≤-6.00 D) with 49 eyes and high refractive power group(＞-6.00 D) with 22 eyes.The horizontal rectus insertion distance to the scleral spur and its thickness were measured by Visante OCT.The correlation of the refractive power with the rectus insertion distance or thickness was analyzed.Written informed consent was obtained from each subject before medial assessment.Results The average distance from the scleral spur to the lateral and medial rectus insertion were (5.23±0.50)mm and (3.81±0.46)mm respectively.The average thickness of the lateral and medial rectus insertions were (0.39±0.06)mm and (0.39±0.06)mm respectively,showing no significant differences in comparison with those of ultrasound biomicroscopy (P=0.338,P=0.759).The lateral and medial rectus insertion distances were (5.25±0.45)mm and (3.74±0.53)mm in the low refractive power the group,(5.22±0.60)mm and (3.81±0.42)mm in the moderate group and (5.20±0.35)mm and (3.90±0.42)mm in the high refractive power group,presenting inconsiderable difference among these three groups(lateral rectus: χ2=0.054,P=0.974;medial rectus: F=0.508,P=0.604).The thickness of the lateral and medial rectus insertions were (0.41±0.06)mm and (0.40±0.06)mm in the low refractive power group,(0.40±0.07)mm and (0.37±0.07)mm in the moderate refractive power group,(0.36±0.05)mm and (0.39±0.05)mm in the high refractive power group with a significant difference among lateral rectus (F=4.922,P=0.009) but not medial rectus (F=2.152,P=0.125).The lateral rectus insertions thickness in the high refractive power group was thinner than that in low refractive power group (P＜0.05).A positive correlation was found between refractive power and the thickness of lateral or medial rectus insertions (r=0.284,P＜0.01).Conclusion Visante OCT is a uscful way in measuring the distance and thickness of the extraocular muscles.Lateral rectus insertions thickness tends to be thinner with the worsening of myopia,which is obvious in high myopia.