According to the characteristics of Chinese medicine profession,the author explores the theory and practice of developing personnel training program and formulate compre-hensive,scientific,practical clinical skills for medical students to improve and dialectical thinking program. Through practice study,students'basic medical knowledge and clinical medicine are more closely combined to adapt to clinical study and clinical practice and their clinical basic skills have generally been consolidated and developed.

Objective To evaluate the clinical performance of porcelain laminate veneer in front teeth. Metheds 79 porcelain laminate veneers in front teeth in 38 cases were observed after finished repair and 18-month follow-up. The evaluator examined the restoration for shade, surface lubricity, marginal fit, plaque index and gingival index. Results Shade satisfaction was 82 % and 87 %, surface lubricity satisfaction was 100 % and 100 %, marginal fit satisfaction 84 % after restoration and 18-month follow-up. The plaque index of experince atal groups was 0.73?0.45 and the gingival index of experinceatal groups was 0.28?0.67. There was no statistically significant difference with regard 82 % and to plaque index and gingival index. Conclusion The effect of porcelain laminate veneer in front teeth is satisfactory.

Objective To investigate the effect of the prescription of Yiqiyangyin Huoxuehuayu on the mice model with viral dilated cardiomyopathy by examining the levels of serum ?-IFN.Methods Replicated the animal models of early viral dilated cardiomyopathy by injecting the CVB3m virus to the peritoneal cavity of the Balb/c mice.Two hundred and ten Balb/c mice were divided into 4 groups at random:blank group,model group,high and low dose traditional Chinese medicine group.The blank group has 30 mice.The other three group has 60 mice each.The mice of high dose traditional Chinese medicine group and low dose traditional Chinese medicine group were treated with the prescription of Yiqiyangyin Huoxuehuayu.The change of pathomorphology in the cardiac muscle tissue,the rate of death,the weight change and the cardiac weight index were observed after 4 weeks of the treatment.At the same time,ELISA method was used to exam the levels of serum ?-IFN.Results The prescription of Yiqiyangyin Huoxuehuayu can induce the expression of serum ?-IFN in the mice with viral dilated cardiomyopathy.The mean level of serum ?-IFN of the high dose traditional Chinese medicine group and low dose traditional Chinese medicine group were significantly higher than that of the model group.Conclusions The prescription of Yiqiyangyin Huoxuehuayu can inhibit the viral replication and regulate the immunologic function.

Objective To identify shortcomings in the current evaluation index system of medical quality. Methods The documentary analysis focused on the existing index system comprises the Hospital Management and Quality Evaluation Standards (2007) by China Hospital Association, Hospital Management Evaluation Guidelines (2005) by the Ministry of Health, and Implementation Rules of Hospital Management Evaluation Standards for Beijing (2007). JCI Accreditation Standards for Hospitals (edition 2) (2003), and New Hospital Accreditation Standards for Taiwan (2005, 2006) were referred to in the study. Results The shortcomings found include the weak operability of indexes, and the deficiency of evaluation indexes from the point of hospital visiting process by patients. Conclusion In view of the hospital visiting process of patients, add more indexes for patients' hospital visiting process,and quantize and highlight the operability of indexes, with summary and optimization of experiences in time by steps.

Objective Through smdying the distribution of the Sappan acetic ether extract in transplanted heart of rats,to discuss selectivity of sappan in donor's hearts.Methods Improved Ono model was used to replicate the heart transplantation model of rats.Successfully operated rats were separated into 2 groups:a model group and a sappan group.Distributions of sappan in transplanted heart were observed by HPLC-FPC.Results One kind of original substance.of sappan was detected in transplanted heart sample,but not in un-transplanted hearts.Conclusion The substance of sappan may have selectivity in transplanted heart.

Background Recently,small incision lenticule extraction (SMILE) procedure is used to correct myopia.The clinical safety and efficiency of SMILE have been approved,but its predictability to corneal ablation depth is brought into focus.Objective This study was to compare the predictability of ablation depth in central cornea between SMILE and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for myopia.Methods A nonrandomized controlled clinical study was performed.Two hundred and seventy eyes of 135 myopic patients who were going to receive corneal refractive surgery were included in Beijing Tongren Hospital from October 2015 to May 2016.SMILE and FS-LASIK were performed on 138 eyes of 69 patients and 132 eyes of 66 patients matched in demography respectively under the informed consent.Central corneal thickness was measured by RTVue FD-OCT before and 1 week after surgery.The refractive power,actual ablation depth (difference of central corneal thickness before and after surgery) and central corneal cutting error (difference between theoretically expected ablation depth and real ablation depth) were intergrouply compared,and the correlation of real ablation depth with theoretically expected ablation depth was assessed.Results No significant difference was found in spherical power,astigmatic power and spherical equivalent after surgery between SMILE group and FS-LASIK group (t =-1.826,-1.405,-1.420,all at P＞0.05).The actual ablation depth was (76.96± 15.27)μm in the SMILE group,which was significant lower than (96.76± 16.52) μm of theoretically expected ablation depth (t =-23.016,P ＜ 0.01);however,there was no significant difference in the FS-LASIK group between actual and expected ablation depth ([77.92 ± 18.69] μm versus [77.42± 15.60] μm) (t =-0.604,P =0.547).The central corneal cutting error was (20.55 ± 8.51) μm in the SMILE group and (7.17±5.97) μm in the FS-LASIK group,showing a significant difference between them (t=14.950,P＜0.01).The positive linear correlations were seen between actual and expected ablation depth in both SMILE group and FS-LASIK group (r=0.799,0.867,both at P＜0.01).The actual ablation depth was increased over expected ablation depth,with the regression equations of Y=3.892+0.749X in the SMILE group and Y=3.443 + 0.957X in the FS-LASIK group.Conclusions The actual corneal ablation depth is less than expected corneal ablation depth in SMILE procedure,while in FS-LASIK procedure,the actual corneal ablation depth appears to be consistent with the expected one,inferring a good predictability in corneal ablation depth in FS-LASIK surgery.

Objective To compare the treatment of displaced intra-articular calcaneal fractures by homeopathic closed leverage anatomical plate with compression bolt through small posterior lateral approach vs.traditional open reduction and internal fixation.Methods A retrospective case control study was made on 98 cases of displaced intra-articular calcaneal fractures admitted from September 2012 to May 2015.According to the random number table,the subjects were assigned to homeopathic closed leverage anatomical plating with compression bolt through small posterior lateral approach (experiment group,58 cases,66 sides) and open reduction and internal fixation through L-shape approach (control group,40 cases,45 sides).Experiment group consisted of 50 male and eight females cases aging from 27-56 years (mean,41.9 years),and the Sanders classification was 40 cases of type Ⅱ,24 type Ⅲ and two type Ⅳ.Control group consisted of 36 male and four female cases aging from 25-58 years (mean,43.7 years),and the Sanders classification was 25 cases of type Ⅱ,18 type Ⅱ and two type Ⅳ.Operation time,bone reduction,postoperative Bohler's angle,width of the calcaneum,and incision healing were recorded.Functional outcomes were evaluated with Maryland hindfoot scoring system at last follow-up.Results Operation time was (52.6 ± 11.2) min in experiment group,significantly shorter than that in control group [(86.4 ± 14.1) min] (P ＜ 0.01).All cases were followed up from 18-50 months (mean,30.8 months).Reduction of the calcaneal posterior facet in 53 sides (80％) was graded as nearly anatomical in experiment group,and 38 sides (84％) in control group (P ＞ 0.05).Postoperative Bohler's angle was (28.0 ± 6.2) ° in experiment group,and (26.8 ± 7.0) ° in control group (P ＞ 0.05).Width of the calcaneum was (31.3 ±3.6)mm in experiment group and (34.9 ± 4.0)mm in control group (P ＜ 0.01).All cases presented satisfactory shape of the calcaneus without lateral-side impact syndrome.No case had wound infection and incision-edge necrosis in experimental group,while two cases of superficial wound infection and three cases of incision-edge necrosis were found in control group (P ＜ 0.01).At last follow-up,Maryland hindfoot score was (87.1 ± 7.6)points in experiment group and (84.9 ± 9.1)points in control group (P ＞ 0.05).Conclusion Homeopathic percutaneous leverage and anatomical plate with compression bolt through small posterior lateral approach is an effective method for treatment of displaced intra-articular calcaneal fractures,for it has advantages of minimal invasion,less operation time,good reduction and function,and less wound complications.

BACKGROUND: Both biological and physical methods contribute to the repair of white meniscal tears, so the combined use will be better. OBJECTIVE: To study the influence of radiofrequency combined with platelet-rich plasma (PRP) on the repair of white meniscal tears. METHODS: Forty-eight adult New Zealand white rabbits were randomly divided into four groups, including simple suture, radiofrequency, PRP, and combination groups, and then the model of medial meniscus posterior root tears was established in all experimental animals. The simple suture group underwent interrupted mattress suture; the radiofrequency group was treated with radiofrequency (20 W, 45 ℃) after suture; the PRP group received the intra-articular injection of PRP after suture; the combination group was firstly treated with radiofrequency after suture, and then underwent the intra-articular injection of PRP. The gross and histological changes of the meniscus were observed, and the expression levels of transforming growth factor β1, vascular endothelial growth factor and platelet-derived growth factor were detected at 3 and 12 weeks postoperatively. RESULTS AND CONCLUSION: At 12 weeks after operation, the simple suture group showed no healing; the radiofrequency and PRP groups healed partially; and the combination group healed completely, and chondrocytes and collagen fibers arranged regularly. There was a significant difference in the healing rate between combination and simple suture groups (P=0.003). At 3 weeks postoperatively, the expression levels of vascular endothelial growth factor in the radiofrequency, PRP and combination groups were obviously higher than that in the simple suture group, which decreased markedly at the 12th week. At 3 weeks postoperatively, the expression level of platelet-derived growth factor was increased in all groups, especially in the PRP and combination groups. The PRP group showed the highest level of transforming growth factor β1 at 12 weeks postoperatively. These results manifest that the combination of radiofrequency and PRP promotes the repair of white meniscal tears by increasing the cell proliferation, cell mitosis and angiogenesis.

Humans ; Retroperitoneal Neoplasms ; pathology ; Rhabdomyosarcoma ; pathology

Background Keratectasia after laser in situ keratomileusis (LASIK) is a rare but severe complication,which threatens the visual acuity and corneal strength.Corneal collagen crosslinking (CXL) is a new therapy that increases the security and decreases the risk of complication.However,the effectiveness and safety of LASIK-CXL is still need to be concerned.Objective This study was to evaluate the safety of LASIK-CXL for myopia and astigmatism with thin cornea.Methods A prospective cohort study was designed.A total of 128 eyes of 64 patients with thin corneal and myopic astigmatism enrolled in Beijing Tongren Eye Center from January 2014 to January 2015.The patients were assigned to LASIK group (74 eyes of 37 patients) and LASIK-CXL group (54 eyes of 27 patients).Refractive surgery was performed by Visumax femtosecond lasrer and VISX S4 excimer laser.Eyes of LASIK-CXL group applied accelerated CXL immediately after LASIK.The follow-up was 6 months.Manifest refraction,uncorrected (UDVA) and corrected distance visual acuity (CDVA),average keratometry values (AveK),anterior segment OCT (AS-OCT),corneal hysteresis (CH) and corneal resistance factor (CRF) were examined before and after operation.This research passed through Ethics Committee of Beijing Tongren Hospital.Results The spherical equivalent (SE) of the LASIK group and LASIK-CXL group were (-6.49 ±2.41)D and (-6.97 ±2.41) D before operation and decreased to (-0.68 ±0.88) D and (-0.75 ±0.94) D 6 months after operation.The UDVA (LogMAR) was 1.18±0.28 and 1.05±0.38 before operation and elevated to-0.06±0.09 and-0.03±0.186 months after operation in the LASIK group and LASIK-CXL group.The preoperative AveK values were (44.37 ±1.46) D and (44.47± 1.50)D in the LASIK group and LASIK-CXL group and reduced to postoperative (39.30±2.06) D and (38.66± 1.80) D.The preoperative SRI of LASIK group and LASIK-CXL group were 0.25 ±0.21 and 0.24±0.22,which increased to 0.29±0.24 and 0.28±0.24.The SAI values were 0.36±0.16 and 0.39±0.15 before operation,which increased to 0.57 ±0.31 and 0.75 ±0.376 months after operation,and the SAI value of the LASIK-CXL group was significantly higher than that of LASIK (F =10.220,P--0.002).CRF values of LASIK and LASIK-CXL were (8.44±1.44)mmHg and (8.63±1.35) mmHg in preoperation,which decreased to (5.74±1.31) mmHg and (6.25± 1.24) mmHg in postoperation.The result of LASIK-CXL was higher than that of LASIK (F=8.650,P =0.040).CH values were 8.78 ± 1.51 and 8.69 ± 1.62 in preoperation,which decreased to (7.23 ± 1.08) mmHg and (6.50±1.32)mmHg.The value of LASIK-CXL was lower than that of LASIK (F =5.860,P =0.017).The mean depth of demarcation line was (228.45±28.24) μm (range 165 to 310 μm) on OCT,which was presented in 45 eyes (81.82％) at 1 month in postoperation.Conclusions Accelerated CXL with FS-LASIK is effective and safe in improving visual acuity in myopic astigmatism patients with thin cornea,which also can increase the rigidity of the cornea.