Objectives: To study the clinical meaning of condyle-form asymmetry and its osseous changes shown on TMJ images of lateral oblique transcranial projection and lateral tomography. Methods: 113 patients with partial posterior teeth lose were enroled in the study.Among them 25 were with temporomandibular disorder (TMD group),39 with slight TMD sings (sub-TMD group) and 45 without TMD(TMD-free group). Radiographs were taken and studied for each patient. Results: It was found that the condyle form asymmetry and osseous changes were not significantly different among the three groups. Osseous change was related to the number of teeth-lose (P0.05). The symptoms and signs of TMD had close relationship with occlusal interferences. Conclusions: The changes shown on TMJ images do not show close relationship with TMD symptoms and signs. Occlusal interferences resulted from teeth-lose are related to the clinical symptoms and signs of TMD.

OBJECTIVE:A RP-HPLC method was established to determine the concentration of ambroxol hydrochloride in human plasma.METHODS:Waters HPLC instrument was used with the Hypersil BDS C 18 column(5?m,250mm?4.6mm). Ditiazem hydrochloride was chosen as the internal standard.The mobile phase was composed of acetonitrile-methyl alcohol-0.01mol/L phosphatic buffer(pH7.0)-tetrahydrofuran(35∶35∶27.5∶2.5).Flow rate was1.0ml/min.Detection wavelength was242nm.A single oral dose of90mg imported ambroxol hydrochloride tablet was given to9healthy male volunteers.Ambro xol concentration in plasma was assayed.RESULTS:The standard curve of ambroxol hydrochloride was linear in the range of10～640ng/ml.The minium detection concentration was10ng/ml.The extraction recovery was more than90%.A one-compartment open pharmacokinetic model was adopted in ambroxol plasma concentration-time data analysis.The main pharmac okinetic parameters were as follows:C max =(226.53?34.59)ng/ml,T max =(1.82?0.80)h,T 1/2ke =(6.27?0.66)h,AUC 0～24 =(2363.55?448.86)ng/(h?ml).CONCLUSION:The method is simple.The sensitivity and accuracy are high.It is applicable to study the pharmacokinetics of ambroxol hydrochloride in healthy male volunteers.

Objective To study atrioventricular conduction during right coronary artery infarction and its correlation with sympathetic nerve.Method AIMI model by ligating the fight coronary artery of denervated autonomic nervous cats was used.The A,H and V-wave were measured from the His electrode by template matching.The AA,AH,HV intervals with and without sympathetic nerve stimulation were measured respectivelv.Results The decreased percentage of AH intervals was (7±5)% vs.(14±5)% (without pacing) and (12±2)% vs.(23±7)% (with pacing) respectively in ischemia and normal after sympathetic nerve stimulation,and the decreasing amplitude were 50% and 48% respectively.Conclusion The regulating function of sympathetic nerve on atrioventricular conduction decreased after ischemia related to the right coronary artery.This decrease may be one of the mechanisms that lead to atrioventficular block after acute inferior myocardial infarction.

Currently,surgical treatments in tennis elbow include open,arthroscopic and percutaneous procedures.Open surgery,having definite curative effects,is commonly used.There are different surgical methods based on different hypotheses about the pathogenesis of tennis elbow,such as detachment of common extensor origin,resection of annular ligament,denervation surgery and resection of microvascular nerve bundle.There is a huge difference in open surgery of tennis elbow between China and abroad.Debriding or releasing extensor carpi radialis brevis and common extensor tendon are mostly used abroad though it remains controversial whether we should release or debride with tendon,as well as whether it is better to decorticate on lateral epicondyle or not.In China,tennis elbow is treated with resection of microvascular nerve bundle except for debridement and release of tendon.As for evaluation criteria,the following methods,grip strength,grading system and visual analogue scale have been used in researches.However,cure rate and response rate are valuation criteria for resection of microvascular nerve bundle in China.The evaluation criteria are different among various surgical methods,even in the methods,especially for grading system.Each research has unique standards to define excellent,good,fair and poor outcomes.Complications of tennis elbow open surgery are rare,while subcutaneous hematoma is the common complication.

Objective To study the predictive validity of fidgety general movement assessment in pre-term twins and multiplets for motor development outcomes.Methods A total of 53 pre-term twins or multiplets delivered between July 2011 and February 2016 participated in this study.They were assessed using a general movements (GM) assessment and participated in the follow-up program until one year old.The motor development outcomes of the infants at one year old were determined according to clinical diagnoses and the Peabody developmental motor scale number two (PDMS-2) evaluation.The predictive validity of fidgety general movement assessment for motor development outcomes was calculated against the standard motor development of infants at one year old.Results There were 53 twins or multiplets who accepted the GM assessment of fidgety movement period.Of these,43 were assessed as normal (NF) and ten (19％) as lacking a normal level of fidgety movement (F-).All 53 cases were followed-up for the motor development outcome.Forty-three cases (81.1％) were assessed as normal at one year old,while ten (18.9％) were assessed as abnormal.All ten had cerebral palsy,and no motor development retardation was found.The predictive value of F-for cerebral palsy was 90.0％ in terms of sensitivity,97.7％ in terms of specificity,90.0％ in positive predictive value,and 97.7％ in terms of negative predictive value.Conclusions Among pre-term twins or multiplets,the fidgety general movement assessment can be a useful early indicator of motor development difficulties.

Objective To describe the clinical features,diagnosis and treatment of osteomyelitis caused by Burkholderia pseudomallei.Methods Three cases of osteomyelitis caused by B.pseudomallei were treated in Haikou People's Hospital affiliated to Xiangya Medical College of Central South University from April 2007 to April 2017.The clinical data were reviewed and analyzed retrospectively.Relevant reports of osteomyelitis due to B.pseudomallei in China and abroad from 2007 to 2017 were comprehensively reviewed.Results The clinical manifestations included hot feeling,redness,swelling,and pain at site of infection.The infection usually occurred in tibia,femur,and skull bone.There were usually multiple lesions,frequently involving spleen,soft tissue and joints.The main imaging finding was osteomyelitis.The diagnosis was confirmed by bacterial culture in all patients.Antimicrobial therapy combined with surgical intervention was the most common approach in the stage of intensive treatment.Ceftazidime,trimethoprim-sulfamethoxazole and carbapenems were the mostly used antibiotics.However,in the stage of bacterial eradication,trimethoprim-sulfamethoxazole and doxycycline were used.The duration of treatment was very long in both stages.The recurrence was low after standard treatment.Conclusions The osteomyelitis caused by B.pseudomallei lacks specific clinical manifestation.Imaging techniques can identify the site of infection,and bacterial culture helps confirm the diagnosis.Timely and effective antimicrobial therapy combined with surgical intervention can reduce mortality.Full course and standard anti-infective therapy may prevent recurrence.

Objective To explore the diagnostic value of serum thyroglobulin antibody (TGAb),thyroid microsomal antibody (TMAb)and thyroid peroxidase antibody (TPOAb)in au-toimmune thyroid disease (AITD).Methods 100 patients with thyroid dysfunction were divided into hyperthyroidism group and hypothyroidism group according to the levels of serum triiodothy-ronine (T3),thyroxine (T4)and thyroid stimulating hormone (TSH),50 cases in each group.An-other 50 patients with normal thyroid function were collected and designed as control group.5 mL venous blood was collected,and the serum was separated.The levels of TGAb,TMAb,TPOAb, T3,T4 and TSH were detected by radioimmunoassay in each group,positive rates of TGAb,TMAb and TPOAb were observed,and the serum levels of positive TGAb,TMAb and TPOAb were com-pared among all the groups.Results The positive rate of serum TPOAb was significantly higher than those of TGAb and TMAb in hyperthyroidism group and hypothyroidism group.The positive rates of serum TGAb,TMAb and TPOAb in hyperthyroidism and hypothyroidism groups were sig-nificantly higher than the control group,and those in hypothyroidism group were higher than hy-perthyroidism group.The levels of serum TGAb,TMAb and TPOAb in hyperthyroidism group and hypothyroidism group were significantly higher than the control group,and those in hypothyroidism group were obviously higher than hyperthyroidism group.Conclusion TPOAb shows an important significance in diagnosing AITD,which provides an important evidence for AITD diagnosis, treatment and prognosis.

Objective To explore the diagnostic value of serum thyroglobulin antibody (TGAb),thyroid microsomal antibody (TMAb)and thyroid peroxidase antibody (TPOAb)in au-toimmune thyroid disease (AITD).Methods 100 patients with thyroid dysfunction were divided into hyperthyroidism group and hypothyroidism group according to the levels of serum triiodothy-ronine (T3),thyroxine (T4)and thyroid stimulating hormone (TSH),50 cases in each group.An-other 50 patients with normal thyroid function were collected and designed as control group.5 mL venous blood was collected,and the serum was separated.The levels of TGAb,TMAb,TPOAb, T3,T4 and TSH were detected by radioimmunoassay in each group,positive rates of TGAb,TMAb and TPOAb were observed,and the serum levels of positive TGAb,TMAb and TPOAb were com-pared among all the groups.Results The positive rate of serum TPOAb was significantly higher than those of TGAb and TMAb in hyperthyroidism group and hypothyroidism group.The positive rates of serum TGAb,TMAb and TPOAb in hyperthyroidism and hypothyroidism groups were sig-nificantly higher than the control group,and those in hypothyroidism group were higher than hy-perthyroidism group.The levels of serum TGAb,TMAb and TPOAb in hyperthyroidism group and hypothyroidism group were significantly higher than the control group,and those in hypothyroidism group were obviously higher than hyperthyroidism group.Conclusion TPOAb shows an important significance in diagnosing AITD,which provides an important evidence for AITD diagnosis, treatment and prognosis.

Objective To explore application on improving basic knowledge of clinical scientific research based on PDCA circle in the standardized training of pediatrics residents and to provide scientific basis for improving the capability of clinical scientific research in standardized training of pediatrics residents. Methods Based on previous research results, the training courses of improving the capability of clinical scientific research based on conception of PDCA were practiced . The examination of basic knowledge of clinical scientific research before and after training and satisfaction questionnaire in pattern, contents , time arrangements as well as effect of training courses were conducted among 22 pediatrics residents from April to July, 2017. Data were analyzed using Mean, Standard deviation and proportion for description and the data before and after training were given a independent-sample t test. The training courses were taken for 3 months. Results ①Compared with the training courses before, the average scores of basic knowledge in capability of clinical scientific research were improved after training [(54.14±23.06) vs. (73.63±21.05)]. ②Insufficiency of some basic clinical scientific research knowledge still existed and there was no statistical difference between the results before and after the training in those areas. ③ In the standardized training, pediatrics residents were satisfied with the pattern, contents and results of training courses, except for the time arrangement. Conclusion The training courses based on PDCA circle can significantly improve the capability of clinical scientific research in the standardized training of pediatrics residents.

Objective:To understand the clinical research knowledge, attitude and practice of pediatrics residents in standardized residency training, and to provide scientific basis for improving their capability of clinical medical scientific research.Methods:A self-complied questionnaire survey including demographic information, knowledge and attitudes toward capability of medical scientific research as well as personal interview was conducted in 22 pediatric residents during the standardized residency training from April to July, 2017. Data were analyzed by (mean±standard deviation) and percentage for description, and qualitative data were analyzed by classification and induction. SPSS 18.0 was used to analyze the data.Results:Firstly, the total score of basic knowledge in clinical scientific research was (54.14±23.06), with the scores between 31 and 60 being the most. Secondly, all these residents believed that capability of clinical medical scientific research was very important for them and clinical research training was necessary for them during the standardized residency training. Thirdly, the residents had the scientific research practices but no article published during the standardized residency training. Fourthly, the residents hoped to improve their capability of clinical scientific research by various means during the training.Conclusion:It is indicated that basic knowledge on capability of clinical medical research is still insufficient in standardized residency training of pediatrics residents, so relevant measures should be taken to cultivate their capability of clinical scientific research.