With increasing demands and recognition, emergency medicine has advanced rapidly in China in recent decades. The education and training of professionals in this field are important for the further development of emergency medicine. With an attempt to investigate the way to strengthen residency training system in emergency medicine, this article reviews its potential development direction, training modes, learning materials, and quality control.
China ; Emergency Medicine ; education ; organization & administration ; Internship and Residency ; methods ; standards ; trends

Objective To assess the role and its tecnhique superiority of 64-slice spiral CT angiography(CTA) in lower limb arterial diseases.Methods MSCT studies in 33 cases suspected diseases of lower limb arteries was performed,the helical scans covered the extent of renal artery to the artery of the lower extremity.3D reconstruction of vessel was done in Wizard workstation.The manifestations of MSCTA were compared with that of conventional angiography . Results Of the 693 segments of arteria , 683 were assessable on both DSA and CTA.Using the DSA images as the standard reference,the sensitivity,specificity and accuracy of CTA were 97.6%(95% CI,94.9%~100.7%),98.9%(95% CI,98.0%~99.8%),98.7%(95% CI,97.9%~99.5%)in detecting the segments occluded . With the regard the detection of segments that had more than moderate stenosis , the sensitivity , specificity and accuracy of MIP were 98.9% ( 95% CI , 97.4%~100.4%),99.4%( 95% CI, 98.7%~100.1%) and 99.3%(95% CI, 92.4%~99.9%).Conclusion In assessment of diseases of lower limb arteries with 64-slice spiral CT angiography is equal to DSA basically, it is a highly accurate and non-invasive angiography in diagnosing arterial diseases of the lower extremities.

Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Occupational Diseases ; diagnosis ; etiology ; Ulna ; injuries ; Wrist Injuries ; diagnosis ; etiology ; Young Adult

Female ; Humans ; Endometriosis

Objective To reconstruct sparse views CT image based on defective projection data.Methods The position of bad bins in detector determined whether the linear interpolation was applied to the defective projection data.Moreover,reconstruction of air pixels in CT image was achieved rapidly and accurately.Results he experimental results showed that the proposed method could solve the problem from classical ART-TV method that the robustness was unstable due to the different positions of bad bin in CT detector.Conclusion Compared to analytical reconstruction methods,iterative methods can solve the reconstruction problems in this modality so that the radiologist is facilitated to perform image processing and quantitative analysis.

Objective To find out severity and types of syphilis infection in blood donors, attendants and persons to have their premrital medical examination in Zhoushan City and offer a new measure for prevention and treatment of syphilis. Methods Totally, 174 589 blood donors, attendants and persons to have their premarital medical examinations were screened preliminarily for inapparent syphilis with non-TPHA, and then TPHA was applied to confirm the diagnosis, according to the National Standard No. GB 15974-1995, combining with clinical symptoms and physical check-up. Results A total of 1 327 cases of syphilis from 174 589 samples tested, including blood donors, attendants and persons to have their premarital medical examinations, were diagnosed, with an inapparent infection rate of 7. 60‰ in average, 6. 42‰in males and 8. 74‰ in females, with a sex ratio of 0.71 (X2 = 29. 92, P

OBJECTIVETo observe the clinical effect and safety of circumcision stapler in the treatment of phimosis and redundant prepuce.

METHODSWe treated 120 patients with redundant prepuce or phimosis using circumcision stapler and another 60 by conventional dorsal-incision circumcision. We observed intraoperative blood loss, operation time, postoperative pain, wound healing time, cosmetic appearance of the penis, and postoperative complications and compared them between the two groups of patients.

RESULTSStapler circumcision showed obvious advantages over the conventional method in intraoperative blood loss ([2. 3 ± 1. 3] vs [15.6 ± 2.9] ml), operation time ([7.1 ± 1.4] vs [22.6 ± 4.6] min), wound healing time ([12.0 ± 2.9] as [16.3 ± 3. 1] d), postoperative pain score (1. 9 ± 1. 3 vs 5. 2 ± 1. 7), incision edema, and cosmetic appearance of the penis (all P <0. 05). Besides, stapler circumcision exempted the patients from stitch-removal pain. However, the incidence rate of postoperative local ecchymosis was significantly higher in the circumcision stapler group than in the conventional circumcision group (20. 8% vs 8. 3% , P <0. 05).

CONCLUSIONCircumcision stapler, with its advantages of easier manipulation, shorter operation time, better cosmetic penile appearance, less pain, and fewer complications, is superior to conventional circumcision in the treatment of phimosis and redundant prepuce.

Blood Loss, Surgical ; Circumcision, Male ; instrumentation ; methods ; Ecchymosis ; etiology ; Humans ; Male ; Pain, Postoperative ; Penis ; abnormalities ; Phimosis ; therapy ; Postoperative Complications ; Postoperative Period ; Surgical Staplers ; adverse effects ; Wound Healing

OBJECTIVETo investigate the growth activity of osteoblast on a novel strontium incorporated calcium sulfate and make comparison with normal calcium sulfate material.

METHODSOsteoblast was inoculated on samples and cell proliferation was measured on the 1st, 3rd, 5th days, and the activities of ALP and osteocalcin were observed on the 5th day. And microcosmic morphology of osteoblast was observed by scanning electron microscopy(SEM).

RESULTSOsteoblast grows robustly on tested material. Cell quantity on the surface of novel material was obviously higher than normal calcium sulfate material (P < 0.05). The activity of ALP and osteocalcin on novel material was 57.8% and 40.2% higher than on normal calcium sulfate material respectively (P < 0.05). On strontium incorporated surface, osteoblast spread well. Cells were polygonal with abundant cytoplasm and the morphology was active.

CONCLUSIONStrontium incorporated calcium sulfate can sustain robust growth activity of osteoblast, which is promising to be used for bone substitute materials.

3T3 Cells ; Alkaline Phosphatase ; metabolism ; Animals ; Bone Substitutes ; chemistry ; pharmacology ; Calcium Sulfate ; chemistry ; pharmacology ; Cell Proliferation ; drug effects ; Mice ; Osteoblasts ; cytology ; drug effects ; metabolism ; Osteocalcin ; metabolism ; Strontium ; chemistry

Objective To evaluate the efficacy of DSA-guided percutaneous transhepatic gallbladder catheter drainage (PTGCD) in treating aged patients with acute cholecystitis complicated by severe diseases. Methods The clinical data of 15 aged patients with acute cholecystitis or complicated by severe diseases, who were encountered at authors’ hospital in the past three years and were treated with PTGCD, were retrospectively analyzed. The clinical results were discussed. Results PTGCD was successfully accomplished with single procedure in all 15 patients. Abdominal pain was relieved within one to three days, and the abdominal symptoms and signs subsided or disappeared. Reexamination of routine blood test showed that the white blood cell count decreased to normal range in 1 - 2 weeks, and complete cure was achieved in some patients. Secondary surgery was carried out in some patients after the clinical condition was improved. During the follow-up period no complications occurred in all patients except one who developed biliary leakage after the catheter was retrieved two weeks after the treatment. Conclusion For the treatment of complicated acute cholecystitis in aged patients who are not suitable to receive surgery, DSA-guided percutaneous transhepatic gallbladder catheter drainage is an ideal therapeutic means as it can significantly relieve clinical symptoms.

Objective To study the changes of agrin expression in spinal cord motor neurons after somatic-autonomic ventral root(VR) anastomosis and somatic-somatic VR anastomosis,and the factors related to the synapse formation of foreign nerve regeneration. Methods Artifical somatic-automomic reflex pathway and somatic nerve self-anastomosis were established in rats.Retrograde tracing was carried out to label the motor neurons,and the neurons were isolated by flow cytometry.Real-time PCR was used to investigate the agrin mRNA expression of the neurons.Anterograde tracing and immunofluorescence technique were employed to label the new synapses of pelvic ganglia(PG). Results After 4 months of surgery,the somatic nerve can regenerate into PG successfully and form new synapses observed under laser scanning confocal microscope.The neurons involved in foreign nerve regeneration can be isolated successfully by retrograde tracing and flow cytometry.The expression of agrin in L_4-L_6 VRs anastomosis group was lower than that of the control group of L_4-L_4 VR self-anastomosis(P