Resident standardization training is a major part of education of medical students after graduation , and is extremely important for high-level physician training and raising the quality of medical treatment. We trained the residents comprehensively according to the characteristics of echocardiography in terms of theoretical knowledge, clinical manipulative skills, clinical thinking ability, scientific research ability and communication and team cooperation ability, and carried out the relative examination according to the training. On the basis of practice, we explored the establishment of a standardized training mode and evaluation system suitable for echocardiography resident doctors in China.

AIM: To compare the differences of corneal diameter measured with wavelight anterior segment analyzer(Wavelight),IOL-master optical bio-measurement(LS900), anterior segment OCT(AS-OCT)and gauge.

METHODS: Totally 89 patients(177 eyes)with myopia who want to accept ICL were examined before operation with more than five kinds of instruments respectively, white to white(WTW)were examined with Wavelight, IOL-master, LS900 and gauge, angle to angle(ATA)with AS-OCT. Then the size of ICL was calculated based on the value of gauge. The vault of ICL was examined with OCT 3mo after operation.

RESULTS: WTW was(12.45±0.73, 11.96±0.39, 11.92±0.36, 11.49±0.30)mm measured by Wavelight, IOL-Master, LS900 and gauge respectively, ATA was(11.80±0.44)mm with AS-OCT. The value of gauge was the smallest one among them(all P<0.01). Among four instruments, there was no statistical difference between LS900 and AS-OCT(P=0.098), they can instead of each other; there were differences among other instruments(P<0.01). The size of ICL based on gauge was(12.77±0.37)mm. The vault of ICL is(537.41±181.22)μm 3mo after implantation obtained by OCT.

CONCLUSION: Gauge is ideal tool for measuring corneal diameter, it cannot be instead. Wavelight, IOL Master, LS900 and AS-OCT can be taken as reference.

OBJECTIVETo study the combination of Mandibular distraction and orthognathic techniques for the reconstruction of adult hemifacial microsomia.

METHODSThe three-dimensional CT reconstruction data was used with Mimics for preoperation design. The osteotomy location, distraction vector, distraction distance were decided before operation with a surgical guider. At the first stage, internal distractor was implanted after ostetomy through an extra-oral approach. The distraction begun 5-7 days after operation with a frequency of 1 mm/day. After distraction, the distractor was maintained for 3-6 months. At the second stage, the distractor was removed. Le Fort I osteotomy was performed in order to correct the cross-bite and improve the facial contour. Usually, bone graft was inserted into the gap after Le Fort I osteotomy. The genioplasty was also performed if necessary.

RESULTS9 cases of adult hemifacial microsomia with severe mandibular deviation were treated. The facial asymmetry were improved greatly. 1 patient suffered an wound infection in the maxillary region after Le Fort I osteotomy and healed uneventfully with wound irrigation.

CONCLUSIONSMandibular distraction combined with orthognathic surgery is an effective procedure for adult hemifacial microsomia with complicated mandibular hypoplasia.

Adult ; Aged ; Bone Transplantation ; Facial Asymmetry ; surgery ; Goldenhar Syndrome ; surgery ; Humans ; Mandible ; surgery ; Osteogenesis, Distraction ; methods ; Osteotomy, Le Fort ; methods

OBJECTIVETo evaluate the efficacy and safety of etanercept plus Tripterygium wilfordii polyglycoside (TWP) in elderly patients with active rheumatoid arthritis (RA).

METHODSTotally 46 elderly patients with active RA were randomly assigned to the treatment group (22 cases) and the control group (24 cases). All patients received subcutaneous injection of etanercept, 25 mg each time, twice per week. The dosage was reduced to once per week 3 months later. Patients in the treatment group took TWP Tablet (10 mg each time, three times per day), while those in the control group took methotrexate (MTX), 10 mg each time, once per week. The whole course lasted for 24 weeks. Patients' rest pain, tender joint number, swollen joint number, health assessment questionnaire (HAQ), patients' global assessment, physicians' global assessment, erythrocyte sediment rate (ESR), C reactive protein (CRP), rheumatic factor were assessed at week 0, 4, 8, 12, and 24. The curative effect was statistically evaluated by the United States Institute of Rheumatology ACR20, ACR50, and ACR70 improvement criteria. Meanwhile, any adverse event was recorded and evaluated.

RESULTSTotally 41 completed the trial, and 5 dropped off (3 in the treatment group and 2 in the control group). Compared with the control group, there was no statistical difference in ACR20, ACR50, or ACR70 in the treatment group (P > 0.05). Compared with before treatment in the same group, there was some improvement in tender joint number, swollen joint number, visual analogue scale (VAS) for patients' global assessment, VAS for physicians' global assessment, ESR, CRP, and HAQ between the two groups, showing statistical difference (P < 0.05). Compared with the control group in the same phase, there was no statistical difference in the treatment group (P > 0.05). There was no statistical difference in the occurrence of adverse events between the two groups.

CONCLUSIONSEtanercept plus TWP could achieve equivalent therapeutic effect to that of Etanercept plus MTX. The two regimens could improve clinical signs, symptoms, and QOL related to RA. They were well tolerated in the treatment of elderly patients with active RA.

Aged ; Antirheumatic Agents ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Drug Therapy, Combination ; Etanercept ; Female ; Glycosides ; therapeutic use ; Humans ; Immunoglobulin G ; therapeutic use ; Male ; Middle Aged ; Receptors, Tumor Necrosis Factor ; therapeutic use ; Treatment Outcome ; Tripterygium ; chemistry

Background In recent years,with the contiunous progress of the refractive surgery,the operation skill of phakic intraocular lens(PIOL)implantation for correcting extreme high myopia,astigmatism,farsightedness have made greater progression,and its security,effectiveness in clinical attract much more attention. Objective This study was to evaluate the efficacy,safety and stability of Toric Implantable Collamer Lens(TICL)for extreme high myopic astigmatism. Methods This retrospective case series included 33 eyes of 27 patients from May 2008 to February 2009.A TICL was intraocularly implanted via a 3 mm clear corneal incision after paraocular anesthesia.Patients were examined preoperatively and followed-up at 1 day,1 week,1 month,3,6,12 and 18 months postoperatively.The examinations included uncorrected visual acuity,best corrected visual acuity(BCVA),slit lamp examination,refraction,intraocular pressure,endothelial cell morphometry,etc.The written informed consent was obtained from each patient before any medical procedure. Results The uncorrected visual acuity in 96.97% eyes was equal or improved after operation in comparison with BCVA of preoperation.The spherical refraction was within-1.00 D-+0.25 D.The cylinder refraction was within-1.00 D-0 D.The axial deviation of TICL within 10 degree was 93.94%(31/33).No significant differences were found in the intraocular pressure and endothelial cell morphometry between preoperation and postoperation(intraocular pressure:F=3.35,P=5.49;endothelial cell morphometry:t=1.835,P=0.082).The visual acuity and refraction were stable during the follow-up.Astigmatic axial rotation required surgical intervention on one eye.One eye occurred high intraocular pressure because of bigger TICL diameter.The intraocular pressure returned to normal after TICL was exchanged.No cataract occurred during the follow-up duration. Conclusion TICL implantation appears to be an effective,safe and reliable method for extreme high myopic astigmatism.

The interaction in two mixtures of a nonionic surfactant AEO9 (C12H25O(CH2CH2O)9H) and different ionic surfactants was investigated. The two mixtures were AEO9/sodium dodecyl sulfate (SDS) and AEO9/cetyltrimethylammonium bromide (CTAB) at molar fraction of AEO9, alpha(AEO9) The surface properties of the surfactants, critical micelle concentration (CMC), effectiveness of surface tension reduction (gamma(CMC)), maximum surface excess concentration (Gamma(max)) and minimum area per molecule at the air/solution interface (A(min)) were determined for both individual surfactants and their mixtures. The significant deviations from ideal behavior (attractive interactions) of the nonionic/ionic surfactant mixtures were determined. Mixtures of both AEO9/SDS and AEO9/CTAB exhibited synergism in surface tension reduction efficiency and mixed micelle formation, but neither exhibited synergism in surface tension reduction effectiveness.
Cetrimonium Compounds ; analysis ; chemistry ; Colloids ; analysis ; chemistry ; Complex Mixtures ; analysis ; chemistry ; Ions ; Phase Transition ; Sodium Dodecyl Sulfate ; analysis ; chemistry ; Solutions ; Surface Tension ; Surface-Active Agents ; analysis ; chemistry

In this work, the surface activity of block copolymer nonionic surfactants (RPE) has been determined, i.e., critical micelle concentration (CMC), surface excess concentration (gamma), surface area demand per molecule (A), surface tension at CMC (gamma(CMC)). A linear decrease of ln[CMC] vs number of oxypropylene units in copolymer molecule was observed. The change in the work of cohesion per oxypropylene group when passing from molecular into micellar state, calculated from the Shinoda equation, was 0.43 kT for the studied compounds.
Colloids ; chemistry ; Epoxy Compounds ; chemistry ; Ethylene Oxide ; chemistry ; Materials Testing ; Micelles ; Molecular Structure ; Polymers ; chemistry ; Structure-Activity Relationship ; Surface Tension ; Surface-Active Agents ; chemistry

Brain ; abnormalities ; Cerebral Cortex ; abnormalities ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Nervous System Malformations ; diagnosis ; Prognosis

Adolescent ; Adult ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Recovery of Function ; Tibial Fractures ; diagnostic imaging ; physiopathology ; surgery ; Tomography, X-Ray Computed ; Young Adult

Adult ; Bone Screws ; Denture, Partial ; Female ; Humans ; Male ; Middle Aged ; Molar ; diagnostic imaging ; pathology ; Orthodontic Anchorage Procedures ; instrumentation ; methods ; Radiography, Panoramic ; Tooth Movement Techniques ; methods