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 study influences of magnetic field on behavior of depressive rats under chronic unpredictable mild stress,and possible mechanisms under such phenomena.Methods Thirty-six Wistar rats were divided into model group,magnetic field group and control group (n =12 in each group) according to random number table.The model group and the magnetic field group received CUMS stimulation daily for 5 weeks,while the control group received no any treatment.At the end of the fifth week,rats in the magnetic field group were placed in the center of a magnetic machine (400 mT),and the model group was raised freely for4 weeks.The severity of depressive behaviors,cortisol levels and contents of C-reactive protein in blood and urine sample were tested pre-treatment,at the end of 5 weeks and 9 weeks.Results After 5 weeks,consumption of glucose solution of the control group was higher than the other two groups (P ＜ 0.05).After 5 and 9 weeks,body weights of the magnetic group and the model group were lower than the control group (P ＜ 0.05).At the end of 9 weeks,performance of the magnetic group as indicated by frequency of grid crossing,grooming time and suspending tail test were improved to a significantly greater extent than the other two groups (P ＜ 0.05).In addition,the urine content of cortisol in 24 hours in magnetic field and model groups was higher than the control group at the end of 5 weeks,and the serum level of cortisol in the magnetic field group were significantly higher than the model group at the end of 9 weeks (P ＜ 0.05).Conclusion The 400mT magnetic field can reduce the severity of behavior changes of rats with CUMS-induced depression,which might be attributable to its influence on the cortisol levels in blood and urine.

Objective This study is to investigate the influences of USP7 on the cytobiological characteristics of laryngeal cancer cells by small interfering RNA (siRNA) interfering the USP7 expression in the laryngeal cancer cells .Methods The self‐de‐signed highly efficient siRNA was used to conduct the specific interference on USP7 expression in laryngeal cancer HEP2 cells . Then the influence on the capacity of cell proliferation and migration ,as well as apoptosise after USP7 interference were observed by using the CCK‐8 method ,Transwell chamber migration test and flow cytometry .Results The self‐designed siRNA could effi‐ciently inhibit the expression of USP7 mRNA in laryngeal cancer cells ,furthermore markedly suppressed the proliferation and mi‐gration of laryngeal cancer cells ,enhanced the cell apoptosis in laryngeal cancer HEP2 cells in vitro .Conclusion The siRNA inter‐fering USP7 can inhibit the proliferation and migration capacity of laryngeal cancer cells ,and promoted their apoptosis .

Objective To evaluate the significance of CT assessment for extraarticular anatomy in treatment of displaced intraarticular calcaneal fractures.Methods(1)Measurement of normal calcaneum 40 pieces of adult calcaneum specimen were measured,items of measurement included height of culmination of posterior facet and tuberosity,width of posterior edge of sustentaculum and tuberosity.(2)CT measurement of calcaneum.Transverse(axial)and coronal CT scanning were obtained from 20 feet with displaced intraarticular calcaneal and 20 normal feet as control.Following items were measured in CT scanning:the height of culmination of posterior facet and tuberosity,the coronal talocalcaneal angle,in coronal scanning,the width of posterior edge of sustentaculum and tuberosity,the axial calcaneocuboid angle,in axial scanning.Results(1)Measurement of height of calcaneum height of culmination of posterior facet and tuberosity of calcaneal specimen were(43.07?2.85)mm and(44.69?3.67)mm respectively,and these two items from CT scanning of normal feet were(42.84?1.66)mm,(43.40? 3.01)nun,and from CT scanning of feet with calcaneal fractures were(34.76?3.24)mm,(40.41? 3.69)mm.There was a statistically significant different between these two items for normal calcaneal specimen and for CT scanning of feet with ealcaneal fractures(P

Objective To investigate the influence of motor impersistence on functional recovery and prog- nosis of patients with left hemiplegia. Methods A total of 64 in-patients with left side hemiplegia who were able to understand the oral instructions were assigned into a motor impersistence group (n = 31 ) and a control group (n = 34) , respectively, according to the assessment with Scale of Motor Impersistence developed by Joynt. Both groups were comparable in terms of the basic clinical characteristic and motor function of patients except motor impersis- tence. The conventional rehabilitation training programs were adopted for all patients in this study. Brunnstrom func- tional category, Ueda Satoshi hemiplegic finger function assessment scale, upper limb function assessment scale, Berg balance scale, Functional ambulatory category, Modified Barthel Index were employed to evaluate the subjects before and after 1 and 2 months of treatment, with regard to the motor function of their upper limbs, walking ability, activities of daily living performance and balance ability. Results After 1 month of treatment, the patients in the M1 group were significantly improved with regard to the motor function of upper limbs, hand function, standing ba- lance and activity of daily living performance( P0.05 ) , while those in the control group were improved with all the parameters except the lower limb function. After 2 months of treatment, patients in both groups were all significantly improved ( P

Objective To retrospectivel y analyze the abdominal CT findings and pathological results of the chronic schist osomiasis so as to improve the diagnostic accuracy of the disease. M ethods The plain abdominal CT scanning was performed in 103 cases an d enhanced CT scanning in 81 cases. The pathological specimen which was consist ent with the section of CT scan was obtained in each cases. Results On CT scanning, liver cirrhosis was seen in 84 cases, various calci fication in liver in 71 cases, liver cancer in 12 cases, enlargement of sple en in 78 cases, calcification in spleen in 13 cases, wall-thickening in colon i n 27 cases, calcification in colon in 31 cases, and colon cancer in 9 cases. Pa thological examination revealed various fibrosis and formation of pseudolobule. The eggs and calcification could be seen in pseudolobule and septa, colonic sub mucosa, and regional lymph nodes. Fibrous hyperplasia in colonic wall and hyper plasia in mucous membrane were obvious. Fibrous hyperplasia and calcification w ere seen in spleen, but the eggs were not found. Conclusion The liver and colon are the major organs affected by chronic schistosomias is in abdomen, and the CT findings are obvious too. The pathological features o f spleen are accompanied with liver cirrhosis. CT is the important imaging meth od in diagnosing chronic schistosomiasis and pathological changes.

OBJECTIVE: To study ApoB gene genetic polymorphism of Han nationality and Mongolian nationality in midwest area of Inner Mongolia. METHODS: Some unrelated individuals of Han nationality and Mongolian nationality in midwest area of Inner Mongolia were selected. Polymerase chain reaction-restriction fragment length polymorphism technology was used to check the presence of Xba I (X+) and EcoR I (E-) sites of rare alleles. The genotype frequency, allelic frequency and population genetics parameters were calculated. RESULTS: The frequencies of Xba I (X+) and EcoR I (E-) rare alleles were 2% and 4.6% in Han population. There was no Xba I (X+) or EcoR I (E-) rare alleles found in Mongolian nationality. CONCLUSION The allelic frequencies of ApoB gene Xba I and EcoR I sites are very different in different races. These sites may be used in identification of ethnicity.
Alleles ; Apolipoprotein B-100/genetics* ; Asian People/genetics* ; China ; Ethnicity ; Gene Frequency ; Genotype ; Humans ; Mongolia ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length

Background: Nonlinguistic cognitive impairment has become an important issue for aphasic patients, but currently there are few neuropsychological cognitive assessment tests for it. To get more information on cognitive impairment of aphasic patients, this study aimed to develop a new cognitive assessment test battery for aphasic patients, the Non?language?based Cognitive Assessment (NLCA), and evaluate its utility in Chinese?speaking patients with aphasia. Methods: The NLCA consists of five nonverbal tests, which could assess five nonlinguistic cognitive domains such as visuospatial functions, attention test, memory, reasoning, and executive functions of aphasic patients. All tests are modified from the nonverbal items of the current existed tests with some changes to the characteristics of Chinese culture. The NLCA was tested in 157 participants (including 57 aphasic patients, 50 mild cognitive impairment (MCI) patients, and 50 normal controls), and was compared with other well?established relative neuropsychological tests on the reliability, validity, and utility. Results: The NLCA was fully applicable in the MCI patients and the normal controls, almost working in the aphasic patients (57/62 patients, 91.9%). The NLCA scores were 66.70 ± 6.30, 48.67 ± 15.04, and 77.58 ± 2.56 for the MCI group, the aphasic group, and the control group, respectively , and a significant difference was found among three groups (F = 118.446, P < 0.001). The Cronbach's alpha of the NLCA as an index of internal consistency was 0.805, and the test?retest and interrater reliability was adequate (r=0.977 and r= 0.970, respectively). The correlations of the cognitive subtests and their validation instruments were between 0.540 and 0.670 (all P < 0.05). Spearman's correlation analysis indicated that the coefficient of internal consistency of each subtest itself was higher than other subtests.When choosing the Montreal Cognitive Assessment score of <26 as the diagnostic criteria of cognitive impairment, the area under the curve for all participants in the control and MCI groups was 0.942 (95% confidence interval: 0.895–0.989), and an optimal cutoff point of 75.00 seemed to provide the best balance between sensitivity and specificity. Age (r = ?0.406, P < 0.001) was the main influence factor for the NLCA. Conclusions: The NLCA could efficiently differentiate the cognitive impairment patients from the normal controls and is a reliable and valid cognitive assessment test battery to specially find nonlinguistic cognitive function for aphasic patients.

OBJECTIVETo study the indication and character of the lateral-cervical approach for treating dumble-shape neurogenic tumors in cervical spine.

METHODSRetrospectively review the clinical data of 14 dumble-shape neurogenic tumors in cervical spine, from October 2005 to October 2011. Among them 8 were males and 6 were females, range from 11 to 60 years old. The maximum tumor diameter range from 3.0 to 8.0 cm, with an average of 4.8 cm; the intraspinal tumor diameter range from 1.3 to 3.8 cm, with an average of 2.1 cm. According to Asazuma classification, 9 cases were type IIc, 2 cases were type IIIb, 2 cases were type IV, 1 case was type VI. Involving the neck segment C(1)-C(2) in 1 case, C(2)-C(3) in 1 case, C(3)-C(4) in 2 cases, C(4)-C(5) in 2 cases, C(5)-C(6) in 3 cases, C(6)-C(7) in 4 cases and C(2)-C(4) in 1 case. All cases performed surgery with general anethesia. The head and neck surgeon performed surgery with lateral cervical approach, in the space between the anterior and the medius scalenus, exposed the transverse process and the intervertebral foramen as the anatomy marker, resected the extraspinal tumor part. The neurosurgery expanded the intervertebral foramen, and resected the intraspinal tumor with microscope, and repaired the dura. Then head and neck surgeon closed the wounds.

RESULTSPathology proved 3 neurolimmoas and 11 Schwannomas, 12 cases received gross total resection, 2 cases received subtotal resection, the average blood loss during operation was 292 ml, the average operation time was 129 minutes, the average stay in hospital days was 7.1 days. The vertebral artery were exposed in 2 cases, and no vertebral artery injury occurred, there were 3 cases dissect the cervical nerve roots. No cerebrospinal fluid leakage, hematoma, newly branchial plexus injury, sympathic nerve injury or tracheal edema occurred. In 3 to 24 months, with an average of 13.5 months follow-up period, 2 cases with subtotal resection had no tumor progression, and 12 cases with gross total resection had no tumor recurrence.

CONCLUSIONSLateral-cervical approach is minimal invasive, easily to perform and recovery fine. It can be adopt for Asazuma type IIc, IIIb and IV tumors which not grow over the midline in spine and expand to deep layer of the deep cervical fascia out spine.

Adolescent ; Adult ; Cervical Vertebrae ; surgery ; Child ; Female ; Humans ; Male ; Middle Aged ; Neurilemmoma ; surgery ; Neurofibroma ; surgery ; Neurosurgical Procedures ; methods ; Retrospective Studies ; Spinal Neoplasms ; surgery ; Young Adult

In the present study, the correlated activities of adjacent ganglion cells of transient subtype in response to full-field white light stimulation were investigated in the chicken retina. Pharmacological studies and cross-correlation analysis demonstrated that application of the GABA(A) receptor antagonist bicuculline (BIC) significantly down-regulated the correlation strength while increasing the firing activities. Meanwhile, application of the GABA(A) receptor agonist muscimol (MUS) potentiated the correlated activities while decreasing the firing rates. However, application of the GABA(C) receptor antagonist (1,2,5,6-Tetrahydropyridin-4-yl)methylphosphinic acid (TPMPA) did not have a consistent influence on either the firing rates or the correlation strength. These results suggest that in the chicken retina, correlated activities among neighborhood transient ganglion cells can be increased while firing activities are reduced with the activation of GABA(A) receptors. The GABA(A)-receptor-mediated inhibitory pathway may be critical for improving the efficiency of visual information transmission.
Action Potentials ; Animals ; Bicuculline ; pharmacology ; GABA-A Receptor Antagonists ; pharmacology ; Mice ; Muscimol ; pharmacology ; Phosphinic Acids ; pharmacology ; Pyridines ; pharmacology ; Receptors, GABA-A ; metabolism ; Retina ; physiology ; Retinal Ganglion Cells ; physiology ; gamma-Aminobutyric Acid