AIM:To investigate the effect of case-based learning ( CBL) teaching combination with paper review method in the teaching of ophthalmology residents. ·METHODS:The study was conducted from 2015 to 2016. The residents in Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital were included in the research. During the year of 2015, the traditional lecture-based learning ( LBL) method was applied (as a control group). During the year of 2016, the CBL teaching combination with paper review teaching method was applied (as an experimental group). At the end of the course, exams and questionnaires were conducted to evaluate the teaching effect of two different methods. The exams consisted of theoretical and operational assessment. The teaching satisfactions, learning interests, scientific research interests and clinical abilities were included in the questionnaires. The data was analyzed by SPSS 16. 0. ·RESULTS:The results of final exams indicated that the scores of the experimental group (88. 2±6. 5) were higher than the control group ( 75. 6 ± 6. 0 ). The difference showed statistically significant (t=6. 68, P<0. 05). The results of questionnaires indicated that students showed much more satisfied with CBL teaching combination with paper review teaching method ( 91%) than traditional teaching method (50%, x2 =8. 84, P<0. 05). Students in the experimental group improved learning interest ( x2 =6. 29, P<0. 05), increased research interest (x2=4. 54, P<0.05) and approved clinical ability (x2 =4. 25, P<0. 05). The comparison of two groups showed the statistically difference (P<0. 05). ·CONCLUSION: CBL teaching combination with paper review teaching method is beneficial to improve the teaching effect, and it is also beneficial to train residents'clinical skills and research abilities.

A 44-year-old male complained recurrent swelling and pain in the left pre-auricular mass over 4 years, which aggravated for 4 months. Ultrasonography revealed a mixed mass echo in the left parotid gland. Computed tomography showed an enlarged parotid gland and a 1.5 cm x 0.9 cm low density shadow in the superficial lobe area with strip high-density shadow in the edge. Although the facial nerves of the patient were found adhered to the foreign body during the operation, the foreign body in parotid gland was removed surgically without any injure to them due to facial nerves protection. In conclusion, facial nerves dissection is necessary to avoid the postsurgical facial paralysis in the surgical removal of foreign bodies in parotid gland.
Adult ; Facial Nerve ; Foreign Bodies ; Humans ; Male ; Parotid Gland

The association of polymorphisms of calcium channel?1 subunit ( Cav1.1 ) gene ( - 1551T/C at exon 11 ) with thyrotoxic periodic paralysis (TPP) was investigated by PCR-RFLP.The distributions and frequencies of - 1551TC + CC genotype and C allele in TPP group were significantly higher than those in hyperthyroidism (HT) and normal control (CON) groups.There was no statistic difference between HT and CON groups.Cavl.1 gene - 1551TC + CC genotype and allele may contribute to the development of TPP in male HAN population from North China.

Objective The aim of this study was to assess the relationship between the oral health habit and halitosis. It can provide an advisory basis for nurse giving individualized oral health instruction to patients of halitosis and can improve the result of prevention and treatment for halitosis accordingly. Methods 202 patients with periodontal disease were chosen to participate in this study. The study included the questionnaire of oral health habit and the halitosis diagnosis by organoleptic assessment.Comparisons of difference in the knowledge of oral health habit between the subjects with and without halitosis were conducted. Results Brushing times in subjects without halitosis were significantly more than that in subjects with halitosis. Brushing teeth in evening and interproximal brush usage were much better in subjects without halitosis than that in subjects with halitosis,respectively. Conclusions Good oral health habits could decrease the incidence of halitosis.

Objective To explore imaging features of Zinner syndrome.Methods Eight male patients with clinically diagnosed Zinner syndrome performed abdominal and pelvic CT and /or MRI scan.The radiological data was studied retrospectively.Results Eight cases showed seminal vesicle cyst with ipsilateral renal agenesis on CT and/or MR imaging ( left side, n =5; right side, n =3).The maximal diameter of seminal vesicle cysts varied from 4.2 to 7.0 cm, and appeared as oval cystic lesion with irregular contour or tube-like dilatation , which appeared low density on CT image and hypo-or hyperintensity on T 1 WI and hyperintensity on T 2 WI.Bladder compression was found in 6 cases.Fuild-fuild level in the cysts was seen in 2 cases.Remnants of ureter structure were seen in only 1 case.There was no other accompanying abnormality of urinary system.Conclusions Zinner syndrome presents with characteristic imaging features , and the key issue is differential diagnosis of seminal vesicle cysts.

Objective To point out the weak link of general medical education and explore the training mode and evaluation mechanism for communication. Methods Totally 100 general practi-tioners from four Shanghai hospitals took a questionnaire survey to know the present situation and the training needs of doctor-patient communication skills. Results Among all the subjects, there were 73%who thought strengthening the doctor communication ability was the key to improving the doctor-patient relationship, 71%who chose doctor-patient communication practice course as the training con-tent, 78%who tended to personalized analysis and guide, 57%who accepted experienced GP in class. Conclusion For GPS communication skills training requirements, curriculum integration, clinical practice teaching should be strengthened to set up the corresponding training evaluation system.

Background Compare with the lamellar laser refractive surgery,the laser slip on the surface operation is a better method in the correct of refractive error without the flap-related complications.However,whether to remain corneal epithelial flap and its influence for epithelial healing and visual restoration are still under investigation.Objective The aim of this study was to compare the short-term clinical efficacy of epipolis laser insitu keratomileusis (Epi-LASIK) and flap-free Epi-LASIK for correction of refractive error in high myopia.Methods The paired control design was adopted.Sixty eyes of consecutive 30 patients with high myopia were collected in this study.The written consent form was obtained from each patients prior to operation.Regular EpiLASIK was performed in the right eyes and the flap-free Epi-LASIK was carried out in the left eyes.Patients were followed-up for one month.The postoperative ocular irritation symptoms were scored,and the healing period of corneal epithelium and uncorrected visual acuity were examined at 1,3 and 5 days after operation.The naked visual acuity,diopter,best corrected visual acuity and the grading of haze were recorded and compared between the two groups at one month after operation.Results After surgery,the scores of corneal irritation were 3.13 ±0.43 and 3.30±0.47on the first day,showing insignificant differences between these two groups (t =- 1.54,P＞0.05 ).However,there existed statistically significant difference in the scores of corneal irritation on the third day after operation between the two groups (t =- 17.95,P＜0.01 ).The average time of corneal epithelial healing were (2.58 ±0.49 ) days in the flapfree Epi-LASIK group and ( 3.98 ±0.74) days in Epi-LASIK group with the significant difference between them (t=-11.36,P＜0.01 ).There was no statistical difference in uncorrected visual acuity in the first day (0.59±0.12 vs 0.58±0.11,t=0.39,P＞0.05),the fifth day (0.69±0.08 vs 0.67±0.09,t=0.84,P＞0.05) and 1 month (t =-1.90,P＞0.05 ).No significant difference was seen in the diopter between the two groups in 1 month after surgery (-1.03±0.45 vs -1.07 ±0.38,t =-0.31,P＞0.05 ).The eye numbers of corneal haze for 0 grade were 27 ( 90.00％ ) and over the 0.5 grade were 3 ( 10.00％ ) in flap-free Epi-LASIK group respectively,and those of corneal haze for 0 grade were 26(86.66％ ) and above the 0.5 grade were 4 (13.33％) in Epi-LASIK group respectively,showing a considerably difference between the two groups (x2 =0.0031,P＞0.05).Conclusions Both the flapfree or reserved epithelial Epi-LASIK allow the safe and effective correction of refractive error in high myopia,showing good predictability and stability in short term.Flap-free Epi-LASIK can relieve the corneal irritation symptom and accelerate the healing of corneal epithelium and recovery of visual acuity.

Objective To determine clinical characteristics and the effects of drug-eluting stents on the occurrence of major adverse cardiac events during percuteneous coronary artery interventional(PCI)and long- term outcomes in patients with chronic renal insufficiency(CRI).Methods Nine hundreds and seventy three patients with angiographically-documented coronary artery disease(lumen inner diameter narrowing＞50%), included 516 patients complicated with experienced renal impairment(CRI group)and 457 with normal renal function(control group).Baseline clinical data and coronary angiographic features were recorded.Results Comparing with control group,patients in CRI group were older with higher incidence of hypertension or diabetes and simultaneously complicated by reduced left ventricular ejection fraction,and more complex coronary lesions(type C).During follow-up(mean 17 months),the mortality was significantly higher in CRI than in control group(6.2% vs 3.3%,P＜0.05),but the former with CRI was significantly lower by using drug-eluting stents in comparing with bare-metal stents(4.1% vs 8.5%,P＜0.05).Conclusion Patients with CRI often complicated with severe coronary artery disease,the mortality after PCI would be significantly reduced by using drug-eluting stents.

The exploration of drug toxicity and mechanisms is a vital component in ensuring the safe use of drugs in clinical practice, as this topic has attracted widespread concern. The intestinal flora holds great significance for drug metabolism, efficacy and mechanism, and is an instrumental metabolic organ that facilitates material information transfer and biotransformation. However, an increasing number of studies have shown that intestinal bacteria are closely related to the toxicity of specific drugs. On the one hand, drugs are transformed into toxic metabolites under the influence of intestinal bacteria, thus inducing direct drug toxicity. On the other hand, the composition and function of the intestinal flora are altered under drug influence, resulting in disruption of endogenous metabolic pathways. Consequently, this disruption compromises the intestinal barrier and affects other organs, leading to indirect drug toxicity. This review meticulously compiles recent examples of drug toxicity attributed to intestinal bacteria, explores in depth the contention that metabolic enzymes of gut microbiota may be of great influence on oral drug toxicity, and outlines prospective avenues for future research on gut microbiota and drug toxicity and mechanisms. This not only provides novel perspectives for the judicious clinical utilization of drugs but also offers insights for the safety assessment of innovative pharmaceuticals.

Objective To summarize the ultrasonic characteristics of urinary calculus in infants who had history of feeding melamine contaminated milk powder.Methods A total of 163 children[aged(19.4?10.9)months] with urolithiasis,who had feeding melamine contaminated milk powder,were retrospectively analyzed using ultrasonography.Twenty children [aged(16.7?9.9)months] with urolit-hiasis,who had no feeding history of melamine contaminated milk powder,were chosen as controls.Ultrasonic characteristics were compared between the 2 groups.Results For melamine calculus cases,sporadic spot or hyperechic mass with different size and shape in the collecting system,partly without acoustic shadow,was found in 65 cases;dense echo and luminous belt with obscured acoustic shadow under a band without echo was found in 48 ureteral calculus cases;irregular strong echo mass or small spot with thick acoustic shadows without side lobe artifact in the dark liquid areas was found in 8 cases with bladder calculus.There was significant difference in morphology of the calculus(P0.05).Conclusions The unique ultrasonic characteristics in infants with melamine calculus had become a very useful tool to diagnose the pediatric urinary melamine calculus.J Appl Clin Pediatr,2009,24(1):67-69