Good standardized training of resident physicians is indispensable for high quality medical personnel building.This paper gives a brief introduction to the experiences of endocrinology fellowship trainings in three top hospitals in USA.On the basis of current simation in China,a new and improve the quality'is proposed,and a new approach is explored,which is a valuable reference for the endocrine resident trainings in China.

Blast Injuries ; Deafness ; etiology ; Humans

Air Pollutants, Occupational ; analysis ; Gas Chromatography-Mass Spectrometry ; methods ; Volatile Organic Compounds ; analysis ; Workplace

Air Pollutants, Occupational ; analysis ; Chromatography ; methods ; Sulfur Dioxide ; analysis ; Workplace

Objective:To investigate the diagnostic value of spiral CT head and neck angiography on carotid artery stenosis in patients with acute cerebral infarction.Methods:A total of 60 patients with acute cerebral infarction(ACI),who were treated in Affiliated Hospital of Yan'an University from January 2014 to January 2016,were selected as observation group,and 60 patients with non-acute cerebral infarction,as control group.The two groups of patients underwent spiral CT head and neck angiography.The degrees of carotid artery stenosis and the distribution of vascular plaques were compared between the two groups.The diagnostic value of spiral CT head and neck angiography in the diagnosis of carotid artery stenosis of the patients with ACI was evaluated.Results:The detection rates of mild and moderate stenosis in the observation group were significantly higher than those in the control group (P＜0.05),while the detection rates of severe stenosis and occlusion had no significant difference compared with the control group (P＞0.05).The total detection rate of stenosis in the observation group was higher than that in the control group (P＜0.05).There were plaques detected in the carotid bifurcation,common carotid artery,internal carotid artery and external carotid artery in the two groups.The total detection rate (69.4％) of the observation group was significantly higher than that (41.2％) of the control group (P＜0.05).Conclusion:Application of 128-slice spiral CT can effectively assess the head and neck angiography on carotid artery stenosis in patients with acute cerebral infarction.This method has a higher detection rate from mild to moderate stenosis and bilateral carotid artery plaques in the patients with ACI,and it has application value in the clinical diagnosis and prognosis.

Aim To research the protective effect and mechanisms of taurine on myocardial ischemia and reperfusion injury in rats. Methods Myocardial ischemia reperfusion models were established in SD rats. The effects of taurine on the size of myocardial infarction and the changes of activity of SOD , and the levels of MDA and NO in myocardium and plasma of rats with myocardial ischemia and reperfusion injury were observed. Results In rats with myocardial ischemia and reperfusion injury, the taurine could reduce the size of myocardial infarction (P

A BBB co-culture cell model consisting of rat brain microvascular endothelial cells (BMEC) and astrocytes (AS) was established to study the effect of Angelica dahurica coumarins on the transport behavior of puerarin across blood-brain barrier (BBB) in vitro and in vivo. The barrier function of this model was evaluated by measuring the transendothelial resistance, phenol red permeability and BBB related protein expression. The permeability assay and western blot methods were performed to study the effects of Angelica dahurica coumarins on the BBB permeability and the expression of BBB related protein. The animal experiment protocols in this study were approved by the Animal Ethics Committee of Xi'an Jiaotong University (Animal Ethics No.: 2021-1329). The results showed that the established BMEC/AS co-culture model could be used to evaluate drug transport across BBB in vitro. After combined with Angelica dahurica coumarins, the transport capacity of puerarin was significantly increased in vitro and in vivo. Additionally, Angelica dahurica coumarins enhanced BBB permeability and inhibited the protein expression of P-glycoprotein (P-gp), zonula occludens-1 (ZO-1) and occludin. Angelica dahurica coumarins might increase BBB permeability by inhibiting the expression of P-gp and tight junction protein, thereby increasing the content of puerarin in brain tissue.

Objective To improve the level of early detection and treatment of pyonephrosis. Methods This study included 41 cases(17 men and 24 women;mean age,49 years)of pyonephrosis.A variety of examinations,including urinary analysis,blood analysis,kidney nuclear medicine scan,ultrasonog- raphy,intravenous urography(IVU),and CT were used for the early diagnosis of pyonephrosis.Pereutaneous nephrostomy(PCN)drainage was done for the interim management of pyonephrosis,then phase 2 operation was performed in 28 cases.The double-J tube was placed in ureter by ureteroscope for drainage,and then phase 2 operation was done in 2 cases.Emergency operation was done in 10 cases.The remaining 1 case un- derwent ESWL after anti-infective therapy.Results Definite diagnosis of pyonephrosis before operation was made by invasive examinations in 31 cases(75.6%),and by percutaneous drainage in 4 cases;the other 6 cases were detected during operation.Only 6 cases(14.6%)underwent nephrectomy;the other 35 cases (85.4%)underwent kidney-sparing operation.Follow-up of 3 months to 9 years was available in 37 cases. No nephrectomy was needed in 33 cases with spared kidney.Serum creatinine was normal in the 4 cases un- dergoing nephrectomy.Conclusions The key to the treatment of pyonephrosis by kidney-sparing surgery is early diagnosis,timely drainage and relief of obstruction.Ultrasonography plays an important role in the early diagnosis of pyonephrosis,and CT has a high sensibility in the diagnosis.Pereutaneons nephrolithotomy (PCNL)secondary to drainage through pereutaneous nephrostomy was beneficial to the patients with kidney stones or upper ureter stones.

ObjectiveTo analyze therapeutic effects of conservative treatment and the causes of malunion of intertrochanteric fracture in elderly patients, and try to find the way to deal with the problems. MethodsFifteen cases aged 75 to 101 years with intertroehanterie fracture treated conservatively were included.Their average age was 88.8 years.All fractures were classified according to Evens-Jensen.Because of the medical complication or other reasons, they were conservatively treated by methods of traction, wearing shoes et al. X-ray examination was taken at regular time and their final functions were assessed. ResultsTwo cases were died 1-3 months after admission, and the fractures were only partially healed. The remaining thirteen cases got complete healing. Among the fifteen cases, the deformity did not happen in 4 cases of IA without fixation and 1 case of IIB with bone traction. All others got the deformity of varus, shorting and external rotation in different degree, which interfered the lower extremity motor function. ConclusionsThe fracture position not kept and fixed satisfactorily during treatment would lead to more joint deformity and deteriorated hip joint function for the displaced intertroehanterie fractures in elderly patients.

Objective To analyze the diagnosis and prognosis value of abdominal CT scans in patients with acute pancreatitis complications.Methods 151 cases with acute pancreatitis were selected.The relationship between abdominal CT performances and the common complications and death in patients was analyzed.The prognosis of patients with different Balthazar CT severity index (CTSI) grade was compared.Results The complication rate of patients with CT signs of fatty liver, pleural effusion, liver gap effusion, adrenal gland involvement (AGI), penirenal space involvement (PSI) and gastric bare area involvement (GBAI) was significantly higher than that of patients with negative CT findings above (P<0.05).With CTSI grading increasing, the patient''s fasting time, heating time, hospital stay, recovery time of blood amylase were extended, and the incidence of pseudo cyst, transit surgery, organ failure and death was gradually increasing (P<0.05).Conclusion Severe fatty liver, AGI, GBAI, PSI and liver gap effusion are risk factors for acute complications and death in patients with pancreatitis.