Objective To discuss the feasibility of application of laryngeal mask airway(LMA)in pediatric corrective surgery of lingual frenum. Methods Retrospective study was conducted of 42 chil-dren using laryngeal mask airway in selective surgical correction of lingual frenum under general anesthe-sia in our hospital. The childrenˊs vital signs were recorded at five different time points:baseline before an-esthesia(T0),consciousness and eyelid reflex disappear just after anesthesia induction(T1),time right af-ter the LMA insertion(T2),3 ~ 5 min after beginning of operation(T3),and time at the extubation(T4). The success rate of first LMA insertion and the number of changing to other ventilation way were recorded. The shift of LMA and postoperative sore throat within 24h were recorded. Results The success rate of the first LMA insertion was 85. 71% . Intraoperative laryngeal mask airway leak and shift did not occur and the ventilation was also good. Vital signs of the children were stable during operation. The incidence of postop-erative sore throat was 15% within 24h. As to the heart rate,the vital signs of baseline T0 were significant-ly different from other time points(T1,T2,T3,T4). After the anesthesia,there were no significant differ-ences in heart rate among different time points(T1,T2,T3,T4). Compare with T2 and T3,the values of partial end expiratory pressure of CO2 at T0,T1,and T4 were significantly different. Compare with T0,the values of mean arterial pressure at T1,T2 and T3 were significantly different,but there was a significant difference in mean arterial pressure between T1 and T4. As to the pulse oxygen saturation,all the values were above 95% . Conclusion Laryngeal mask airway is a supraglottic airway management method. The advantages of fewer haemodynamic changes and postoperative complication are confirmed. It is feasible and safe for securing the airway in surgical correction of lingual frenum.

Objective To describe the prevalence and distribution of anxiety disorders among people aged 18～65 yrs in Liaoning Province. Methods 15 518 subjects in 7 200 families aged 18～65 yrs were randomly selected from 3 cities and 3 counties by multi-stage stratified random cluster sampling.They were assessed for DSMⅢ-R diagnoses by face to face interview with Composite International Diagnostic Interview(CIDI-1.0). Results There were 13 359 subjects had finished the survey,and the response rate was 86.09%.The 2-week,12-month and lifetime prevalence of anxiety disorders were 2.22%,4.60% and 7.21% regulated by Liaoning provincial population in 2000,and1.91%,3.97%and6.32% regulated by countrywide population in 2000.The major disorders were specific phobia and agoraphobia,and their lifetime prevalence were 3.80% and 3.04%,respectively.The people with higher prevalence were females,aged 25~55,with lower educational and economic level. Conclusion Anxiety disorders become a serious public health problem in Liaoning province.Prevention measures should be taken among people with high risk.

Objective To retrospectively analyze the serum enzymes in childhood amputees as a result of earthquake,and to discuss their clinical significance.Methods From 150 children amputees who were victims of Sichuan Wenchuan earthquake in 2008 and Sichuan Lushan earthquake in 2013,45 cases with complete records of serum enzymes examinations were reviewed retrospectively.They were divided into three groups:amputation group (n=6),fasciotomy decompression group (n =5),general trauma without injury to extremity group (n =34).Serum enzyme examination data were compared for statistical analysis to find the difference among groups.Ten children who were not victims of earthquake were selected from department of orthopaedics to serve as controls,and 20 adult amputees as a result of earthquake served as another control group.Results There were significant differences in injury severity scale (ISS) and the contents of all serum enzymes,including aspartate transaminase (AST),alanine aminotransferase (ALT),creatine kinase (CK),lactate dehydrogenase (LDH),and hydroxybutyrate dehydrogenase (HBDH),between the amputation group and other patients (FISS=15.474,P＜0.001 ; FAST=10.770,P＜0.001 ; FALT=12.799,P＜0.001 ; FcK=12.848,P＜0.001; FUDH=13.126,P＜0.001; FHBDH=13.186,P＜0.001),and the difference in amputation group was even more significant.AST,LDH,HBDH in childhood amputees group were significantly higher than those in adult amputation group.The contents of ALT and CK were slightly increased.Serum enzyme contents were found to be significantly helpful for prediction of disease condition and prognosis.It was also found that CK was extremely helpful in assessing the degree of illness in patients with severe trauma,especially in patients complicated by severe soft tissue injury.In all the groups,of patients,it was found that CK rose from (129 ± 62) U/L in non-earthquake induced trauma group to (44 208 ± 39 788) U/L in earthquake amputation group,and it was thus increased more than 300 times.Its highest value even reached 117 513 U/L,which was more than 840 times of the normal.If a timely amputation or muscle compartment decompression was performed,CK might decline rapidly down to the normal value.Conclusions The comprehensive and continuous assessment of serum enzymes is mandatory during the treatment of children with acute trauma.It is of important clinical significance to correctly judge the condition and to determine optional treatment measures.

Eight-year program education is the heated topic in the field of medical education across the country.The system of eight-year program education can be discussed as a system,from the view of system philosophy.We analyzed beth internal relationships and external relationships connected to the system,so as to look upon the eight-year program education in its entirety.And then we discussed about the problems of epistemology and methodology on that basis.

Objective In order to enhance the understanding of Churg- Strauss syndrome, the clinical manifestations and the pathological features of 15 patients were reviewed. Methods The clinical and patho- logical findings of 15 patients with Churg- Strauss syndrome admitted to Peking Union Medical College Hospi- tal were retrospectively analysed. Results In 15 cases, the initial clinical manifestations were poly- mononeu- ropathy, gastrointestinal disorders and skin lesions. Peripheral eosinophilia was significant in all cases. Biopsies were taken in all cases. The typical pathological features usually demonstrated in diffiferent stage of the dis- ease. Conclusions If a patient shows a clinical manifestation of fever, skin lesions, neuropathy, abdominal pain and diarrhea, as well as eosinophilia in peripheral blood, the diagnosis of Churg- Strauss syndrome should be considered. It is necessary to take biopsies from several sites at different time.

Objective To evaluate the efficacy and safety of video-assisted thoracoscopic surgery in the treatment of esophageal leiomyoma.Methods Clinical data of 49 patients with esophageal leiomyoma from September 1996 to February 2009 treated by video-assisted thoracoscopic enucleation were reviewed retrospectively.Three or four trocars were used during the operation.The procedure of the surgery was similar to that of open thoracoscopic enucleation.Results In the 49 patients,video-assisted thoracoscopic leiomyoma enucleation was successfully completed in 42 cases.The other 7 patients were converted to open thoracotomy because of the following reasons:dense pleural adhesion in 2,location failure of small tumor(

OBJECTIVE:To establish a method for the content determination of tanshinol,protocatechuic aldehyde,salvianolic acid B,paeoniflorin and ferulic acid in Xinning tablets. METHODS:Multi-target with multi-wavelength HPLC was performed on the column of Agilent Zorbax Eclipse XDB-C18 with the mobile phase of acetonitrile-methanol-0.5% H3PO4 aqueous solution(gradi-ent elution) at the flow rate of 1.0 ml/min. The column temperature was 30 ℃,volume was 10 μl and the detection wavelength was 280 nm for tanshinol,protocatechuic aldehyde and salvianolic acid B,230 nm for paeoniflorin and 320 nm for ferulic acid. RESULTS:The linear range was 66.25-1060.00 μg/ml for tanshinol(r=0.999 9),5.55-88.86 μg/ml for protocatechuic aldehyde (r=0.999 9),187.20-2 995.20 μg/ml for salvianolic acid B(r=0.999 7),23.71-379.39 μg/ml for paeoniflorin(r=0.999 9)and 0.20-3.12μg/ml for ferulic acid(r=0.999 7);the RSDs of precision,stability and repeatability tests were all less than 2%;the av-erage recoveries were respectively 98.85%(RSD=0.12%,n=6),97.95%(RSD=0.19%,n=6),99.18%(RSD=0.37%,n=6), 98.14%(RSD=0.25%,n=6) and 97.16%(RSD=1.36%,n=6). CONCLUSIONS:The method is simple and convenient with good separation effect,and can be used for the content determination of the 5 components in Xinning tablets.

Objective The purpose of our study is to evaluate high-resolution 3.0 T MRI in the identification of finding in patients with a clinical diagnosis of femoroacetabular impingement (FAI). Methods From June 2008 to May 2010, 54 consecutive patients with clinically diagnostic FAI received an high-resolution 3.0 T MR scan (Siemens AG, Germany), including 38 males and 16 females with an average age of 33.5 years (range, 18-50). All cases were assigned into 3 groups according to the morphology changes of the hip joint: Group Cum, Group Pincer, and Group Normal. The frequency of abnormal signs in 3 groups was calculated. Nonparametric tests by SPSS were used in data analysis. Results Forty-four patients (81.5%, 44/54) showed acetabular labrum disorders, 35 patients (64.8%, 35/54) showed femoral-acetabular cartilage lesions on MRI, 19 patients (35.2%, 19/54) showed arthroedema, 14 patients (25.9%, 14/54) showed femoralacetabular bone disorders, 4 patients (7.4%, 4/54) showed articular capsule and ligaments disorders. There was no statistically significant in the frequency of abnormal sign in MR1 between male and female. The frequency of acetabular labrum disorders, femoral-acetabular cartilage lesions and femoral-acetabular bone lesions in Group Cum was more than that of Group Pincer and Group Normal. The frequency of acetabular labrum disorders was the most disorders (Group Cum 88.5%, Group Pincer 77.8%, Group Normal 70.0%),next high-frequency was acetabular cartilage lesions. Conclusion 3.0 T MRI provides a useful assessment of patients in whom a FAI is clinically diagnosed. A high-resolution, nonarthrographic technique can provide preoperative information. Acetabular labrum disorders and femoral-acetabular cartilage lesions maybe characterized as an earlier period of FAI.

Objective To explore the efficacy of bismuth containing quadruple therapy in the treatment of peptic ulcer in patients with Helicobacter pylori.Methods We selected 307 peptic ulcer patients with Helicobacter pylori.infection,and randomly divided them into observation group (152 cases)and control group (155 cases).The observation group received quadruple therapy:colloidal bismuth pectin,pantoprazole,amoxicillin and furazolidone, 14d.The control group received the standard triple therapy:pantoprazole,clarithromycin and amoxicillin,14d.The ulcer healing rate,H.pylori eradication rate and adverse reaction were compared between the two groups.Results The ulcer healing rates,remission rates,H.pylori eradication rates in the observation group were 93.5%,92.7%, 94.8%,92.3% respectively,which in the control group were 83.4%,82.7%,84.1%,80.6% respectively,there were statistically significant differences (χ2 =4.15,4.9,6,0.94,all P <0.05).The incidence of adverse reactions did not differ significantly between the two groups (P >0.05).Conclusion Bismuth containing quadruple therapy is associated with a higher rate of H.pylori eradication compared with the standard triple therapy.

Objective To survey the current working status of general practitioners (GPs) who received residency training in Shanghai.Methods The current status of general practitioners,who completed residency training in Shanghai from 2013 to 2014,was surveyed with self-designed questionnaire by e-mail.The survey items included current employers,job specification,clinical practice,teaching,scientific research and so on.Results Three hundred and thirteen out of 377 GPs,who completed residency training from 2007 to 2012,participated in the survey (83.0％),including 85 males and 228 females with a mean age of (31.2 ± 2.6) years.Among all participants,298 (95.2％) worked in community health service centers,12.8％ (40/313) of them were involved in general practice teaching,9.9％ (31/313) undertook management,9.3％ (29/313) did academic research in community,and 7.7％ (24/313) had chance for overseas study.The survey also showed that 134 person/times received various commendations and awards.Conclusion Most GPs who completed residency training are undertaking clinical practice in community health service centers,and they are also well involved in management,teaching,and research.