Objective To evaluate the results of teaching in both Chinese and English with 7-year-program clinical medicine majors and analyze the influencing factors.Methods Data from a questionnaire survey of 25 students exposed to bilingual teaching were analyzed.Results The students generally approved of the model of bilingual teaching,which was contributory to improving their proficiency in specialized English.However,uneven English levels on the part of teachers and students and imperfect materials and methods as well as discontinuity affected the overall results of bilingual teaching and to some extent the students' mastery of specialized knowledge.Conclusion Bilingual teaching with 7-year-program clinical medicine majors is a must,and yet persistent efforts need to be made in enhancing the teachers' English level,compiling proper textbooks and improving teaching methods so as to genuinely better the results of bilingual teaching.

ObjectiveTo summarize the clinical characteristics of pt osis,one of complications after double eyelid blepharoplasty, and to explore i ts causes and attempt for the resolutions. MethodsThe clinica l symptoms were divided into three types based on the degrees of the ptosis afte r double eyelid blepharoplasty. The causations in 25 cases of different degree o f ptosis after double eyelid blepharoplasty were investigated and analyzed durin g operations. The local adhesive deformities were analyzed so as to take differe nt resolutions for the complication. Results It seemed that th e operative damage to the aponeurosis was the main reason for the complication. So it caused the scar adhesive deformities between the palpabralis aponeurosis a nd the orbital membrane or the skin of upper eyelid, resulting in the difficult y of the palpabralis muscle's contract and unablility of the muscle function in different degrees. Conclusion The ptosis can surely be av oided if we have good knowledge about the mechanism of double fold formation and the anatomy of eyelids and perform the operation meticulously.

Objective To observe the oculocardiac reflex during the ocular plasty and to study its possible mechanism. Methods A total of 132 cases were studied by dynamic electrocardiography to analyze the changing of heart rate before and after operations. Results Heart rate decreasing by over 10 times during operations was regarded as the positive standard of the oculocardiac reflex. Of all cases the oculocardiac reflex appeared in 41 cases and 53 times were observed including of continual two times happened in 6 cases. In all the reflex ,9 cases was observed in injection of anaesthetic, 5 cases in pulling eyelids, the orbicular muscle and the palpabralis muscle, 21 cases in resecting orbital fats,6 cases in stressing the eyeball after operations. The incidence of oculocardiac reflex was 31.1%. Conclusion Some steps in the process in ocular plasty are more possible to elicit the reflex, such as dragging peripheral eyeball muscles,stressing eyeball and pulling eyelid. The reflex will result in heart rate decreasing, heart rhythm and respiratory changing,even render heart to sudden stop . Therefore, we should operate gentlely and accurately,and also avoid overly stress on eyeball to elicit the oculocardiac reflex.

Objective To study the relationship between climatic factors and cerebral hemorrhagic disease.Methods A total of 1125 cerebral hemorrhage patients were included in this study.The relationship between the onset time of cerebral hemorrhage and daily climatice factors (including temperature,humidity,atmospheric pressure,wind direction and rainfall volume) was analyzed and the onset time of cerebral hemorrhage in each patient was analyzed according to the X2 test for goodness of fit.Results The number of male cerebral hemorrhagy patients was greater than that of female cerebral hemorrhage patients.The mean age of femalc cerebral hemorrhage patients was older than that of male cerebral hemorrhage patients (P＜0.01).The incidence of cerebral hemorrhage accounted for 11％ in January in a greatest number of such patients,accounted for 5.0％ in September in a smallest number of such paticnts,and was the highest at h 4-8 AM and at h 16-20 FM in ≤45 years old cerebral hemorrhage patients.Univariate correlation analysis showed that cerebral hemorrhage was negatively related with daily mean temperature,daily mean maximal and minimal temperature (r=-0.157,r =-0.163,r=-0.156,P＜0.05),positively related with daily mean atmospheric pressure (r=0.157,P＜0.05).Multivariate linear stepwise analysis showed that cerebral hemorrhage was related with daily mean temperature,maximal and minimal temperature,and daily mean atmospheric pressure (P＜0.05,P＜0.01).Conclusion The incidence of cerebral hemorrhage differs in seasons and months,is higher in winter and lower in summer,and is thus related with temperature,atmospheric pressure and wind direction.

ObjectiveTo study the clinical efficacy of Kegel on fecal incontinence in patients with anal endoscopic microsurgery.Methods Totally 60 patients with anal endoscopic microsurgery were randomly selected by purpose sampling method from October 2013 to June 2016,and they were divided into the control group and the observation group according to the random number table method,with 30 cases in each group. Patients in the control group received routine care,while patients in the observation group was trained by Kegel exercises before and after surgery. Incidence of fecal incontinence,anal function excellent rate and duration of fecal incontinence were observed and compared between two groups.Results The incidence rate of fecal incontinence in the observation group was 3.3%(1/30),while that of the control group was 23.3% (7/30) (P=0.052). The postoperative duration of fecal incontinence in the observation group was (3.3±0.5) d,while that of the control group was (5.3±2.4) d (t=4.468,P<0.05). Four days after surgery,the number of patients with good anal function in evaluation in the observation was 28,while that of the control group was 22 (Z=-2.020,P<0.05). ConclusionsKegel exercises before and after anal endoscopic microsurgery can effectively improve patients' anal function and shorten the duration of fecal incontinence. This method is simple,practical and can be widely used.

Objective:To investigate the long-term death of patients with ischemic stroke and its influencing factors.Methods:Based on the data of patients with ischemic stroke in the multi-center oral fibrinogen-lowering drug secondary prevention database, the follow-up patient information and the cause of death were registered through the epidemiological investigation method, and then compared with the baseline data of patients in the original database.Results:A total of 278 patients completed the follow-up, and 166 were in lumbrokinase group and 112 were in control group. There were 124 deaths (44.6%) within 10 years, of which 92 (74.2%) were vascular deaths. In the lumbrokinase group, 74 patients (44.6%) died of all causes and 55 (33.1%) died of vascular diseases; in the control group, 50 (44.6%) died of all causes and 37 (33.0%) died of vascular diseases. Cox proportional risk model analysis showed that lumbrokinase treatment had no significant effect on the 10-year survival rate of patients with ischemic stroke. The analysis of death influencing factors showed that the baseline international normalized ratio (INR) was significantly associated with the 10-year non-vascular death risk of patients (hazard ratio [ HR] 1.98, 95% confidence interval [ CI] 1.21-3.25; P=0.006). The greater the decrease of tissue plasminogen activator (tPA) within half a year, the lower the 10-year all-cause mortality risk ( HR 0.94, 95% CI 0.90-0.99; P=0.011); the greater the decrease in INR within one year , the lower the 10-year vascular death risk ( HR 0.41, 95% CI 0.17-0.96; P=0.040); the greater the decrease of D-dimer within one year , the higher the risk of the 10-year vascular death ( HR 1.37, 95% CI 1.02-1.83; P=0.034). The greater the decrease of INR in patients with ischemic stroke within one year, the higher the 10-year non-vascular death risk ( HR 2.15, 95% CI 1.29-3.59; P=0.004). Conclusions:The 10-year mortality rate of patients with ischemic stroke is higher, and about 3/4 are vascular deaths. The fibrinogen-lowering treatment in the acute stage has no significant effect on the 10-year all-cause mortality of patients with ischemic stroke. The greater the decrease of tPA in half a year, the lower the all-cause mortality; the greater the decrease of D-dimer level at baseline and within 1 year, the higher the 10-year vascular death; the greater the decrease of INR at baseline and within 1 year, the higher the 10-year non-vascular death risk.

Objective: To compare and analyze the epidemiological characteristics of hospitalized elderly, young and middle-aged patients with severe burn in recent years, so as to provide reference for the prevention and treatment of elderly patients with severe burn. Methods: Relying on the entry system of epidemiological case data and biological sample of severe burn from multicenter in clinic, medical records of patients with severe burn, aged above 18, hospitalized in 8 burn wards from January 2012 to December 2015 were collected. Six hundred and fifteen patients who were more than 18 years old and less than or equal to 65 years old were included in young and middle-aged group (YM). Eighty-two patients aged more than 65 years old were included in elderly group (E). Data of age, gender, residence, education level, cause of injury, location of injury, season of injury, total burn area, occurrence and area of full-thickness burn injury, wound site, inhalation injury incidence and severity, post burn admission time, proportion of delayed resuscitation, proportion of escharectomy or tangential excision and skin grafting, preinjury systemic disease, system complication during hospitalization, length of hospital stay, outcome of treatment, and reason of abandoning treatment of patients were analyzed. Data were processed with chi-square test and Mann-Whitney U test. The odds ratios of preinjury systemic disease, system complication during hospitalization, and adverse outcome of patients in group YM were compared with those in group E. Results: (1) The majority of patients in the two groups were male, but the proportion of male patients in group YM was higher. There was statistically significant difference in gender distribution of patients between the two groups (χ²=18.727, P<0.001). The majority of patients in the two groups were from rural areas, but the proportion of rural patients in group E was higher. There was statistically significant difference in residence distribution of patients between the two groups (χ²=9.306, P=0.002). Patients in group YM mainly had secondary education, while patients in group E mainly had primary education. There was statistically significant difference in distribution of education level of patients between the two groups (χ²=146.797, P<0.001). (2) The most common causes of injury of patients in the two groups were both flame, but the proportion of patients with flame burn injury in group E was higher. There was statistically significant difference in distribution of cause of injury of patients between the two groups (χ²=25.063, P<0.001). The main locations of injury of patients in groups YM and E were respectively public place and private residence. There was statistically significant difference in location distribution of injury of patients between the two groups (χ²=46.313, P<0.001). The main seasons of injury of patients in groups YM and E were respectively summer and winter. There was statistically significant difference in season distribution of patients between the two groups (χ²=23.143, P<0.001). There was statistically significant difference in distribution of total burn area of patients between the two groups (χ²=25.799, P=0.002). The occurrences of full-thickness burn injury of patients in the two groups were similar (χ²=2.685, P=0.101), while there was statistically significant difference in area of full-thickness burn injury of patients between the two groups (χ²=26.702, P=0.002). There was no statistically significant difference in distribution of wound site of patients between the two groups (χ²=3.954, P=0.785). There were no statistically significant differences in incidence and severity distribution of inhalation injury of patients between the two groups (with χ² values respectively 0.425 and 0.672, P values above 0.05). (3) There was statistically significant difference in distribution of admission time of patients between the two groups (χ²=6.632, P=0.036), but there was no statistically significant difference in proportion of delayed resuscitation of patients between the two groups (χ²=1.261, P=0.261). The proportion of escharectomy or tangential excision and skin grafting of patients in group YM was 72.0% (443/615), which was significantly higher than 35.4% (29/82) of group E (χ²=44.498, P<0.001). The incidence of preinjury systemic disease of patients in group YM was 13.2% (81/615), which was significantly lower than 61.0% (50/82) of group E (χ²=108.337, P<0.001). The risk of preinjury systemic disease of patients in group E was 10.30 times of that of patients in group YM [with 95% confidence interval (CI) of 6.24-17.01, P<0.001]. During hospitalization, 59.8% (49/82) of patients in group E suffered from system complications, which was significantly higher than 36.6% (225/615) of group YM (χ²=16.282, P<0.001). The risk of system complication of patients in group E was 2.57 times of patients in group YM (with 95% CI of 1.61-4.12, P<0.001). The length of hospital stay of patients in group E was significantly shorter than that of group YM (U=36 735, P<0.001). There was statistically significant difference in treatment outcome of patients between the two groups (χ²=106.251, P<0.001). The risk of adverse outcome of patients in group E was 7.52 times of group YM (with 95% CI of 4.40-12.88, χ²=67.709, P<0.001). The proportion of abandoning treatment of patients in group E was significantly higher than that of group YM (χ²=150.670, P<0.001). The risk of abandoning treatment of patients in group E was 15.86 times of that of group YM (with 95% CI of 9.36-26.88, P<0.001). There was no statistically significant difference in distribution of reason of abandoning treatment of patients between the two groups (χ²=4.178, P=0.243). Conclusions There were significant differences in the epidemiological characteristics of patients in groups E and YM. In elderly burn patients, the proportion of rural population was higher and the education level was lower. Flame burn was common and burns mostly occurred in private residences and in winter. The total burn area was slightly lower but the area of full-thickness burn injury was larger. The length of hospital stay was shorter and the proportion of surgical treatment was lower. The incidences of preinjury systemic disease and system complication during hospitalization were higher, and therefore the risks of adverse outcome and abandoning treatment were higher.

Objectives:Distolingual root of the permanent mandibular first molar(PMFM-DLR)has been frequently reported,which may complicate the treatment of periodontitis.This study aimed to assess the morphological features of PMFM-DLR and investigate the correlation between the morphological features of PMFM-DLR and periodontal status in patients with Eastern Chinese ethnic background.Materials and methods:A total of 836 cone beam computed tomography(CBCT)images with 1497 mandibular first molars were analyzed to observe the prevalence of PMFM-DLR at the patients and tooth levels in Eastern China.Among them,complete periodontal charts were available for 69 Chinese patients with 103 teeth.Correlation and regression analyses were used to evaluate the correlation between the morphological features of DLR,bone loss,and periodontal clinical parameters,including clinical attachment loss(CAL),probing pocket depth(PPD),gingival recession(GR),and furcation involvement(FI).Results:The patient-level prevalence and tooth-level prevalence of DLR in mandibular first molars were 29.4%and 26.3%,respectively.Multiple linear regression analysis suggested that bone loss at the lingual site and CAL were negatively affected by the angle of separation between distolingual and mesial roots in the transverse section,while they were significantly influenced by age and the angle of separation between distobuccal and mesial roots in the coronal section.Conclusions:The prevalence of PMFM-DLR in Eastern China was relatively high in our cohort.The morphological features of DLR were correlated with the periodontal status of mandibular first molars.This study provides critical information on the morphological features of DLR for improved diagnosis and treatment options of mandibular molars with DLR.