Objective To explore advantages of simulation-based medical education for overseas students on training of anesthcsia emergency skills.Methods twenty eight oversea students accepting anesthesia practice course were divided into two groups,each group fourteen.The students of simulation group (group S) were lectured with simulation-based medical education method,while the students of control group (group C) were lectured with tradition education method.Results the practice examination record and satisfaction degree for teaching in group S were both higher than that in group C (P＜0.05).Conclusion The simulation-based medical education was better than tradition education method on training of anesthesia emergency skills for oversea students.The simulation-based medical education may raise the learning interest of oversea students obviously,and it is beneficial to students' mastery of practice skills.

Objective To explore the effectiveness of sandplay therapy combined with family counseling in children with school phobia and its influence of child′ self-consciousness. Methods Integrative sandplay therary with family consulting were used to treat 28 patients with school phobia regularly for 2 months. Sandplay and family consulting therapy were given once a week for 45 minutes . Clinical outcomes were assessed using CGI-GI and Piers-Harris children′s self-consciousness scale before and after treatment as well as 3 months posttreatment. Results Overall response rate was 85%. In addition, the physical appearance and characteristic factor before and after treatment were no significant difference (P>0.05). The rest of the various factors and total score compared with pre-treatment significantly improved (P<0.05). After treatment for 3 months, every factor in self-consciousness of children and total score were no significant difference (P>0.05). Conclusion Integrative sandplay therapy with family counseling has better and long-lasting treatment effect to self-consciousness of children with school refusal.

Objective To assess the safety of intrathecal administration of betamethasone.MethodsTwenty-four adult white rabbits of both sexes were randomly divided into four groups with 6 rabbits in each group.Group Ⅰ (blank control group)in which nothing was injected intrathecally;group Ⅱ(NS control group)in whichnormal saline(NS)0.2ml was injected into the subarachnoid space through great occipital foramen once a weekand the animals were killed at the end of the 3rd week;in group Ⅲ and Ⅳ betamethasone 200 ?g or 400 ?g in 0.2ml was injected intrathecally once a week instead of NS.The animals were anesthetized and killed by intra-aorticinjection of NS and 2% glutaraldehyde.The cervical section of the spinal cord(C_(1-6))was immediately removedand fixed with 2% glutaraldehyde for microscopic examination.Results No neural histo-pathologic changes shownby microscopic examination were observed in group Ⅰ and Ⅱ.In group Ⅲ and Ⅳ microscopic examination showeddifferent degrees of swelling and demyelination of the nerve fibers and edema and vacuolization ofmitochondria.Conclusion Intrathecal betamethasone can damage the spinal cord.

Objective To investigate the expression of vascular endothelial growth factor/vcascular endothelial growth factor receptor(VEGF/VEGFR) in bone marrow of children with acute leukemia(AL),and explore their relationship of the clinical features,and observe changes before and after chemotheropy.Methods The bone marrows of 53 children with AL were assayed to study the expression of VEGF/VEGFR(KDR,Flt-1)before and after chemtheropy with S-P immhistochemical staining.Their relations to the clinical features were evaluated.Results The expressions of VEGF,Flt-1,KDR were significantly higher in newly diagnosed children with AL than those of control group.They were significantly higher in children with acute myeloid leukemia(AML) than in children with ALL.The expressions of VEGF,Flt-1,KDR in remission chidren after chemotheropy were significantly lower than before chemotheropy.There was a positive correlation of the percentage of bone marrow blasts with VEGF expression in children with AL.There was also a positive correlation of the percentage of leukemic cell in blood rountine with VEGF expression.For the untreated group of children,no correlation was found between expressions of VEGF,Flt-1,KDR and age,sex,extramedullary infiltration.Conclusions Expression levels of VEGF,Flt-1,KDR in bone marrow of children with AL increases.VEGF/VEGFR may play an important role in process of chidhood AL.

Objective To explore the clinical characteristics and the remedial measurement of measles complicated with severe pneumonia and the acute respiratory distress syndrome(ARDS) in children.Methods From Jan 2004 to Jul 2007,clinical data of 32 cases with measles complicated with severe pneumonia and ARDS in PICU of Chongqing Children's Hospital were retrospective analyzed.In addition,the ratio of partial pressure of oxygen in arterial blood fractional concentration of oxygen in inspired gas[pa(O2)/FiO2] between the death group and survival group,the mortality rates between the hormone therapy group and control group were performed.Results Sixteen cases were cured and 16 cases were died,with the mortality rate 50%.The ratio of pa(O2) /FiO2 before mechanical ventilation in death group was lower than that in the survival group [(11.93?1.67) kPa,(21.77?1.16) kPa,respectively,P0.05).Conclusions ARDS is a severe complication in children with measles pneumonia and associated with a high mortality,which requires early diagnosis and intervention to improve survival rate and prognosis.The ratio of pa(O2)/FiO2 may provide reference to evaluation for severity and prognosis of ARDS.

OBJECTIVETo investigate the feasibility and the mid-term effects of unilateral pedicle screw fixation and transforaminal lumbar interbody fusion in treating lumbar degenerative diseases.

METHODSFrom August 2005 to May 2010, 56 patients with lumbar degenerative diseases underwent lumbar posterolateral fusion,their clinical data were retrospective analyzed. The patients were divided into two groups (unilateral group and bilateral group) according to fixation methods,27 patients in unilateral group who were underwent unilateral pedicle screw fixation, including 18 males and 9 females with a mean age of (57.5 ± 7.1) years old (ranged from 41 to 66 years); and 29 patients in bilateral group who were treated with bilateral pedicle screw fixation (on the basis of the above, with contralateral vertebral pedicle screw fixation), including 19 males and 10 females with a mean age of (54.6 ± 5.1) years old (ranged from 43 to 68 years). The clinical data such as operation time, blood loss volume, hospitalization time and cost were compared between two groups. JOA score system was used to evaluate the neurological function. And fusion status and cage-related complication were also analyzed.

RESULTSAll patients were followed up from 36 to 60 months with an average of 45.8 months. No iatrogenic nerve, blood vessels or organs injury were found during operation. Operation time, blood loss volume, hospitalization time and cost in unilateral group were better than that of bilateral group (P < 0.05). There was no significant difference in JOA score between two groups (P > 0.05). Two patients in unilateral group developed with cage related complications, 1 case was cage displacement and 1 case was cage subsidence, while 2 patients in bilateral group developed with complications of no-fusion, and there was no significant differences between two groups (P = 0.58).

CONCLUSIONUnilateral pedicle screw fixation is a satisfactory method and can obtain good effects in treating lumbar degenerative diseases in mid-term, however, the indications should be well considered.

Adult ; Aged ; Biomechanical Phenomena ; Female ; Humans ; Intervertebral Disc Degeneration ; physiopathology ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Pedicle Screws ; Spinal Fusion ; methods

Objective:To explore the clinical effect of mycophenolate mofetil combined with glucocorticosteroid on the children with anaphylatic purpura nephritis.Methods:70 cases of children treated and diagnosed as anaphylatic purpura nephritis in our hospital from March,2012 to September,2015 were enrolled in this study.They were randomly divided into the observation group and the control group.Conventional therapy was applied to both groups,the observation group was treated by mycophenolate mofetil combined with prednisone,the control group was given cyclophosphamide combined with prednisone.The total effective rate,disappearence time of clinical symptoms,biochemical indicators,immune function as well as the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of observation group was 94.29％,which was 85.17％ in the control group,no statistical difference was found between two groups(P＞0.05).After therapy,the disappearence time of albuminuria,hematuria in observation group showed no significant difference compared with those of the control group,the level of 24 h urine protein quantitation and CD19+ of both groups were significantly decreased,and the level of CD19+ of observation group was significantly lower than that of the control group (P ＜0.05),the level of albumin,total protein and CD3+,CD3+CD4+ of both groups were significantly increased,and the level of CD3+,CD3+CD4+of observation group were significantly higher than those of the control group (P＜0.05).The incidence of adverse reactions in observation group was significantly lower than that of the control group (P ＜0.05).Conclusion:Mycophenolate mofetil combined with glucocorticosteroid was more effective and safe on the children with anaphylatic purpura nephritis than that of cyclophosphamide combined with prednisone.

This paper analyses the defects of bubble oxygen inhalators currently used, and investigates into their solutions for improvement.
Oxygen Inhalation Therapy ; instrumentation ; methods ; Oxygenators ; standards

National Natural Science Foundation of China becomes a dominating competitiveness that reflects to hospitals' ability of scientific research in China.Based on application and fund availability of National Natural Science Foundation of Shanghai 6th people's hospital in recent years,this article compared data with other hospital's condition to analyze shortcoming and challenge.It also gave suggestions of selecting a subject,raising rate of support,training outstanding young researchers,enhancing interdisciplinary study,and advancing quality of academic papers.This article would give a reference to promote high-speed,harmonic and sustainable development of scientific research in our hospital.

Objective To investigate the effect of prosthetic replacement for senior patients with unstable intertrochanteric fractures of the femur.Methods Fifty-three senior patients with comminuted intertrochanteric fracture of the femur were subjected to total hip arthroplasty (n =23) and bipolar artificial femoral head replacement (n =30).Uncemented long-stem prostheses were used in 50 patients and cemented long-stem prostheses in 3.Time interval between admission and surgery was 3-13 days (mean 6 days).Results The total hip arthroplasty had the operation time for mean 90 minutes (range,80-110 minutes) and blood loss for mean 350 ml (range,260-410 ml).While the hemiarthroplasty had operation time for mean 65 minutes (range,50-90 minutes) and blood loss for mean 230 ml (range,180-290 ml).Fifty-one patients were available to mean 49.6-month follow-up (range,13-65 months).Four patients presented with frequent hip pain at a tolerable level after hemiarthroplasty and the symptom was relieved after oral non-steroidal anti-inflammatory drug therapy.One patient with postoperative infection was cured by timely debridement.Seven patients were died of heart and brain disorders in 5 years,with no relation to surgical complications.The period for fracture healing was mean 10 months,with excellence rate of 96％ for hip function but with no acetabulum abrasion,implant loosening or submersion.Conclusion Early prosthetic replacement is an effective treatment for unstable intertrochanteric femoral fractures in the elderly.