For better adaptation to clinical work and scientific research as well as self-development,medical postgraduates are required to improve their reading ability to harvest information from medical English articles.Constructing formal schema based on linguistic schema and enriching content schema can significantly enhance medical English reading ability,according to schema theory and education practice.Therefore,the learning mode was explored based on schema theory and this theory was applied in practice to elevate reading ability by means of reading report.

The present study is aimed to investigate the early clinical effects of nano-hydroxyapatite/polyamide 66 intervertebral fusion cage (n-HA/PA66 cage) for the treatment of lumbar degenerative diseases. We selected 27 patients with lumbar degenerative diseases who were managed by posterior decompression or reset operation combined with n-HA/PA66 cage intervertebral fusion and internal fixation from August 2010 to January 2012. The oswestry disability index (ODI), low back and leg pain visual analogue score (VAS), and intervertebral height (IH) were evaluated at preoperation, 1 week postoperation and the last follow-up period, respectively. Intervertebral bony fusion was evaluated at the last follow-up time. The patients were followed up for 12-24 months (averaged 19 months). The ODI, VAS and IH were significantly improved at 1 week postoperation and the last follow-up time compared with those at preoperative period (P < 0.05). But there was no significant difference between 1 week postoperative and the last follow-up time (P < 0.05). Brantigan's standard was used to evaluate fusion at the last follow-up time. There were 19 patients with grade 5 fusion, 8 with grade 4 fusion, with a fusion rate of 100%, and none with grade 1-3 fusions. There was no cage translocation and internal fixation breakage. These results suggested that n-HA/PA66 cage was an ideal biological material in the posterior lumbar interbody fusion and internal fixation operation for treatment of lumbar degenerative diseases. It can effectively maintain the intervertebral height and keep a high rate of bony fusion. The early clinical effect has been satisfactory.
Back ; Decompression, Surgical ; Durapatite ; Follow-Up Studies ; Fracture Fixation, Internal ; Humans ; Lumbar Vertebrae ; Nanostructures ; Nylons ; Spinal Fusion ; Treatment Outcome

Objective To investigate clinical value of inflame factors in child patients with sepsis at different time points before the diagnosis time.Methods A retrospective model was performed in this study.24 child patients with sepsis in Department of Paediatrics from January 2014 to October 2016 were selected.At the time 72 h(group A),48 h(group B),24 h(group C) before the diagnosis time,plasma levels of HBP and serum levels of IL-6,IL-10 were detected by ELISA,and pre calcitonin (PCT) and high sensitive C reactive protein (hs-CRP) were detected by immunofluorescence.Compared to the same period,22 healthy cases were selected as the control.Repeated measure anova and Receiver operating characteristic curve analysis were performed.Results The plasma levels of HBP were (9.69 ± 1.30) μg/L,(12.82 ±2.03) μg/L,(15.46 ± 1.02) μg/L,(18.60 ± 1.10) μg/L at group A,group B,group C before the diagnosis time respectively.The plasma levels of HBP at all time points before the diagnosis time were significantly higher than the control (t =6.27,P ＜ 0.01;t =16.82,P ＜ 0.01;t =25.16,P ＜ 0.01).The serum levels of HBP at group B,group C were significantly higher than the last time point (t =5.62,P ＜0.01;t =10.25,P ＜ 0.01).Receiver operating characteristic curve(ROC) revealed that the areas of HBP at group A(0.823),group B (0.898),was significantly higher than the other inflame factors(Z =2.41,P ＜0.01;Z=2.02,P＜0.05;Z=0.38,P＞0.05;Z=0.32,P＞0.05)(Z=0.43,P＞0.05;Z=0.46,P＞0.05;Z =0.26,P ＞ 0.05;Z =0.57,P ＞ 0.05).It also revealed that at group C,area of PCT(0.941) was significantly higher than the other inflame factors (Z =0.12,P ＞ 0.05;Z =0.08,P ＞ 0.05;Z =0.03,P ＞0.05;Z-0.10,P ＞ 0.05).Conclusions HBP has a wide diagnostic window period for sepsis.IL-6,IL-10,PCT and hs-CRP have diagnostic value in partial periods of sepsis.

Objective: To learn the mutation types and hearing screening results in local newborns of Zhoushan,in order to provide evidence for prevention and early detection of deafness. Methods: The newborns in Zhoushan Maternal and Child Health Hospital from August 2015 to May 2018 were recruited and detected by matrix-assisted laser desorption ionization time of flight mass spectrometry（MALDI-TOF-MS）for twenty-two mutation sites of GJB2,SLC26A,GJB3 and 12SrRNA genes. The results of genotyping and hearing screening were analyzed and the hearing condition of abnormal newborns was followed up. Results: Among 4 029 newborns,180（4.47%）newborns were identified to carry mutations,including 94 males（4.66%）and 86 females （4.28%）. There was no statistically significant difference in the rate of carrying mutations between male and female infants （P>0.05）. Totally 135 （3.35%）newborns failed in primary hearing screening,13（9.63%）of whom carried the deafness genes;3 894（96.65%）newborns passed,167（4.29%）of whom carried the deafness gene. There was statistically significant difference in the the rate of carrying mutations between newborns who passed and failed in primary hearing screening （P<0.05）. Eleven newborns were diagnosed with hearing loss,with a rate of 2.73‰. Among 180 mutations identified,there were 91 GJB2 mutations（2.26%）,57 SLC26A4 mutations（1.41%）,14 GJB3 mutations （0.35%）,15 mtDNA 12SrRNA mutations （0.37%）and 3 with mutations of two genes （0.07%）. Sixteen mutation sites （184 cases）were found,and the detection rate was 4.57%. Conclusion The rate of carrying deafness genes in Zhoushan newborns was 4.47%. The deafness genes found were mainly GJB2 and SLC26A4,the carrying rate of mtDNA 12SrRNA gene mutation was also high.

Objective To investigate the risk factors of pregnancy-induced hypertension (PIH) in Zhoushan Area. Methods A total of 55 PIH patients who were treated in Zhoushan Women and Children Hospital from January 2010 to December 2012 were enrolled as the PIH group, and another 55 pregnant women without PIH were set as the control group. The serum calcium(Ca2+), phosphorus(P3+), total cesterol(TC), and triglyceride(TG) were detected by biochemical analyzer. Univariate and multivariate analyses were performed to reveal the potential correlations between these biochemical indicators and PIH. Results The serum levels of Ca2+, P3+, and TC between PIH group and control group were significantly different (P<0.01 or P<0.05), while the TG showed no significant difference between these two groups (P=0.15). Multivariate Logistic regression analysis showed that serum P3+and TC were risk factors for PIH (P<0.01 or P<0.05) whereas serum Ca2+was a protective factor (P<0.01). Conclusion Serum Ca2+, P3+and TC levels can be used for monitoring PIH in the islands.

Objective:Based on the core competence of stroke certified registered nurses, this study construct the theoretical raining curriculum system for stroke certified registered nurses and made a preliminary evaluation.Methods:Using Delphi expert consultation method and based on literature research, the first draft of training course for stroke certified registered nurses was formed. In the form of Email, 14 experts in the field of stroke care who met the selection criteria were sent a questionnaire, and two rounds of consultation were conducted. The theoretical raining curriculum system for the training of stroke specialist nurses was constructed; the purpose sampling method was used to evaluate the application effect of the stroke specialist nursing theoretical training curriculum system through the theoretical performance and satisfaction evaluation of 127 trainees who participated in the first phase of the stroke specialist nursing theoretical training curriculum.Results:The recovery rate and effective rate of the two rounds of expert consultation questionnaire were 14/14, the authority coefficient of the second round of expert consultation was 0.94, and the expert Kandall coordination coefficients of the first, second and third-level indexes were 0.356, 0.216, 0.207 respectively ( P<0.05). The training curriculum of stroke specialist nurses finally formed included 5 primary indicators (Professional practice concept, general nursing knowledge, stroke diagnosis and treatment, acute stroke nursing management, secondary prevention of cerebrovascular disease), 21 secondary indicators and 63 tertiary indicators. The Analytic hierarchy process was used to determine the weight coefficients of all levels of indicators, and the consistency Ratio <0.1. Based on the curriculum system as the content framework, theoretical courses were set up to train stroke specialist nurses. 109 trainees completed the post-training assessment. Before training, the qualified rate of theoretical performance of stroke certified registered nurses was 77.95% (99/127), and after training, the qualified rate of theoretical performance of stroke certified registered nurses was 100% (109/109). The difference was statistically significant ( χ 2=27.60, P<0.01). The excellent rate of theoretical performance of stroke certified registered nurses before training was 35.43% (45/127), and 100% (109/109) after training, the difference was statistically significant ( χ 2=24.17, P<0.01).The average score of the trainees′ satisfaction was (38.90±2.55) points. Conclusions:The theoretical raining curriculum system for stroke certified registered nurses setting constructed in this study standardizes the training system of stroke nurses to a certain extent, and provides a basis for the construction of homogeneous training courses in China in the future.