Objective To understand the current circumstance of the surgical resident training bases in Beijing Methods The reassessment data of the 11 surgical resident training bases in Beijing were collected and analyzed. Results 73%(8/11)surgical resident training bases have passed the assessment; and 27%(3/11)have not completely reached the requirements The most prominent problems found in the reassessment were that the numbers of clinic and emergency patients in some departments;the qualification and teaching level of the instructors;the administration in the training process;the test after finishing the rotation and the training results, Conclusion Surical resident training bases criterion,instructor for resident training and administration in the training process are the most important factors which influence the surgical resident training results

BACKGROUND:Cartilage injury is stil one of the clinical problems difficult to be treated completely so far. Recently, the discovery of synovial mesenchymal stem cells (SMSCs) has brought about the new hope to cartilage repair.
OBJECTIVE:To explore the process concerning SMSCs-based therapy for cartilage repair in the past few years, such as the characteristics of SMSCs, culture conditions, preclinical and clinical studies, and then to summarize the literatures published in recent years.
METHODS:A computed-based online search of PubMed and SpringerLink databases was performed using the key words of“synovial mesenchymal stem cells, cartilage repair”for literatures published from January 1993 to May 2013.
RESULTS AND CONCLUSION:Final y, 37 articles were included. SMSCs have a greater proliferative capability, colony-forming potential and chondrogenic potential than other mesenchymal stem cells. The diseases such as osteoarthritis and rheumatoid arthritis can influence the characteristics of SMSCs. Numerous articles have aimed at the studies of cellculture in vitro and celltransplantation in vivo. However, the process of SMSCs therapy is mostly at its preliminary stage. Reports on its unique characteristics, optimal culture conditions and the high-quality clinical studies are stil largely lacking. In a word, though further studies are needed, SMSCs appear to be a promising cellsource for cartilage repair in the future.

Objective To investigate the epidemiology of bacterial infections after liver transplantation and anaIyze the antimi- crobial susceptibility of major pathogens to provide reference for clinical therapy.Methods A retrospective survey was conduc ted in 174 patients who underwent liver transplantation during 2001 and 2004.Identification and susceptibility of pathogens were assayed by Microscan Walkaway 40 Automatic System.Results Infection was identified in 59.8% of the 174 patients after liver transplantation.A total of 218 non-duplicate strains were isolated.Most infections were caused by single pathogen.The infection was frequently identified in respiratory tract,biliary tract,blood stream or intra-abdominal cavity.The top 5 patho- gens were Acinetobacter baumannii,Staphylococcus aureus,Pseudomonas aeruginosa,Stenotrophomonas maltophilia and Escherichia coli.Gram-negative bacilli were usually resistant to multiple antimicrobial agents,but less resistant to piperacillin- tazobactam or imipenem.Most of S.aureus isolates were methicillin-resistant,which were susceptible to vancomyein.Conclu- sions Pathogens of postoperative infections in liver transplantation recipients are mostly multi-drug resistant.The microbiologi- cal surveillance is important for guiding clinical therapy.

Objective To estimate the methodology for evaluating the analytical measurement range ( AMR) and the clinically reportable range ( CRR) in lab-developed system in clinical chemistry .Methods Method evaluation .Take serum CK for instance , a series of samples were prepared from both a specimen with a high concentration of the analyte of interest and a specimen with a low concentration for the following assays.Average slope method , linear dilution recovery method and the method recommended by Clinical and Laboratory Standards Institute ( CLSI ) EP6-A were used to established AMR in the lab-developed clinical chemistry system.Based on the maximum valid dilution of the specimen and the results of AMR , CRR were determined.One-half of the total error allowance ( TEa) of Chinese health standard was set up as allowance error (7.5%).Results X-Y scatter plot was made by assigning sample numbers to the horizontal axis and actual measured values to the vertical axis , which determined the upper limit of AMR was approximate 1 651 U/L.The results analyzed by average slope method indicated that the linear correlation between expected values and actual measured values was determined , the correlation (r), the intercept (a) and the slope (b) met the linear standard, and AMR was 5-1 699 U/L.The results analyzed by EP6-A indicated that the best fitting curve was obtained by using cubic polynomial method , and the linearity deviation of the minimum concentration was -77.1%, which exceeded one-half of TEa.Followed by the deletion of the maximum concentration , the resumed experiment was done .The results showed that the nonlinear coefficient c of quadratic polynomial and the nonlinear coefficient c and d of cubic polynomial have no significant difference to 0, and AMR was 7.5-1 458.0 U/L.By linear dilution recovery method , the linear correlation between expected values and actual measured values was determined , the correlation ( r) , the intercept ( a) and the slope ( b) met the linear standard , the recovery rates was between 100.0%and 104.8%, and AMR is 5 -1 699 U/L.The CRR was determined to be 5 -33 880 U/L, which met the standard of TEa . Conclusions Average slope method, linear dilution recovery method and EP 6-A method were all used to established AMR in lab-developed clinical chemistry system .Without complicated statistical analysis , linear dilution recovery method was suitable for clinical use .The linearity deviation of the minimum concentration analyzed by EP6-A did not meet the standard of the quality objective system , suggesting defects in the statistical analysis of the results .CRR was feasibly determined by using linear dilution recovery method align with AMR.

Objective: To screen for the differentially expressed genes in laryngeal squamous cell carcinoma and normal laryngeal tissue using cDNA microarray. Methods: The PCR products of 4 096 genes were spotted on a chemical material coated glass plates in array. The DNAs were then fixed on the glass plate by a serial of treatments. The total RNAs were isolated from the tissues, and then were purified to mRNAs by Oligotex. Both the mRNAs from the laryngeal squamous cell carcinoma and normal tissue were reversely transcribed to cDNAs with the incorporations of fluorescent dUTP, for preparing the hybridization probes. The mixed probes were then hybridized to the cDNA microarray. After high stringent washing, the cDNA microarray was scanned for the fluorescent signals and showed the differences between 2 tissues. Results: Among the 4 096 target genes, there were 36(0.88%) genes whose expression levels differed between the carcinoma and normal tissues in all 4 cases. Bioinformatical analysis of those genes had been performed. Conclusion: DNA microarray technology is an effective technique in screening for differentially expressed genes between 2 different kinds of tissue. Further analysis of the obtained genes will help to understand the molecular mechanism of malignant carcinoma. [

Objective To systematically evaluate the efficacy and safety of decompressive craniectomy and conservative treatment within 48 h of onset in malignant middle cerebral artery infarction.Methods Cochrane Library,Pubmed,Embase,CNKI,Chinese Biomedical Database,VIP information database,Wanfang database were searched,and the retrieval time was from the library being built to April 31,2015.Review Mannager 5.2 statistical analysis software was used to evaluate the treatment efficacy of decompressive craniectomy and conservative therapy,amd modified Rankin scale (mRS) scores were considered as the efficacy evaluation criteria.Results A total of six randomized controlled trial studies and two prospective studies were selected,including 201 patients from the decompressive craniectomy group and 197 patients from the conservative treatment group.The mortality of the two groups atter 12 months of treatment was significantly different (mRS scores=6,P=-0.000,OR=0.18,95％ CI:0.12-0.29).Moderate or severe disability rate after 6 months of treatment was significantly different (mRS scores=4-5,P=0.000,OR=3.36,95％CI:1.95-5.78),and that after 12 months of treatment was also significantly different (P=0.000,OR=4.62,95％CI:2.64-8.07).The number of patients enjoyed good life quality (mRS scores ≤ 3) 6 and 12 months after treatment between the two groups was statistically significant (P=0.010,OR=2.69,95％CI:1.21-5.96;P=0.020,OR=2.07,95％CI:1.11-3.87);mortality rate (mRS scores=6) and disability rate (mRS scores=3-5) of patients aged more than 60 years between the two groups were significantly different (P=0.000,OR=0.20,95％CI:0.10-0.42;P=0.000,OR=4.94,95％CI:2.35-10.35).Conclusion Regardless of age greater or less than 60 years old,decompressive craniectomy can significantly reduce the mortality of patients with malignant middle cerebral artery infarction within 48 hours as compared with conservative treatment,but surgery may increase moderate to severe disability.

Objective To investigate the relationship between the characteristics of psychological defense style and clinical symptoms of eating attitude in patients with anorexia nervosa patients. Methods Totally 92 ca?ses ( 46 cases of restricting type,46 cases of binge?eating/purging type,48 cases of early onset before 16 years old, 44 cases of late onset after 16 years old) meeting the Diagnostic and Statistical Manual of Mental Disorders,Forth Edition ( DSM?4) for anorexia nervosa (AN) were collected.92 gender?marriage?and education?matched normal cases in a psychiatric hospital were selected as the healthy control group(HC) .All were assessed with defensive style questionnaire(DSQ) and eating attitude test?26(EAT?26).DSQ and EAT?26 were compared between AN and HC,between early onset of AN( before 16 old years) and late onset of AN( after 16 old years) ,and between AN?R and AN?P.Then correlation study was done for the AN. Results Compared with HC,AN showed higher scores in the immature defense,neurotic defense ((4.49±1.13)vs (3.55±0.93),(4.33±0.76)vs (3.88±0.69), P<0.001), and higher EAT?26 median total and factor scores of dieting scale items,bulimia&food preoccupation scale items, oral control subscale items (P<0.01).Compared with AN?R,AN?P showed higher scores in the immature defense ((4.49±1.03)vs (4.79±1.13), P=0.01),and higher EAT?26 median total and factor score of bulimia&food pre?occupation scale items (P<0.05, P<0.01).The correlations between immature defense and EAT?26 total score,be?tween neurotic defense and EAT?26 total score were significant( r=0.472, P<0.001;r=0.315, P=0.002). The correlations between immature defense and EAT?26 dieting score, between neurotic defense and EAT?26 dieting score were significant( r=0.343, P<0.001, r=0.257, P=0.014).The correlations between immature defense and EAT?26 bulimia & food preoccupation score,between neurotic defense and EAT?26 bulimia & food preoccupation score were significant( r=0.523, P<0.001, r=0.267, P=0.010).The correlations between immature defense and duration were significant( r=0.375, P<0.001).The correlations between all defense factors and BMI were not sig?nificant( r=-0.15?0.25, P>0.05) . Conclusion AN patients tend to use more immature defense and neurotic de?fense compared with HC,and AN?P patients use more immature defense compared with AN?R. Immature defense and neurotic defense are related to the eating attitude,and the immature defense is related the duration.

Esophagectomy is one of the most complicated procedures. Satisfactory anesthesia not only ensures the safety in terms of low morbidity and mortality postoperatively, but also one of the potential factors relevant to long-term survival. Most of physicians, however, ignore the significance of anesthesia. This article focuses on the recent advances of anesthesia for esophagectomy in preoperative preparation for induction, rapid-sequence induction, one-lung ventilation, fluid management during surgery and postoperative early extubation and analgesia.
Analgesia ; Anesthesia ; methods ; Esophagectomy ; methods ; Fluid Therapy ; Humans

OBJECTIVETo compare the perioperative complications between Ivor-Lewis approach and McKeown approach in minimally invasive esophagectomy and gastric tube reconstruction for the treatment of middle and lower thoracic esophageal cancer.

METHODSRetrospective analysis of clinical data was performed on 288 patients with middle and lower thoracic esophageal cancer who underwent completely minimally invasive esophagectomy by one surgical team in Fujian Medical University Union Hospital from December 2010 to March 2014. Among the 288 patients, 103 patients underwent combined laparoscopic and thoracoscopic esophagectomy and intrathoracic esophagogastric anastomosis using a transoral anvil(Orvil)(Ivor-Lewis group, 2-incision) and 185 patients underwent combined laparoscopic and thoracoscopic esophagectomy and cervical anastomosis(McKeown group, 3-incision). Patients were stratified by surgical approach and perioperative outcomes were compared between the two groups.

RESULTSThere were no statistical differences between two groups in intra-operative blood loss, conversion to open, extubation time, time to resume oral intake, postoperative hospital stay, the median number of lymph nodes resected. The operation time of Ivor-Lewis group was significantly shorter than that of McKeown group [(283.4±32.0) min vs. (303.6±43.7) min, P=0.003). The hospital cost of Ivor-Lewis group was significantly higher than that of McKeown group [(76 492±18 553) yuan vs. (68 923±17 331) yuan, P<0.01]. There were no statistical differences between two groups in chylothorax, delayed gastric emptying, atrial fibrillation, postoperative bleeding, admission to ICU, short-term postoperative mortality (P>0.05). The total postoperative complication morbidity of Ivor-Lewis group was significantly lower than that of McKeown group(16.5% vs. 31.4%, P<0.01). Ivor-Lewis group had lower pulmonary complication(8.7% vs. 25.9%, P<0.01), anastomotic leakage(1.9% vs. 13.0%, P<0.01), anastomotic stricture (0% vs. 4.9%, P<0.05), recurrent laryngeal nerve injury(1.0% vs. 7.0%, P<0.05).

CONCLUSIONIvor-Lewis approach is associated with less postoperative complications, but higher cost as compared to McKeown approach in the treatment of middle and lower thoracic esophageal cancer.

Anastomosis, Surgical ; Anastomotic Leak ; Blood Loss, Surgical ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Humans ; Laparoscopy ; Length of Stay ; Minimally Invasive Surgical Procedures ; methods ; Operative Time ; Postoperative Complications ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies

OBJECTIVETo compare endoscopic approach with lateral rhinotomy for treatment of the sinonasal inverted papilloma in terms of advantage, indications and limitations of the procedures.

METHODSEighty-six cases with inverted papilloma were reviewed retrospectively, among which 23 cases underwent transnasal endoscopic procedures including 10 combined with Caldwell-Luc intervention, and 63 cases underwent lateral rhinotomy. The follow-up period ranged from 11 - 36 m (mean 23 m). The data were processed statistically by SPSS 10.0 software.

RESULTBoth procedures permitted removal of most sinonasal inverted papilloma. The endoscopic surgery provided an excellent visualization, and preserved a vital anatomic structure and left no facial scar. Lateral rhinotomy was associated with postoperative facial scar or deformity. The recurrence rate in lateral rhinotomy group was 9.5% and in endoscopic approach was 13% (P >0.05).

CONCLUSIONEndoscopic approach is favored for the treatment of non-massively extending sinonasal inverted papilloma because of an acceptable recurrence and a better cosmetic results.

Adolescent ; Adult ; Aged ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nose ; surgery ; Nose Neoplasms ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Papilloma, Inverted ; surgery ; Paranasal Sinus Neoplasms ; surgery ; Retrospective Studies ; Treatment Outcome