Objective To observe whether Mini-Clinical Evaluation Exercise ( Mini-CEX ) is effective and feasible for improving the clinical competency of residents receiving standardized training. Methods 40 residents receiving standardized training in the Second Affiliated Hospital of Amy Medical university were randomly divided into control group and experimental group, with 20 trainees in each group. From October 2015 to April 2018, the experimental group was trained by the traditional teaching methods combined with Mini-CEX, and the other was trained by traditional teaching method. At least 2 Mini-CEX were conducted for each trainee of the experimental group in each department. The Mini-CEX, defense of case report and OSCE evaluation were carried out to assess the clinical competence of residents after the standardized training. Satisfaction surveys were conducted for teachers and students who had used Mini-CEX . SPSS 18 . 0 was used to analyze the data . Independent samples t test was used for inter-group comparison and paired sample t test was used for intra-group comparison. P<0.05 was statistically significant. Results Mini-CEX showed that the scores of the two groups in the clinical competence assessment were improved; the scores of the experimental group were higher than those of the control group , and the improvement in scores of experimental group was higher than that of the control group (the differences were statistically significant, P<0.05). The average score of defense of case report of the experimental group was (81.16 ±3.75),while that of the control group was (70.13 ±3.88) (t=-9.140, P=0.000). The average total score of OSCE evaluation of the experimental group was (96.300±4.681), while that of the control group was (91.775 ±3.227) (t=-3.559, P=0.001). Satisfaction rate of teachers and students were 95.0％ and 92.5％respectively. Conlusion Mini-CEX can improve the clinical competence of residents receiving standardized training.

Objective To evaluate the 1-year follow-up effect of smoking cessation contest among government functionaries in Shanghai in 2015, providing evidence and basis for the effective intervention of smoking cessation. Methods A case-control study design was used for those who had quit smoking periodically, and their 1-year smoking cessation situation was investigated. Results At the 1-year follow-up after the contest, the relapse rate was 19.70%, of which 79.49% occurred within 2 months after quitting smoking.The main causes of relapse were the peer pressure and attack of smoking addiction. Conclusion After the smoking cessation contest, the 1-year follow-up relapse rate is at a low level, which indicates the contest among government functionaries in Shanghai in 2015 is effective.Education level is found to be a risk factor for relapse.

Objective To investigate the general situation, smoking status, smoking cessation status and one-month follow-up examination in Shanghai, providing scientific basis for further effective development of smoking cessation clinics in Shanghai. Methods A total of 841 smokers who visited the smoking cessation clinic from 2016 to 2018 were investigated and 725 patients were followed up one month later.The data thus obtained were analyzed by SPSS software. Results In general, of the visiting patients in 2018, 91.3% were male, 50.6% were 35-55 years old, 57.1% had educational background in primary school or below, and 60.2% were employees of enterprises, businesses and service industries.In terms of smoking, 44.1% of the patients smoked 10-20 cigarettes a day, 34.6% smoked for 10-20 years, and 38.6% smoked the first cigarette within 5 minutes after getting up.With regards to the situation of smoking cessation, 72.1% of the patients tried to quit smoking before going to the clinic; 14.8% of the patients used electronic cigarettes to help quit smoking; 33.9% learned about the smoking cessation clinic through the doctors; 61.4% decided to quit smoking because they were concerned about their health and the health of their family members.According to the follow-up, the rate of quitting smoking in one month in 2018 was 48.8%;44.0% of the patients believed that their own determination was the key to quit smoking; 46.2% of the patients who failed to quit smoking believed that if they tried to quit smoking again, the biggest obstacle was the onset of smoking addiction. Conclusion The establishment of smoking cessation clinics in Shanghai can help patients quit smoking.However, there are still some problems in this regard.In view of the characteristics of the patients going to the smoking cessation clinic, we should find out the weaknesses in the propaganda of the smoking cessation clinic in time.For example, it is found that there are fewer smoking women, less educated and less farmers visiting the clinic; according to the smoking situation of the patients, we should clearly focus on updating the service quality of the smoking cessation clinic; proceeding from the follow-up situation, we should find out the the approach to the construction and perfection of smoking cessation clinics in Shanghai.

OBJECTIVETo investigate the clinical symptoms, diagnosis and treatment of congenital petrous apex cholesteatoma.

METHODSA retrospective review of clinical symptoms, image findings and effect of operation in nine patients with congenital petrous apex cholesteatoma were performed.

RESULTS

CLINICAL SYMPTOMStwo cases of congenital petrous apex cholesteatoma patients had peripheral facial paralysis, and progressively aggravated;four cases of peripheral facial paralysis were repeated, without hearing loss; three cases firstly appeared hearing loss, followed by paralysis. When hospitalized, nine cases of patients had peripheral facial paralysis and hearing loss. Seven patients were complicated with tinnitus, and four had vertigo. HRCT scans showed petrosal apex damage; MRI showed that petrosal apex was occupied;and the facial nerve electromyography and evoked potential examination showed moderate-severe neurogenic changes. All were treated by surgeries, among them, 8 cases were by middle fossa approach, 1 case was by middle cranial fossa-translabyrinth combined approach. Two cases whose labyrinthine segment of the facial nerve injured severely, were operated by end to end anastomosis; 3 cases with facial nerve compression thinning, were operated by facial nerve decompression; 4 cases were horizontal segment of facial nerve exposed and edema. None of them had recurrence in a follow-up of 6 to 32 months. 3 cases of peripheral facial paralysis were lessened in different degrees.

CONCLUSIONSPatients with congenital petrous apex cholesteatoma have peripheral facial paralysis in the early stage. Computed tomography scanning, magnetic resonance imaging and facial nerve imaging has important significance to clinical diagnosis, choosing the approach of operation and dealing with the facial nerve during operation.

Cholesteatoma ; congenital ; diagnosis ; Decompression, Surgical ; Ear, Inner ; Facial Nerve ; Facial Paralysis ; Hearing Loss ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies

Objective:To investigate the safety and dose of 4D template (real-time adjustable angle template) in the treatment of advanced malignant tumors with 125I seeds. Methods:98 patients with advanced malignant tumors admitted to Department of Thoracic Surgery of Shaanxi Provincial Tumor Hospital were treated with 4D template-navigated radioactive 125I seed implantation from June 2018 to December 2019. Preoperative TPS plan, intraoperative optimization, postoperative verification of immediate dose and postoperative evaluation of implantation dose were performed. The treatment results were observed. Results:All 98 patients completed the seed implantation. The implantation dose of GTV of implantation site receiving external irradiation was (12 489±414) cGy and the dose of no external irradiation was (15 036±514) cGy. V 100% was 84.7%-94.1%, and 88.2%-93.7%. The implantation dose of CTV was (7 450±621) cGy, and (9 080±761) cGy. The quality of dose implantation was evaluated as: excellent in 89 cases (91%, 89/98), good in 7 cases (7%, 7/98), fair in 2 cases (2%, 2/98), and poor in 0 case, respectively. The symptom relief rate of patients with pain was 92%(36/39). The 1-and 2-year local control rates were 61%, 36% and 82%, 54% in patients treated with and without external irradiation, respectively. The difference was statistically significant ( P=0.02). The incidence rates of pneumothorax and hemoptysis were 19%(9/48) and 10%(5/48). No corresponding complications were observed in other parts of the patients. Conclusion:4D template-assisted 125I seed therapy is safe and effective for malignant tumors, and intraoperative adjustment of needle angle and dose optimization can realize the precise control of implantation dose.

ObjectiveTo analyze the timeliness of health science popularization during the outbreak of coronavirus disease 2019 （COVID-19） and its correlation with the epidemic situation and policies. MethodsThe original reports of health science popularization by 26 major media in Shanghai during the COVID19 outbreak between January 19 and March 25 of 2020 were retrieved， and the timeliness of the number of reports， media sources and categories， and contents were analyzed. ResultsDuring the epidemic of COVID-19， public media reported timely. Online media accounted for 63.35%， and text-based reports accounted for 85.90%. There was a correlation between the trend of the number of reports and the development of COVID-19 and the prevention and control policy issued by the government. After the change in the epidemic or the release of policy， the number of reports increased. The top four topics were personal protection， disease treatment， healthy lifestyle and psychological health， accounting for 18.62%， 18.54%， 12.96% and 11.74%， respectively. Reports focused on different aspects at different stages of COVID-19 epidemic， and the number of reports tended to increase one week after the occurrence of major events. ConclusionDuring the COVID-19 epidemic， the coverage of health science on media is timely and targeted. For future similar public health emergencies， it is suggested to respond quickly to major events according to the trend， to carry out publicity timely， to innovate the report forms， and thus make it easy for the public to accept and implement.

Objective: To examine the prevalence and trend of tobacco and e-cigarettes uses and identify the influencing factors for smoking behavior in junior middle school students in Shanghai, and provide data support and scientific basis for the development of tobacco control intervention strategy in adolescents. Methods: Multi-stage stratified random sampling method was used to select junior middle school students in 8 districts and 10 districts in Shanghai in 2013 and in 2019 respectively. Information about tobacco and e-cigarettes uses in the students were collected by using self-administrated questionnaire. The prevalence of tobacco and e-cigarettes uses were calculated, the difference between two years was compared with χ² test. The influencing factors were identified by multivariate logistic regression analysis. Results: In 2019, the current smoking rate was 0.6% in junior middle school students in Shanghai, and the smoking attempt rate was 2.9%, both were lower than the levels in 2013 (0.7% and 6.9%). The current use rate of e-cigarettes was 0.6% in 2019,with no significant change compared with 2013 (0.6%). The proportion of the students who had heard of e-cigarettes in 2019 (78.4%) was higher than that in 2013 (47.2%). In 2019, the second-hand smoke (SHS) exposure rate at home, in both indoor and outdoor public places and on public transportations was 72.5%, which was slightly lower than the level in 2013 (73.0%), the differences were all significant (P<0.05). In 2019, the students seeing close friend smoking (OR=27.381, 95%CI: 12.037-62.287), seeing someone smoking in school (OR=2.477, 95%CI: 1.155-5.312), believing that SHS may not be harmful (OR=8.471, 95%CI: 1.464-49.005) had higher possibility of smoking. Being aged ≥15 years (compared with being aged ≤12 years, OR=8.688, 95%CI: 1.922-39.266), exposure to SHS in outdoor public place (OR=8.608, 95%CI: 1.048-70.692), close friend smoking (OR=8.115, 95%CI: 1.754-37.545) were positively associated with e-cigarettes use, and believing that smoking results in uncomfortable social contact [compared with believing that smoking results in comfortable social contact (OR=0.105,95%CI: 0.018-0.615)] were negatively associated with e-cigarettes use, the difference was significant (P<0.05). Conclusion: The prevalence of tobacco and e-cigarette uses in junior middle school students in Shanghai remained at a low level in recent years. The SHS exposure rate in junior middle school students is high. Smoking behavior of junior middle school students is closely related to personal attitude and awareness of tobacco, exposure to SHS, peer smoking and the situation of tobacco control in schools. Prevention and intervention should be carried out from multi-dimensions to effectively protect teenagers from tobacco hazards.
Adolescent ; China/epidemiology* ; Electronic Nicotine Delivery Systems ; Humans ; Prevalence ; Students ; Tobacco ; Tobacco Smoke Pollution