Animals ; Diet, Atherogenic ; Disease Models, Animal ; Heart ; physiopathology ; Myocardium ; pathology ; Obesity ; etiology ; physiopathology ; Rats ; Renin-Angiotensin System ; physiology

Objective To investigate the critical thinking ability of medical students and its related factors in order to provide evidence for higher medical education reform. Methods A total of 325 medical students were selected by cluster sampling method, and Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) was adopted for survery. Results The average total score of critical thinking ability of medical students was above 280, and 51.08% of students showed positive critical thinking ability. Among all the seven critical thinking dispositions, average scores of each item were all positive (>40) except that the significance of truth seeking (37.23) and systematicity (39.05) were indefinite. There were significant differences in critical thinking ability between medical students with different gender and academic years (P<0.05). Conclusion The critical thinking ability of medical students is positive, however, there still exist some shortages. An equal relationship between teachers and students should be established, the traditional course system be continuously reformed, a good environment for clinical training be created, and a variety of teaching methods be implemented to further strengthen the critical thinking ability of medical students.

Adult ; Endoscopy ; Female ; Humans ; Maxillary Sinus ; Neurilemmoma ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Paranasal Sinus Neoplasms ; surgery ; Temporal Bone ; innervation

OBJECTIVETo evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy and repair of the injured posteromedial complex structure of the knee joint in the treatment of posterolateral knee dislocation with multiple ligament injuries.

METHODSFrom March 2008 to August 2012,22 patients (16 males and 6 females, ranging in age from 20 to 53 years old, with an average of 30.5 years old) with posterolateral dislocation of the knee were treated with primary reconstruction of ACL and PCL, combined with the repair of injuries in the posteromedial complex and soft-tissue. Eight patients had injuries caused by sports,5 patients road accidents and 9 patients falling down. The ACL was reconstructed using the gracilis and semitendinosus tendons. The PCL was reconstructed using LARS artificial ligaments (14 cases), or gracilis and semitendinosus tendons (8 cases). Suture repair was performed in 17 patients with posteromedial ligament injuries,and self-semitendinosus strengthening operations were performed in 5 patients. Continuouspassive montion (CPM) and active exercises were executed after operation at early stage. The IKDC and Lysholm system were used to evaluate therapeutic effects.

RESULTSAll the patients were regularly followed up, and the duration ranged from 11 to 56 months (averaged, 39 months). According to the IKDC scale,9 patients got a grade A result, 10 got a grade B result, and 3 got a grade C result. The IKDC subject score was 89.6±3.1 and the Lysholm scores was 90.7±1.8 at the latest follow-up, which were both better than those before operation.

CONCLUSIONReconstructing the ACL and PCL and repairing injured posteromedial complex of the knee followed by an active rehabilitation is an effective method to treat posterolateral knee dislocation.

Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; methods ; Female ; Humans ; Knee Dislocation ; surgery ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Reconstructive Surgical Procedures ; methods

Objective To investigate the role of acid-sensing ion channels (ASICs) in global cerebral ischemia-reperfusion (I/R) injury in rats. Methods Forty-eight adult male Sprague-Dawley rats weighing 250-310 g were randomly divided into 4 groups ( n = 12 each): sham operation group (group S); global cerebral I/R group (group I/R); normal saline group (group NS) and specific ASIC blocker amiloride group (group A). Global cerebral I/R was produced by occlusion of 3 vessels ( 10 min occlusion of the bilateral common carotid arteries and basilar artery) followed by reperfusion. In group NS and A, NS 6 ml/kg and amiloride 0.6 mg/kg were injected through femoral vein immediately before reperfusion respectively. Six rats in each group were selected, the dialysate in CA1 area was collected before ischemia (baseline), immediately after ischemia and during 20 min reperfusion (once every 10 min) for determination of lactate concentrations. The left 6 rats in each group were elected at 8 h of reperfusion and the open field test and inclined plane test were peeformed to assess neurological behavior.The rats were then sacrificed and brain tissues taken for microscopic examination and brain water content was calculated. Results Compared with group S, the concentration of lactate in the dialysate and brain water content were significantly increased and neurological deficits developed in group I/R and NS (P ＜ 0.05). Compared with group I/R, the concentration of lactate in the dialysate and brain water content were significantly decreased and neurological deficits were improved in group A ( P ＜ 0.05 ), but no significant change in the parameters mentioned above was found in group NS ( P ＞ 0.05). Microscopic examination showed that the damage to the brain tissues was attenuated in group A compared with group I/R. Conclusion ASICs are involved in the development of global cerebral I/R injury in rats.

Apnea ; epidemiology ; pathology ; therapy ; Birth Weight ; China ; epidemiology ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Very Low Birth Weight ; Male ; Risk Factors ; Time Factors

OBJECTIVE To estimate the cost of concentrated disinfectant supply of medical appliances,so as to provide the primary basis for improving the concentrated disinfectant supply model,along with regional integration.METHODS Using contrasting methodologies,the cost level before and after the concentrated disinfectant supply with regional integration was compared,and the individual cost and total cost were analyzed.RESULTS Material and human resource cost was the core of total cost.Concentration management of regional medical appliances disinfection supply could significantly reduce costs.CONCLUSIONS Integrated management of concentrated disinfectant supply could reduce cost and economize expenses.Actually,this model is worth promoting.

Objective To study the clinical application of quantitative ultrasound(QUS) which evaluate skeletal status of children and adolescents.Methods Subjects were children and adolescents aged 0-18 years old.Tibia/radial bone strength was obtained using QUS.Children who were younger than 2 years old only were measured at midpiece of tibia,and children who were older than 2 years old were measu-red at midpiece of tibia and radius.At the same time,calcium in peripheral blood was measured by the method of atomic absorption.Results 1.Radial and tibial bone strength presented nonlinear growth with age in healthy children and adolescents.2.Bone strengths of different anatomic-sites were different and the disparity rate of evaluation at different anatomic sites was 30.1%.3.The bone strength of the children who had some risk factors that could induce decrease of bone strength or had some diseases of bone metabolism was lower than healthy children.Composition of low bone strength children was 71.1% in high risk children,and was 47.9% in those who had some symptom or physical sign of calcium deficiency.4.Composition of low bone strength children was 44.2% in those who had normal peripheral blood calcium,and composition of normal bone strength children in those who had low peripheral blood calcium was 59.7%.The 2 methods had no correlation.Conclusions QUS is a quite useful technique in evaluation skeletal status of children and adolescents,and is sensitive for high risk children.It is necessary to measure radius and tibia,and consider blood calcium and bone strength to evaluate practical level of calcium and nutritional state of children.

Objective To understand the status and drug resistant patterns of strains of extended spectrum ?-lactamase(ESBLs) in children with lower respiratory tract infection,and to give clinical suggestions for rational treatment.Methods Escherichia coli and klebsiella pneumoniae were isolated from the 2 969 nasopharyngeal secretions which collected from lower respiratory tract of children in our hospital from Jan.2006 to Dec. 2007.Dual-sheets and sheets-diffusing method (K-B method) were used to determine the ESBLs and antibiotic susceptibility was tested by K-B method which included 18 kinds of antibiotics,the results were marked by resistant,intermedial and sensitive.Chi-square test was used to analyze the data.Results Total 135 strains were detected,73 strains were escherichia coli,of which 54 strains(74.0%)produced ESBLs,62 strains were klebsiella pneumoniae,of which 33 strains(53.2%)produced ESBLs.The 2 bacterias were found more in children with 1-6 months old than those in other age groups,the ratio of which were 50 strains and 41 strains,respectively (Pa0.05).The resistant rate of ESBLs-producing strains to penicillins,cephalosporins,quinolones,aminoglycosides and sulfamido was higher than that of non ESBLs-producing strains respectively.And the resistant rates to beta-lactam antibiotics of ESBLs strains were located on a high level.Whether producing ESBLs or not,the 2 bacterias were still sensitive to amikacin,cefoxitin,cefoperazone/sulbactam and imipenem.Conclusions The prevalences of ESBLs-producing escherichia and klebsiella pneumonia were high.There was a multi-drug resistance to the varied antibiotics.It is very important to make sputum culture and use sensitive antibiotics in treatment according to drug sensitivity test to control the occurrence and conveying of the ESBLs.

Objective To investigate the change of cardiac function in elderly hypertensive patients with heart valve degenerative by echocardiography.Methods A total of 126 cases were divided into a valve disease group and non-valve disease group groups.The parameters of trial size,cardiac function and pulmonary artery pressure were detected.Results Of all 126 cases were the patients with hypertension including 28.6% (36/126) of valve disease group and 71.4% (90/126) of non-valve disease.There were 31 cases with mitral valve disease,22 cases with tricuspid valve disease; 26 cases with aortic valve disease; 36 cases with double or three alvular lesions in valve disease group.There was a significant difference in ventricle size and systolic function among valve disease group and non-valve disease group and control group.But there was no significant difference in thickness of ventricular wall between valve disease group and non-valve disease group.Conclusion The elderly hypertensive patient with valve disease was an independent factor for the development of congestive heart failure.