Angioplasty, Balloon, Coronary ; adverse effects ; Coronary Restenosis ; prevention & control ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Endothelial Cells ; drug effects ; physiology ; Humans ; Phytotherapy ; Stents ; adverse effects

Objective To evaluate the safety and clinical effects of radiofrequency single catheter ablation (RESCA)for right ventrieular arrhythmia(RVA).Method A total of 111 patients data in the Second Affiliated Hospital of Wenzhou Medical College from May 2003 to May 2008,were retrospectively analyzed aged(45.2±16.7)years old including 41 men and 70 women,consisted of 13 patients of ventricular tachycardia(VT)and 98 patients of premature ventricular contractions(PVC).There were 104 casess from right ventricular outflow tract arrhythmia(RVOTA)and 7 cases from right ventricular inflow tract arrhythmia(RVITA).According to use single catheter approach or common technique,electrophysiolo-gical study,pacing and/or activation mapping and Catheter ablation were performed,were separated into two groups.①Single catheter group:27 men and 49 women,ages(44.5±16.9)years old;consisted of 62 patients of RVOT-PVC,9 patients of RVOT-VT and 5 patients of RVIT-PVC.②Control group:14 men and 21 women,ages(46.7±16.5)years old;consisted of 29 patients of RVOR-PVC,4 patients of RVOT-VT and 2 patients of RVIT-PVC.Results Operations in two groups came off smoothly and no ablation related complications in two groups.Procedure time and fluoroscopy time[(55.23±26.24)min and(9.93±5.32)min]in single catheter group were significantly shorter than those in control group [(68.37±21.83)min and(12.96±4.54)min,t=2.76 and 3.09,all P<0.01].Cost in the fromer (12440.32±761.24)RMB were significantly less than those in the latter[(22119.51±1071.07)RMB,t=46.09,P<0.01].Ablated successful rate in the near future,at a specified future date and other parameter were similar in two groups.Conclusions Right ventricular arrhythmia can be ablated with single catheter approach in safety,efficacious,easy to operate and lower cost.

Objective To explore the application of PBL teaching method and brainstorming method in the training of medical students' medical record writing ability,in order to strengthen the cultivation of medical students' medical record writing ability.Methods 122 medical undergraduate interns of Grade 2010 majoring in clinical medicine in our hospital were taken as the research object,of which 60 were in the experimental group,62 were in the control group.PBL teaching combined with brainstorming method was used in the experimental group,while the control group used the traditional teaching method of teaching.After the end of the training course,data were analyzed using SPSS 19.0 software,count data and measurement data were analyzed using chi square test and t test to carry out the significant test between the two groups of data,the training effect was compared between the two groups.Results The results of questionnaire in the experimental group were significantly higher than those in the control group,and the difference was statistically significant,The experimental group theory test scores were higher than the control group[(84.28 ± 6.65) vs.(74.52 ± 6.75)],and the difference was statistically significant;The experimental group outstanding achievement ratio was higher than the control group,and the difference was statistically significant;The proportion of operation and non operative medical records in the experimental group were higher than that in the control group (P=0.005,P=0.004).Conclusion Combined application of PBL teaching method and brainstorming method plays a positive role in superposition and complementation.It gives full play to and mobilizes the students' enthusiasm and initiative,and the training effect is obviously superior to the traditional teaching method,therefore it is worth popularization and application in the training of students' medical record writing ability.

BACKGROUND: Anterior cruciate ligament (ACL) injury directly impacts the individual's lower limb function. It is very important for althelets whether rehabilitation training after ACL reconstruction is reasonable, effective and can restore the normal function of the knee joint.OBJECTIVE: To explore the effect of rehabilitation training on graft healing and knee joint function recovery after ACL reconstruction. METHODS: An elite rugby player was enrolled and subjected to phased rehabilitation training after ACL reconstruction. MRI examination was done before and after rehabilitation training. Then, the following indicators were tested, including joint flexion of knee, leg circumference degrees, isokinetic muscle strength of the lower limb, feedback test, the test of YBT, the Balance Error Scoring System, feedforward test, static balance test on one foot, dynamic balance test on the feet, Lysholm knee score, anaerobic work of the upper extremity, torso strength, to analyze the graft healing, body shape, the knee joint function and physical quality improvement after ACL reconstruction. RESULTS AND CONCLUSION: After 10 months of phased rehabilitation training, the graft healed well; the knee flexion degree was back to normal; knee joint swelling basically eliminated; the muscle strength of the extensor flexor of the knee joint was back to over 95% of the normal level; the function of the injured knee joint was good and returned to a higher level; the Lysholm knee score was 85 points; the anaerobic work of the upper limbs and trunk strength reached to 120% of the normal level; and the quality of the body was greatly improved. To conclude, a great improvement in graft healing, knee joint function, recovery of muscle strength and physical qualities has been achieved in athletes who receive rehabilitation training after ACL reconstruction.

Objective:To understand the current situation of physicians′ competency in China and statistically analyze its influencing factors, hence providing referential evidences for promoting their competency.Methods:The evaluation scale for Chinese physicians′ competency was developed by referring to sophisticated overseas evaluation frameworks. Based on the electronic platform of the medical alliance, stratified sampling was conducted at 39 hospitals in 13 provinces, from which 2 156 physicians were surveyed, and statistical analysis was made on the current situation and influential factor of their competency in 6 dimensions(medical knowledge, diagnosis and treatment, scientific research and teaching, interpersonal communication, spirit of professionalism, population health)Results:The score range in multiple dimensions of physicians′ competency was between 2.85 and 3.89(5 in total), among which spirit of professionalism dimension scores the highest, and teaching and research dimension scores the lowest. Logistic regression analysis shows that their competency level in 6 dimensions is correlated to a range of factors, including gender, degree, title, supervisor qualifications, standardized training program of specialist physicians, and affiliation or not to teaching hospitals( P<0.05). Conclusions:Their overall competency is expected to be elevated. To name a few, they are lack of teaching and research abilities, and need to conduct clinical-oriented scientific research; they are expected to enrich knowledge structure, and need to embrace a wider concept of health; they need to improve their non-technical service abilities, and should further emphasize their humanistic quality; physicians′ practice competency depends upon their extent of medical education, and ensuring the quality of standardized training becomes the key measure.

Objective To report our self-designed guide module for placement of posterior column lag screws in anterior-posterior column acetabular plate using CT reconstruction data.Methods The CT scan data of 50 normal adult pelves were collected from February 2012 to April 2013,involving 30 males and 20 females with an average age of 46.4 years(range,from 25 to 69 years).The data were imported into Mimics 10.01 software for reconstruction of semi-pelvic models.Virtual cylindrical implants were placed intraosseously in both the left and the right posterior columns.The perpendicular distance (OP) from the insertion point O of the virtual cylindrical implant to the arcuate margin (P) and the distance (PI) from the point P to the point I,the crosspoint of the extension line of the ischial ramus and the arcuate margin were measured respectively.The angle (∠φ) between the direction of screws and the plane of guide module and the angle (∠θ) between the direction of screws and the long axis of guide module were also measured respectively.Results The average length of PI was 0.98 ± 0.13 cm,with 1.08 ± 0.22 cm in females and 0.95 ± 0.27 cm in males.The difference between genders was not statistically significant (P ＞ 0.05).The average length of OP was 1.09 ± 0.26 cm,with 1.06 ± 0.29 cm in females and 1.12 ± 0.24 cm in males.The gender difference was not statistically significant either (P ＞ 0.05).The mean value of ∠ φ was 55.43° ± 3.64°,with 55.33° ± 4.00° in females and 55.50° ±3.43° in males.The difference between genders was not statistically significant (P ＞ 0.05).The ∠θ value in females was 39.21 ° ± 2.45° and 35.58° ± 2.31 ° in males.The gender difference was statistically significant (P ＜ 0.05).Conclusions In design of the guide module,the nail holes should be located about 1 cm away from both the posterior edge and the medial edge,the angle between the screw direction and the module plane should be approximately 39° in females and 35° in males,and the angle between the screw direction and the long axis of the module approximately 55°.

Objective To investigate the reference intervals of mean corpuscular volume (MCV) ,mean corpuscular hemoglo‐bin(MCH) and mean corpuscular hemoglobin concentration (MCHC) examined by the MindrayBC‐6800 hematological analyzer to establish the reference intervals suitable for our laboratory .Methods According to the method recommended by the NCCLS C28‐A3 ,600 healthy adult individuals were selected as the reference individuals .MCV ,MCH and MCHC levels were determined by the MindrayBC‐6800 hematological analyzer for constructing the reference intervals ;other 150 healthy persons undergoing the physical examination were selected and their MCH ,MCV and MCHC detection results were collected for verifying the established reference intervals .Results The detection results of MCV ,MCH and MCHC in healthy adults showed a normal distribution ,MCV had sta‐tistical difference among different age periods (P<0 .05);the reference intervals :82 .278 -94 .242 fL for young adults ,83 .032-94 .608 fL for the middle‐aged persons and 83 .137-96 .343 fL for the elderly .MCH had statistical differences between different se‐xes and among different age periods ;the reference intervals :27 .785-32 .415 pg for male young adults ,28 .324-32 .456 pg for male middle‐aged persons and 28 .274-32 .966 pg for male elderly ;27 .367-31 .973 pg for female young adults ,27 .445-32 .215 pg for female middle‐aged persons and 27 .532 -32 .468 pg for female elderly .MCHC had statistical difference between different sexes (P<0 .05) ;the reference intervals :328 .611-352 .810 g/L for male and 323 .771-348 .750 g/L for female .In 150 individuals un‐dergoing the physical examination ,the proportion of individuals locating at the outside of reference interval was less than 10 .0% , therefore the newly established intervals were suitable for this laboratory .Conclusion The sex difference or/and age differences of MCV ,MCH and MCHC exist among adult populations .So the reference intervals are respectively established according to the prac‐tical situation ,which are suitable for this laboratory by verification .

Objective To explore the clinical outcomes of different mild-stimulation in poor ovarian responders in vitro culture/intracytoplasmic injection (IVF/ICSI) to provide the evidence for clinical treatment,and investigate clinical parameters including pre-ovulation rate,rate of oocytes retrieved,fertilization rate,good quality embryo rate,and pregnancy rate per cycle.Methods The clinical date of a total 180 IVF cycles of infertile patients undergone from Jan 2013 to May 2016 in medical reprodution center of Xiang Tan Central Hospital.According to the different methods of controlled ovarian hyperstimulation (COH),the cycles were divided into 3 groups:group A with 60 cycles of early five days using clomiphene,group B with 60 cycles of persistent using clomiphene,and group C with 60 cycles using artificial luteal-phase ovarian stimulation protocol.Results The basic situations in three groups were no significant difference (P ＞0.05).Compared to groups B and C,the pre-ovalution rate was more in group A (P ＜ O.05),and the rate of oocytes retrieved,fertilization rate,good quality embryo rate,and preganacy rate per cycle were higher in groups B and C (P ＜ 0.05).The rate of oocytes retrieved,fertilization rate,good quality embryo rate,and preganacy rate per cycle were no significant difference among gourps B and C.The good quality embryo rate and preganacy rate per cycle in groups B and C were higher than group A,and group B was higher than group A (P ＜ 0.05).Conclusions Persistent using clomiphene or persistent using clomiphene in COH could decrease the rate of pre-ovalution,and get more rate of oocytes retrieved,good quality embryo rate,and preganacy rate per cycle.

Objective To study the use of a preoperative predictive scoring system established by the Beth Israel Deaconess Medical Center,Washington University School of Medicine and Hospital of the University of Pennsylvania for patients with clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy.Methods The clinical data of 394 patients who underwent pancreaticoduodenectomy at the Provincial Hospital Affiliated to Anhui Medical University from September 2007 to December 2015 were retrospectively analyzed.The four indexes including the gland texture,pathology,pancreatic duct diameter and intraoperative blood loss were calculated for the predictive score system using the logistic regression test.The factors associated with CR-POPF were analyzed.The sensitivity and specificity of the predictive scoring system were determined by the receiver operating characteristic (ROC) curve analysis.Results Of the 70 patients who were diagnosed to have postoperative pancreatic fistula (POPF),34 were CR-POPF,which included 36 with grade A,23 with grade B and 11 with grade C.Univariate analysis showed that male,preoperative serum total bilirubin level ≥ 170 mmol/L,pancreatitis or pancreatic cancer,portal vein invasion,soft pancreatic texture,main pancreatic duct diameter ≤ 3 mm,and pancreaticojejunostomy were significantly related to POPF after pancreaticoduodenectomy (P ＜ 0.05).Portal vein invasion,pancreatic texture and main pancreatic duct diameter were the risk factors of CR-POPF after pancreaticoduodenectomy (P ＜ 0.05).Multivariate analysis showed the independent risk factors associated with POPF were male,preoperative serum total bilirubin level ≥ 170 mmol/L,soft pancreatic texture and main pancreatic duct diameter ≤3 mm (P ＜ 0.05),while soft pancreatic texture and main pancreatic duct diameter ≤3 mm were the independent risk factors of CR-POPF (P ＜ 0.05).There were significant differences in the clinical relevant postoperative pancreatic fistula rates among the negligible risk,low risk,intermediate risk,and high risk patients with CR-POPF (P ＜ 0.05).The results of ROC curve analysis showed that the sensitivity and specificity of the Fistula Risk Scoring system were 76.5％ and 95.8％,respectively.The nomogram showed the area under the curve was 0.913 (95％ CI:O.858 ～ 0.968).Conclusion The preoperative predictive scoring system accurately predicted the occurrence of CR-POPF.

Objective To investigate the iodine content of food in six provinces of China,to add the results of this survey to the food iodine content database,and to provide a scientific basis for iodine supplementation in different parts of China.Methods A total of 8 categories and 39 species common food produced locally in the six provinces of Fujian,Chongqing,Shandong,Anhui,Gansu and Jilin were collected.Samples of cereals,beans and other dry samples were crushed into powder; samples of fresh fruits and vegetables were washed and dried to constant weight,and crushed into powder; poultry,meat and fish samples were washed and then their edible parts were crushed into meat paste,bake dried to constant weight,and crushed into powder.Iodine content in the above-mentioned food was determined by catalytic spectrophotometry,and the wavelength was 405 nm.Data processing and statistical analysis were carried out by using SPSS 13.0 statistical software.The results of total iodine content of the various types of food were expressed as median(P50) and interquartile range(P25 and P75).Results The iodine content of the cereal in Fujian,Chongqing,Shandong,Anhui,Gansu and Jilin were 11.9,12.0,48.0,95.1,13.0and 3.1 μg/kg,respectively; of the potato were 53.9,26.3,74.9,43.7,76.8 and 38.5 μg/kg,respectively; of the meat and the eggs were 56.0,30.4,78.6,124.6,47.7 and 34.8 μg/kg,respectively; of the aquatic products were 319.3,144.7,186.6,241.3,155.4 and 213.3 μg/kg,respectively; of the vegetables were 166.6,145.1,131.7,218.0,205.4 and 98.1 μg/kg,respectively; of the fruits were 105.5,17.8,80.9,1.7,76.7 and 10.3 μg/kg,respectively; of the kelp and laver were 36.0 × 103,1292.0 × 103,2810.0 × 103,48.0 × 103,75.0 × 103 and 120.0 × 103 μg/kg,respectively; of the Chinese pickled vegetables were 640.4,4163.5,3073.7,2635.3,1540.9 and 492.0 μg/kg,respectively.ConclusionsThe iodine content of different types of food,and same kind of food from different provinces are different.The results are a complement to the 2004 Chinese food composition database.