According to teaching outline and clinical training characteristic of psychophy-laxis speciality(including Psychiatry and Medicopsychology),we explored how to strengthen the clinical thinking ability and clinical skill training for clinical medicine students based on cultiva-tion of elementary knowledge and theory,and we also established a set of more appropriate item system of clinical skills assessment so as to improve the practice quality in psychiatry and medical psychology departments.

AIM:To investigate the cause of blindness, except those caused by cataract, in Haimen city.METHODS:According to the WHO`s criteria of blindness, the blindness level was decided through ophthalmic tests by associate chief or chief ophthalmologists who were trained especially for disability evaluation.The analysis of the the leading cause were taken too.RESULTS:Totally 3 266 persons were blindness, in which 2 118 were first level blindness, 1 148 persons were second lever blindness, and 1 308 persons were male, 1958 were female.The leading cause of blindness were retina and uveitis diseases (31.58%), genetic diseases(23.47%), cornea disease(14.49%).CONCLUSION:The leading cause of blindness are retina and uveitis diseases, genetic diseases, cornea diseases in Haimen city of Jiangsu province.Early prevention and treatment should be strengthened to reduce the occurrence of blindness.

Objective To review the experience of perioperative management and effect of valve replacement combined with renal dysfunction.Methods 536 cases of valve replacement.According to preoperative glomerular filtration rate(GFR),renal dysfunction was classified as normal in 322 cases,mild in 162,moderate in 40 and severe in 12.Logistic regression analysis was used to assess the effect of preoperative renal dysfunction on operative mortality and morbidity.Results Patients with a lower GFR were older and more likely to have hypertention.They also tended to have larger left ventricular end-diastolic diameter and worse left ventricular ejection factor.Operative mortality rose inversely with declining renal function,from 2％ for those with normal renal function to 17％ for patients with severe renal dysfunction.Renal dysfunction was significantly associated with a large blood transfusions,re-intubation,longer mechanical ventilation,intensive care unit stay and hospital stay.Conclusion Preoperative renal dysfunction is an important factor of postoperative mortality and morbidity for valve replacement.We must pay more attention to perioperative management.

ObjectiveTo improve the teaching quality of medical humanity education in medical university.MethodsA cluster sampling survey was given to 448 sophomores who studied the outline of medical humanities course in military medical university,and the data were descriptively and statistically analyzed.ResultsThe survey shows that 90％ sophomores satisfy with this course,95％ sophomores understand the importance of medical humanity education,and the students have more requirements on education resources and teaching ways.ConclusionOutline of medical humanities course is important to cultivate the medical humanity spirit of medical students,and the course still needs more improvements.

Objective Investigate the reasonable surgical approach combined with frozen sections pathological features of papillary thyroid microcarcinoma.Methods Clinical data of 96 cases papillary thyroid microcarcinoma nearly 5 years of follow-up in our clinic referral was retrospectively analyzed.Metastasis and recurrence rate were compared between group of ipsilateral lobe plus isthmus resection (unilateral group) and group of ipsilateral lobe plus isthmus resection and contralateral lobe subtotal (bilateral group).Metastasis and recurrence rate were compared between group of central lymph node dissection (dissection group) and non-dissection group (non-dissection group),and the injury rate of the recurrent laryngeal nerve was also compared between the two groups.Results The diagnosis of cancer by intraoperative frozen pathology were 53 cases (55％).Whether in high or low risk populations,the metastasis and recurrence between unilateral and bilateral groups showed no significant difference (P ＞ 0.05).Whether in high or low risk populations,the metastasis and recurrence between dissection group and non-dissection groups showed no significant difference (P ＞0.05).The temporary injury rate of recurrent laryngeal nerve in dissection group were higher than thatin non-dissection group both in high-risk populations (P =0.040,P ＜ 0.05) and low risk populations(P =0.037,P ＜ 0.05).Conclusions Intraoperative frozen pathological diagnosis of papillary thyroid microcarcinoma is difficult.The reasonable surgical approach for the first time is ipsilateral lobe plus isthmus resection.Preventive cervical dissections operation should not be carried out if the exploratory of lymph node showed no metastasis.

The main active components in Ginkgo biloba extracts were Ginkgo biloba flavonoids and lactone compounds. This pa-per reviewed on the kinds and pharmacological effects of the active ingredients in Ginkgo biloba extracts, and focused on four aspects including controlled-release preparations, solubilized solid preparations, nanoparticle formulations and time- and site-specific formula-tions to introduce the development in the new dosage forms of Ginkgo biloba flavonoids and lactone compounds.

Objective To investigate the esthetic effect of anterior ultra-thin veneers which were fabricated from heat pressed IPS e.max press ingots of high translucency.Methods The whole 62 anterior teeth of 12 patients,who wanted to receive aesthetic restorative treatment,were invloved in the study.Grooves with 0.5 mm depth were marked at the center of the labial face by the use of spherical diamond burs with 1 mm in diameter.At the cervix of the teeth,the design of 0.3 mm shallow concave shoulder was adopted.IPS e.max HT ingots of different color were chosen to be hotpressed; the straining technique was used on the marginal ridge and incisor ridge of the ultra thin veneers after they had been carefully trimmed.Subsequently,the restorations were bonded with Variolink Veneer resin cement.After a short-term follow-up for 3 years,a modified USPHS criterion was used to evaluate the esthetic effect.Results The thickness of the ultra-thin veneers fabricated by heat pressing was 0.3-0.5 mm,marginal integrity of the veneers was perfect and fitted well with the marginal finishing line of the abutment,and then the translucency of veneers was high.There was no edge discoloring after the veneers were used for 6 months to 3 years,and they might produce an excellent chameleon effect by mixing the color of adjacent teeth and gums,and appeared a surface morphology of natural enamel after carefully carved.In the short-term clinical observation,none of the 62 veneers fractured or fell off; there was no case of dentin hypersensitivity.Conclusions Ultra-thin veneers fabricated from IPS e.max Press ingots have the following advantages,a simple operating procedure,high mechanical strength,and satisfactory esthetic effect.

Medicine, Chinese Traditional ; Translations ; Yin-Yang

OBJECTIVE: To investigate and analyze the status of anxiety and depression among patients with four types of peripheral vertigo. METHOD: The clinical data of patients with one of the four types of peripheral vertigo, namely benign paroxysmal positional vertigo (BPPV), vestibular migraine (VM), Menière's disease (MD), and vestibular neuritis (VN), were collected. Thorough otological and neuro-otological examinations were performed on these patients, and their status of anxiety and depression were assessed using self-rating anxiety scale (SAS) and self-rating depression scale (SDS). RESULT: A total of 129 patients with one of the four types of peripheral vertigo(49 cases of BPPV, 37 cases of VM, 28 cases of MD and 15 cases of VN) were included in the study. The scores of SAS and SDS were higher in the patients with VM or MD than those with BPPV or VN (P < 0.05), and the incidence of anxiety (VM = 45.9% MD = 50.0%) and depression (VM = 27.0% MD = 28.6%) were higher in the patients with VM or MD than those with BPPV or VN (P < 0.05). Paired comparisons showed the differences between the incidences of BPPV and MV groups, BPPV and MD groups, and MD and VN groups were statistically significant (P < 0.05). CONCLUSION Among patients with different types of peripheral vertigo, anxiety/depression is more common in patients with VM or MD. This may be due to the different mechanisms involved in different types of vertigo, as well as differences in the prevention and self-control of the patients against the vertigo.
Anxiety ; complications ; Benign Paroxysmal Positional Vertigo ; Depression ; complications ; Ear, Inner ; Humans ; Incidence ; Meniere Disease ; Migraine Disorders ; Psychiatric Status Rating Scales ; Vertigo ; classification ; complications ; Vestibular Neuronitis ; Vestibule, Labyrinth

Objective:To evaluate the role of hemopexin (HPX) in cerebral ischemia-reperfusion (I/R) injury in rats.Methods:One hundred and twenty healthy male Sprague-Dawley rats, aged 7-8 weeks, weighing 250-280 g, were divided into sham operation group (S group, n=36), cerebral I/R group (I/R group, n=36), vehicle group (V group, n=24), and HPX group ( n=24). The model of cerebral I/R injury was established by 120 min middle cerebral artery occlusion followed by reperfusion in anesthetized rats.At 6, 12 and 24 h of reperfusion, 4 rats in S group and I/R group were sacrificed, and the ischemic penumbra of the ipsilateral cerebral cortex was obtained to detect the expression of HPX by Western blot.In I/R, V and HPX groups, 0.9% normal saline 10 μl, 0.1% NaN 3 10 μl, and 1.86 mg/ml HPX 10 μl were injected into the lateral ventricle, respectively, immediately after reperfusion.Eight rats in each group were selected, and neurological deficit was scored at 1-7 days of reperfusion.Eight rats in each group were sacrificed at 1 and 7 days of reperfusion, brains were removed, and brain tissues were obtained for measurement of infarct size, and the percentage of infarct size was calculated. Results:Compared with S group, the expression of HPX in cerebral ischemic penumbra was significantly up-regulated at 24 h of reperfusion in I/R group, and the neurological deficit scores were significantly decreased at 1-7 days of reperfusion, and the percentage of cerebral infarct size was increased at 1 and 7 days of reperfusion in I/R, V and HPX groups ( P<0.05). Compared with I/R group, the neurological deficit scores were significantly increased at 1-7 days of reperfusion, and the percentage of cerebral infarct size was decreased at 1 and 7 days of reperfusion in HPX group ( P<0.05), and no significant change was found in the above indicators in V and I/R groups ( P>0.05). Conclusion:Up-regulation of HPX expression is the endogenous protective mechanism of cerebral I/R injury in rats.