This article analyzes and summaries the problems and difficulties existing in the first-aid medicine's clinical teaching.Combined with his own teaching experience,the author has made some exploration on the teaching time,the way of teaching and inspection form,which has got a good teaching effect.It provids the reference and development for the clinical teaching of first-aid medicine.

Brain Infarction ; diagnosis ; etiology ; therapy ; Cerebral Angiography ; Child ; Echocardiography, Doppler, Color ; Heart Atria ; Heart Neoplasms ; complications ; diagnosis ; surgery ; Humans ; Intracranial Embolism ; diagnosis ; etiology ; therapy ; Male ; Myxoma ; complications ; diagnosis ; surgery ; Pulmonary Edema ; diagnosis ; etiology ; therapy ; Thrombosis ; diagnosis ; etiology ; therapy

Objective To investigate the efficacy of the first radioiodine (131 I) ablation of residual thyroid on differentiated thyroid carcinomas after surgery and to analyze the influential factors for efficacy.Methods All 91 differentiated thyroid carcinoma (DTC) patients were treated with 131I after surgery.According to pathologic types of the tumor,surgical options,and time interval between surgery and radioiodine treatment,patients were divided into different groups,then the efficacy was observed.Results Fifty of 91 patients (54.9％) achieved successful thyroid remnant ablation after the first dose.The success rate of first ablation of residual thyroid tissues had no relationship with the pathologic type of the tumor(P ＞ 0.05).While it was statistically related to the surgical options,among which patients undertaking the total thyroidectomy possessed the highest success rate (79.3％)(P ＜0.05).Ninety one patients were divided into 3 groups according to the time interval between surgery and radioiodine ablation:group less than 3 months (3M group),group from 3 to 12 months (3 ～ 12 M group),group beyond 12 months (12M).Among them,the 3M group possessed the highest success rate (68.0％) (P ＜0.05).Conclusions There would be better effect of the first ablation of residual thyroid tissues with total thyroidectomy,ablation conducted within 3 months after surgery.

Objective:To compare soft-tissue morphology changes by cephalometric measurements be-tween extraction and non-extraction orthodontic treatment in borderline cases.Methods:The samplesconsisted of 33 cases selected as borderline cases by 5 orthodontic specialists.They were divided into 21extraction cases(including 13 four first premolar extraction cases and 8 four second premolar extractioncases)and 12 non-extraction cases by checking patients' treatment records.Conventional cephalometricanalysis was made to compare soft tissue structures before and after orthodontic treatments and the samecomparison was made between two different extraction patterns.Results:No statistical difference wasfound in pretreatment soft-tissue morphology between extraction and non-extraction groups divided fromborderline cases.The PosBs/FH of the four first premolars extraction group was smaller than that of non-extraction group,and the Ns-Sn-Pos of the four first premolars extraction group was smaller than that offour second premolar extraction group.None of the post-treatment soft-tissue measures showed significantstatistical differences between four first premolars extraction group and non-extraction group,but therewere 6 items showed significant statistical differences between four second premolars extraction group andnon-extraction group.Compared with extraction and non-extraction treatments,the most significant soft-tissue changes were:PosBs/FH,LL-SnPos,and Bs-EP.Conclusion:Although pre-treatment soft-tissuemorphology of second premolar extraction group was close to that of non-extraction group,the post-treat-ment soft-tissue morphology of first premolar extraction group became closer to that of non-extractiongroup.Compared with non-extraction treatment,the more significant changes caused by extraction treat-ment were located in the lower lip and chin,but not the upper lips.

Objective: To investigate the effects of novel targeted non-viral vector in gene therapy of human glioma. Methods: The EGF-R targeting gene delivery system GE7 was constructed. Human Glioma cell line U251 was transfected in vitro with ?－gal as reportor gene and p21 as therapeutic gene using this gene delivery system. By means of the assay of ?-galactosidase staining, Western blotting, in situ end labeling apoptosis cells and DNA ladder, the transferring of exogenous genes and the apoptosis of the tumor cells were examined.Results: It was showed that gene transfer efficiency is over 80%. When transfected with p21 gene, the growth of cells was inhibited significantly, and the apoptosis was detected in the transfected cell by the methods of in situ end labeling and DNA ladder. Conclusion: The GE7 gene delivery system has the ability to transfer exogenous gene to tumor cells and the expression of the therapeutic gene can inhibit the growth of the cells.

AIM: To investigate the clinical effects of intravitreal Bevacizumab for 26 cases with retinopathy of prematurity (ROP) in Zone Ⅰ.
METHODS:A retrospective study. Totally 26 ROP infants between September 2013 and October 2014 diagnosed as high - risk ROP in Zone Ⅰ had been treated with intravitreal bevacizumab. They were divided into three groups, pre - threshold ROP, threshold ROP and acute posterior ROP ( APROP ). Postoperative effects were compared.
RESULTS:There were 26 infants (52 eyes) diagnosed as ROP in Zone Ⅰ, including 3 infants( 6 eyes) with pre -threshold ROP, 15 infants (30 eyes) with threshold ROP and 8 infants (16 eyes) with APROP. The first operation recovery rate of three groups respectively were 100% (6 /6), 60% ( 18 / 30 ) and 75% ( 12 / 16 ), which were not significantly different (P>0. 05).
CONCLUSION:Intravitreal bevacizumab for ROP in ZoneⅠ seems effective and has some advantages over conventional laser treatment, which could be first line treatment for high-risk ROP in Zone Ⅰ.

Objective:To discuss the oncologic safety, aesthetic outcome, and upper extremity function of single-port insufflation endoscopic nipple-sparing mastectomy (SIE-NSM) in the treatment of early breast cancer.Methods:From January 2014 to August 2019, a total of 80 patients with stage Ⅰ and Ⅱ breast cancer underwent SIE-NSM, at Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed and followed up. Estimated the oncologic safety, aesthetic outcome, and upper extremity function.Results:SIE-NSM was performed successfully on all 80 patients.There was no serious complication after surgery.The follow-up time was 16-82 months and the median follow-up time was 42 months. Local recurrence occurred in two patients, and there was no distant metastases. Four (5%) patients developed grade 1-3 nipple-areola complex ischemia. There were no cases of subcutaneous effusion.The satisfaction with breasts, chest well-being, psychosocial well-being, and sexual well-being scores were confirmed to be highly rated by Breast-Q scale. Upper extremity function score confirmed that good upper limb function was preserved after surgery. The mean length of incision was (3.6±0.8) cm, and the blood loss was (24.7±19.3) mL.Conclusions:SIE-NSM can achieve a higher cosmetic score and a better recovery of upper limb function on the premise of ensuring the safety of the tumor.This novel method is an appropriate surgical option for patients with early breast cancer.

OBJECTIVETo investigate the association of fasting and postpiandial triglyceride with carotid intima-media thickness among type 2 diabetic patients in southeast China.

METHODSA total of 78 type 2 diabetic patients from southeast China were recruited. All the subjects underwent a standardized mixed-meal test (SMMT) and an oral glucose tolerance test. Carotid intima-media thickness (IMT) was measured by color doppler ultrasound examination.

RESULTSPostprandial triglyceride (PTG) after SMMT increased significantly in type 2 diabetic patients. The carotid IMT in patients with postprandial hypertriglyceridemia was significantly greater than that in patients with postprandial normal-triglyceridemia (0.90 mm vs 0.81 mm, P < 0.05), which remained significant after adjustment for fasting TG and HDL-c levels, and the IMT in patients with fasting hypertriglyceridemia only had tendency to increase compared to patients with fasting normal-triglyceridemia (0.87 mm vs 0.84 mm, P > 0.05).

CONCLUSIONThe results suggest that postprandial hypertriglyceridemia may be an independent risk factor of early atherosclerosis in type 2 diabetes.

Carotid Arteries ; diagnostic imaging ; Diabetes Mellitus, Type 2 ; blood ; diagnostic imaging ; Eating ; Female ; Humans ; Male ; Middle Aged ; Risk Factors ; Triglycerides ; blood ; Tunica Intima ; diagnostic imaging ; Tunica Media ; diagnostic imaging ; Ultrasonography

Objective To study the feasibility and characteristic findings of contrast-enhancedultrasound(CEUS)on peripheral pulmonary tumors.Methods Twenty patients with peripheral pulmonarytumors proven by pathology were studied.They were divided into two groups:primary pulmonary tumors (n=15),and metastatic pulmonary tumors(n=5). The dynamic enhancement images were stored and Strip enhancement was dominant in the primary pulmonary tumors,while dot enhancement was dominant in ascended quickly and descended slowly,while ascended slowly and descended slowly in majority of metastaticThe modes of enhancement and time-intensity curves were all different in primary and metastatic pulmonary tumors.Contrast-enhanced uhrasound is promising in the diagnosis of peripheral pulmonary tumors.

Ex-RAD (ON01210) is a novel and efficient anti-radiation drug with low toxicity developed by US army and Onconova Pharmaceuticals in recent years. The significant survival advantage and low toxicity of Ex-RAD have contributed to the approval by the FDA as an investigational new drug in December 2008. Meanwhile, the drug is currently in phase I clinical trials in humans. In this paper, the chemical structure, synthesis route, detection method and pharmacological action of Ex-RAD were reviewed, and the appli-cation prospect of Ex-RAD was also explored.