Objective To improve the training system of the combined education mode between professional master degree students of clinical medicine and resident standardization training (RST) in Zhe-jiang province, and improve the professional quality of medical graduate students. Methods A question-naire was designed through literature review and expert interview, and the data of 77 clinical training post-graduates were collected, and the effect of the training was evaluated by taking the reaction level, learning level, behavior level and achievement level of Ke's evaluation as the breakthrough point. Statistical analysis was performed by SPSS 20.0, and the mean score was used as the standard deviation. The scores were compared with t test, and the scores of multiple groups were made variance analysis. Results The RST attitude value in reaction layer was 9.26±1.08, RST content value was 29.29±4.36, RST teacher enthusiasm value was 11.13±2.17, RST experience value was 17.38±3.10, which indicated that residents' overall satisfaction to RST was high, but the satisfaction on teachers, evaluation and compensation was relatively low;The grade difference before and after RST in learning layer was statistically significant (P<0.05), indicating that before and after RST the grades were obviously improved, and the sense of belonging is high. The behave layer showed the residents' behavior changed obviously before and after RST (P<0.05), and their abilities in various aspects such as ward round and dealing with common diseases were largely improved;The result layer showed 77 graduate students had no medical accident and complaint , and all of them passed the annual assessment and participated in the research projects. Conclusion In general, RST graduate students are relatively satisfied with the plan, content and methods of the training, on the other hand, there are problems such as the absence of timely information feedback, teachers' poor enthusiasm, lack of effective competition mechanism, etc. Kirkpatrick Model made a comprehensive and objective eval-uation on graduate students RST from a overall perspective, and it can be introduced into the effectiveness evaluation for graduate students RST.

Objective To understand the status quo of the target management assessment of medical institutions in Anhui province, and provide a basis for further improving the performance appraisal mechanism and strategy of medical institutions. Methods In June 2017, 21 medical institutions in Anhui province conducted a questionnaire survey on the setup and implementation of target management indicators. Results Among the 21 medical institutions, there were 2, 16 and 3 hospitals in the first, second and third grades respectively. The average number of available beds was 681.35, and the average time for conducting target assessment was 4.42 years. The coverage rates of the clinical departments, medical technology departments, efficiency and efficiency, scientific research teaching, and department management of 21 medical institutions were 80% (316/397), 84% (52/63), 71% ( 120/168), 38% (48/126 ) and 60% (61/102) respectively. There were significant differences in coverage rates between clinical departments, medical technology departments, efficiency and efficiency, and research and teaching in different levels of medical institutions( P <0.05 ). Judging from the effectiveness of the current target assessment, it was considered that 64% ( 37/78 ) of the overall assessment results of the departments were in line with expectations, and the ratio of target management to hospital development management, department quality management, and functional department execution was 75% (42/64). Conclusions The status quo of performance assessment of medical institutions in Anhui province is running well, but the target management indicators and models of different medical institutions are different. It is necessary for the health administrators to establish a unified, authoritative and standard target performance assessment system.

Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis. The high incidence rate, drug resistance rate and mortality rate of TB infection cause serious social and economic burden in developing countries. Due to high occupational exposure, medical institutions and healthcare workers take the potential risk of TB infection, which have negative impact on the public health and occupational health. As one of the countries with high burden of TB in the world, the occupational exposure of healthcare workers in China is serious, and the infection rate is far higher than that of developed countries. This article reviews the prevalence of latent tuberculosis infection among health care workers and the status quo of occupational protection in medical institutions in China.

Objective To assess the feasibility of utilizing the ExacTracDynamic surface monitoring system(ETD)for setup and body surface monitoring in patients with thoracic tumors undergoing intensity-modulated radio-therapy(IMRT).Methods Patients receiving IMRT for thoracic tumors were included in this study.The enrolled patients were alternatively assigned to either conventional cross curve positioning(control group)or surface monitoring system-assisted positioning(experimental group).ETD X-ray images were utilized for calibration purposes prior to radiotherapy,enabling the determination of setup errors.A region of interest(ROI)was delineated on the body surface above the sternum,and real-time body surface monitoring was performed based on this ROI during radiotherapy.Post-radiotherapy X-ray images were obtained to verify patient position.Data regarding left-right(X),head-foot(Y),abdomen-back(Z),pitch,roll,and yaw directions were recorded and analyzed.Results A total of 60 patients were enrolled,with 754 fractions of radiotherapy in the control group and 718 fractions in the experimental group.The setup errors in the X and Z directions were significantly smaller in the experimental group compared to the control group(P<0.05).Moreover,there was a significant reduction in the number of setup errors≤0.50 cm for X,Y,and Z directions,as well as≤1.00° for Roll angle in the experimental group compared to the control group(P<0.05).Additionally,differences were observed between surface monitoring and X-ray image verification regarding position deviation along Y and Z directions(P<0.05),although these deviations remained within submillimeter levels on average.Conclusion Surface monitoring system-assisted positioning can enhance radiotherapy setup accuracy among thoracic tumor patients,particularly along X and Z directions.Furthermore,when setting ROI above sternum on body surface area,surface monitoring provides better reflection of target area's position deviation.

Objective:To explore the effects of depressive symptoms on sleep quality in adolescents with depressive disorder, and the mediating roles of cognitive fusion and sleep belief.Methods:A sample of 210 adolescents with first episode depressive disorder aged 12-18 years were recruited to complete 17-item Hamilton depression scale (HAMD-17), Pittsburgh sleep quality index (PSQI), cognitive fusion questionnaire (CFQ), and dysfunctional beliefs and attitudes about sleep scale (DBAS-16) from November 2021 to July 2022. SPSS 26.0 software was used to perform descriptive analysis and correlation analysis. The mediating effect was tested by Bootstrap analysis using PROCESS V 3.4 Macro program.Results:The incidence of low sleep quality in adolescents with depressive disorder was 69.0%(145/210). HAMD-17 score was (22.4±7.9), PSQI score was (9.7±3.7), CFQ score was (51.6±7.8), DBAS-16 score was (43.5±8.4).PSQI was positively correlated with the scores of HAMD-17 and CFQ( r=0.613, 0.463, both P<0.001).HAMD-17 was positively correlated with CFQ score ( r=0.488, P<0.001).DBAS-16 was negatively correlated with scores of PSQI, HAMD-17 and CFQ( r=-0.326, -0.284, -0.354, all P<0.001). The direct effect of depression on sleep quality was 0.230(95% CI=0.169-0.293). The indirect effect of depression on sleep quality through two pathways, the separate mediating effect value of cognitive fusion was 0.041 (95% CI=0.011-0.074), and the chain mediating effect value of cognitive fusion and sleep beliefs was 0.008(95% CI=0.001-0.020). Conclusion:Depressive symptoms can directly affect sleep quality of depressive disorder adolescents and indirectly through cognitive fusion and sleep beliefs.

Objective: To explore the clinical effect of bulk-fill composite resin combined with transparent preformed crowns for aesthetic restoration of deciduous incisor of children. Methods: A predesigned clinical prospective randomized controlled research method was used to select 90 patients (123 teeth). The random number table method was divided into three groups: A, B, and C. Group A was treated with a bulk-fill composite resin of SF (SonicFill) combined with a transparent preformed crown (41 teeth in 30 cases), and group B was treated with a large block of Tetric N-Ceram Bulk Fill Composite resin combined with transparent preformed crowns (39 teeth in 29 cases). Group C was treated with 3M Z350 XT universal nano resin combined with transparent preformed crowns (43 teeth in 31 cases). The visual analog scale (VAS) and the modified USPHS standard were used to evaluate the completeness, marginal steps, marginal discoloration, surface condition, secondary caries and satisfaction of the parents with prostheses after 12 months. Results : Twelve months after the operation, the evaluation indexes of group A were better than those of group B and group C, and the differences were statistically significant, including edge integrity (χ2=10.847, P=0.028), edge step (χ2=7.799, P=0.020), edge discoloration (χ2=10.391, P=0.034), surface state (χ2=11.476, P=0.021), and secondary caries (χ2=10.447, P=0.034). The satisfaction of parents in group A on the overall contour (χ2=10.238, P=0.037), shape and texture (χ2=11.521, P=0.021) were better than those in group B and group C, and the differences were statistically significant. There was no significant difference in the evaluation of color satisfaction among the three groups (χ2=0.990, P=0.610). Conclusion SonicFill bulk-fill composite resin combined with transparent preformed crown is good for short-term aesthetic restoration of deciduous incisor, and parental satisfaction is high.

Objective:To analyze the in vitro inhibitory effects of resveratrol on rabies virus. Methods:The challenge virus standard (CVS)-11 strain of rabies virus and BHK-21 cells were used to establish the infection model. In vitro inhibitory effects of resveratrol on rabies virus were analyzed at different stages of infection by direct immunofluorescence and cell fluorescence focus unit assay. Results:Without affecting cell growth, resveratrol could block the adsorption of virus, interfere with the entry of virus into cells and inhibit virus proliferation in a concentration-dependent manner. The inhibition rate could reach up to about 95%. The results of co-incubation experiment showed that 40 μmol/L resveratrol could directly kill the virus.Conclusions:This study indicated that resveratrol inhibited the activity of rabies virus in a concentration-dependent manner.

Objective: To compare the effects of surgical and conservative therapy in the treatment of orbital blow-out fracture. Methods: 90 cases of obital blow-out fracture were treated by surgical(n = 40) and conservative(n = 50) trerapy respectively, the patients were fllowed up for 12 months. The treatment outcome was retrospectively analysed. Results: Of the 40 patients managed surgically 39 were with complete follow up data, 19 had diplopia in peripheral gaze before surgery, 13 (33％) had at 3-month and 12 (31％) had at 6-month follow-up. 31 had enophthalmus before surgery and 3(8％) had at 3-month and 6-month follow-up. Of the 50 patients managed conservatively 26 were with complete follow-up data, 11 had diplopia in peripheral gaze initially, 9(35％) had at 3-month and 8(31％) had at 6-month follow-up. 15 had enophthalmus initially and 13(50％) had at 3-month and 6-month followup. Conclusion: Surgical therapy is more effective for the treatment of enophthalmus. The effects tend to be stable 3 months after treatment, the ratio of diplopia in peripheral gaze after treatment by the 2 treatments is similar(about 30％ of the total cases).

Periodontitis and periapical periodontitis have a high incidence rate and often result in the progressive ab-sorption of alveolar bone.This is one of the main causes of tooth loosening and loss.Prolonged local inflammation leads to the proliferation of capillaries,fibroblasts,and inflammatory cells such as neutrophils and lymphocytes.This process results in the replacement of surrounding bone tissue with inflammatory granulation tissue.Traditionally,it has been ad-vocated that inflammatory granulation tissue is pathological and should be completely removed from the extraction sock-et to avoid complications such as bleeding,infection,and poor bone healing after tooth extraction.Although the regener-ative capacity of inflammatory granulation tissue is reduced,it can be enhanced by increasing the body's immunity or by eliminating pathogenic stimuli(such as tooth extraction and root canal treatment).As a result,the fibrous components in the inflammatory granulation tissue gradually increase,while infiltrating inflammatory cells gradually decrease.Ulti-mately,this transformation leads to the formation of reparative granulation tissue,followed by ossification.Furthermore,the use of granulation tissue from the tooth extraction socket for immediate implantation to facilitate wound closure or soft tissue reconstruction has yielded favorable clinical outcomes,and histological studies simultaneously confirmed the presence of mesenchymal stem cells within the inflammatory granulation tissue.Therefore,it is necessary to reconsider the traditional belief that inflammatory granulation tissue must be completely removed.Given the potential of inflamma-tory granulation tissue to undergo osteogenic transformation under appropriate interventions,regulating the transforma-tion of inflammatory granulation tissue into reparative granulation tissue with osteogenic potential represents a novel strategy for the regenerative treatment of dental alveolar inflammatory lesions.This approach holds broad clinical appli-cation prospects and is an important research direction for the future.Reactive oxygen species,NOD-like receptor pro-tein 3,and matrix metalloproteinase K are key regulatory factors involved in the transformation of inflammatory granula-tion tissue into reparative granulation tissue.Furthermore,bone morphogenetic protein 2 and vascular endothelial growth factor are key regulatory factors involved in the osteogenic regeneration of reparative granulation tissue.Howev-er,the molecular mechanisms of these regulatory factors remain unclear;therefore,elucidating their molecular mecha-nisms will help identify suitable targets for promoting the regeneration of dental alveolar inflammatory lesions.Further-more,this will contribute to the development of related biological treatment technologies and drugs,which may ultimate-ly provide a more minimally invasive and effective treatment for inflammatory lesions of alveolar bone.However,it is im-portant to note that research in this field is still in its early stages.There is still considerable progress to be made before clinical translation and application can be achieved.

The irreversible destruction of periodontal tissue caused by periodontitis is the result of an imbalance be-tween external pathogenic factors and the internal immune response.As human immune cells,macrophages have both pro-and anti-inflammatory roles in the occurrence and development of periodontitis.Pathogenic bacteria,inflammatory cytokines,and neutrophils in the periodontal microenvironment can significantly affect the metabolism and functional status of macrophages,and the status of macrophages can regulate disease processes.By activating the NF-κB signaling pathway,the bacteria cause macrophages to undergo M1 proinflammatory polarization and pyroptosis,forming a microen-vironment that induces periodontal tissue destruction.With the development of the disease,numerous apoptotic neutro-phils are recognized and phagocytized by macrophages(i.e.efferocytosis),which can both inhibit the NF-κB pathway and activate the nuclear receptors PPAR and LXR,promoting the anti-inflammatory polarization of M2 and further en-hancing the efferocytosis activity of macrophages.As a result,these treatments can limit tissue inflammatory damage and promote tissue repair.In recent years,periodontitis treatment strategies focusing on macrophage regulation have re-ceived extensive attention,including gene knockout,nanoparticles,exosomes,miRNA,and polyunsaturated fatty acid di-ets.In this article,we review the specific role of macrophages in periodontitis from three aspects,including macrophage polarization,pyroptosis,and efferocytosis,which may improve our understanding of periodontitis and provide possible di-rections for periodontitis treatment strategies.