Objective:To evaluate the application of flipped classroom based on rain classroom in standardized residency training of orthopedics.Methods:Sixty-two orthopedics residents were randomly divided into flipped classroom teaching group and traditional teaching group, with 31 residents in each group. The flipped classroom teaching group the flipped classroom teaching mode based on rain classroom, including three aspects: learning in advance before rain classroom, personalized discussing cases in class and teaching after class. The theoretical knowledge, clinical skills and evaluation of teaching activities were compared between the two groups. SPSS 19.0 was used for rank sum test and chi-square test.Results:All the residents completed the evaluation of theoretical knowledge, clinical skills and effect. The results showed that the scores of theoretical knowledge and clinical skills in the flipped classroom teaching group were (88.7±10.3) points and (26.8±2.2) points, which were significantly higher than those of the traditional teaching group (79.2±18.6) points and (20.4±2.9) points, with statistical significance ( P<0.05). The evaluation of teaching activities, including participation, satisfaction, enthusiasm and learning effect, was significantly better than that of the traditional teaching group ( P<0.05). Conclusion:In the orthopedics standardized residency training and teaching activities, the application of flipped classroom teaching mode based on rain classroom is conducive to improving students' learning performance, cultivate their autonomous learning ability, and improve their learning satisfaction and enthusiasm.

Objective To explore the application of auto-regressive integrated moving average (ARIMA) product season model in predicting number of inpatient and hospitalized expense of malignant tumor,and to provide scientific basis for hospital business management.Methods We collected inpatient data of malignant tumor from January 2007 to December 2015 in one hospital for model fitting,and used monthly data 2016 to verify the effect of model prediction.We predicted the number of inpatient and hospitalized expense of malignant tumor in 2017.Results ARIMA (0,1,1) (1,1,0) 12 was the best model for number of inpatient and hospitalized expense of malignant tumor,with prediction fitting errors of 1.1％ and 1.47 ％,respectively.The number of inpatient and hospitalized expense of malignant tumor in 2017 were predicted to be 7631 and 0.336 billion.Conclusion ARIMA product season model can better applied in the predicting of hospital business management.

Pender′s health promotion model explains the factors influencing health behaviors, which provides a framework for nursing practice and research. Functional exercise compliance in postoperative patients with breast cancer was in a low level, this article reviewed factors influencing functional exercise among breast cancer survivors through three aspects based on health promotion model and made some suggestions on nursing intervention, to promote the rehabilitation of this population.

By establishing a series of Dynamic Cervical Implants (DCI) within C5-C6 cervical spinal segments, the biomechanical finite element analysis for DCI with different width and thickness were carried out to investigate the influence of the width and thickness of DCI's curved section on its equivalent stress and range of motion (ROM), so as to provide some theoretical basis for the optimization of DCI's design. The results show that the width of DCI's curved section has more obvious influence on the ROM of lateral bending and torsion, in comparison with the thickness of DCI's curved section. By appropriate reduction in width, the ROMs of lateral bending and torsion increase obviously, i.e. the overall movement function of patients is improved. Furthermore, the increase of equivalent stress could be counteracted by corresponding increase of thickness.
Biomechanical Phenomena ; Cervical Vertebrae ; Finite Element Analysis ; Humans ; Movement ; Neck ; Prostheses and Implants ; Prosthesis Design ; Range of Motion, Articular

Objective To explore the relationship between vicarious traumatization and personality in trauma helpers. Methods Questionnaire about vicarious traumatization and Revised eysenck personality questionnaire short for Chinese(EPQ-RSC) have been carried out on a random sample of 86 trauma helpers in Wenchuan earthquate region from Tangshan. And all the data of the questionnaire scales will be dealt with by the software SPSS11.5. Results ( 1 ) There were significant gender differences on vicarious traumatization of trauma helpers in emotional reaction( famale :20.03 ± 4.92; male: 15.09 ± 3.93 ), behavioral reaction ( famale: 16. 43 ± 4. 49;male: 12.11 ± 2.57 ), cognitional reaction( female: 10.27 ± 3.28; male: 8.29 ± 2.81 ), faith of life ( famale: 14.17± 3.53; male: 11.20 ± 3.37 ), physiological reaction ( female: 21.23 ± 5.31; male: 17.32 ± 4.80) and the total core of vicarious traumatization( famale: 82.70 ± 17.74; male: 64.00 ± 12.49) (P＜0.01). (2) There were significant differences of vicarious traumatization of trauma helpers on professional training and experience of trauma help (P ＜ 0.05 ). ( 3 ) Comparing to helpers of non-vicarious traumatization, the helpers of vicarious traumatization were high in N scale questionnaire (P＜ 0.01 ). Conclusion Vicarious traumatization of trauma helpers are affected by sex, professional training and experience of trauma help. The best choice of trauma helper is steady emotion personality..

Objective To observe change of T regulatory cells (Tregs) and its relation with in-jury severity and sepsis following severe muhiple injury. Methods A total of 60 patients were em-ployed in the study and divided into severe group (30 patients) and critical group (30 patients) based on ISS scores and into sepsis group (22 patients) and non-sepsis group (38 patients) based on complication of sepsis. The proportion of Tregs in peripheral blood in different groups was detected by flow cytometry at days 1,3,5 and 8 after injury. Results The proportion of Tregs was significantly increased at day 5 postinjury, with statistical difference compared with that at day 3 postinjury (P < 0.01). The proportion of Tregs remained increasing at day 8 pestinjury (P < 0.05). At day 8 postinjury, the proportion of Tregs in critical group was significantly higher than that in severe group (P < 0.01). At the same time, the proportion of Tregs in sepsis group was significantly higher than that in non-sepsis group (P < 0.05). Spearman correlation analysis showed a positive correlation of Tregs proportion with ISS score (rs =0.654, P < 0.01). Conclusions Tregs play an important role in suppression of T cell-mediated im-munity after severe injury. The variation of Tregs can help evaluate prognosis and predict the risk of com-plicating sepsis in patients with severe multiple injury.

Cerebrolysin is an aqueous mixture of amino acids extracted from porcine brain, and mainly composed of 85% free amino acids and 15%small peptides. Cerebrolysin increase the metabolism of amino acids and glucose transport in the brain, improve the anti-anoxia ability of cells, and to enhance the brain's resistance to various types of malignant stimulation like stress and damage. Cerebrolysin can also promote synapse formation, induce neuronal differentiation, and help reverse brain injury. Because of its efficacy and safety, cerebrolysin has been widely used in the pediatric clinical practice, and primarily to treat neonatal hypoxic ischemic encephalopathy, childcerebral palsy, hyperactivity disorder, speech communication disorders, etc.The clinical symptoms were improved to some extent after the treatment of cerebrolysin. The recovery of consciousness, enhancement of comprehensionand memory, and improvement of the extremity motor function were observed. The treatment of cerebrolysincan not only enhance the cure rate, but also reduce the incidence of sequelae. This paper systematically summarized the clinical application of cerebrolysin in the pediatric population and relevant preclinical studies, to provide more guidance for clinical application of cerebrolysin in the treatment of pediatric diseases.

Objective To investigate the dynamic characteristics of the pacemaker current of canine sino-atrial node cells and compare them with the wild type mHCN2 pacemaker current overexpressed in neonatal rat myocardial cells.Methods Fresh canine sino-atrial node cells were enzymatically isolated in a calcium-free solution containing collagenase and elastase,and the funny current was recorded and compared with the mHCN2 current overexpressed in cultured neonatal rat myocardial cells under the same experimental conditions.Results The canine sinus node cells were elongated,spindle-shaped or polygonal,with well-defined boundaries,and showed spontaneous beating.The elicited pacemaker current was an inward current and its rise in amplitude quickened as the hyperpolarization potential increased.At V ＝-75 mV,the canine sinus atrial node pacemaker current was (-2.1±0.3) pA/pF and had the same activation kinetics as those of the mHCN2 channel current overexpressed in neonatal rat myocardial cells [τact:(728±137) ms vs.(530±65) ms,P＞0.05].Conclusions Within the physiological range,the pacemaker current in canine sino-atrial node cells and the wild type mHCN2 pacemaker current over expressed in neonatal rat myocardial cells have similar activation kinetics.

Objective To analyze the effect of dominant accessory atrioventricular pathways (AP) on the end vector of ventricular depolarization. Methods All patients had single AP confirmed by radiofrequency cathteter abalation (RFCA) and were free from organic heart disease (including 102 cases of dominant accessory AP and 38 cases of concealed AP). The AP was divided into posterior septal(P3) ,mediate septal (MS) ,anterior septal (AS), left posterior free wall (LP), left anterior free wall (LA), right posterior free wall (RP) and right anterior free wall (RA). Results The end 40 ms vector of QRS wave changed in 102 patients with manifested AP and in 4 patients with concealed AP (P < 0. 05). Conclusion The end 40 ms vector of QRS wave of any site manifested AP can change and the changes have the specihty of leads.

Objective To investigate the value of multi-b value DWI combined with PSA evaluation on the effect of endocrinotherapy for prostate cancer (PCa), and to study the correlation between the signal intensity(SI), apparent diffusion coefficient(ADC) with PSA.Methods Forty patients with PCa diagnosed by pathology or biopsy were tested for serum PSA levels before and after endocrine therapy.All patients underwent DWI at b-value of 300,800 and 1 000 s/mm2 by using a GE Signa HDx 3.0T MRI scanner.The serum PSA,the value of SI and ADC at different b values before and after endocrine therapy,and their correlation with PSA were observed and measured, respectively.Results (1)The serum PSA before and after endocrine therapy were (35.63±20.91) ng/mL and (5.98±3.84) ng/mL, respectively.The difference was statistically significant (P<0.05).(2)On the condition of different b values, ADC values were (1.06±0.06)×10-3 mm2/s, (0.83±0.04)×10-3 mm2/s, (0.73±0.03)×10-3 mm2/s, respectively before endocrine therapy, and (1.33±0.09)×10-3 mm2/s, (1.16±0.09)×10-3 mm2/s, (1.10±0.08)×10-3 mm2/s, respectively after endocrine therapy.There were significant difference between the ADC values before endocrine therapy and those after endocrine therapy (P<0.05).SI were 809.09±79.06, 417.42±26.65 and 327.42±25.26 in 40 patients with Pca before the endocrine therapy, and 780.10±78.52,409.33±33.93 and 320.00±31.10 after endocrine therapy.The difference was not statistically significant (P>0.05).(3)Pearsoncorrelation analysis showed that ADC value was negatively correlated with serum PSA (r300=-0.58,P<0.01;r800=-0.60,P<0.01;r1 000=-0.66,P<0.01) before endocrine therapy.ADC value was also negatively correlated with serum PSA (r300=-0.55,P<0.01;r800=-0.52,P<0.01;r1 000=-0.61,P<0.01) after endocrine therapy.In addition,SI was negatively correlated with serum PSA (r300=-0.09,P<0.01;r800=-0.18,P<0.01;r1 000=-0.28,P<0.01) before the treatment, as well.Conclusion ADC value at different b values increased after endocrine therapy in Pca, and is negatively correlated with serum PSA.The correlation is the most significant at b value of 1 000 s/mm2.The combination of DWI and serum PSA could be used to monitor and evaluate the effect of endocrinotherapy for Pca, and better guide the clinical treatment of Pca.