To compare the effect of surgical and non-surgical treatment for multiple fractured ribs retrospectively, with 30 cases in each group. Patient's length of stay, visual analogue scale ( VAS) pain, independent ambulation time, cost of hospitalization, thoracoplasty degree and the lung ventilation function were evaluated. The results showed that VAS declined obviously in patients of surgical group, length of stay and independent ambulation time were shorter. Compared to the non-surgical group, the maximal voluntary ventilation increased significantly and ref-erral rib reduction was significantly better, but cost of the surgical group was higher. It's an effective treatment for using nickel titanium memory alloy embracing fixator in the treatment of multiple fractured rips, and is worthy of clinical application.

Objective To explore and establish the effective model of assessment for residen-cy training. Methods Totally 181 residents completed general specialist stage of resident training of Liaoning province in 2010. Assessment process was designed and implemented for general specialist training stage, including theory exam (basic knowledge, professional knowledge and public knowledge) and objective structured clinical examination (OSCE) (standardized patient(SP), computer-based case simulations(CCS) and clinical skills operation). T test and variance analysis were used and P≤0.05 stands for statistically significant difference. Results The total results consisted of two parts, theory examination results (40.00%) and OSCE results (60.00%) and two students failed the examination. The mean score of OSCE was up to standard (66.58±5.50). The mean score of SP and CCS was close to standard. The mean score of clinical skills operation reached a good level. In terms of the OSCE, SP examination and CCS examination, the performance of residents from the two universities had sig-nificant difference (t=3.818, P=0.000; t=5.581, P=0.000; t=5.419, P=0.013) and the performance of residents from the five hospitals also had significant differences. Conclusions The assessment of standardized resident training is improving gradually. Through the widespread application of OSCE in the assessment;it could be helpful to the clinical training of residents.

It is an essential component of medical exams to evaluate the clinical competency of medical students. After introducing Standardized Patients and non-Standardized Patients examinations into the final comprehensive examination, China Medical University continued to undertake the construction of computer-based case simulations examination system, a project of National Medical Examination Center. The article introduced the design and some crucial points in constructing the examination system.

OSCE is an examination of objective evaluation of the clinical skills.This article introduced the development of OSCE at home and aboard,and compared the difference of the exam setting in America,England,Canada and China Medical University.The advantages and disadvantages of SP in OSCE were also analyzed.It was discussed that OSCE would be widely applied in China.

Objective The empirical validity of the National Medical Licensing Examination (NMLE) has rarely been studied. This is one of the first studies comparing NMLE and annual assess-ment scores. This study provided the criterion-related validity evidence for the NMLE. The NMLE can be used to test the abilities and skills of physicians. Method We evaluated the test 163 residents in 12 medical school-affiliated hospitals who had finished their first year of tralning and had taken the NMLE and an annual skills assessment. We used Pearson correlations to estimate the relationship be-tween NMLE scores and annual assessment scores. Results A total of 163 residents met inclusion requirements. Correlations between NMLE scores and annual assessment scores ranged from 0.300 to 0.843. Conclusions The criterion-related validity of NMLE was high, so it can be use to evaluate the residents clinical competence indeed.

Objective The purpose of this study was to analyze and evaluate the educational measurement indexes from the undergraduates clinical skills competition in a medical university.The rationality of the competition was discussed in the view of education survey.Methods 84 students' results which selected from the China Medical University 2nd Clinical Skills Competition were the research objects in this study.The indexes of the difficulty,discrimination,reliability and criterion-reated validity of the competition were evaluated based on the Education surveying principle.The difficulty was calculated by subjective topic difficulty computing formula,and other indexes were carried out with SPSS 18.0 except the difficulty index.Results The average difficulty of the questions of this university was 0.61,the average discrimination was 0.77 and the overall reliability was 0.926.The OSCE scores of the participating students were taken as the criterion in this study.The calculated criterion-related validity was 0.416.Conclusion The college students' clinical skills competition has good reliability,discrimination and effective criterion-related validity.For the selective competition,the difficulty can be further improved while considering the scope of the topic.

The Information and Management Platform of Standardized Training of Residents in Liaoning Province is a comprehensive management platform with information network , containing the whole process of the standardized training for residents. Liaoning, the populous province, has too many management staff in training residents, so it is very necessary to explore the information-based method for the training management. This platform has realized the whole-course network management of resi-dent training, and many common functions such as the application of training base , on-line registra-tion, on-line real-time monitoring of trainees' daily training state, on-line graduation exam arrangement, and inquiry of statistical information of trainees in the province . It saves human and management costs , improves management efficiency , and orderly pushes forward the standardized of residents training.

Objective To explore the mechanism of protective effect of Rhodioloside in cerebral ischemia-reperfusion rats and its relevance to phosphatidylinositol 3-kinases ( PI3-K)/protein serine-threonine kinases ( AKT) signaling pathway .Methods Forty eight Sprague-Dawley rats were randomly divided into four groups: sham-operation group , ischemia-reperfusion group , and Rhodiolo-side treatment groups (5 and 10 mg/kg).The model of right middle cerebral artery occlusion was established with thread ligation meth -od.The score of the neurological deficit was estimated 2 h followed by 24 h reperfusion.Histopathological changes were observed by hematoxylin-eosin(HE) staining.The infarct volume was measured with triphenyltetrazolium chloride (TTC) staining.Apoptotic cells were assessed with terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) method.The expressions of PI3-K and p-AKT were evaluated with immunohistochemistry .Results The score of the neurological deficit was decreased more ob-viously, the number of apoptotic were decreased more significantly , the expressions of PI3-K and p-AKT were increased more signifi-cantly in the Rhodioloside treatment groups (5 and 10 mg/kg) than in the ischemia-reperfusion group ( P <0.05).The score of the neurological deficit was decreased , the number of apoptotic was decreased , and the expressions of PI 3-K and p-AKT were increased in the Rhodioloside treatment group (10 mg/kg) than the Rhodioloside treatment group (5 mg/kg) ( P <0.05).Conclusions The protective mechanism of Rhodioloside therapy against cerebral ischemia r-eperfusion injury might be associated with activating the PI 3-K/AKT signaling pathway and then inhibiting neuronal apoptosis .

Stage assessment is an important part of standardized resident training.After two years of practice and exploration,Liaoning had established the complete examination and evaluation system including the theory test and skill test and this system was future improved through analyzing two years' results and summing up the experiences making it more suitable for residency training in the future.

Data were analyzed from self-filled questionnaires for the students who took the elective course of general practice in China Medical University. 95.5% of students thought it was necessary to study general practice in the college. 0-10 was used to score the degree of how they want to choose general practice as a career, the median was 0 before they had the class and the median was 5 after the class (Wilcoxon rank test, P<0.01). But there were still some places need to be improved in terms of curriculum design, teaching methods and community practice. The General Practice teaching need to be innovated and the teaching mode should be different from the traditional one.