Objective To evaluate the reliability of transversus abdominis muscles measure with ultrasonography. Methods The thickness of bilateral transversus abdominis muscles of 20 volunteers at rest and during different postures for training was measured with ultrasonography by 2 examiners. The rate of contraction was calculated. Results The measurement was correlated strongly between examiners (r>0.7). There was significant difference in variety of thickness among postures except head rise to contralateral leg rise (P<0.01). Conclusion Ultrasonography is reliable in measuring transversus abdominis muscles.

ObjectiveTo evaluate the usefulness of an ultrasonography-based method to examine quadriceps femoris contracting. MethodsThe thickness of bilateral rectus femoris (RF) and vastus intermedius (VI) and the cross-sectional area (CSA) of RF was measured in 10 healthy subjects （n=20） in a relaxed position and 3 isometric contraction states using ultrasonography by two examiners. The date was compared with paired t test. Half of these subjects （n=10） were also measured with MRI at rest. The date was also compared with paired t test. ResultsThere was no significant difference between MRI and static compound ultrasonography, nor between two examiners. There was a significant difference (P<0.05) in thickness of RF and VI between relaxed and isometric contraction conditions. There was no significant difference among isometric contraction conditions. There was no significant difference among measurements of RF-CSA. Conclusionultrasonography shows good validity and reliability in measuring quadriceps shape.

Objective To evaluate the effect of lumbar multifidus muscle training on muscle thickness.Methods The morphological changes in volunteers' lumbar multifidus muscles were observed in response to 11 kinds of training.Muscle thickness was measured at rest and during contraction using ultrasonography and two examiners.The rate of change in muscle thickness and the contraction rate were calculated.Results There was no significant difference in the contraction rates determined by the two examiners using ultrasound imaging.There was no significant difference in average contraction rate between the males and females.Pairwise,there was no significant difference among contralateral leg-raising,ipsilateral leg-raising,contralateral hand-raising,ipsilateral hand-raising and contralateral leg-lifting.Pairwise,there was no significant difference among ipsilateral leg-lifting and ipsilateral arm-lifting compared with contralateral leg-lifting,contralateral arm-lifting or contralaleral lower limb-lifting.There was no significant difference between contralateral arm-lifting and ipsilateral arm-lifting.There was no significant difference between ipsilateral arm-lifting with contralateral leg-lifting and contralateral arm-lifting with ipsilateral leg-lifting.Pairwise,there was a significant difference in lumbar multifidus muscle contraction rates among these actions.Conclusion Lumbar multifidus muscle training has various effects.Muscle thickness as measured using ultrasonography can provide a basis for formulating a rehabilitation training plan.

The ability of clinical teachers plays a key role in residents standardized training. The teachers should fully understand the relevant policies and improve the awareness of resident standardized training. The construction of clinical teaching ability is the essential ability for clinical teachers and is the focus of the teacher training, which can guarantee to guide the improvement of residents' clinical thinking ability and the training of their clinical skills. Establishing teacher training system, making a suitable train-ing plan, selecting applicable training content and participating in various types of teacher training should effectively improve the comprehensive teaching ability of clinical teachers for resident standardized training.

The resident standardized training is an important stage in clinical medical personnel training sys-tem. Medical ethics education and accomplishment is one of the main training contents in this stage is, the necessa-ry requirement for physician growth, and the effective guarantee for training organization and implementation. Learning for relevant theory of medical ethics is the basis of medical ethics education, and the medical practice is the fundamental way of medical ethics accomplishment. In medical practice, the inner perception is the gradual sublimation of medical ethics accomplishment. The formation of residents′ medical ethics quality is dominated by heteronomy and guided by medical morality code. It emphasizes more on self-regulating the ethical behaviors and abiding by medical ethics faith and standards.

Standardized residency training is a systematic, standardized and homogeneous project. With the continuously increasing requirements for fine management, the management of standardized residency training is facing enormous challenges, and the construction of management information system is imperative. This paper introduces the basic modules design and application experience of management information system for standardized residency training in training hospitals, aiming at improving work efficiency, standardizing process management and ensuring training quality.

Objective To explore the applicative effects of visualization techniques in clinical education of anesthesia resident standardizing training. Methods A total of 50 physicians who were receiv-ing resident standardizing training were recruited. They were randomly divided into the control group and visualization group with 25 residents each. The control group was taught to perform intratracheal intubation, using traditional laryngoscope and to perform indwelling catheter via femoral vein puncture, using traditional"blind puncture"method. The visualization group was taught to perform intratracheal intubation, using visual laryngoscope and to perform indwelling catheter via femoral vein puncture through ultrasound guidance method. Both groups conducted training on anthropomorphic dummy and patients. The operating time, success rates and incidence of complication were recorded. Learning curves were also graphed. GraphPad Prism 6 was used for statistical analysis. Data compared between groups were analyzed by t test and χ2 test. Results The time of intratracheal intubating on anthropomorphic dummy in control group was (45.1± 16.3) s and that in visualization group was (32.8 ±13.4) s (P<0.05). The learning curve decreased more quickly in visualization group. The time of intratracheal intubating on patients in control group was (44.1± 10.1) s and that in visualization group was (36.7±9.8) s (P<0.05). Rates of complications such as oral bleeding and postoperative sore throat was lower in visualization group (P<0.05). The femoral catheterization time of control group was (11.7±2.4) min and that of visualization group was (10.6±2.5) min (P<0.05). The success rate of control group was 76.8％ and that of visualization group was 89.6％ (P<0.05). Furthermore, the rate of inadvertent arterial puncture was lower in visualization group (P<0.05), and the learning curve decreased more quickly in visualization group. Conclusion Visualization techniques can provide an effec-tive teaching method for anesthesia resident standardizing training and has broad prospects in application.

Objective To understand the effect of standardized training teachers for fellowship training and to summarize the experience, in order to provide practical basis for standardized training of fellowship training and teachers training. Methods According to the requirements of standardized training for fellowship in Shanghai, the content of teacher training is drawn up. The training lasts for 4 days and 32 academic hours. After the training, 317 questionnaires were distributed through the form of electronic ques-tionnaire, and 301 questionnaires were recovered, with a recovery rate of 94.95％. Data statistics are in EXCEL (2016), and the data are expressed as percentage. Results Teachers participating in the training believe that fellowship training should pay most attention to the training of clinical operation skills and clin-ical thinking ability. Teachers have a high demand for training related to fellowship training policies, teach-ing ability, training quality control, teachers' professional quality and other aspects. The most popular teach-ing methods are teaching observation and discussion in small classes. 288 teachers (95.69％) thought that the teacher training was very effective or good, and 290 teachers (96.55％) thought that the teacher training would be very helpful or helpful to the future fellowship training and teaching work. Conclusion This teachers training has achieved good results. In the future, stratified and specialized training can be carried out to further improve the pertinence of teachers training. At the same time, we should strengthen the man-agement of the special training process and consolidate the special training quality. We will improve the evaluation methods and test the results.

Objective To investigate the value of neurite orientation dispersion and density imaging (NODDI) in quantitative evaluation of the microstructural changes in basal ganglia and thalamus in Wilson's disease (WD) patients,and to assess the diagnostic efficacy of NODDI.Methods Totally 27 WD patients (WD group) and 26 age-and sex-matched controls (control group) were enrolled.All subjects underwent MR scanning with NODDI.Parameters of NODDI,including intracellular volume fraction (Vic),orientation dispersion index (ODI) and isotropic volume fraction (Viso) of bilateral caudate nucleus,globus pallidus,putamen and thalamus were compared between the 2 groups.Correlation analysis was performed between each parameter of NODDI and clinical Young scores.Random Forest model was used to assess the relative importance of each parameter and to evaluate the diagnostic efficacy.Results The Vic and ODI of bilateral caudate nucleus,globus pallidus and putamen in WD patients were significantly lower than those in normal controls (all P＜0.05),while Viso was significantly higher than that in normal controls (all P＜0.05).The Vic of bilateral thalamus was lower,while Viso was higher in WD patients than those in normal controls (all P＜0.05),and ODI had no significant difference between the 2 groups (P=0.055).In WD patients,Vic and ODI of bilateral caudate nucleus,globus pallidus and putamen were negatively correlated with clinical Young scores.Viso of globus pallidus and putamen were positively correlated with clinical scores.The prediction accuracy of NODDI was 96.23％,and the area under ROC curve was 0.96.Conclusion NODDI can effectively evaluate changes in microstructures and metabolism during copper deposition in WD patients,and it may be useful in detecting changes of brain deep nuclei and assessing the progression of WD.

Objective:To explore the relationship between lipid accumulation product (LAP) and disease activity, nutritional status in patients with Crohn disease (CD).Methods:The clinical data of 74 patients with CD in the Affiliated Hospital of Yangzhou University from July 2020 to June 2021 were retrospectively analyzed. The patients were divided into active group (32 cases) and remission group (42 cases) according to simplified Crohn disease activity index (CDAI). The general clinical data, laboratory examination results and body fat indexes were recorded, body fat indexes including body mass index (BMI), waist circumference, waist-to-height ratio, LAP and nutritional risk screening 2002 (NRS2002) score. Spearman method was used for correlation analysis; the receiver operating characteristic (ROC) curve was drawn to analyze the efficacy of LAP in predicting the disease activity and nutritional status in patients with CD.Results:The proportion of males, body weight, hemoglobin, albumin, total cholesterol, triglyceride and high-density lipoprotein cholesterol in active group were significantly lower than those in remission group: 46.9% (15/32) vs. 71.4% (30/42), (53.58 ± 8.13) kg vs. (61.05 ± 9.38) kg, (109.94 ± 23.70) g/L vs. (134.19 ± 18.03) g/L, (34.01 ± 5.71) g/L vs. (39.15 ± 4.27) g/L, (3.23 ± 0.68) mmol/L vs. (3.66 ± 0.74) mmol/L, (1.12 ± 0.36) mmol/L vs. (1.34 ± 0.55) mmol/L and (0.91 ± 0.23) mmol/L vs. (1.04 ± 0.33) mmol/L, the nutritional risk rate, platelet count, C-reactive protein and erythrocyte sedimentation rate were significantly higher than those in remission group: 68.8% (22/32) vs. 19.0% (8/42), (317.97 ± 130.19) ×10 9/L vs. (194.00 ± 51.91) × 10 9/L, 14.15 (6.15, 41.35) mg/L vs. 1.51 (0.22, 5.58) mg/L and 40.00 (20.50, 64.25) mm/1 h vs. 9.00 (3.00, 20.00) mm/1 h, and there were statistical differences ( P<0.01 or <0.05); there were no statistical difference in age, height, total protein and low-density lipoprotein cholesterol between the two groups ( P>0.05). The BMI, waist circumference, waist-to-height ratio and LAP in active group were significantly lower than those in remission group: 19.46 (17.70, 21.45) kg/m 2 vs. 21.08 (18.87, 23.12) kg/m 2, (72.51 ± 5.92) cm vs. (77.67 ± 7.27) cm, 0.44 ± 0.03 vs. 0.46 ± 0.04, 13.42 (5.07, 17.72) cm·mmol/L vs. 15.49 (9.37, 31.71) cm·mmol/L, the NRS2002 was significantly higher than that in remission group: 3.00 (1.00, 3.75) scores vs. 1.00 (0, 2.00) scores, and there were statistical differences ( P<0.01 or <0.05). Spearman correlation analysis result showed that LAP was positively correlated with BMI, waist circumference and waist-to-height ratio ( r = 0.701, 0.766 and 0.829; P<0.01); LAP was negatively correlated with NRS2002 score, platelet count and erythrocyte sedimentation rate ( r =- 0.609, - 0.249 and - 0.243; P<0.01 or<0.05). ROC curve analysis result showed that the areas under the curve of LAP predicting disease remission and nutritional status improvement in patients with CD were 0.645 and 0.832 (95% CI 0.520 to 0.770 and 0.739 to 0.925), the best cut-off values were 20.89 and 12.86 cm·mmol/L, the sensitivities were 45.2% and 81.8%, and the specificities were 87.5% and 73.3%. Conclusions:LAP has good predictive value for disease remission and nutritional status improvement in patients with CD.