Objective To investigate the clinical value of medial approach in the treatment of posterior tibial plateau fractures.Methods 60 cases with posterior tibial plateau fractures were randomly divided into observation group and control group.The observation group was operated by medial approach,and the control group was operated by medial approach.Results The operation time of the observation group was (138.4 ±18.2)min,which of the con-trol group was (119.2 ±15.8)min,the difference between the two groups was statistically significant(t =4.363,P <0.01).The excellent and good rate of rehabilitation in the observation group was 96.7%,which was significantly higher than 83.3% of the control group (Z =2.237,P <0.05).The fracture healing time of the observation group was (14.5 ±3.3)weeks,which was significantly shorter than (17.9 ±3.6)weeks of the control group (t =3.813, P <0.01).The hospitalization time and incidence rate of complications had no statistically significant differences between the two groups (P >0.05).Conclusion The medial approach in the treatment of the posterior tibial plateau fractures has relatively small injury,reliable fixation,and good rehabilitation.It is one of surgical approaches which worthy of clinical consideration.

Flipping the classroom is a new teaching mode in which the students learn some-thing through the network autonomous learning before class, in classroom students interact with teach-ers, internalized and absorb what they have learned, and then consolidate it after class. So it can resultin real-timeevaluation of learning effect by different means, different objects and form and can ef-fectively give secondary feed back comments, which has important significance for the improvement of teaching and learning effects at all levels. Article discusses how to effectively use formative assess-ment method to conduct effective monit oringand feed back to improve the flipped classroom activi-ties. It also explore show to strengthen and exercise their student's ability in the application process.

Aged ; Carcinoid Tumor ; diagnosis ; therapy ; Humans ; Laryngeal Neoplasms ; diagnosis ; therapy ; Male

After the culture in college and university medical library was described, the necessity of its construc-tion was elaborated, and its implementation measures were stressed, such as setting up experience area, bringing into play of Primal interactive 3D anatomical database, planning subject activities according to the health holidays, providing personal space for users based on library websites, effectively popularizing reading, consecutively expan-ding service space, and carrying out personal service.

[Objective]To investigate the effect of surgical treatment of scapular fractures through posterior approach.[Method]From May 2000 to November 2007,14 patients(10 females,4 males;mean age 34.6 years)with scapular fractures were treated by open reduction and internal fixation through a posterior approach.Eight patients were injurred in traffic accidents,3 due to falling,2 by direct violence and 1 due to cut.There were eleven patients with close fractures and 3 with open fractures.According to Hardegger classification system,there were 8 cases of scapular body fracture,9 of scapular spine fracture,6 of scapular acromion,10 of scapular neck fracture,6 of glenoid rim fracture and 4 of glenoid fossa fracture.[Result]Fourteen patients were followed up,with a mean follow up time of 18 months.According to Rowe score system,10 patients showed an excellent result,2 showed a good result,the other two showed a fair result.[Conclusion]The posterior approach for fixing scapular fractures has advantages of wide exposure,safety,easy operation,and reliable effect.It is a choice of operation for most types of scapular fractures,especially for scapular body fracture,spina scapular fracture and scapular multiposition fracture.

Objective To explore the expression of protein phosphotase-2A(PP-2A) in plasma in the patients with mild cognitive impairment. Methods The expression of PP-2A was measured by Western-blot in control group(n=11),1-year MCI group(n=10),2-year MCI group(n=10) and 3-year MCI group(n=10). Results The expression of PP-2A in 1-year MCI group(0.96±0.06) and in 2-year MCI group(0.93±0.07) was not obviously lower as compared with control group(1.00±0.08)(P>0.05),but a significant difference was induced between 3-year MCI group and control group(P<0.05),and between 3-year MCI group and 1-year MCI group(P<0.05),but wasn't between 3-year MCI group and 2-year MCI group(P>0.05). Conclusion Lower expression of PP-2A in plasma implies a possible value of MCI diagnosis.

Objective To compare the difference between intermittent epidural bolus(IEB) combined with patient controlled epidural analgesia(PCEA)and continuous epidural infusion(CEI)combined with PCEA mode in labor analgesia. Methods It was a retrospective cohort study ,which subjects were assigned to CEI+PCEA and IEB + PCEA group. Correlated data were collected to compare the effect of the two analgesic mode on perinatal events. Results There were less consumption of ropivacaine and sufentanil per hour ,less PCEA request and actual bolus in IEB + PCEA group. There were no significant difference between the delivery mode and the percentage of low Apgar score in neonates. Conclusion IEB+PCEA mode has better analgesic effect ,meanwhile doesn't disturb the delivery mode has no effect on the neonate outcome.

This article summarized two medical cases of Professor SHI Da-zhuo treating acute myocardial infarction by Yiqi Huoxue Tuodu Shengji TCM therapy on the basis of conventional Western medicine therapy. Comparison of echocardiography before and after treatment showed that Yiqi Huoxue Tuodu Shengji TCM combined with conventional Western medicine therapy could inhibit the expansion of atrium and ventricle, improve the cardiac ejection fraction and improve the cardiac function after acute myocardial infarction, which could provide references for integrated traditional Chinese and Western medicine therapy for acute myocardial infarction.

In the context of higher medical education reform in our country,to vigorously promote the development of teachers' teaching work can promote the improvement of teachers' teaching ability and level.This study describes the history of the development of teacher education at home and abroad,introduces the form and content of teachers' workshops,seminars,micro courses and lesson study,and compares the form and content of teacher education at home and abroad,which provides scientific reference and basis for the introduction of policies of China's education related departments and the construction of the teacher development alliance between universities and colleges.

Based on the theory of Donabedian quality theory,namely structure-process-outcome theory,the evaluation and maintenance of nursing environment is analyzed.Through related websites,retrieval of patient safety case and literature and combined with the relationship with three layers,the high quality nursing environment and patient safety is analyzed,to study its localization and reference,and to put forward the corresponding suggestions in order to help ensure the safety of patients.