OSCE is a new method which has strong objectivity for the evaluation of clin-ical skills examination.According to the actual situation of our college,we chose medicine sta-tion of OSCE to assess the level of the clinical skills of the clinical graduates.

Dentin Sensitivity ; diagnosis ; Humans

Objective To study the therapeutical effect of glutathione(GL),a powerful antioxidant on the symptoms and ECG in patients with coronary heart disease and its mechanisms.Methods Eighty-five subjects with coronary heart disease were recruited(45 male and 40 female).The patients were randomized to receive GL (240 mg,ivgtt,qd,for 14 days,n=44)on the top of conventional treatment(aspirin+?-blocks+ACEI)or conven- tional treatement alone(control,n=41).The serum MDA,SOD,NO levels were determined.Electrocardio- graphy(ST stage,T wave)was examined.Results GL significantly improved clinical symptoms scores(2.0+0.5 vs control:1.5+0.5,P

Objective To detect and explore the expression of ARD1 and its clinical significance in the nasopharyngeal in-flammatory tissue ,nasopharyngeal carcinoma group and its subgroups .Methods Expression of ARD1 in nasopharyngeal carcinoma (56 cases) and nasopharyngeal inflammatory tissue (20 cases) were detected by immunohistochemical staining SP ,the correlation between the expression of ARD1 and age ,gender ,histological grade ,TNM clinical stage and tumor metastasis were analysed . Results The positive expression rate of ARD1 were 10 .00% (2/20) ,55 .35% (31/56) in the nasopharyngeal inflammatory tissue and nasopharyngeal carcinoma ,respectively .The expression level of ARD1 in nasopharyngeal carcinoma was significantly higher than in the nasopharyngeal inflammatory tissue ,the difference was significant (P< 0 .05) ;expression of ARD1 in the nasopharynge-al carcinoma was correlated with the histological grade of nasopharyngeal carcinoma(P< 0 .05) and the expression was increased in poor differenciation tissue .But there was no statistical difference between the expression of ARD1 and the patient′s age ,gender , TNM clinical stage ,tumor metastasis(P> 0 .05) .Conclusion The expression of ARD1 is high in nasopharyngeal carcinoma ,and has a closely correlation with diffferentiation level of tumor ,which suggested that ARD1 may be involved in the the occurrence and development of nasopharyngeal carcinoma .However ,further research needs to be done for its mechanism in the nasopharyngeal car-cinoma .

Multimedia teaching and SimMan,which is a portable and advanced patient simulator for team training,were used to develop a new course for the medical students of grade four. This course was named "SimMan clinical techniques training". The course of Sim-Man clinical techniques training can help students comprehend truly all kinds of cases in clinical practices,improve their capabilities of clinical thoughts and clinical techniques,and it makes fine basis for their clinical practices in the hospitals.

The article introduced the importance of learning the medical documents writing for the clinical medical students and the fundamental condition of setting up medical document writing,including the course setup,course target,course content,teaching method,teaching materials,curriculum implementation,assessment methods and so on. And through the questionnaire survey,the comparison of the internship students'writing quality before and after the course setup,and the statistics analysis,the article also suggested that it was necessary and feasible to establish the curriculum of medical documents writing in clinical specialty.

Objective The mortality rate of the children after surgical repair of congenital heart disease associated with acute renal injure has been reported to be 30％-79％.Peritoneal dialysis is the common treatment method for those patients,but the optimal time to initiate peritoneal dialysis is still controversial.The aim of this study was to investigate the clinic outcome of early peritoneal dialysis to the children following cardiac surgery.Methods We performed a retrospective chart of children following cardiac surgery from January 2008 to December 2009.The total number was 4561,62 of them were performed PD treatment.Data on the PD treatment children were collected from pre-operation to hospital discharge.Early peritoneal dialysis group was defintes as PD initiated at operation room or the interval between the end of operation to starting peritoneal dialysis less than 3hrs.the others were traditional PD group.Results The whole PD treatment rate was 1.36％,15 patients died.The mortality were 10.71％ (3/28) in early PD and 35.29％ (12/34) in conditional PD group respectively (P =0.036).2 patients were met RIFLE(risk,injury,failure,loss,and end-stage renal disease,RIFLE)classification as failure grade in early PD group while 10 patients in traditional PD group (P =0.001).After PD treatment 24hrs,the Vasoactive-Inotrope Scores and serum creatinine values were much lower in the early PD group children than those in the traditional PD group[(19.00 ±2.39) vs(37.00±5.22),P=0.002;(50.51 ±21.84) vs(130.13±76.09),P=0.001)].Conclusion This study shows that early PD can prevent the children after congenital heart surgery to develop AKI,and reduce the severity of the clinic status.Early intervention with PD is associated with low mortality.

Objective To discuss the method of interventional intravascular treatment in traumatic carotid cavernous fistula(TCCF)and the significance of clinical application in emergency.Methods In 297 cases of TCCF,36 cases were treated by interventional intravaseular embolization by detachable balloon, embolization orificium or occlusion in one side of carotid artery.In the 36 cases,serious epistaxis occurred in 22 cases,cortical vein inflow in 9 cases,intracranial hemorrhage in 3 cases,aggravation of eyesight in 3 cases,and limb dysfunction in 2 cases.Results Fistula was successfully embolized and internal carotid artery remained patent in 19 cases.Complete embolization of orificium or internal carotid artery was achieved in 17 cases.The serious epistaxias in 22 cases and intracranial hemorrhage in 3 cases stopped.Eyesight recovered in 2 cases and improved in 1 case.Limb dysfunction improved evidently in 2 cases. Conclusion Intravascular embolization treatment is the first therapeutic choice for TCCF,especially in emergency.It is necessary,safe and effective.

OBJECTIVE To investigate the distribution and the drug resistance of Klebsiella pneumoniae in our hospital,and provide reference for the rational use of antimicrobial agents in clinic.METHODS The strains of K.pneumoniae isolated from clinical samples were identified by the VITEK-32 system.Extended spectrum ?-lactamases(ESBLs) were determined by phenotypic confirmatory test.Susceptibility test to antimicrobial agents was performed by disk diffusion methods and analyzed by WHONET 5.3.RESULTS 93.6% Of total 256 strains of K.pneumoniae were isolated from urine,sputum,blood and secretion samples,and 54.3% of them were isolated from sputum.81.6% Of infections caused by K.pneumoniae were frequently occurred in patients in intensive care units(ICU),departments of respiratory medicine and gastroenterology,departments of hematology and endocrinology,cadred wards and department of nephrology.The isolated ratio of ESBLs producing K.pneumoniae were 39.8%.The rates of resistance to piperacillin,cefuroxime,ceftazidime, cefotaxime,ceftriaxone,aztreonam,gentamicin,ciprofloxacin,and sulfamethoxazole/trimethoprim were between 32.4% and 50% in all strains;and the resistance rate to cefoperazone/sulbactam,piperacillin/tazobactam,cefepime,cefoxitin,and amikacin was less than 22.7%.There were isolates producing ESBLs,which showed much higher resistance to antimicrobial agents tested(but susceptible to imipenem and meropenem) than that of non-ESBLs-producing K. pneumoniae(P

The article introduced the goal,principle,method and the characteristics of the physical diagnosis operation skill of our academy training,especially emphasizing on the training way,the standard and the effect.