Dentin Sensitivity ; diagnosis ; Humans

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.

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 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.

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 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 .

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 breed homozygous mice of Treg-Th17 fluorescence double labeling and to investigate the role of Treg-Th17 balance in endotoxemia. Methods Mice of Treg and Th17 fluorescence single labeling were brought from Harvard Medical School,USA and were mated and bred based on the genetic rules.The genomic DNA was extracted from the tails of second generation weaning mice for genotyping by polymerase chain reaction (PCR).Thereafter,the homozygous mice of fluorescence double labeling were selected to have successive inbreeding for three generations and their genotypes and growth status were measured.The endotoxemia model in vivo was duplicated and changes of Treg-Th17 balance were detected by flow cytometry analysis at 24 h and 48 h after endotoxemia. Results Among the seven second generation mice in the first batch,only three (two males and one female) were the wanted homozygotes.Meanwhile,the genotypes of their offsprings for the next three generations were all Foxp3 RFPKI-homo IL-17A GFPKI with normal growing status.As important component of endotoxin,lipopolysaccharide (LPS)could induce significant signal expressions of red fluorescence protein (RFP) and green fluorescence protein (GFP).The ratio of CD8a + Foxp3 +,CD8a + IL-17A +,CD4 + Foxp3 + and CD4 + IL-17A + in the lymphocytes went up significantly in the group of 24 hours of LPS treatment,as compared with the control group (P ＜ 0.01 or P ＜ 0.05 ),while the difference between the control group and the group of 48hours of LPS treatment had no statistical significance (P ＞ 0.05). Conclusion Foxp3 RFPKI-homoIL-17A GFPKI mice have identical genotypes and stable genetic characteristics and is a model animal and novel research platform that can provide real-time monitoring of the changes of Treg-Th17 balance in vivo.The role of T reg-Th17 balance works significantly at 48 hous after the subject is exposed to LPS stimulation,and the roles of CD8a + Foxp3 and CD8a + IL-17A + in Treg-Th17 balance require further investigation.

Objective To explore the guidance significance of the functional MRI and DTI (fMRI ,DTI) ,intraoperative ultra-sound(IOUS) ,neuronavigation ,electrocorticography(EcoG) monitoring used in surgical treatment of low-grade gliomas with epi-lepsy as main symptom located near the eloquent brain regions .Methods 23 neurosurgical patients in the First Affiliated Hospital of Chongqing Medical University during 2009-2010 were performed the retrospective analysis .The preoperative fMRI ,DTI deter-mined the positional relation between the lesions with the conduction bundle and the eloquent brain regions ,the electrophysiological and imageological examinations positioned the epileptogenic focus and lesions ,the MRI-mediated neuronavigation system was adopt-ed to formulate the surgical plan and choose the best surgical approach ,IOUS was used to perform the realtime monitoring for pre-cisely positioning the lesion range and determining the extent of resection ,and the intraoperative EcoG was adopted to determine the epileptogenic focus localization ,the lesions and the epileptogenic focus was dealed by the operating microscope for avoiding the func-tional region ,and the patient′s prognosis was evaluated and recored in detail after operation .Results By the precisely positioning the lesions and epileptogenic focus by fMRI ,DTI ,neuronavigation and ultrasound ,the lesion resection degrees by the operative mi-croscope and intraopertaive pathological guidance were 17 cases of Ⅰ-Ⅱ grade ,4 cases of Ⅲ grade and 2 case of Ⅳ-Ⅴ grade .1 case of motor aphasia ,4 cases of hemiplegia and monoplegia and 1 case of disturbance of consciousness after operation were improved by the treatment of neurotrophy ,dehydration and hyperbaric oxygen and discharged from hospital with rehabilitation .No death case occurred .The evaluation of the life quality :20 cases ofⅠ-Ⅱ grade ,3 cases of Ⅲ grade and no vegetable survival case of Ⅳ grade . The evaluation of resection clinical effect :20 cases of cure ,3 cases of improvement ,no case of as before and exacerbation .After fol-lowed up for 6-24 months ,according to Engel classification of seizure efficacy assessment :Ⅰ-Ⅱ grade in 21 cases ,Ⅲ grade in 2 case ,no case of Ⅳgrade .Conclusion fMRI ,DTI ,neuronavigation ,IOUS and EcoG for guiding the operation of low grade gliomas located near the eloquent brain regions can resect the lesion to the largest extent and simultaneously deal with epileptogenic focus , effectively protect the neurological function of the functional region ,greatly reduce the side-injury of the normal brain tissues in the functional region ,at the same time increase the curative effect of symptomatic epilepsy .