Objective To explore the unified assessment methods based on present situation of after-department examination during the internship in the department of obstetrics and gynecology.Methods The present situation of after-department examination in the department of obstetrics and gynecology in 36 comprehensive hospitals of Chongqing Three Gorges Medical College were investigated through interviews and research papers including 12 grade A hospital of the first class hospital (33.33％),19 grade A hospital of the second class(52.78％) and 5 grade B hospital of the second class(13.89％).Totally 137 students of clinical major in 4 grade A hospital of the second class were enrolled and were divided into study group(n=72) and control group(n=65).hems of theoretical examination and skill examination as well as the evaluation standard were established combining with the syllabus of the licensed assistant doctors and the talent training scheme requirements.Students in study group were trained according to the practice syllabus,skill examination requirement and evaluation require-ment while those in control group had no cmresponding requirement.After-department examination was organized by school at the end of internship.The full score of theoretical examination and skill examination score was 50 respectively.Smvey results of after-depamnent examination were analyzed by Fisher's Exact Test and the results of after-depamnent examination were analyzed by t test.Results The hospitals having the after-department examination accounted for 80.56％(29/36).The hospitals having the after-depamnent examination according to the practice syllabus requirements accounted for only 20.69％(6/29).After the intervention,theoretical examination scores of study group and control group were 40.31 ± 3.47 and 35.78 ± 4.92,respectively,with statistically significant differences(t=6.26,P=0.000).The skills assessment scores of study group and control group were 40.42 ± 3.02 and 34.05 ± 5.18,respectively,with statistically significant differences(t=8.90,P=0.000).Conclusions The after-department examination in hospital is in a state of randomness,so unified assessment methods are necessary.

Objective To discuss the feasibility of endoscopic axillary lymph node dissection by using balloon dilatation.Methods Seven patients with breast cancer from June 2005 to October 2005 were studied.Methylene blue injection around the areola or the tumor in combination with balloon placement in the axilla was performed to create surgical space for further endoscopic axillary lymph node dissection.Results The number of resected lymph nodes was 9~17(mean,12.3).No crushed lymph node was found.Positive lymph nodes were found in 4 patients.The operation time was 95~140 min(mean,114.3 min).The axillary vein and other important anatomic structures were clearly exposed.There was no edema of the upper limbs or other complications in the axillary area.No recurrence was noted during a follow-up survey for 2~6 months(mean,4.6 months).Conclusions Endoscopic axillary lymph node dissection can be performed after the establishment of surgical space by using balloon dilatation.

Objective To validate the therapeutic effect of acupuncture stage treatment on facial spasm and seek a better method for treating this disease. Method One hundred and forty patients were randomly allocated to stage treatment (50 cases), acupuncture (50 cases) and Western medicine (40 cases) groups. In the stage treatment group, treatment was divided into early, middle and late stages according to the patients’ duration of disease. Each stage provided acupuncture point injection of different medicine plus warm needling. The acupuncture group received conventional acupuncture with 1 hour retention of needles and the Western medicine group, oral administration of carbamazepine tablets, 0.2 g 3 times a day. After the completion of treatment course, a six-month follow-up was performed to determine no relapse or aggravation in the three groups and the therapeutic effects were evaluated using Cohen and Albert spasm grading criteria.Result The complete resolution rate was 56% (28/50) in the stage treatment group, 14.0% (7/50) in the acupuncture group and 20.0% (8/40) in Western medicine group. The complete resolution rate was significantly higher in the stage treatment group than in the acupuncture and Western medicine groups (P<0.05). The total efficacy rate was 100.0% (50/50) in the stage treatment group, 70.0% (35/50) in the acupuncture group and 60.0% (24/40) in the Western medicine group. The total efficacy rate was significantly higher in the stage treatment group than in the acupuncture and Western medicine groups (P<0.05).Conclusion Stage treatment has a marked effect on facial spasm.

Adult ; Bronchi ; Foreign Bodies ; Humans ; Male ; Trachea ; pathology

Objective To evaluate the damage to the brochial plexus produced by pulsed radiofrequency (PRF)and radiofrequency thermocoagulation(RFTC).Methods Fifty-five male Wistar rats weighing 250-300 g were randomly divided into 3 groups:groupⅠPRF(n=25):groupⅡRFTC(n=25)and groupⅢnormal control(n=5).The animals were anesthetized with intraperitoneal chloral hydrate.The left brochial plexus was exposed and PRF or RFTC was applied to the left brochial plexus.The voltage and current of the minimal stimulation which elecited muscle twitching and the impedance before and after operation were recorded in group PRF and RFTC.The nerve function was scored according to Tarloo(0=flaccid paresis,5=normal gait)before and at 3d after operation.The animals were killed and the left brachial plexus was removed immediately and at 1, 7,14,30 d after operation(n=5 at each time point)for determination of histopathological changes using microscope.Results The impedance and Tarlov score were significantly decreased after operation as compared to the baseline values before operation in group RFTC and were also significantly lower than in group PRF. Microscopic examination showed that the myelinated nerve fibers exhibited Wallerian degeneration and axon regeneration and the cytochondria in cylindraxile were severely injured or disappeared in group RFTC.The myelinated nerve fibers and the cytochondria in cylindraxile were significantly less injured after operation in group PRF than in group RFTC and returned to normal at 7 d and 30 d respectively.Conclusion The injury to brachial plexus produced by PRF is slighter than that produced by RFTC.

Objective To develop the human colon carcinoma(HT-29) liver metastasis model in nude mice,and to detect the expression of human telomerase reverse transcriptases(hTERT) mRNA in liver of nude mice. Methods Liver metastases were established in 30 Balb/c nude mice by intrasplenic injection of colonic cancer cells(HT-29),and the spleens were resected.After being sacrificed,the tumor growth was observed,and the pathological examinations were performed.The expression of hTERT mRNA in the livers of nude mice was detected by RT-PCR technique. ResultsHuman colon carcinoma(HT-29) liver metastasis model was developed in all the 30 nude mice,with the liver metastasis rate of 100%.The pathological results revealed the occurrence of liver metastases,and the expression of hTERT mRNA was positive in the liver tissues. Conclusion Intrasplenic injection of HT-29 cell is a reliable way for producing colonic cancer liver metastasis model,and the positive expression of hTERT mRNA in liver tissues indicates the significance of hTERT in the early diagnosis and treatment of colon carcinoma liver metastasis.

Objectives To investigate the role and mechanism of p38 mitogerra activated protein kinase (p38MAPK) in up-regulation of prostanoid 2 induced by uric acid in rat glomerular mesangial cells (GMCs).Methods Rat glomerular mesangial cells were cultured in vitro,then stimulated with different concentrations of uric acid (50,100,300 μmol/L),or stimulated with different concentrations of uric acid (50,100,300 μmol/L) after pretreatment with p38MAPK specific inhibitor SC68376 (10 μmol/L) for 30 min.Activated p38MAPK was detected by Western blotting.The expression of prostanoid 2 was measured by ELISA.Cyclooxygenase-2 mRNA expression was determined by RT-PCR.Results Uric acid could activate p38MAPK and up-regulate the mRNA expressions of prostanoid 2 and cyclooxygenase-2 in rat glomerular mesangial cells (all P ＜ 0.05).SC68376 inhibited those effects of the above-described induced by uric acid.Conclusion Uric acid can promote the expression of prostanoid 2 in rat glomerular mesangial cells,whose mechanism may be related to the activation of p38MAPK and the promotion of cyclooxygenase-2 synthesis,and further up-regulation of prostanoid 2 expression.

Objective: To study the effect of Shenxiong Xintong Pill(SXP) on cardiac hemodynamics. Methods: Parameters of cardiac hemodynamics were examined in anesthetic chest-opened dogs medicated with various doses of SXP. Results: After intraduodenal administration of SXP of 2.0g/kg, the coronary blood flow was raised, coronary resistance decreased, heart rate slowed and the left ventricular diastolic end pressure fallen in the dogs. No obvious changes were found in the contraction , works and ejection of left ventricle. Conclusion: The mechanism of SXP in relieving angina pectoris was probably related to the dilatation of coronary artery and increase of coronary flow with the increase supply of oxygen.

Humans ; Aortic Dissection/surgery* ; Aortic Rupture/surgery* ; Death ; Treatment Outcome

Objective To study the imaging manifestations and clinical significance of simple cochlear nerve canal(CNC)stenosis. Methods The HRCT findings of 14 patients(1 7 ears)with simple CNC stenosis diagnosed sensorineural hearing loss(SNHL)were retrospectively analyzed.The width of CNC and internal auditory canal was measured and compared with the normal ears,the data were statisti-cally analyzed by SPSS1 6.0.Thin-sliced MRI of internal auditory canal (axial and oblique sagittal position)was performed in 8 cases. Results HRCT displayed obvious CNC stenosis in all 14 patients(1 7 ears),2 ears with cochlear nerve canal atresia.Width of CNC and internal auditory canal was (0.5±0.3)mm and (4.6±1.0)mm,it was (2.1±0.2)mm and (5.1 ±1.3)mm in normal ears (1 1 ears),the width of CNC was of significant difference between normal ears and ears with SNHL,and there was no statistical sig-nificant difference in width of internal auditory canal.12 ears(from 1 7 ears with simple CNC stenosis)were lacking of fissure in the cribriform area,1 1 ears(normal ear)were existence of fissure in the cribriform area;cochlear nerves were not shown in 8 patients with MRI examination.Conclusion CNC stenosis can be isolated from internal auditory canal stenosis,MRI could display cochlear nerve dysplasia(CND).