Acute Disease ; Adolescent ; Adult ; Aged ; Child ; Female ; Follow-Up Studies ; Humans ; Ivermectin ; analogs & derivatives ; poisoning ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Adenocarcinoma ; therapy ; Breast Neoplasms ; therapy ; Carcinoma, Endometrioid ; therapy ; Carcinoma, Squamous Cell ; therapy ; Cystadenocarcinoma, Serous ; therapy ; Endometrial Neoplasms ; therapy ; Female ; Genital Neoplasms, Female ; therapy ; Hormone Replacement Therapy ; Humans ; Ovarian Neoplasms ; therapy ; Treatment Outcome ; Uterine Cervical Neoplasms ; therapy

AIS group or NS group. 2)Cross sectional area of type Ⅰ fibers on the convex side: SS group

Long educational system is an effective form in training high-level medical talents.Doctor-patient communication skill is one of tbe basic qualifications for 8-year program medical students.Standardized patients can be applied in training and evaluating of the 8-year program medical students'ability to deal with doctor-patient relationship so as to cultivate their communication competence.

Objective:To investigate the effect of arterialised Flow-through venous flap with palmaris longus tendon in repairing dorsal digit composite tissue defect.Methods:From March, 2010 to December, 2018, 23 cases (23 digits) of dorsal digit composite tissue defect were repaired with arterialised Flow-through venous flap with palmaris longus tendon. There were 17 males and 6 females aged between 23 to 53 (average, 37.2) years old. Causes of injury: 15 cases of strangulation, 5 of electric plane and 3 of thermal crush. Number of injured digit were 1 thumb, 11 index fingers, 9 middle fingers and 2 ring fingers. All of the injured digits had skin and extensor tendon defects with an area of 2.0 cm×1.8 cm-4.2 cm×2.6 cm, and the length of extensor tendon defect was 1.6-2.6 cm. One case had terminal and central tendon insertion defects and 5 suffered with terminal tendon insertion defect. Three cases were repaired by emergency surgery, and 20 were repaired by sub-emergency surgery. All donor sites were directly sutured. The shape, colour, texture, sensation, recovery of digit function and donor site appearance were followed-up at outpatient clinic.Results:The patients were followed-up for 8 to 23 (average, 11) months. The flap was soft, with mild pigmentation and recovery of protective sensation. The range of motion of the proximal and distal interphalangeal joints was 145°-170° (average,162.6°). According to Strickland hand function evaluation method, the results were excellent.Conclusion:The arterialised Flow-through venous flap with palmaris longus tendon is an ideal method in repair of the dorsal digit composite tissue defect.

Objective To evaluate reformative encircling constriction combined with the retrograde venograms in operation for treating primary deep venous insufficiency. Methods The clinical data of 25 cases (29lower extremities) undergoing primary deep venous insufficiency from March 1998 to December 2006 were analyzed retrospectively. 25 eases(29 lower extremities) were treated with reformative encircling constriction combined with the retrograde venograms in operations. Results 25 eases were treated with reformative encircling constriction combined with the retrograde venograms in operations,the leg swelling improved and no deep vein thrombus occurred; all the varicose veins are welt controlled. Conclusion Reformative encircling constriction operations are eutherapeutic for severe femoral venous valve dysfunction, when combined with the retrograde venogram, it can be a guidance in encircling constriction of superficial femoral vein and number of femoral venous valves.

Hospital entrustment will incur cultural conflicts,which calls for cultural integration as the best means to ease such frictions and conflicts between two hospitals of cultural difference.Renmin Hospital of Wuhan University (Hubei general hospital)directly hosted Hanchuan people's hospital,and implemented the president responsibility system under the leadership of the management committee.By means of cultural integration to reshape Hanchuan hospital culture,Hubei general hospital has rebuilt the latter's culture.Such reshaping features the following:development as the core,scientific management as the breakthrough,employees as the center,technology upgrade as the basis,and patients service as the direction.Cultural integration has furthered development of the hospital entrusted,and turned frictions and conflicts into infiltration and integration.As a result,Hanchuan hospital is upgraded in general in terms of management and service quality.

Constructivism teaching theory emphasizes the central role of student in learning and this theoretical framework holds that learning always builds upon the active exploring and discovering new knowledge.Department of orthopedics in the first affiliated hospital of Chongqing Medical University introduced and implemented constructivism teaching in teachers' research and teaching activity as well as in students' learning.This mobilized students' learning enthusiasm and improved clinical teaching quality.

Objective To provide a clinical anatomic basis for the bi-pedicled gastrocnemius myocuta- neous flap which is to be used to repair defects of the Achilles tendon and posterior skin of the ankle.Methods In anatomic study,out of 30 cadaver specimens,bi-pedicled V-Y gastrocnemius myoeutaneous flaps were harvested to measure the downward sliding lengths of the flap when the knee was at flexion of different degrees.In clinic,12 patients with the Achilles tendon and posterior ankle skin defects were repaired with the bi-pedicled gastrocnemius myocutaneous flaps.The areas of composite defects ranged from 10 cm?6 cm to 6 cm?4 cm.They were followed up for four months to 12 years.Results The maximal sliding length of the flap reached (9.2?0.9)cm when the knee was at flexion of 90?.All the clinical flaps survived and ambulation of the patients recovered.The dorsiflexion and plantarflexion of the ankles reached 11.0??1.4?and 35.0??4.6?respectively.Conclusion This flap is suitable for one-stage repair of composite Achilles tendon defects.

Objective To-identify the factors associated with radiation-induced liver disease (RILD) and to describe the probability of RILD using the Lyman normal tissue complication(NTCP) model for primary liver carcinoma(PLC) treated with hypofractionated conformal therapy (CRT).Methods A total of 109 PLC patients treated with hypofractionated CRT were prospectively followed according to the Child-Pugh classification for liver cirrhosis,93 patients in class A and 16 in class B.The mean dose of radi- ation to the isocenter was (53.5?5.5) Gy,fractions of (4.8?0.5) Gy,with interfraction interval of 48 hours and irradiation 3 times per week.Maximal likelihood analysis yielded the best estimates of parameters of the Lyman NTCP model for all patients;Child-Pugh A and Child-Pugh B patients,respectively.Results Of all the patients,17 developed RILD (17/109),8 in Child-Pugh A(8/93 ) and 9 in Child-Pugh B(9/ 16).By multivariate analysis,only the Child-Pugh Grade of liver cirrhosis was the independent factor (P= 0.000) associated with the developing of RILD.The best estimates of the NTCP parameters for all 109 pa- tients were n=1.1,m=0.35 and TD_(50) (1)=38.5 Gy.The n,m,TD_(50) (1) estimated from patients with Child-Pugh A was 1.1,0.28,40.5 Gy,respectively,compared with 0.7,0.43,23 Gy respectively,for patients with Child-Pugh B.Conclusions Primary liver cancer patients who possess Child-Pugh B cirrho- sis would present a significantly greater susceptibility to RILD after hypofractionated CRT than patients with Child-Pugh A cirrhosis.The predominant risk factor for developing RILD is the severity of hepatic cirrhosis in the liver of PLC patients.