Objective To explore and establish the effective model of assessment for residen-cy training. Methods Totally 181 residents completed general specialist stage of resident training of Liaoning province in 2010. Assessment process was designed and implemented for general specialist training stage, including theory exam (basic knowledge, professional knowledge and public knowledge) and objective structured clinical examination (OSCE) (standardized patient(SP), computer-based case simulations(CCS) and clinical skills operation). T test and variance analysis were used and P≤0.05 stands for statistically significant difference. Results The total results consisted of two parts, theory examination results (40.00%) and OSCE results (60.00%) and two students failed the examination. The mean score of OSCE was up to standard (66.58±5.50). The mean score of SP and CCS was close to standard. The mean score of clinical skills operation reached a good level. In terms of the OSCE, SP examination and CCS examination, the performance of residents from the two universities had sig-nificant difference (t=3.818, P=0.000; t=5.581, P=0.000; t=5.419, P=0.013) and the performance of residents from the five hospitals also had significant differences. Conclusions The assessment of standardized resident training is improving gradually. Through the widespread application of OSCE in the assessment;it could be helpful to the clinical training of residents.

Objective To explore the dead reasons and related factors of acute leakemia(AL)in children.Methods The clinical data of 42 dead cases of children with AL,who were admitted to Guangzhou Children's Hospital between Jan.1999 and Mar.2007 were reviewed.Nineteen cases were boys,23 cases were girls;the aging from 4 months to 12 years old and 5 months.Of 42 children,21 cases were acute lymphoblastic leukemia(ALL),18 cases were acute myeloid leukemia(AML),3 cases were unclassified AL.Results Ten out of 12 early-dead cases died of bleeding.Among 30 cases who received chemotherapy,4 cases died of bleeding,others of myelosuppression combined with infection,14 of whom died from sepsis,3 cases with fungal infection,1 case with virus infection,4 cases with unknown pathogens.Sixteen children relapsed among those who got remission,half of them relapsed within 1 year since diagnosed.Treatment-related mortality(TRM)was 90%(27 out of 30 cases).The main causes of TRM were infection and hemorrhage.Hyperleukocytosis and bleeding were 2 risk factors related to early death in new-diagnosed children.Conclusions More emphasizes should be put on bleeding tendency during early treatment in children with AL and treatment of infection complications during induction chemotherapy to reduce TRM.

Female ; Humans ; Hyperacusis ; surgery ; Labyrinth Diseases ; surgery ; Middle Aged ; Otologic Surgical Procedures ; methods ; Retrospective Studies ; Semicircular Canals ; pathology ; surgery

BACKGROUND:Previous studies have demonstrated that nano-hydroxyapatite/polyamide 66 (nHA/PA66) composites as a root canal filing material possess the basic physical and chemical properties, have antibacterial properties against the infection of medulary cavity, and have no cytotoxicity. However, it is rarely reported as a direct pulp capping agent.
OBJECTIVE: To observe the histological reaction of nHA/PA66 composites as the pulp capping agent.
METHODS:The first and second molars from 12 Wistar rats were selected to prepare class I cavities by exposing the dental pulp. Then, these rats were randomized into three groups and subjected to dental pulp capping using nHA/PA66 composite, nHA and calcium hydroxide, respectively, folowed by filing with glass ionomer cement. At 7 and 30 days after filing, histological changes of odontoblasts and microvessels in the dental pulp were observed using ink perfusion method.
RESULTS AND CONCLUSION: At 7 days after filing, significant changes in dental pulp fibroblast proliferation, predentin thickening, dilation of blood vessels were observed in the nHA/PA66 group; only dental pulp fibroblast proliferation with no predentin thickening and dilation of blood vessels was found in the nHA group; in the calcium hydroxide group, the pulp tissues in the pulp chamber were mostly damaged, and obvious hyperplasia in dental pulp fibroblasts and certain inflammatory cel infiltration with vascular necrosis were observed. At 30 days after filing, predentin thickness was increased further, dental pulp fibroblasts proliferated, the number of odontoblasts increased, and dilation of blood vessels was observed in the nHA/PA66 group; predentin thickening and dilation of blood vessels were obviously visible in the nHA group; pulp necrosis was found on the pulp surface below the pitting pore, odontoblasts grew actively at the pulp junction, with no obvious thickening of the predentin, and there were dense vessels below the necrotic area. These findings indicate that the nHA/PA66 composite can induce the regeneration of dental pulp cels.

BACKGROUND:The mechanical properties of SonicFil ultrasonic resin are better than those of the traditional light-cured composite resin, but its effect on odontoblasts and dental pulp vessels is unclear.
OBJECTIVE:To study the effect of SonicFil ultrasonic resin on odontoblasts and dental pulp vessels of rats using histological methods.
METHODS:Twenty-five Wistar rats are selected for experiment. Ninety-six teeth from the first and second molars were selected and randomly divided into SonicFil ultrasound resin group and Filtek Z350 nano resin group with 48 teeth in each group. Experimental teeth in each group were equaly subdivided into 7 days group and 30 days group. Besides, randomly selected five teeth with no intervention served as normal control group. After anesthesia and disinfection, class I cavities on the occlusal surface of the maxilary first and second molars were prepared and filed with SonicFil ultrasound resin and Filtek Z350 nano resin group, respectively. The rats were sacrificed by ink perfusion method, and tooth specimens were taken to observe the changes of odontoblasts and pulp microvessels.
RESULTS AND CONCLUSION: At 7 days after filing, two groups had similar changes in the pulp presenting with mild inflammation. Besides, there were scattered inflammatory cels distributing in the cave pulp tissue, and in most of the specimens, odontoblasts arranged disorderly with little vacuoles and microvascular dilatation in the pulp. At 30 days after filing, in the SonicFil ultrasonic resin group, odontoblasts arranged orderly, inflammatory reaction and microvascular dilatation disappeared basicaly. In contrast, in the Filtek Z350 nano resin group, disordered odontoblasts decreased, inflammatory reaction weakened, as wel as microvascular dilatation became less. These results show that under the experimental condition, both of the SonicFil ultrasonic resin and Filtek SonicFil Z350 nano resin play certain roles in the formation of odontoblasts and dental pulp vessels, but over time al of these effects can automaticaly disappear.

Objective To evaluate the effect of external direct current shock on left atrial(LA) diamension and volumes after cardioversion for atrial fibrillation(AF) and the relation between LA size and function.Methods The initial study population included 68 patients with AF.According to cardioversion patterns, the patients were divided randomly into cardioversion with direct-current shock(36 patients) and cardioversion with drugs(32 patients). Echocardiographic evaluations included LA size and volume,LA passive and active emptying volumes were calculated,and LA function was measured as LA ejection force (LAEF).The correlation between LA diameters and volumes and LA systolic function was analyzed. Results LA was dilated in all the patients during AF and the superior-infra dimensions of LA decreased after restoration of sinus rhythm in the patients reverted with external direct current shock and the patients reverted with durgs (P

Objective To provide a good anatomical foundation for transposition of the branch of median nerve superficial flexor muscle repairing the movement branch of ulnar nerve to recover the function of intrinsic muscle, by anatomic study of the muscle branch of the superficial flexor muscle of the median nerve and the movement branch of ulnar nerve. Methods Twenty adult upper limb specimens immersed fixed by formalin were elected and expose the midian nerve and ulnar nerve. Then every anatomical index was measured. Simulate to manipulate that the branch of superficial flexor muscle repair the motor b ranch of ulnar nerve. Calculate the number of myelinated nerve fibers of the branch of superficial flexor muscle. Results The distance between the position into muscle and styloid process of radius and styloid process of ulna: (21.4±1.8)mm, the distance that can be separated: (27.1±1.2)mm, the transverse diameter: (1.2±0.2)mm, anteroposterior diameter: (0.7 ± 0.1 )mm. No injury separated distance between the sensory branch and motor branch of ulnar nerve: (7.1 ± 0.7)cm. The 4th muscular branches of median nerve flexor digitorum superficialis was 1378.9± 107.9. Conclusion The 4th muscular branches of median nerve flexor digitorum superficialis can be used to repair the motor branch of the ulnar nerve to recover the function of intrinsic muscle of hand.

Stage assessment is an important part of standardized resident training.After two years of practice and exploration,Liaoning had established the complete examination and evaluation system including the theory test and skill test and this system was future improved through analyzing two years' results and summing up the experiences making it more suitable for residency training in the future.

Objective To observe the changes of peripheral blood CD27+B cells percentage in patients with HBV-related disease of different severity and the clinical significance.Methods 20 cases of chronic viral hepatitis B,23 cases of HBV-related liver cirrhosis,21 cases of liver cancer were selected,25 cases of healthy controls in the corresponding period who had the physical examination were set as the healthy control group.The peripheral blood in the healthy controls and the patients with HBV-related disease was collected.The cellular immune level changes and CD27+ B cells percentage was detected by flow cytometry,the humoral immunity was detected by immune transmission turbidty method:IgM,IgD.Results (1)Compared with the healthy control group,CD27+B cells percentage significantly decreased in the three groups of patients with HBV-related disease [(5.16 ± 0.36) ％ vs.(4.52 ± 0.22) ％,(2.24 ± 0.15) ％,(0.58 ± 0.02) ％,F =4.32,P ＜ 0.05],and the downward trend gradually obvious as the disease degree exacerbated.nnnnn(2)IgM,IgD in the three groups of HBV related disease patients rised obviously,and the increase range became more obvious as the disease degree exacerbation(F =3.29,5.23,P =0.02,0.03).Conclusion CD27+B cells has a close relationship with HBV-related disease,and rebuilding the body's immune defense system is great importance for evaluating prognosis and the clinical guidance in HBV-related disease.

Objective To check the maneuverability of the nursing safety management indicators for skilled nursing facilities.Methods A hospital based skilled nursing facility in Chongqing was chosen as the main study target while a Red Cross nursing hospital in Shanghai which operated earlier was also included as a comparison object.Combination of files reference,on-the-scene observation,manager interviews,sampling survey and institution's self-assessment,scores of indicators were calculated,and the total scores for both institutions were calculated as well.Results The institution from Chongqing marked 81 points while the other one got 86 points.Conclusions The indicator system had good maneuverability and the weight of indexes was consistent with the practical requirement of safety management.This indicator system could provide reference for standardize skilled nursing facilities' management,but still needed further revision and consummation.