With increasing demands and recognition, emergency medicine has advanced rapidly in China in recent decades. The education and training of professionals in this field are important for the further development of emergency medicine. With an attempt to investigate the way to strengthen residency training system in emergency medicine, this article reviews its potential development direction, training modes, learning materials, and quality control.
China ; Emergency Medicine ; education ; organization & administration ; Internship and Residency ; methods ; standards ; trends

Objective To observe the effect of Yishen Paizhuo Decoction(Decoction for reinforcing the kidney and discharging the turbid)on chronic renal failure(CRF)patients.Methods The 82 CRF patients were randomized into observation group(42 cases) and control group(40 cases).In addition to the routine treatment,the observation group was administered modified Yishen Paizbuo Decoction,and the control group was given coated aldehyde oxystarch.The course of treatment was 6 months for both groups. Changes of clinical symptoms,renal functions,blood fat,and hemoglobin were observed,and the linear regression evaluation and renal survival evaluation were employed to evaluate the development of CRF.Results The improvement of observation group in renal func- tions and blood fat was remarkable with the increased renal survival rate,compared with the control group,the difference was signifi- cant(P

Objective To find out severity and types of syphilis infection in blood donors, attendants and persons to have their premrital medical examination in Zhoushan City and offer a new measure for prevention and treatment of syphilis. Methods Totally, 174 589 blood donors, attendants and persons to have their premarital medical examinations were screened preliminarily for inapparent syphilis with non-TPHA, and then TPHA was applied to confirm the diagnosis, according to the National Standard No. GB 15974-1995, combining with clinical symptoms and physical check-up. Results A total of 1 327 cases of syphilis from 174 589 samples tested, including blood donors, attendants and persons to have their premarital medical examinations, were diagnosed, with an inapparent infection rate of 7. 60‰ in average, 6. 42‰in males and 8. 74‰ in females, with a sex ratio of 0.71 (X2 = 29. 92, P

OBJECTIVETo observe the clinical effect and safety of circumcision stapler in the treatment of phimosis and redundant prepuce.

METHODSWe treated 120 patients with redundant prepuce or phimosis using circumcision stapler and another 60 by conventional dorsal-incision circumcision. We observed intraoperative blood loss, operation time, postoperative pain, wound healing time, cosmetic appearance of the penis, and postoperative complications and compared them between the two groups of patients.

RESULTSStapler circumcision showed obvious advantages over the conventional method in intraoperative blood loss ([2. 3 ± 1. 3] vs [15.6 ± 2.9] ml), operation time ([7.1 ± 1.4] vs [22.6 ± 4.6] min), wound healing time ([12.0 ± 2.9] as [16.3 ± 3. 1] d), postoperative pain score (1. 9 ± 1. 3 vs 5. 2 ± 1. 7), incision edema, and cosmetic appearance of the penis (all P <0. 05). Besides, stapler circumcision exempted the patients from stitch-removal pain. However, the incidence rate of postoperative local ecchymosis was significantly higher in the circumcision stapler group than in the conventional circumcision group (20. 8% vs 8. 3% , P <0. 05).

CONCLUSIONCircumcision stapler, with its advantages of easier manipulation, shorter operation time, better cosmetic penile appearance, less pain, and fewer complications, is superior to conventional circumcision in the treatment of phimosis and redundant prepuce.

Blood Loss, Surgical ; Circumcision, Male ; instrumentation ; methods ; Ecchymosis ; etiology ; Humans ; Male ; Pain, Postoperative ; Penis ; abnormalities ; Phimosis ; therapy ; Postoperative Complications ; Postoperative Period ; Surgical Staplers ; adverse effects ; Wound Healing

An analysis method has been established to test 27 elements (Li, Be, B, Mg, Al, Sc, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Ga, As, Sr, Mo, Cd, Sn, Sb, Ba, La, Hg, Pb, Bi) in Maca nationality's medicine with microwave digestion-ICP-MS. Sample solutions were analyzed by ICP-MS after microwave digestion, and the contents of elements were calculated according to their calibration curves, and internal standard method was adopted to reduce matrix effect and other interference effects. The experimental results showed that the linear relations of all the elements were very good; the correlation coefficient (r) was 0.9994-1.0000 (Hg was 0.9982) ; the limits of detection were 0.003-2.662 microg x L(-1); the relative standard deviations for all elements of reproducibility were lower than 5% (except the individual elements); the recovery rate were 78.5%-123.7% with RSD lower than 5% ( except the individual elements). The analytical results of standard material showed acceptable agreement with the certified values. This method was applicable to determinate the contents of multi-elements in Maca which had a high sensitivity, good specificity and good repeatability, and provide basis for the quality control of Maca.
Lepidium ; chemistry ; Mass Spectrometry ; methods ; Microwaves ; Reproducibility of Results ; Trace Elements ; chemistry ; isolation & purification

OBJECTIVETo investigate the early clinical effects and radiological outcome of dynamic cervical implant (DCI) internal fixation in treating cervical spondylosis, and evaluate its safety and efficiency.

METHODSFrom June 2009 to December 2011, 19 patients with cervical spondylosis correspond to the indication of DCI internal fixation in the study, including 5 cases of cervical spondylotic myelopathy and 14 cases of cervical spondylotic radiculopathy. There were 8 males and 11 females, aged from 35 to 54 years with a mean of 43.2 years. Pathological segments included C3,4 in 1 case, C4,5 in 6, C5,6 in 6, C6,7 in 4, C3,4 and C5,6, C6,7 in 2. All patients were treated with anterior discectomy and decompression and DCI internal fixation, meanwhile, 2 cases of them with anterior cervical corpectomy and fusion plate fixation. Clinical evaluation included Modified Japanese orthopedics association (mJOA), neck disability index (NDI), visual analogue scale (VAS) score and patient satisfaction index (PSI) at pre-operation and final follow-up. Radiographic evaluation included flexion/extension lateral view at operative level and adjacent segment. The adjacent level degeneration was analyzed according to Miyazaki classification on MRI images.

RESULTSAll patients were followed up from 12 to 42 months with an average of 19.8 months. Preoperative mJOA score was 13.6±1.1 and at final follow-up was 16.3±1.2 with improvement rate of 85.0%. Preoperative VAS,NDI was 6.6± 1.4, 17.1±7.4 and at final follow-up was 1.4±0.8, 6.1±3.9, respectively; there was statistical significance in all above-mentioned results between preoperative and final follow-up (P<0.05). Preoperative ROM at operation level was (7.6±1.9)° and final follow-up was (7.8+2.1)°; preoperative ROM at C2-C7 was (38.6±7.2)° and final follow-up was (39.9±6.4)°; there was no statistical significance in all above-mentioned results between preoperative and final follow-up (P>0.05). Preoperative DHI at operation level was (6.3±1.1) mm and final follow-up was (7.1±0.8) mm, there was statistical significance in DHI between preoperative and final follow-up (P<0.05). No heterotopic ossification was found. All patients followed up MRI, degeneration of 3 segments aggravated 1 degree in 38 adjacent segments, without clinical symptom.

CONCLUSIONTreatment of cervical spondylosis with dynamic cervical implant can got satisfactory outcome in early follow-up. Activity of operative segment obtain reservation in some degree. The incidence of adjacent segment degeneration is lower and no adjacent segment disease occur. Nevertheless a longer follow-up time should be needed to assess the long term functionality of the DCI and the influence on adjacent levels.

Adult ; Cervical Vertebrae ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Prostheses and Implants ; Range of Motion, Articular ; Spondylosis ; physiopathology ; surgery

OBJECTIVETo observe the protective effect on renal function of Chinese drugs combined with benazepril in patients with diabetic nephropathy (DN).

METHODSAdopting stratified randomized and controlled design, 108 patients with DN were assigned to two groups. Besides the same measures of diet regulation, exercise, education, hypoglycemic and symptomatic treatment applied, benazepril was administered to all patients, and Chinese drugs were given to patients in the treated group additionally. The treatment course was 3 months. The changes before and after treatment of symptoms and signs, 24-h urinary protein (24 hUpro), serum creatinine (SCr), serum creatinine clearance rate (CCr), blood urea nitrogen (BUN), plasma glucose (PG) and blood pressure (BP) were observed, and the time of dialysis therapy initiating was recorded.

RESULTSSCr and 24 hUpro decreased and CCr increased in the treated group significantly (P < 0.01), and the improvement were superior to that in the control group (P < 0.05 or P < 0.01), the renal living time in the treated group was longer than that in the control group, but no significant different in BUN, PG and BP was found between the two groups (P > 0.05).

CONCLUSIONThe treatment program of Chinese drugs combined with benazepril could obviously reduce the levels of SCr and 24 hUpro, increase CCr in patients with DN, and its effect in improving renal function is better than that of using benazepril alone.

Aged ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Benzazepines ; therapeutic use ; Diabetic Nephropathies ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Treatment Outcome

Anemia, Hemolytic ; etiology ; Child ; Female ; Humans ; Insecticides ; poisoning ; Trichlorfon ; poisoning

Objective To study the changes of agrin expression in spinal cord motor neurons after somatic-autonomic ventral root(VR) anastomosis and somatic-somatic VR anastomosis,and the factors related to the synapse formation of foreign nerve regeneration. Methods Artifical somatic-automomic reflex pathway and somatic nerve self-anastomosis were established in rats.Retrograde tracing was carried out to label the motor neurons,and the neurons were isolated by flow cytometry.Real-time PCR was used to investigate the agrin mRNA expression of the neurons.Anterograde tracing and immunofluorescence technique were employed to label the new synapses of pelvic ganglia(PG). Results After 4 months of surgery,the somatic nerve can regenerate into PG successfully and form new synapses observed under laser scanning confocal microscope.The neurons involved in foreign nerve regeneration can be isolated successfully by retrograde tracing and flow cytometry.The expression of agrin in L_4-L_6 VRs anastomosis group was lower than that of the control group of L_4-L_4 VR self-anastomosis(P

Objective To investigate the clinical manifestations and treatment regiment of children with juvenile dermatomyositis(JDM).Methods The clinical manifestation,changes of serum muscale enzyme,myopathic laboratory examination,treatment and prognosis of 15 children with JDM retrospectively admitted from Jan.1990 to Jan.2004 were analyzed.Results All of the children had symmetrical weakness of the proximal muscles.The most frequent features were heliotrope and Gottron's papules.Elevated muscle enzymes were noted in all cases.Electromyography revealed typical change of myopathic type and muscle biopsy was compalible with myositis in all cases.Most of patients achieved normal muscle enzymes within 1 month and had improved muscle strength with 2.5 monthes of the initiation of corticosteroid therapy.Conclusion It is very important to know the clinical features of JDM,and prompt diagnosis and treatment will result in an improved prognosis.