Standardized residency training is the main form of postgraduate medical education.In this article, we analyzed a delayed diagnosed case with Cushing syndrome.The patient saw the doctors in provincial level hospitals for many times within a year, while specialists missed diagnosis by only concerning the symptoms related to their own specialties, instead of integrating all the manifestations.We believe that standardized residency training provides residents a broader horizon of related specialties, which is irreplaceable by fellowship training program, and is the essential of comprehensive analysis of complex clinical situations.Standardized residency training will also be helpful for diminishment of the educational gap between different medical colleges and improvement the medical level of the whole nation.

Bronchial Diseases ; diagnosis ; etiology ; Child, Preschool ; Humans ; Male ; Pulmonary Artery ; pathology

Objective:To evaluate the efficacy of combining extracorporeal shock wave therapy (ESWT) with local anesthesia in treating chronic plantar fasciitis.Methods:Reports of randomized and controlled trials about treating plantar fasciitis using ESWT were sought in the CNKI, Wanfang, Pubmed, Embase, Cochrane Library and Web of Science databases from their inception until October 2018. Each report found was screened by two independent researchers and the characteristics were abstracted. The risk of bias was assessed according to the methods recommended in the Cochrane Handbook. Version 5.3 of the RevMan software was used for the meta-analysis.Results:Eight reports of randomized and controlled trials were identified covering 779 patients treated with shock wave therapy and 710 controls. The meta-analysis showed that ESWT could significantly relieve the pain and improve functioning. Local anesthesia did not affect the outcome. Focued and radial shock wave were both significantly more effective than placebo stimulation, so as the medium and high-intensity.Conclusions:ESWT can significantly relieve the pain and improve the walking ability of patients with chronic plantar fasciitis. The use of local anesthesia during the intervention and different ESWT modes and intensities will not affect its efficacy.