Objective:To develop employer's satisfaction evaluation index system towards post competency of residents.Methods:Using Delphi method, the employer's satisfaction evaluation index system towards post competency of residents was formulated through a two-round expert consultation among 19 experts. SPSS 20.0 was used for statistical analysis to calculate the positive coefficient, authority coefficient and coordination degree of experts.Results:For the two rounds of the expert consultation, the questionnaire recovery rate was 95.0% and 100% respectively. The experts' authority coefficient was 0.92, and the system was ultimately determined, including 5 first-level indicators, and 32 secondary indicators. The coefficient of variation (CV) of first-level indicators was 0.00, and the Kendall's W of secondary indicators was 0.663. Conclusions:Employer's satisfaction evaluation index system towards post competency of residents is scientific and reliable, which could provide employer with systematic and objective tool to evaluate residents' post competency.

Humans ; Adult ; Serum Albumin, Human ; Consensus ; Cardiac Surgical Procedures ; Thoracic Surgery

Objective:To explore the relationship between the relative expression of miRNA-676-3p and the survival of renal cancer patients, and its effect on the proliferation and invasion of renal cancer by targeting and regulating prefoldin 1 (PFDN1).Methods:OncoRank online software was selected to analyze the relationship between the relative expression of miRNA-676-3p and the survival rate of renal cancer patients. Real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the relative expression of miRNA-676-3p in renal cancer cell lines. Renal carcinoma CAKI1 cells were resuscitated, and the transfected miRNA-NC was used as the control group, and the transfected precursor miRNA-676-3p was used as the overexpression group. The relative expression of miRNA-676-3p was detected by RT-qPCR. The cell absorbance and invasion number of the two groups were measured by CCK-8 and Transwell invasion assays, respectively. The target gene of miRNA-676-3p was predicted and verified by referring to the TargetScan Release 8.0 website and dual-luciferase reporter gene experiment. The expression of PFDN1 gene and Wnt/β-catenin molecular pathway protein in the two groups of cells were determined by RT-qPCR and Western blotting, respectively. Measurement data were expressed as mean ± standard deviation ( ± s), t-test was used for comparison between two groups, and one-way analysis of variance was used for comparison between multiple groups. Results:The survival rate of renal cancer patients with high expression of miRNA-676-3p was significantly higher than that of renal cancer patients with low expression of miRNA-676-3p, the difference was statistically significant ( P<0.01). The relative expression of miRNA-676-3p in renal cancer cell lines was significantly lower than that in normal renal tubular epithelial cells, the difference was statistically significant ( P<0.01), and the relative expression of miRNA-676-3p in CAKI1 cells was the lowest, the difference was statistically significant ( P<0.01). The relative expression levels of miRNA-676-3p in the control and overexpression groups were 1.04±0.59 and 15.90±1.70, respectively, and the overexpression group was significantly higher than the control group, the difference was statistically significant ( P<0.01). After 24, 48, 60, and 72 h of culture, the absorbance of cells in the overexpression group was lower than that in the control group, the difference was statistically significant ( P<0.05). The number of invasion cells in the control group and the overexpression group were (115.90 ± 24.73) and (43.83 ± 21.94) cells, respectively, and the number of cell invasion in the overexpression group was significantly lower than that in the control group, the difference was statistically significant ( P<0.01). PFDN1 was the downstream target gene of miRNA-676-3p ( P<0.01). The relative expression of PFDN1 gene in the overexpression group was significantly lower than that in the control group, the difference was statistically significant ( P<0.01). The expression of Wnt/β-catenin molecular pathway proteins in the overexpression group was lower than that in the control group. Conclusions:Renal cancer patients with high expression of miRNA-676-3p had a higher survival rate. miRNA-676-3p inhibited the proliferation and invasion of renal cancer CAKI1 cells by significantly down-regulating the expression of PFDN1, thereby inhibiting the development of renal cancer.

Objective:To analyze the factors affecting the disappearance time of airway necrosis and repair time of airway scar stenosis in patients with ulceration necrosis tracheobronchial tuberculosis (TBTB Ⅱ) after standardized chemotherapy and bronchoscopic intervention.Methods:The clinical data of 222 TBTB Ⅱ patients admitted to Hunan Chest Hospital from January 2015 to December 2018 were collected, bronchoscopic interventional treatment was performed on time. The texture, blockage of lumen, granulation proliferation, airway stenosis of TBTB patients before treatment, the disappearance time of airway dead objects, scar repair time and stenosis degree after treatment were followed up. The disappearance time of airway necrosis and repair time of airway scar stenosis and its influencing factors were recorded and analyzed.Results:In 222 patients, 508 ulceration necrosis airway lesions were found under bronchoscopy, with a median of 2(1-6); 170(76.6%) cases of airway lesions had different degrees of stenosis before treatment. 79(35.6%) patients had tough necrosis, and 86(38.7%) patients had necrosis blocking the lumen; 132(59.5%) patients had granulomatosis. The disappearance time of airway necrosis after treatment was 1 to 32 weeks, and M( Q1, Q3) was 6(3, 9) weeks; the repair time of airway scar stenosis was 2 to 73 weeks, and M( Q1, Q3) was 14(10, 19) weeks; after treatment, there were 90.5%(201/222) patients with different degrees of scarring in the airways. Cox multiple analysis showed that the risk factor for the disappearance time of airway necrosis was tough tough necrosis ( HR=1.52, 95% CI: 1.10-2.10); the risk factor for the repair time of airway scar stenosis was the disappearance time of airway necrosis 6-9 weeks ( HR=2.73, 95% CI: 1.84-4.05). Conclusions:90.5% of patients with type Ⅱ TBTB developed airway scar stenosis after treatment. The median time for the disappearance of airway necrosis was 6 weeks, and the median time for the repair time of airway scar stenosis was 14 weeks. In the interventional process, attention should be paid to the removal of tough necrosis and the efficiency of necrosis removal to reduce the risk of airway scar stenosis.

Objective To investigate the clinical value of serum activin A,endoglin combined with uterine artery pulsatility index in predicting preeclampsia.Methods One hundred cases pregnant women who were admitted to the obstetrics clinic of Longhua New District People′s Hospital in Shenzhen from December 2016 to July 2017 were selected ,50 cases of preeclampsia were in the observation group,and another 50 cases of healthy pregnant women were in the control group.Serum activin A,endoglin and uterine artery pulsatility index ( UAPI ) were measured at 11 ～ 13 weeks respectively.Receiver operating characteristic curve was used to analyze the diagnostic value of activin A,endoglin and UAPI in different gestational weeks separately and jointly in predicting preeclampsia.Results At 11～13 weeks of pregnancy, the serum activin A((379.98±153.80)ng／L],endoglin((9.87 g±1.62)μg／L) and UAPI (0.97±0.09) in the observation group were significantly higher than in the control group ((205.45±93.29)ng／L,(6.61 ±1.54)μg／L, ( 0.82 ± 0.15 )), and the difference was statistically significant ( all P＜ 0.05 ).The multivariate Logistic regression analysis showed that serum activin A, endoglin level and UAPI in early pregnancy were the risk factors for preeclampsia ( all P＜0.05).ROC curve analysis showed that the joint prediction of activin A, endoglin and UAPI in different gestational weeks was better than that in single detection.The maximum area (AUC) of the joint prediction of activin A,endoglin and UAPI at pregnant 11～13 weeks was 0.969, the sensitivity was 82.0%, and the specificity was 100.0%.Conclusion The combined detection of serum activin A, endothelial factor and uterine artery pulsation index in early pregnancy can be used to predict preeclampsia with high sensitivity and specificity,and can be used as a clinical index to predict preeclampsia.

Objective To analyze the effects of enteral nutrition through nasal duodenal nutrition tube on the nutritional status and radiologic lesion of the patients with esophageal carcinoma radiotherapy.Methods Forty-six patients with esophageal carcinoma radiotherapy in our hospital from June 2015 to December 2016 were selected as research subjects,and were randomly divided into the nutrition intervention group and the conventional group,each consisting of 23 patients.Before radiotherapy,the patients in the nutrition intervention group received duodenal nutrition tube surgery and had enteral nutritional support through the nasal duodenal nutrition tube,while the patients in the conventional group had routine diet during radiotherapy.Various nutritional indicators of the patients in the 2 groups were compared both before and after radiotherapy,and acute radiological lesion occurred in the patients of the 2 groups was evaluated.Results For the patients of the nutrition intervention group,there was no statistical significance in such indicators as hemoglobin (Hb),albumin (ALB),prealbumin (PA) and body weight (WT),when comparisons were made between pre-radiotherapy and postradiotherapy (P ＞ 0.05).However,for the patients of the conventional group,nutrition-related indicators after radiotherapy were significantly decreased,as compared with those before radiotherapy(P ＜ 0.05).Acute radiological reaction for the patients of the conventional group was severer,as compared with that of the nutrition intervention group (P ＜ 0.05).Conclusion The application of enteral nutrition support through nasal duodenal nutrition tube could effectively improve patient nutritional status,alleviate radiological lesion,and was safe and convenient,For this reason,it was worth further clinical extension.

Objective To investigate the influencing factors for post-discharge treatment compliance of patients with multidrug-resistant tuberculosis (MDR-TB).Methods MDR-TB patients who were hospitalized in a tubercu-losis hospital between November 2011 and January 2013 were chosen,post-discharge follow-up was conducted regu-larly through telephone call.Medicine-taking and re-examination of patients was inquired,factors influencing pa-tients’treatment compliance were analyzed.Results 299 patients were included in the study,the total treatment compliance rate was 81 .94% (n=245);249(83.28%)patients regularly took medicine,50(16.72%)didn’t regu-larly take medicine;254 (84.95%)were re-examined on time,45 (15.05%)were not re-examined on time;37 (12.37%)discontinued treatment,260 (86.96%)continuously treated till the survey deadline.Univariate analysis revealed that treatment compliance (including regular medication rate,timely re-examination rate,interrupted treat-ment rate,and total compliance rate)was significantly different among MDR-TB patients of different ages,education levels,treatment time,and with or without adverse reactions(all P <0.05 ).Logistic regression analysis revealed that treatment compliance of MDR-TB patients was negatively correlated with treatment time(β=-1 .47,Wald χ2=24.28,P <0.05)and adverse reactions(β=-2.02,Waldχ2 =24.24,P <0.05 ),while positively correlated with education levels(β=0.79,Wald χ2 =6.50,p <0.05 ).Conclusion Prolonged treatment time and adverse reactions can reduce the treatment compliance of MDR-TB patients,the higher education levels of MDR-TB patients have, the better treatment compliance they implement.

Objective To analysis the constituents of urinary stones in southeast Chongqing district,and provide the percep-tion and treatment of urinary stones.Methods Retrospective analysis of 1 628 random urinary stones samples in southeast Chongqing district from 2008 to 2014.The chemical constituents of stones were analysis with the clinical data.Results Urinary stones were more often found in those 30 to 70 years old,especially in males.The upper system stones were frequently founded.The percentage of mixed stones and pure stones were similar,The constituents of stones were similar to male and female,the most com-mon component of the urinary stones are calcium oxalate,which were found in 82.9% of the stones,infection stones were found 1 9.2%,but only found in renal and ureteral stones,and also increase gradually.The most common component of urinary stones in Qianjiang and Pengshui district were calcium oxalate,the infection stones were frequently found in Youyang and Xiushan district. Conclusion Chemical composition analysis of urinary stones is simple,quick and accurate,it is very important in providing infor-mation to the etiology,treatment and prevention of urinary stones.

Objective To study the use of early bile duct to bile duct end-to-end(side) anastomosis for extrahepatic bile duct injuries.Methods The clinical data of 25 patients with extrahepatic bile duct injuries with early bile duct to bile duct end-to-end(side) anastomosis were retrospectively analyzed.Results Bile duct injuries happened in laparoscopic cholecystectomy (n=17),laparoscopic exploration of common bile duct (n=1),laparotomy (n=5),and knife wound (n=2).All of the repairs were successfully carried out.Except for one patient who was lost to follow-up,the other patients were followed for over 2 years.There was no bile duct stenosis.One patient died after 5 months of repair in other hospital because of a recurrent bile duct calculus.Conclusions Early bile duct to bile duct end-to-end(side) anastomosis had a good long-term results.The operation needs to be done by a good surgeon or supervised by an experienced specialist in biliary surgery.A prolonged period of T tube stenting is a prerequisite for success.

Objective To investigate the effects of sevoflurane on ca2+ transsarcolemmal influx and ca2+ release function of endoplasmic reticulum in isolated outer hair cells (OHCs) of guinea pigs and the possible mechanism by which sevofhlrane acts on cochleas.Methods The experiment was performed in 2 parts.In experiment I:twelve adult guinea pigs(8 male,4 female)weighing 180-230 g were used.OHCs were mechanically sparated after enzymatic incubation.Thirty OHCs with favorable activity were divided into 3 groups (n=10 each):group I control(C);group Ⅱ low concentration sevoflurane (1.7%,group S1) and group Ⅲ high concentration sevoflurane(3.4%,group S2).The OHCs were stained with 6 umol/L Fluo-3AM in estefified form for 40 min.Group S1 and S2 were pretreated with 1.7% and 3.4% sevoflugsne respectively for 20 min.KCI 40 mmol/L was then added.The intracellular ionized Ca2+ concentration ([C2+]I) was determined byintracelhlar Ca2+ fluorescent intensity using laser scanning confocal microscope.The protocol of the experimentⅡ was the same as the experimentI.The only difference was that caffeine 20 mmol/L was added instead of KCI 40 mmol/L.Results In experiment I:there was no significant difference in baseline[ca2+]I and[ca2+]I after being exposed to sevoflurane among the 3 groups.[Ca2+]I was significanfly increased after addition of KCI as compared with the baseline[Ca2+]I and was significantly lower in group Sl and S2 than in group C and was the lowest in group S2.In experimentⅡ:the[ca2+]I was significantly increased after addition of caffeine but there was no significant difference in[Ca2+]I among the 3 groups.Conclusion Sevoflurane can inhibit voltage-dependent Ca2+ channel opening in a concentration-dependent manner but can not affect ryanodine-sensitive Ca2+ release function of endoplasmic reticuhm in isolated outer hair cells of guinea pigs.