Objective:To investigate the effects of preoperative discussions on the surgical acquisition and mastery of gastrointestinal surgery residents.Methods:A prospective randomized controlled trial was conducted in 90 residents and they were randomly divided into the conventional group,the simulation group,and the clinical group,with 30 residents in each group.Residents in each group received traditional review,simulated preoperative discussions training,and real preoperative discussions with patients'family members,respectively.Theoretical knowledge assessments were conducted at three stages.Communication skills were evaluated after stages Ⅱ and Ⅲ.The impact of different teaching methods on learning outcomes were compared.Results:There was no significant difference in the theoretical knowledge scores among the three groups at stage Ⅰ(P＞0.05).At stage Ⅱ and Ⅲ,the theoretical knowledge scores in both the simulation and clinical groups were significantly higher than those in the conventional group(P＜0.01).At stage Ⅲ,the theoretical knowledge score in the clinical group was higher than that in the simulation group(P＜0.05).The communication skill in the simulation group at stage Ⅲ was higher than that at stage Ⅱ(P＜0.05),and family satisfaction scores with the preoperative discussions at stageⅢ in the clinical group was higher than that at stage Ⅱ(P＜0.05).Conclusions:Preoperative discussions,particularly direct interactions with patients'families,significantly enhances both the acquisition of surgical knowledge and the development of communication skills among gastrointestinal surgery residents.Simulated preoperative discussions also proves more effective than traditional teaching methods.

Objective:To investigate the effects of preoperative discussions on the surgical acquisition and mastery of gastrointestinal surgery residents.Methods:A prospective randomized controlled trial was conducted in 90 residents and they were randomly divided into the conventional group,the simulation group,and the clinical group,with 30 residents in each group.Residents in each group received traditional review,simulated preoperative discussions training,and real preoperative discussions with patients'family members,respectively.Theoretical knowledge assessments were conducted at three stages.Communication skills were evaluated after stages Ⅱ and Ⅲ.The impact of different teaching methods on learning outcomes were compared.Results:There was no significant difference in the theoretical knowledge scores among the three groups at stage Ⅰ(P＞0.05).At stage Ⅱ and Ⅲ,the theoretical knowledge scores in both the simulation and clinical groups were significantly higher than those in the conventional group(P＜0.01).At stage Ⅲ,the theoretical knowledge score in the clinical group was higher than that in the simulation group(P＜0.05).The communication skill in the simulation group at stage Ⅲ was higher than that at stage Ⅱ(P＜0.05),and family satisfaction scores with the preoperative discussions at stageⅢ in the clinical group was higher than that at stage Ⅱ(P＜0.05).Conclusions:Preoperative discussions,particularly direct interactions with patients'families,significantly enhances both the acquisition of surgical knowledge and the development of communication skills among gastrointestinal surgery residents.Simulated preoperative discussions also proves more effective than traditional teaching methods.

OBJECTIVE To study the absorption characteristics of phenylpropanoids of Mongolian medicine Tabson-2 decoction(TBD) in Caco-2 cells and to preliminarily clarify the oral absorption mechanism of TBD. METHODS Caco-2 cell monolayer model was used to analyze the uptake components of TBD in Caco-2 cells by UPLC-MS/MS, and UPLC-MS/MS analysis method was established to determine the nine best absorbed components of TBD, protocatechuic acid, neochlorogenic acid, chlorogenic acid, cryptogenic acid, 1,5-dicaffeinate quinic acid, isochlorogenic acid C, caffeic acid, dihydrocaffeic acid, chlorogenic acid. The effects of time, concentration and P-glycoprotein inhibitor on the absorption of each component were investigated. RESULTS The overall intake of caffeic acid and dihydrocaffeic acid showed an upward trend in 0-180 min, and did not show saturation. The absorption of 3-hydroxycinnamic acid was constant at about 90 min and tended to saturation. The intakes of cryptochlorogenic acid, 1,5-dicaffeinate, quinic acid, isochlorogenic acid C, neochlorogenic acid, chlorogenic acid and protocatechuic acid first decreased and then increased with time from about 90 min. The addition of P-glycoprotein inhibitor verapamil and cyclosporin A had an effect on the absorption of dihydrocaffeic acid compared with the phenylpropanoid components, indicated that dihydrocaffeic acid was the substrate of P-glycoprotein. CONCLUSION The main phenylpropanoids of TBD enter Caco-2 mainly by passive diffusion, supplemented by active transport, and the absorption process of the other eight components is not affected by the efflux of P-glycoprotein except dihydrocaffeic acid.

This study examined the wave intensity (WI) of the carotid artery in patients with hyperthyroid in order to assess the hemodynamic changes of hyperthyroid patients. A total of 86 hyperthyroid patients without cardiac morphological changes and arrhythmia, and 80 healthy control subjects were enrolled in the study. Right common carotid artery (RCCA) was selected for ultrasonic imaging to obtain WI indices, including amplitude of the peak during early systole (W1), amplitude of the peak during late systole (W2), area of the negative wave during mid-systole (NA), interval between R wave of electrocardiogram and W1 (R-1st), interval between W1 and W2 (1st-2nd). The levels of serum thyroid hormones, consisting of free triiodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH), were measured in hyperthyroid patients. Echocardiographic indices including left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were determined in each subject. The results showed that the W1, W2, NA, and (1st-2nd×HR) in hyperthyroid patients were significantly higher than those in healthy controls. There was no significant difference in LVEF and LVFS between the two groups. FT3 was correlated with W1, W2, NA, (1st-2nd×HR), pulse pressure (PP) and heart rate (HR) in hyperthyroid patients. Several abnormal waves on WI curves were present in 19 hyperthyroid patients during mid-systole. It was concluded that WI technique may prove a real-time, noninvasive, sensitive and convenient tool for assessing the cardiac function and hemodynamic alterations in hyperthyroid patients.

This study examined the wave intensity (WI) of the carotid artery in patients with hyperthyroid in order to assess the hemodynamic changes of hyperthyroid patients. A total of 86 hyperthyroid patients without cardiac morphological changes and arrhythmia, and 80 healthy control subjects were enrolled in the study. Right common carotid artery (RCCA) was selected for ultrasonic imaging to obtain WI indices, including amplitude of the peak during early systole (W1), amplitude of the peak during late systole (W2), area of the negative wave during mid-systole (NA), interval between R wave of electrocardiogram and W1 (R-1 st), interval between W1 and W2 (1 st-2nd). The levels of serum thyroid hormones, consisting of free triiodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH), were measured in hyperthyroid patients. Echocardiographic indices including left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were determined in each subject. The results showed that the WI, W2, NA, and (lst-2nd×HR) in hyperthyroid patients were significantly higher than those in healthy controls. There was no significant difference in LVEF and LVFS between the two groups. FT3 was correlated with WI, W2, NA,(lst-2nd×HR), pulse pressure (PP) and heart rate (HR) in hyperthyroid patients. Several abnormal waves on WI curves were present in 19 hyperthyroid patients during mid-systole. It was concluded that WI technique may prove a real-time, noninvasive, sensitive and convenient tool for assessing the cardiac function and hemodynamic alterations in hyperthyroid patients.

Objective To assess the value of quantitative color Doppler sonography in patients with systemic lupus erythematosus (SLE). Methods The right renal in 21 patients with SLE and 22 normal subjects were examined with Philips IU22 ultrasonic diagnostic device. Resistence index (RI) of interlobar artery and interlobular artery were measured with color Doppler sonography, vascularity index (VI), flow index (FI) and vascularization flow index (VFI) which reflecting the renal cortical blood flow were calculated with quantitated analysis software. All the parameters between two groups were compared and analyzed. Results The color signals of renal cortical blood flow in patients with SLE were inferior to those of the normal group, especially in the area near the edge of renal. No statistical difference of RI was found between the two groups (P>0.05), while VI, FI and VFI in SLE group were significantly lower than those of the normal group (VI, VFI, P<0.01, FI, P=0.01). Conclusion Color Doppler sonography combined with blood flow quantitative technique provide a helpful, sensitive and convenient tool to detecte the renal changes in SLE patients.

lusions WI parameters reflect both cardiac and vascular changes of hyperthyroid patients. Mid-systolic hemodynamic turbulence appears in a portion of hyperthyroid patients.

Objective To analyze transthoracic echocardiographic characteristics of cardiac amloidosis (CA).Methods Fifteen cases of biopsy-proven CA were retrospectively reviewed.Results Interventricular septal thickening(＞1.3 cm)of varing degrees were found in all cases.In 11 cases,the posterior of left ventricular wall were thickened.Myocardial echoes of interventricular septum and free wall of left ventricular were enhanced evidently and distributed unevenly.The echoes presented as ground glass-like images,with some spotty hyper echoes.Both atria were enlarged,and LVEF decreased,with diastolic function impaired,and mild-moderate hydropericardium found in the CA.Conclusions Transthoracic echocardiography is a relatively sensitive and highly specific non-invasive mothod tO diagnose CA.

Transthoracic echocardiographic characteristics of 17 cases of cardiac amyloidosis (CA),a rare disease in China, were analyzed in order to improve the understanding of the disease. Seventeen cases of biopsy-proven CA, admitted to Wuhan Union Hospital from June 1994 to September 2008 were retrospectively reviewed. Twenty normal volunteers served as control group. Left atrial and ventricular functions and mitral inflow velocity were measured by two-dimensional, and Doppler echocardiography, and tissue Doppler imaging (TDI)-derived peak systolic wall motion velocities (Sv), peak early diastolic wall motion velocities (Ev), and peak late diastolic wall motion (Av) were measured at the septunm. Lateral, inferior and anterior comers of mitral annulus from the apical 4- and 2 chamber views. Compared with the control group, the interventricular septal thickness (IVSd), the left ventricular posterior wall (LVPWd), right ventricular transverse diameter (RVTDd) near the end of diastole and the interauricular septum thickness (IASs), left atrial anteroposterior diameter (LAADs), right atrial transverse diameter (RATDs) near the end of systole were increased significantly (all P<0.05) and left ventricular ejection fraction (LVEF) decreased (P<0.05) in the CA group.Compared with the control group, Sv, Ev at each wall and Av at almost all walls were significantly decreased in the CA group. In the CA group, Myocardial echoes of interventricular septum and free wall of left ventricle were enhanced evidently and distributed unevenly. The echoes presented as ground glass-like images, with some spotty hyper echoes. Both atria were enlarged, and LVEF decreased, with diastolic function impaired, and mild-moderate hydropericardium found in the CA group. It was concluded that echocardiography was a relatively sensitive and highly specific non-invasive method for the diagnosis of CA.