Objective:To explore a systematic training for quick identification for diagnosis and treatment of the causes of reversible cardiac arrest,which was assisted by bedside ultrasound simulator combined with memory mnemonic,so as to improve the treatment skill of physicians for the causes of disease,and enhance the success rate of cardiopulmonary resuscitation.Methods:Thirty clinical resident doctors who were rotating in the emergency intensive care unit(ICU)of Xuanwu Hospital,Capital Medical University,from May 2023 to May 2024 were selected.The bedside ultrasound simulator combined with memory mnemonic was used to simulate training,which can improve the ability of resident doctors in quickly determining the cause of reversible cardiac arrest.The self-made questionnaire was used to investigate the baseline situation of resident doctors before they were trained,and the teaching effectiveness after they received training.After training,the grasping states of resident doctors for the cause of reversible cardiac arrest were detected through 10 kinds of clinical cases included pulmonary embolism,myocardial infarction,aortic dissection,pericardial tamponade,ventricular fibrillation,electrolyte disturbance,hypovolemic shock,tension pneumothorax,poisoning and hypothermia.Results:The duration of quick retelling of resident doctors for the causes of reversible cardiac arrest was(15.07±3.68)s after training,which was lower than(47.27±10.25)s before training,and the difference was significant(t=14.763,P<0.05).The awareness rate of them for the causes of reversible cardiac arrest was 100%after training,which was significantly higher than 3.33%before training,and the difference was significant(x2=56.129,P<0.05).The identification of resident doctor for ultrasonic image was zero basis before training,and the identification rate was 0%.All of resident doctors can achieve 100%identification for routine ultrasound,cardiac arrest,pericardial tamponade and ventricular fibrillation within the simulator after training,and the correct recognition rates of them for pulmonary embolism,tension pneumothorax,acute myocardial infarction and aortic dissection were respectively 86.67%,63.33%,70%and 66.67%.After training,the duration of correct recognition of resident doctors for pulmonary embolism,tension pneumothorax and acute myocardial infarction were respectively(58.77±19.61)s,(69.05±10.47)s and(75.52±10.51)s,all of which were less than the duration of incorrect recognition,and the differences were statistically significant(t=2.153,2.781,2.124,P<0.05).Conclusion:Ultrasound combined with memory mnemonic can help resident doctors to quickly establish the clinical thinking clue about hypoxia,hypovolemia,hypo/hyperkalemia,hypo/hyperthermia,hypo/hyperglycemia,tamponade cardiac,thrombosis pulmonary,thrombosis coronary,toxins,tension pneumothorax(5H5T)for the cause of reversible cardiac arrest,which will contribute to strengthen and improve the practical ability of clinician in quick judgement for reversible etiology.

Objective:To explore a systematic training for quick identification for diagnosis and treatment of the causes of reversible cardiac arrest,which was assisted by bedside ultrasound simulator combined with memory mnemonic,so as to improve the treatment skill of physicians for the causes of disease,and enhance the success rate of cardiopulmonary resuscitation.Methods:Thirty clinical resident doctors who were rotating in the emergency intensive care unit(ICU)of Xuanwu Hospital,Capital Medical University,from May 2023 to May 2024 were selected.The bedside ultrasound simulator combined with memory mnemonic was used to simulate training,which can improve the ability of resident doctors in quickly determining the cause of reversible cardiac arrest.The self-made questionnaire was used to investigate the baseline situation of resident doctors before they were trained,and the teaching effectiveness after they received training.After training,the grasping states of resident doctors for the cause of reversible cardiac arrest were detected through 10 kinds of clinical cases included pulmonary embolism,myocardial infarction,aortic dissection,pericardial tamponade,ventricular fibrillation,electrolyte disturbance,hypovolemic shock,tension pneumothorax,poisoning and hypothermia.Results:The duration of quick retelling of resident doctors for the causes of reversible cardiac arrest was(15.07±3.68)s after training,which was lower than(47.27±10.25)s before training,and the difference was significant(t=14.763,P<0.05).The awareness rate of them for the causes of reversible cardiac arrest was 100%after training,which was significantly higher than 3.33%before training,and the difference was significant(x2=56.129,P<0.05).The identification of resident doctor for ultrasonic image was zero basis before training,and the identification rate was 0%.All of resident doctors can achieve 100%identification for routine ultrasound,cardiac arrest,pericardial tamponade and ventricular fibrillation within the simulator after training,and the correct recognition rates of them for pulmonary embolism,tension pneumothorax,acute myocardial infarction and aortic dissection were respectively 86.67%,63.33%,70%and 66.67%.After training,the duration of correct recognition of resident doctors for pulmonary embolism,tension pneumothorax and acute myocardial infarction were respectively(58.77±19.61)s,(69.05±10.47)s and(75.52±10.51)s,all of which were less than the duration of incorrect recognition,and the differences were statistically significant(t=2.153,2.781,2.124,P<0.05).Conclusion:Ultrasound combined with memory mnemonic can help resident doctors to quickly establish the clinical thinking clue about hypoxia,hypovolemia,hypo/hyperkalemia,hypo/hyperthermia,hypo/hyperglycemia,tamponade cardiac,thrombosis pulmonary,thrombosis coronary,toxins,tension pneumothorax(5H5T)for the cause of reversible cardiac arrest,which will contribute to strengthen and improve the practical ability of clinician in quick judgement for reversible etiology.

Objective:To study the effect of simulated case base on the training of resident’s post competency in the department of emergency.Methods:The study selected 63 residents who had the standardized training in the Department of Emergency, Xuanwu Hospital of Capital Medical University from June 2018 to October 2019, and they were randomly divided into observation group ( n=32) and control group ( n=31). The observation group was trained by emergency simulated case base, while the control group was trained by routine training methods such as theoretical lecturing and single skill training. The differences between the two training methods in the abilities of diagnosis and treatment, medical knowledge, interpersonal communication, practice-based learning and improvement of post competencies were compared by means of theoretical and operational assessments. Two groups were investigated with questionnaires, self-evaluation and satisfaction degree of post competency, and the differences between the two groups were compared. SPSS 19.0 software was used for t test and chi-square test. Results:There was no significant difference in the scores of medical knowledge and skill operation between the observation group [(43.53± 9.26) points and (7.32±1.03) points] and the control group [(42.47±8.64) points and (7.24±1.12) points] ( P>0.05). However, the scores of clinical diagnosis and treatment ability, professional accomplishment, interpersonal communication ability and practice-based learning and improvement were all significantly higher in the observation group than those in the control group ( P<0.05). The questionnaire self-assessment showed that there was no significant difference in scores of medical knowledge and skill operation between the observation group [(4.23±0.46) points and (4.05±0.52) points] and the control group [(4.14±0.38) points and (3.98±0.69) points] ( P>0.05), and the self-evaluation scores of professional accomplishment, interpersonal communication ability, clinical diagnosis and treatment ability, practice-based learning and improvement ability were higher than those in the control group ( P<0.05). The satisfaction with teaching method in the observation group was also higher than that in the control group ( P=0.020). Conclusion:The application of simulated case base can improve post competency in the standardized training of residents in the department of emergency, with good training effect.

Objective To detect the influence of miRNA-34a (miR-34a) on the proliferation of osteosarcoma and the mechanisms responsible for miR-34a regulation.Methods The osteoblastic cell line MG-63 and Saos-2,human osteoblastic cell line hFOB 1.19,10 osteosarcoma tissues and 10 normal bone tissues were selected.The expression of miRNA-34a in osteosarcoma cells and tissues was detected by quantitative real-time polymerase chain reaction (qPCR).Next,a eukaryotic expression vector named pcDNA/miR-34a was constructed.Then,osteosarcoma cells were transfected with this eukaryotic expression vector and the effects of miR-34a overexpression on the proliferation and growth of osteosarcoma were measured using CCK-8,colony formation and xenograft model of nude mice.Finally,Western blot analysis was used to detect the expression of ether-à-go-go 1 (Eag1) gene in osteosarcoma cells after transfected with pcDNA/miR-34a or a miR-34a inhibitor miR-34a-2'-O-Methyl antisense oligoribonucleotide (miR-34a-2'-O-Me).Results Compared with normal bone tissues and osteoblastic cell line,miR-34a was down-regulated in osteosarcoma cell lines and tissues.Compared with the blank group and the control group,the cell survival rates of miR-34a group of the two cell lines were significantly lower [MG-63 72 h:blank group (40.05±4.82) ％,control group (36.88± 4.66) ％,miRNA-34a group (26.24±6.22) ％;MG-63 96 h:blank group (83.55±5.95) ％,control group (80.13± 4.48) ％,miRNA-34a group (30.21±7.26) ％;Saos-2 72 h:blank group (46.45±8.15) ％,control group (43.33± 6.89) ％,miRNA-34a group (26.81±3.17) ％;Saos-2 96 h:blank group (84.79±4.10) ％,control group (80.14± 3.11) ％,miRNA-34a group (31.77±5.17) ％].The similar results were obtained from colony formation assay (MG-63:blank group 83.40±3.29,control group 80.00±3.06,miR-34a group 24.40±2.71;Saos-2:blank group 85.00±3.32,control group 80.60±3.29,miR-34a group 30.40±4.94).The tumor volumes of osteosarcoma xenograft in the miR-34a group was significantly smaller than that in the blank group and control group after 21 days treatment (all P ＜ 0.001).Overexpression of miR-34a could decrease Eag1 expression in osteosarcoma cell lines while inhibition of miR-34a induced the of expression Eag1 (P ＜ 0.001).Conclusion MiR-34a plays a tumor suppressor role in osteosarcoma and could suppress the proliferation and growth of osteosarcoma through the regulation of Eag1.Moreover,it may be a novel target for osteosarcoma therapy.

OBJECTIVETo design a kind of internal fixation device to treat the syndesmosis injury.

METHODSThe elastic syndesmosis hook plate is made of medical stainless steel alloy, which is consisted of locking or common screw fixing hole of the tibial side for the head, tridentate fork like arc anatomical fibula side plate for the tail and serpentine elastic connecting body. By reduction of the joint of the lower tibia and fibula, the steel plate tail is fixed at the side of the fibula and the head is fixed at the side of the tibia for fixing the symphysis.

RESULTSThe design of elastic syndesmosis hook plate is reasonable, and the operation is convenient. There is no need to penetrate the substantia ossea and the plate has elastic micro-movement feature, the problem of internal fixation breakage and loosening is avoid in huge degree, so it is safe and reliable.

CONCLUSIONThe elastic syndesmosis hook plate is a new type medical apparatus of internal fixation of the symphysis, which is worthy of clinical popularization and application.

Objective To evaluate our noval rod-screw construct in anterior single-segmental decompression and fixation for the treatment of Denis type B burst fractures.Methods From February 2007 through May 2010,we treated 28 patients with Denis type B burst fracture.They were aged from 18 to 52 years (average,37.4 years).The fractures were located at T1 1 in 3 cases,at T12 in 10,L1 in 12,and L2 in 3.Of them,7 were complicated with unilateral pedicle fracture and 3 with bilateral pedicle fractures.According to the American Spinal Injury Association (ASIA) scale,the neurological deficits were rated as grade B in 11 cases,as grade C in 9,and grade B in 8.All the patients received anterior single-segmental decompression,titanium mesh and autogenous bone graft,and fixation with our noval rod-screw construct.The therapeutic efficacy was evaluated in terms of visual analogue scale (VAS),cobb angle,and spinal canal encroachment.Results The mean follow-up time was 26 months (range,from 17 to 33 months).The average length of surgery was 144 minutes(range,from 90 to 176 min);the mean blood loss was 580 mL (range,from 300 to 1 100 mL).The mean VAS score,cobb angle and spinal canal encroachment were improved from 8.2 ± 1.5,17.4° ± 4.3° and 53％ ± 16％ preoperatively to 2.7 ± 2.4,9.4° ± 5.8° and 4％ ±2％ at the final follow-up,respectively(P ＜ 0.05).None of the patients exhibited neurological deterioration.Conclusion Our noval rod-screw construct is a safe and effective device that can be used in the anterior single-segmental decompression and fixation for the treatment of Denis type B burst fractures.

Olfactory neuroblastoma is a rare malignant tumor. Although multiple therapeutic modalities including surgery, radio-therapy, or chemotherapy could be used in patients with olfactory neuroblastoma, no standardized treatment has been achieved. This re-view introduces a case of adult olfactory neuroblastoma treated by a multiple disciplinary team in Tianjin Medical University Cancer In-stitute and Hospital. This review also aims to explore a complete set of diagnostic and treatment practices for the benefit of future pa-tients.

Objective Based on the Traditional Chinese Medicine Inheritance Support System (TCMISS) (V2.0), to analyze the point-selection rules in acupuncture-moxibustion prescriptions for gastroptosis indexed by China National Knowledge Infrastructure (CNKI), Wanfang and Vip databases, and to obtain novel prescriptions, for providing clinical references. Method Acupuncture-moxibustion prescriptions for gastroptosis indexed by CNKI, Wanfang and Vip databases were collected and filtered, and then input into the TCMISS. The prescriptions were analyzed by using data mining method. Result The frequency and core combination of the commonly-used acupoints were determined out of the 76 eligible prescriptions for gastroptosis, and 3 novel prescriptions were obtained. Conclusion The TCMISS is an important tool in mining and analyzing the point-selection rules in acupuncture-moxibustion treatment, and the new acupoint prescriptions generated by this system provide references to the treatment of gastroptosis.

Objective To evaluate the safety and efficacy of the newly combined anterior platerod system in treatment of acute thoracolumbar burst fracture combined with neurologic deficit.Methods A retrospective study was carried out on 84 consecutive patients with acute thoracolumbar burst fracture combined with neurologic deficits treated by anterior surgery,bone fusion,and internal fixation with the new plate-rod system.There were 61 males and 23 females with a mean age of 31.4 years (range,19-53 years).Primary pathogenesis was high falls in 67 patients,traffic accidents in 13 patients and others in 4 patients.Fractured segments included T11 in 19 patients,T12 in 22,L1 in 25,and L2 in 18.Visual analogue scale (VAS),spinal canal encroachment,and loss of kyphosis correction were measured for all patients to evaluate radiologic and neurological outcomes.Results Bony union occurred in all patients at the 3-5 months of follow-up.There was no pseudarthrosis or vascular complications related to the fixation device.Percentage of canal encroachment decreased from preoperative 70％ to postoperative 2％.Mean segmental kyphotic angle measured 27.9 ° before operation and 7.4 ° after operation,with a mean correction of 20.5°.All patients demonstrated at least one grade of neurological improvement at final follow-up.Mean VAS was improved significantly from preoperative 7.3 points to postoperative 2.9 points.Conclusion The new anterior plate-rod system is safe and effective in treatment of acute thoracolumbar burst fracture combined with neurologic deficit.

A new production method of spraying dextran-based polyurethane external splints is introduced in this paper. The main raw material components are polymethylene polyisocyanate (PAPI), mixed with surfactants, acetone, soluble starch, catalyst, and so on. The splint is used for temporary fixing after fracture, with small size, light weight, easy portability, fine air perviousness, completely transparent to the X-ray. It also needs a shorter fixed operating time. It can not only fix quickly and effectively the vertebral column and limbs, but also significantly shorten the time of pre-hospital care.
Dextrans ; Equipment Design ; External Fixators ; First Aid ; instrumentation ; Fracture Fixation ; instrumentation ; Fractures, Bone ; surgery ; Polyurethanes ; Splints