Research on the different evaluation from the three parties of the clinical practice medical students' communication ability in OSCE / 中华医学教育探索杂志

Objective To analyze the difference and correlation of the evaluation of the medical students' communication ability between the examiners,standardized patients (SP) and medical students themselves in objective structured clinical examination (OSCE),and to provide scientific basis for the appropriate evaluation method of medical students' communication ability.Methods OSCE was used to evaluate the communication ability of 90 medical students in Daping Hospital,Chongqing,and the three parties were evaluated by the examiners,SP and medical students themselves.Excel and SPSS 17.0 statistical analysis software were used,through Friendman M.test,t test and correlation analysis to analyze the differences and correlation of the three parties evaluations.Results The different evaluation between the three parties on the communication ability of medical students was as follows.Examiner's evaluation was the lowest (8.39 ± 1.18),SP's evaluation was the highest (9.62 ± 0.73),Medical students themselves' evaluation was higher (9.28± 1.09);The examiner's evaluation of Medical students' empathy,verbal communication ability,nonverbal communication ability and etiquette was lower (P=0.00).The correlation analysis of the three parties' evaluation showed that there was a significant correlation between the three parties on the connnunication ability,empathy and nonverbal communication ability (P＜0.05).The evaluation of SP and medical students themselves on medical students' language communication ability and etiquette was significantly correlated (P＜0.05).Conclusions Using examiner or SP or medical students themselves only to evaluate the communication ability of medical students is not accurate,The Examiner and SP as the main trial test personnel should collaborate to evaluate medical students' communication ability.The examiner can evaluate three projects such as what is medical ethics and law,empathy,nonverbal communication ability,while the SP can evaluate the two projects:what is language communication ability and etiquette.The collaborative evaluation of the two sides can be more accurate to reflect the doctor-patient communication ability of medical students.

Analysis of surgical methods and clinical analysis of its long-term effect of laryngeal carcinoma / 中国癌症杂志

Background and purpose:Surgical operation is the main method in the treatment of laryngeal carcinoma, but different patients have different impacts on the survival time and the quality of life with different type of operation. This study was to analyze the methods of surgical treatment and its long-term effect of laryngeal carcinoma, to increase survival rates, laryngeal function reservation and reconstruction and improve life quality.Methods:A total mumber of 424 patients of laryngeal carcinoma treated with surgical treatment during between Jan. 2002 and Dec. 2012 were researched by clinical follow-up and data analysis. Surgical method: CO2 laser-assisted laryngeal microsurgery for laryngeal tumors for 50 cases, frontal partial laryngectomy or modiifed thyroid cartilage window partial laryngectomy without tracheostomy for 42 cases, vertical frontolateral partial laryngectomy for 119 cases, horizontal partial laryngectomy and extended subtotal laryngectomy for 22cases, anastomosis of pharynx and trachea for 4 cases, supra cricoid partial laryngectomy for 129 cases (CHEP of them for 103 cases, CHP for 26 cases), total laryngectomy for 58 cases, cervical lymph node dissection at the same term for 121 cases.Results:Partial laryngectomy without tracheostomy for 92 cases (21.7%), total laryngectomy for 58 cases (13.7%); decannulation rate was 86.5%, vertical frontolateral partial laryngectomy of them for 93.2%, horizontal partial laryngectomy of them for 90.9%,supra cricoid partial laryngeal of them for 82.2%; laryngeal function reservation rate for 86.3%; all patients did outpatient review and telephone follow-up, 9 cases loss to follow-up, a total of tumor recurrence, cervical lymph node metastasis and distant metastasis were 41 cases, mostly occurred in 1 year after surgery; death for 57 cases, relapse of them for 8 cases, cervical metastasis for 13 cases, pulmonary metastasis for 5 cases, hepatic metastases for 2 cases, brain metastases for 1 case, esophagus metastases for 1 case, pulmonary infection for 6 cases, acute renal failure for 2 cases, unknown reason for 19 cases, according to Kaplan-Meier to count survival rate, 3-year and 5-year survival rate were 90.7% and 84.1%, relapse and metastasis were the main causes of death.Conclusion:Surgical treatment is the main therapy mode of laryngeal carcinoma. We choose individualized surgical methods for patients according to tumor staging, invasion site, age, occupation and education background of patient, health condition and so on. On the premise that tumor is completely cut off, we always advocate function surgery and minimally invasive surgery, and adopt comprehensive treatment at the same time, in order to increase survival rates, lesson suffering and improve life quality as far as possible.

Surgical methods and clinical analysis of early-stage glottic carcinoma involved anterior commissure / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the surgical methods for management of early-stage glottic carcinoma involved anterior commissure.@*METHOD@#Fifty-eight cases of early-stage glottic carcinoma (T1, n = 23; T2, n = 35) treated with vertical frontolateral partial laryngectomy and frontal partial laryngectomy or modified window partial laryngectomy without tracheostomy were retrospectively reviewed.@*RESULT@#All patients can swallow smoothly and phonate clearly after operation. And the extubation rate with vertical fronto vertical partial laryngectomy is 97.2%. Tracheostomy was performed in one case after operation because of dyspnea. The most common postoperative complication was subcutaneous emphysema which developed postoperatively in 6 patients, but subsided after discharge. Follow-up was conducted for 8 months to 7 years, recurrence was observed in 3 cases. The 3 and 5 year survival rates were 97.5% and 91.8% respectively.@*CONCLUSION@#To choose the optimal surgical method for patients with early-stage glottic carcinoma not only can reduce the risk of recurrence but also can save the laryngeal function and thus improves the quality of life.

The curative effect analysis of radiation combined with targeted therapy of EGFR-TKI in patients with stage IV NSCLC / 中国综合临床

Objective To evaluate the efficacy and safety of radiation combined with targeted therapy of EGFR-TKI in the patients with stage IV non-small cell lung cancer ( NSCLC). Methods There were 17 female and 9 male patients with NSCLC enrolled into this study, which included 19 adenocarcinoma, 4 alveolar carcinoma and 3 uncertain carcinoma according to the iconography findings. Sixteen patients suffered from single or multiple bone metastasis,and 10 cases with brain metastasis. Gefitinib 250 mg or Erlotinib ISO mg per day were administrated during and after the process of radiation until the disease progressed. Results All patients had complete combined therapy, 12 of them suffered from diarrhea, 8 from emesia and 12 from erythra. The average score of ECOG improved from 3 to 2 after combined therapy. The bone metastasis control rate was 93.8% ,brain metastasis control rate was 70.0% , and the 6-month local lung lumps control rate was 84. 6%. Conclusion Palliative radiation combined with targeted therapy of EGFR-TKI is an effect and safe therapy for the patients with the stage IV of NSCLC, but the influence on survival shall be observed in further study.

The expression of oncogene AKT2 in laryngeal squamous cell carcinoma and its clinical significance / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression and clinical significance of oncogene AKT2 in laryngeal squamous cell carcinoma (LSCC).@*METHOD@#The expression of AKT2 protein was measured with immunohistochemistry (Elivision two steps) in 60 cases of LSCC tissue, 28 cases of peri-cancer tissue and 16 cases of normal laryngeal epithelium, the relationship between AKT2 expression and clinical pathologic factors in LSCC was also analyzed.@*RESULT@#The positive rates of AKT2 protein expression in LSCC and peri-cancer tissue were 56.7% (34/60), 14.3% (4/28) respectively. There was no expression of AKT2 in normal laryngeal epithelium. The positive rate of AKT2 protein expression in LSCC was significantly higher than that in peri-cancer tissue and normal laryngeal epithelium (P 0.05, respectively).@*CONCLUSION@#AKT2 might play an important role in the tumorigenesis and development of LSCC, and it was suggested that AKT2 could be a useful marker for predicting tumorigenesis, invasion and metastasis potential of LSCC.

Functional outcomes after supracricoid partial laryngectomy / 中国耳鼻咽喉头颈外科

OBJECTIVE To evaluate the functional outcomes in patients undergoing supracricoid partial laryngectomy(SCPL).METHODS Twenty-one cases underwent supracricoid partial laryngectomy with functional reconstruction.In these cases.14 were glottic cancers(cricohyoidoepiglottopexy,CHEP),7 were supraglottic cancers(Cricohyokdopexy,CHP). RESULTS The mean time of decanulation was36.4 days,decannulation rate was 90.5%(19/21).All the patients recovered the function of speech and swallowing,but had variously hoarse.CONCLUSION The SCPL technique is effect in laryngeal functional reservation of laryngeal neoplasms.

Effect of TFF_2 gene therapy on the healing of experimental gastric ulcer in rats / 中国实用内科杂志

Objective To study the effect of TFF_2 gene theragy on the healing of experimental gastric ulcer in rats and its mechanism.Methods From Jun.10,2005 to Mar.15,2006.48 Wistar rats were randomly divided into two groups:24 in therapy group,24 in control group.pcDNA3.1-TFF_2 100?g was used in each rat in therapy group,and the same volume of pcDNA 3.1 was used in control group.Each rat was injected under serous membrane of the gastric wall after making model.The rats were executed separately after 3、7、14 days.Results Ulcer index was 9.7?2.9 mm2 in therapy group and was 17.7?3.1 mm2 in control group on the 14th day.There was significant difference between the two groups.The average amount of mucous glycoprotein was 83.35?4.54 mg/g in the therapy group and 70.36?4.22 mg/g in the control group.There was no significant change in the secretion of acid between the two groups.Conclusion TFF_2 gene therapy can promote the healing of experimental gastric ulcer in rats.Its mechanisms may include increasing mucous glycoprotein of the gastric wall without suppressing gastric acid secretion.

The value of serum CA_(125) in the evaluation of pulmonary tuberculosis activity and treatment effect / 中国实用内科杂志

Objective To study the value of serum CA 125. in the evaluation of pulmonary tuberculosis activity and treatment effect.Method This study included 90 subjects who were divided into three groups.Group 1 consisted of 30 patients with active pulmonary tuberculosis.Group 2 included 30 patients with inactive pulmonary tuberculosis.There were 30 healthy subjects in group 3.While measurement of serum CA 125. level were performed only once in groups 2 and 3,CA 125. levels were measured four times in group 1 before and after the treatment.Result The serum CA 125. concentration in group 1 was higher than in the other groups (P0.05).CA 125. levels in group 1 showed a significant decrease after treatment (P

Construction of cloning vector of c-myc-TFF2 fusion gene by PCR based gene assembly / 西安交通大学学报(医学版)

Objective To assemble fusion gene of c-myc tagged human trefoil factor family 2(hTFF2)(in vitro) and construct a cloning vector of this fusion gene.Methods Based on amino acid sequence of hTFF2 and codon of lactococcus lactis,cDNA of htff2 sequence was designed and extended at their 5' ends with a sequence encoding the c-myc tag;and the sequence of fusion gene c-myc-htff2 was designed.According to restriction enzyme sites of pBluescript Ⅱ sk(+),the SalⅠ and BamHⅠ were arranged at 5′ and 3′ ends of the fusion gene respectively.Instructed by DNAWORKS program,the fusion gene sequence of c-myc-htff2 was designed as 14 oligonucleotides that overlapped each other.The target gene fragment of cmyc-htff2 fusion gene was obtained by the means of polymerase chain reaction(PCR) based gene assembly.Then,the c-myc-htff2 was subcloned into vector of pBluescript II sk(+) for identification of the fusion gene by restricting enzyme excision and DNA sequencing.Results Assembly of c-myc-TFF2 fusion gene(in vitro) and construction of pBS-TFF2 had been completed successfully;and DNA sequencing showed that the sequence of synthetic gene accorded with the expectation.Conclusion With the help of DNAWORKS program,the design and assembly of oligonucleotides (in vitro) is effective to synthesize a target gene,and the cloning vector of c-myc-htff2 fusion gene has been successfully constructed.