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Supervision of teaching is of great significance to the substantive equivalence of "online" and "offline" teaching. Compared with the conventional supervision of offline teaching, supervision of online teaching has its particularity. The School of Medicine of Shanghai Jiao Tong University has formulated the online teaching supervision program, relying on the constantly improving supervision system in long-term practice and based on the quality control concept of OBE (outcomes-based education) which aims to improve the learning effect of students. The supervision program of online teaching includes full coverage of expert supervision, smooth feedback channels for students, prompt communication and solutions by management supervision, etc. And the effect of online teaching supervision on students' learning effect can be tested in practice. The effect of the online teaching has been investigated by the questionnaire survey. The results show that online teaching expert supervision has higher satisfaction and students learning effect is better, which illustrates that the online supervision program has played a positive role in teaching.
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Objective To establish a reasonable evaluation system of the training effect of residents and professional master degree graduates in order to meet the needs of the construction of medical education system.Methods A questionnaire study had been conducted by stratified sampling to evaluate the abilities of the residents and medical professional degree graduates who had finished residency training in Beijing from 2015 to 2016.The trainees were evaluated by themselves,their colleagues and patients they had dealt with.Results The results showed that 95.29％ of the trainees and 99.00％ of their colleagues or patients thought that the overall abilities of the trainees were "excellent" or "better",and the evaluation results of all kinds of personnel above were consistent.Statistical analysis showed that some of the sub items of each ability index were evaluated better than the others,such as professional ethics,team cooperation ability and interpersonal communication ability,while some of the sub abilities need to be improved such as the information and management ability as well as teaching and research ability.The comparative analysis indicated that the postgraduates were superior to the residents in abilities of clinical diagnosis and treatment,information and management ability,and teaching and research ability.Conclusion The study showed that the training effect of residents and professional degree graduates had met the basic requirements,but the comprehensive quality and innovation ability needs to be promoted.The combination of degree education and resident training helps to cultivate the comprehensive ability of medical talents.
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The Sino-foreign joint graduate education is an important measure of educational innovation.It has been implemented in Capital Medical University since 2009.Regulatory recruitments,strict managements,information system network and creating international exchange opportunities have been engaged in recent years for graduate students,Which wins great effects in Sino-foreign joint graduate education.The practice of the project has improved the graduate students' professional ability,broadened their international vision,and explored the new mode of cultivating creative talents.
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BACKGROUND:Complex scapular fractures were mainly treated by implant fixation. Standard fixation approach (Judet approach) had long incision and big trauma. With the application of spiral CT and three-dimensional reconstruction, minimal y invasive incision could be designed before implant fixation, and then fixation could be finished by physicians. Thus, trauma was reduced and repair effect was elevated. OBJECTIVE:To observe the effects of the three-dimensional reconstruction design combined with titanium plate reconstruction or lag screw for treatment of scapular fractures. METHODS:From February 2007 to January 2012, 33 cases of scapular fractures were enrol ed from Department of Orthopedics, No. 1 Hospital of Qinhuangdao in China. They were scanned by three dimensional reconstruction of CT before implant fixation to identify the regions needed to be repositioned and fixed. Thus, minimal y invasive incision of implant fixation was designed. The dissection of skin, subcutaneous tissue and muscle was reduced. Reposition was performed. Titanium plate and/or lag screw were used for fixation. RESULTS AND CONCLUSION:The operation lasted for 90-130 minutes in 33 patients, with intraoperative blood loss for 300-400 mL. Fracture was total y healed, and the healing time was 2-4 months. The fol ow up lasted for 12-24 months. According to Hardegger standard, there were excellent in 17 cases, good in 12 cases, average in 3 cases and poor in 1 case, with an excellent and good rate of 88%. These results suggested that three-dimensional reconstruction design combined with minimal y invasive incision treatment for scapular fractures showed fewer traumas, can complete the satisfactory fracture reduction and implant fixation, and obtain good repair effect.
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Objective To evaluate the outcome and safety of endoscopic submucosal dissection (ESD) versus endoscopic mucosal resection (EMR) in the management of esophageal mucosal lesion.Methods The clinical data of 70 patients with esophageal mucosal lesion were analyzed.Twenty-five patients were treated by ESD (ESD group) and 45 patients were treated by EMR (EMR group).The enbloc resection rate,tissue healing resection rate,operation time,complication and recurrence rate were compared between two groups.Results The enbloc resection rate,tissue healing resection rate in ESD group were significantly higher than those in EMR group [60.0％(15/25) vs.48.9％(22/45),48.0％(12/25) vs.40.0％ (18/45)] (P ＜0.05).The local recurrence rate in ESD group was lower than that in EMR group [4.0％ (1/25) vs.20.0％ (9/45)] (P ＜ 0.05).The severe complication such as delayed hemorrhage,perforation,stenosis between two groups had no significant difference (P ＞ 0.05).The operation time in ESD group was (64.3 ±27.1) min,and significantly longer than that in EMR group [(27.6 ± 14.1) min] (P ＜0.05).Conclusions Compare with EMR,ESD has better enbloc resection rate,tissue healing resection rate,and lower recurrence rate.It is more safe and effective in the therapy of esophageal mucosal disease.
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BACKGROUND:The previous literatures have reported that the aneurysmal bone cyst has a high recurrence rate after curettage treatment. OBJECTIVE:To investigate the effect of less invasive stabilization system plate fixation combined with bone cement in the treatment of distal femoral aneurysmal bone cyst. METHODS:A retrospective analysis was conducted in 19 patients with distal femoral aneurysmal bone cyst who treated with less invasive stabilization system plate fixation combined with bone cement in the First Hospital of Qinhuangdao between January 2002 and January 2012. The purpose of the treatment of aneurysmal bone cyst was to completely remove the cyst and prevent recurrence, and to repair and reconstruct the structure and function of the damaged tissues through implant fixation. RESUTLS AND CONCLUSION:The 19 patients were fol owed-up for 1-3 years after treated with less invasive stabilization system plate fixation combined with bone cement, and 18 cases recovered wel , one case had recurrence at 2 years after treatment. Complete removal of aneurysmal bone cyst is the key for the prevention of recurrence. The less invasive stabilization system plate is the combination of advantages of intramedul ary nail and the biological locking plate technology, which has many advantages in the treatment of aneurysmal bone cyst. Fil ing the lesion area with bone cement had certain kil ing effect on tumor, and can increase the bone strength in the lesion area. The surgical treatment of distal femoral aneurysmal bone cyst is to clear the cystic lesions firstly, and then to prevent the recurrence through less invasive stabilization system plate fixation combined with bone cement.
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Objective To describe the surgical technique in reconstructing anterior cruciate ligament (ACL) with six strands harmstring tendon graft fixed by bioabsurbable rigidfix cross pins under arthroseopy and to e-valuate its efficacy. Methods From March 2005 to June 2008,39 patients with ACL injury were treated with ACL reconstruction by transplantation of six strands autogenous harmstring tendon , fixed by bioabsorbable rigidfix cross pins in femoral side. There are 22 male and 17 female,ages from 22 to 55 (the average age is 37). 19 cases were hurt in traffic accident, and another 20 cases in accidental injury. The state of illness is 7 days to 38 months. 13 cases merge the meniscus rupture, and 4 cases of meniscus suture,8 partial meniscectomy, 1 meniscectomy were performed simultaneously ;4 cases associating with the medial collateral ligaments Ⅲ degree injure underwent medial collateral ligament neo-plasty or reconstruction ;no cases merge posterior cruciate ligament injury, the patients were followed up 12 to 51 months , Pre-and post-operative knee joint function and stability were evaluated according to the Lysholm scoring scale system and the results of KT-2000 arthrometer , the clinical results and the reliability of the fixation were analyzed. Results 32 patients were followed-up and there is no limitation of the extention in the knee joints. The flexation of the knee joint is greater than 120°,and the anterior drawer test in 90° of flexation were negative in all patients. The postoperative Lachman test was strong positive in 1 case, negative in 26 cases and positive in 5 cases. The Lysholm scores was (92.6±4.2) points. The results of KT-2000 arthrometer: 31 cases 0-4.5 nun, average 3.2 mm;1 case 6. 5 mm. Conclusions It is a safe and reliable method to reconstruct ACL with six strands harmstring tendon graft fixing by bioabsorbable rigidfix cross pins under arthroscopy, and this procedure can obtain primary stabilization and long term stabilization of the autografts.
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BACKGROUND: There are no ideal substitutes for meniscus. Meniscel allograft transplantation has become a feasible method to retain maniscal function following injury. Currently, the meniscus conservancy methods include fresh meniscus, low temperature preserved meniscus; freeze-dried meniscus.OBJECTIVE: To observe the long-term effects of meniscus allograft transplantation by different methods.METHODS: A total of 70 adult New Zealand rabbits were used, and 30 were selected as meniscus donors. The remaining 40 rabbits were divided into 4 groups (n=10): after meniscectomy, control group was not treated; fresh group underwent fresh meniscus allograft transplantation; low temperature group underwent low temperature preserved meniscus allograft transplantation; freeze-dried group underwent freeze-dried meniscus allograft transplantation. Of 30 donors, 10 received fresh meniscus transplantation, and the other received temperature preserved meniscus and freeze-dried meniscus transplantation 1 week after low temperature and freeze dried preservation. The rabbits were sacrificed 12 months after surgery for gross and histological observation.RESULTS AND CONCLUSION: The meniscus allografts of rabbits healed well, and no rabbits died. Gross observation showed that the appearance and elasticity of fresh meniscus group was similar to normal meniscus; tibial plateau was covered well, with no additional wearing in the cartilage of tibial plateau or condyles of femur. In low temperature and freeze-dried preservation groups,the meniscus grafts healed well, but their volume was small and the elasticity was poor; tibial plateau was only partially covered.Pathological observation suggested that fresh meniscus group had orderly arranged collage fiber and similar chondrocyte appearance, number and distribution to normal meniscus, while sparse collagen fiber end small number of meniscus grafts were observed in the other groups. Results show that meniscal allogrefting can survive, retain certain function and structure and prevent the degenerative changes of the knee joint. Moreover, fresh meniscal grafts exhibit best effects, as the grafts following low temperature or freeze-dried preservation degenerate and their volume diminish 1 year following meniscectomy.
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Acute pancreatitis is one of the common clinical diseases in emergency.The severe acute pancreatitis-associated ascetic fluid is always found in clinic.Its roles related multiple organ dysfunction(MOD)in acute pancreatitis is being understood.In this article，the possible compositions of the ascites，the mechanism of its formation，and its effect on body are recited，in order to better understand the mechanism，the prevention and the treatment of the acute pancreatitis and its compications related MOD.
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Objective The attempts was made to compare the results of a quadruple-strand semi-tendinosus tendon versus patellar tendon reconstruction for anterior cruciate ligament by arthroscopy in chronic complete anterior cruciate ligament injury.Methods60patients were enrolled in a prospective,ran-domized,controlled study.30patients underwent reconstruction with a quadruple-strand semitendinosus tendon autograft,30patients were treated with a bone-patellar tendon-bone autograft.The surgery was car-ried out in an alternating sequence with two autograft constructed materials.At the time of arthoscopy,the knee was examined totally,associated joint pathology was documented,and irreparably torn meniscal frag-ments were removed.60patients were followed up14to30months after operation,and evaluated in terms of the clinical test findings,the activity level,the functional status in daily activities,the range of motion,the stability of the knee,the level of return to sports and the patellofemoral crepitus at final follow-up.Results The objective outcome of replacement with a bone-patellar tendon-bone graft was identical to that obtained with a quadruple-strand semitendinosus tendon graft.The stability of the knee in the quadrupled-strand semitendinosus reconstruction was equal with that in the bone-patellar tendon-bone autograft.The return to sport was more frequent in the quadrupled-strand semitendinosus group comparing with in the bone-patellar tendon-bone group,there was80%and73%in each group respectively with no significant difference.A mild loss(≤3?)of knee extension was more frequent in the patellar tendon group than that in the quadru-pled-strand semitendinosus group,there was40%and6%in each group respectively,the difference was sig-nificant statistically.KT-2000arthrometer side-to-side difference of anterior displancement was13%versus20%in the quadrupled-strand semitendinosus group and patellar tendon group at133.4N.Patellofemoral crepitus was6%and17%in the quadrupled-stranded semitendinosus group and patellar tendon group re-spectively.Conclusion In a chronic complete injury of anterior cruciate ligament,the clinical results of re-construction with a quadrupled-strand semitendinosus tendon or patellar tendon by arthroscopy were satis-factory without significant differences between the two operative procedures.
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In order to study the relationship between the height and the measured results of body parts,the length of the foot,the width of the foot palm,the whole length of the hand,and the length of the forfinger,middle finger,little finger as well as the height of 489 young people were measured.The data was then analyzed by the digital computer.The results showed that the linear relationship existed between the height and the measurement results of six body parts mentioned above in males.The linear regression equations were as follows:(1)y=93 55x+3 26x(by the length of the foot);(2)y=130 79+4 18x(by the width of the foot palm);(3)y=76 15+5 33x(by the whole length of the hand);(4)y=108 61+8 76x(by the length of the forefinger);(5)y=94 85+9 47x(by the length of middle finger);(6)y=120 79+8 68x(by the length of the little finger).Also,the linear relationship existed between the height and the whole length of the hand and the length of the middle finger,The regression equations were as follows:(1)y=119 86+2 44x(by the whole length of the hand);(2)y=129 89+4 08x(by the length of the middle finger).There is not any linear relationship existed between the height and the measurement results of these rwo body parts as mentioned above.