Analysis of causes for dental implant failure / 口腔医学

@#The implant-supported prosthesis has gradually become the preferred treatment for patients with partial edentulous or complete edentulous. Causes for the implant failure have been discussed in the majority of studies conducted in recent years, while their risk factors are still controversial. Patient factors (gender, age, smoking, osteoporosis, diabetes, medication, periodontitis and bruxism), clinical parameters (implant area, bone quality, implant size) and doctor factors (surgical-related factors, prosthesis-related factors) will all affect implant failure. This article presents typical clinical cases and reviews the potential risk factors for dental implant failure, in order to provide guidance for clinical practice.

Application of typical case combined with practice teaching in pediatric clinical teaching / 中华医学教育探索杂志

Objective:To explore the application of typical case combined with practice teaching in the pediatric clinical teaching.Methods:A total of 80 clinical interns majoring in pediatrics who practiced in the Affiliated Hospital of Jining Medical University between September 2019 and January 2020 were selected as the research subjects, and they were randomly divided into observation group ( n=41) and control group ( n=39). The control group adopted conventional teaching while the observation group were given typical case combined with practice teaching model. After 16 weeks of training, the theoretical knowledge, practical operation [direct observation of procedural skill (DOPS) evaluation, and mini-clinical evaluation exercise (Mini-CEX)] and overall performance were analyzed in the two groups of students. SPSS 19.0 was used for t test, chi-square test and rank sum test. Results:After the internship, the theoretical scores of common pediatric diseases, clinical disease characteristics, etiopathogenesis, treatment regimen and complications were enhanced in the two groups, and the above scores in observation group were higher than those in control group ( P<0.05). Besides, the DOPS scores and Mini-CEX scores of the two groups were increased, and the scores were higher in observation group than in control group ( P<0.05). Furthermore, the overall excellent rate of the observation group was 87.80% (36/41), which was higher than 69.23% in control group (27/39). Survey found that the number of interns who believed that the teaching regimen could deepen the knowledge mastery degree, increase the internship interest and improve the comprehensive ability, internship efficiency and clinical thinking ability was more in observation group than in control group. Conclusion:Typical case combined with practice teaching can effectively deepen the interns' understanding of theoretical knowledge of clinical pediatrics, improve the practical operation ability and arouse the interest in learning.

Research on the typical modes of medical alliances in China / 中华医院管理杂志

By means of analysis of related national policies on medical alliances, and investigation of their current development in China, the authors summarized the conceptual category of existing medical alliances. Typical cases were selected for comparative analysis in terms of urban medical groups, medical communities, specialized alliances and telemedicine collaboration networks. In view of such setbacks found as lack of health services, ambiguity of power and duties of stakeholders, and low penetration rate of composite medical insurance payment, as well as lack of effective incentives and poor online diagnosis and treatment mechanism, the authors recommended on development of medical alliances in respect of framework improvement and mechanism optimization among others.

Is hospitalisation necessary? A survey of frail older persons with cognitive impairment transferred from nursing homes to the emergency department.

BACKGROUND: Providing care for frail older persons is complex and demanding, and the transfer of older persons with cognitive impairment to the emergency department is associated with a high risk of them developing complications. AIM: To survey the most ill and frail older persons with cognitive impairment who were transferred from nursing homes to the emergency department, considering reasons for referral, symptoms and actions taken at the hospital. METHOD: A retrospective descriptive survey, conducting a review of 588 referral notes and medical records, analysed and presented with descriptive statistics and visualised with typical case narratives. FINDINGS: The persons who were transferred to the emergency department were frail with complex symptomology. When reviewing the medical records in the light of criteria for avoidable hospitalisation, 75% of the patients could have been examined and treated at the nursing homes or in primary care. CONCLUSION: Frail older persons with cognitive impairment, who are in need of end-of-life care, should be prevented from unnecessary hospitalisation. The majority of these transfers to the emergency department can be avoided if there is better planning beforehand, more specially trained nurses in elderly care in the municipalities, and more physicians making house calls.

Discussion on the construction of "typical case teaching" in the standardized training of resident doctors / 中华医学教育探索杂志

The teaching of typical case analysis for standardized resident training has been con-structed in our hospital, which is organized by medical and teaching administration division. Intractable cases are carefully chosen from the current year representative cases in our hospital. In the class specialists share their diagnosis and treatment processes in the cases, introduce the knowledge relevant to the diseases and set questions for the training students in the key node of the diagnosis and treatment processes. This teaching method introduces PBL elements on the basis of improving CBL. Teaching content extends to new medical technology and new methods. It is expected to open up students' vision, stimulate their interest in learning and standardize their clinical thinking.

Alternating hemiplegia of childhood in Denmark: clinical manifestations and ATP1A3 mutation status.

Alternating hemiplegia of childhood (AHC) is a rare neurodevelopmental disorder characterized by early-onset recurrent distinctive hemiplegic episodes commonly accompanied by other paroxysmal features and developmental impairment. De novo mutations in ATP1A3 were recently identified as a genetic cause of AHC. To describe the entire Danish cohort of paediatric AHC patients we approached neuropaediatricians nationwide. All currently acknowledged Danish patients ≤16 years with AHC were genetically tested and seen by the same child neurologist (PU). Ten patients; seven girls and three boys were identified. Mean present age was 10.0 years (range 1-16). Mean age at presentation was 7.4 months (range 1-18 months). Sequencing of ATP1A3 in all ten patients revealed a pathogenic mutation in seven. Two females with moderate psychomotor impairment were heterozygous for the known p.G947R mutation, whereas one severely retarded boy was heterozygous for the common p.E815K mutation. The prevalent p.D801N mutation was identified in two moderate to severely retarded children. Interestingly, in a set of monochorionic male twins a novel p.D801E mutation was identified, underscoring that the asparagine at position 801 is a mutation hotspot. Three girls aged 5-13 years did not reveal any ATP1A3 mutations. They were rather mildly clinically affected and displayed a normal or near-normal psychomotor development. This is the first study of AHC in the Danish paediatric population. The patients harboured a wide range of psychomotor difficulties. Patients with no mutation detected tended to be less severely affected. Prevalence was approximately 1 per 100,000 children.

Application of Typical Case Image Analysis to the Evaluation of Ophthalmologic Clinical Skills / 中华医学教育探索杂志

3-year practice and questionnaire of the graduates majoring in ophthalmology indicate ophthalmologic typical case image implicates very much clinical information,can satisfy ophthalmologic clinical skills test,reflect examinee's clinical knowledge and technical skill level and guide intern to cultivate clinical thinking capability.