Objective To investigate the effective, economic and viable long-term mechanism of Sichuan college students’ social practice. Methods A questionnaire was designed to investigate the students from North Sichuan Medical College and other 7 colleges in Sichuan province randomly. A secondary research of China students social practice status was combined and the results of Sichuan and other areas were compared. Results A total of 2 200 questionnaires were issued, of which 1 920 effective ones were taken back with the recovery rate of 87.27%. The most common forms of social practice were social investigation (47.5%), public welfare labor (42.3%), novitiate/internship (38.7%); the most interesting contents of social practice were social morality education (54.79%), credit morality education (53.07%), professional skill education (51.88%), and near 80% college students thought the contents had close relationships with their major. College students hoped that the contents could combine their job-hunting, characteristics of their major, local economy, and needs of social development. The social practice department they wanted to go most was public welfare or civil service departments (43.7%), corporations (27.8%), and government bodies (19.2%). The most difficult thing was to get connected with target department, shortage of fund, empty topics, hard-to-determine practice projects (44.1%), and lack of teachers’ guidance (43.6%). Degree of satisfaction from the students was moderate. Compared with other universities, social practice of Sichuan undergraduate students had broader coverage and was more closely related to students’ majors with more attention on the combination with moral education and employment. Conclusion Sichuan college students have higher expectations of social practice. However, the range and the time of actual participation are limited. The students are not very satisfied with status of social practice. The social practice of Sichuan college students should give prominence to the local features, be close to the students and serve the local place, strengthen the construction of practice bases, and establish effective systems of teacher training, funding, principle security mechanism and evaluation system.
Objective To explore the daytime variables which are predictive to nocturnal hyoxemia among COPD patients unqualified for long-term oxygen therapy ( LTOT) . Methods Forty-eight stable COPD patients with SaO2≥90% were enrolled in this study and regarded as patients unqualified for LTOT. All patients underwent lung function examination during daytime. Their nocturnal oxygen saturation was monitored with overnight pulse oximetry ( OPO) . ResultsDaytime oxygen saturation was positively correlated with nocturnal mean SaO2 ( r =0. 79, P lt;0. 0001) , and negatively correlated with time spend with saturation below 90% ( TB90) ( r = - 0. 75, P lt; 0. 0001) . No significant relationship was found between lung function parameters and nocturnal SaO2 . The patients with daytime oxygen saturation between 90% and 95% were more likely to have lower nocturnal oxygen saturation and longer TB90 ( P lt;0. 05) .Conclusions Daytime oxygen saturation may effectively predict the occurrence of nocturnal hyoxemia in stable COPD patients unqualified for LTOT. To reduce COPD complications and improve prognosis, we suggest a relative indication of LTOT for patients with daytime oxygen saturation between 90% and 95% and with nocturnal hyoxemia.
Objective To evaluate the long-term effectiveness of treating early-middle stage avascular necrosis of the femoral head (ANFH) with core decompression and bone grafting. Methods Between January 2000 and December 2006, 87 ANFH patients (114 hips) were treated with core decompression and bone grafting, including 54 cases (62.1%) of alcohol-induced ANFH, 26 cases (29.9%) of steroid-induced ANFH, and 7 cases (8.0%) of idiopathic ANFH. There were 74 males (97 hips) and 13 females (17 hips), aged 20-56 years (mean, 38 years). The disease duration was 3-46 months (mean, 18 months). According to Ficat staging, 16 hips were at stage I, 68 hips at stage II, and 30 hips at stage III. The Harris score and Ficat stage were compared between pre- and post-operation to assess the outcomes clinically and radiologically. The hip survival was analyzed by the Kaplan-Meier method. Results Eighty-seven patients were followed up 5 years to 11 years and 10 months (mean, 8 years and 9 months). The Harris hip score was significantly increased from 73.13 ± 7.17 at preoperation to 81.59 ± 13.23 at postoperation (t= — 9.318, P=0.000). The clinical success rate was 69.3% (79/114) and the radiological success rate was 54.4% (62/114). Kaplan-Meier survival analysis showed that the overall survival rate was 84.2% (96/114); the survival rates of Ficat stage I [100% (16/16)] and stage II [91.2% (62/68)] were higher than that of stage III [60.0%(18/30)] (P lt; 0.01); there was no significant difference between Ficat stage I and II (χ2=1.520, P=0.218). Conclusion Core decompression with bone grafting is a safe and effective procedure for the treatment of Ficat stages I-II (early stage) ANFH, and the long-term effectiveness is satisfactory. But the long-term effectiveness is unsatisfactory for the patients at the Ficat stage III (middle stage).
Objective To retrospectively analyze the long-term effectiveness of percutaneous laser disc decompression (PLDD) in treatment of cervical spondylosis. Methods Between March 2003 and June 2005, 156 patients with cervical spondylosis were treated with PLDD. There were 74 males and 82 females with an average age of 55.4 years (range, 31-74 years). The disease duration varied from 2 months to 15 years. Fifty-nine patients were classified as cervical spondyloticradiculopathy, 48 as vertebral-artery-type cervical spondylosis, 19 as cervical spondylotic myelopathy, and 30 as mixed type spondylosis. The lesions were located at the levels of C3,4 in 32 discs, C4,5 in 66 discs, C5,6 in 89 discs, and C6,7 in 69 discs, and including 71 one-leve lesion and 85 multi-level lesions. All cases were followed up to study the long-term effectiveness and correlative factors. Results A total of 117 (75%) patients’ symptoms were l ightened or eased up immediately after operation. Discitis occurred in 1 case at 3 days after operation and was cured after 3 weeks of antibiotic use. All patients were followed up 5 years to 7 years and 3 months (5 years and 6 months on average). According to Macnab criteria, the long-term effectiveness was excellent in 60 cases (38.46%), good in 65 cases (41.67%), fair in 19 cases (12.18%), and poor in 12 cases (7.69%); the excellent and good rate was 80.13%. No significant difference was observed in the wedge angels and displacements of the intervertebral discs between before and after operations (P gt; 0.05). Multiple-factors logistic regression showed that the disease duration and patient’s age had obvious relationship with the effectiveness of treatment (P lt; 0.05), while the type of cervical spondylosis, disc protrusion degree, mild cervical instabil ity, and lesion scope had no correlation with the effectiveness of treatment (P gt; 0.05). Conclusion PLDD is safe and effective in treatment of cervical spondylosis with less compl ication. There is no impact on the stabil ity in cervical spinal constructs. The disease duration and patient’s age have obvious impact on the long-term effectiveness of treatment. The type of cervical spondylosis, disc protrusion degree, cervical instabil ity, and lesion scope are not the correlative factors.
Objective To evaluate the effect of releasable sutures on shallow anterior chamber, filtering bleb and long-term intraocular pressure (IOP). Methods We searched MEDLINE (1971 to 2007), OVID (1971 to 2007) and National Science and Technology Library (1971 to 2007). Randomized controlled trials (RCTs) of the effect of releasable sutures on trabeculectomy were collected. Study selection and assessment, data collection and analyses were undertaken and cross-checked by two reviewers. Meta-analyses were performed with The Cochrane Collaboration’s RevMan 4.2.10 software. Results Six RCTs involving 341 eyes were included. Significant differences were observed in the reduction of postoperative shallow anterior chamber (RD –0.23, 95%CI –0.31 to –0.14, Plt;0.000 01) and functional filtering blebs (RD –0.15, 95%CI –0.27 to –0.02, P=0.02). But, no differences were observed for the control of long-term IOP (SMD –0.13, 95%CI –0.37 to 0.10, P=0.27). Conclusion The evidence currently available showed that releasable sutures could reduce the incidence of shallow anterior chamber and has no beneficial effect in controlling long-term IOP. The current evidence is insufficient to define the efficacy of maintaining functional filtering blebs. Further large-scale, high-quality randomized controlled trials are needed.
Objectives To establish a course evaluation model for overseas medical students in West China Medical School of Sichuan University, to identify problems in teaching and to solve problems based on evidence so as to futher improve the quality of teaching. Methods We conducted a preliminary course evaluation to determine the limitations of our evaluation methods and to convey our intention to related stakeholders. Firstly, we identified problems in teaching according to the feedback from our students using a questionnaire. Secondly, we proposed an initial list of possible solutions to these problems based on evidence from literature searching and discussion within the Department of Teaching Affairs. We submitted the initial list to the administrative departments, teaching departments (teachers) and students to identify applicable solutions through two rounds of formal consensus. Their attitudes to this procedure of evaluation and decision-making were collected. Finally, incentives were given out by administrative departments and teaching departments to facilitate the implementation of applicable solutions. Results Teachers’ English ability and the didactic teaching methods were the most concerned problems. In addition, some semesters and courses were not well arranged and there was not enough practice time. An initial list of 14 items was submitted to teaching departments and students. They all agreed with the procedure of evaluation and decision-making. We also found that some aspects of the evaluation methods and styles need to be improved. An additional paper would report further results. Conclusion This preliminary evaluation was helpful for improving teaching and formal evaluation in the future. We need to strengthen the English language skills of younger faculty and gradually adopt a model of student-centered and enquiry-based teaching. This process of evaluation and improvement should be applied as a long-term policy and an evidence-based research group should be established to work together with our quality assurance unit.
ObjectiveTo investigate the effects of hippocampal long-term potentiation (LTP) on cognitive dysfunction in immature epileptic rats. MethodsImmature epileptic rats were established by intraperitoneal injection of lithium chloride-pilocarpine (li-pilo). Racine classification standard modified by Becker was used to evaluate behavior of epileptic seizure, and the survival rats within RacineⅣmagnitude were selected in the experiment. The function of learning and memory of epileptic rats when they were adult was assessed using Morris water maze experiment, and their independent exploratory behavior was evaluated by the open-field test. Field potential was recorded by electrophysiological technology to detecte whether hippocampal LTP was essential of cognitive dysfunction. ResultsThe function of learning and memory was significantly impaired when compared with controls(n=8, t=10.86, P < 0.05;n=8, t=9.98, P < 0.05). In addition, independent exploratory behavior was significantly reduced when compared with controls(n=8, t=12.89, P < 0.05). Besides, CA1 hippocampal LTP induced by high-frequency stimulation presented the significant inhibition in epileptic rats with cognitive dysfunction when compared with controls(Slope:n=8, t=13.32, P < 0.05;Amplitude:n=8, t=20.02, P < 0.05). ConclusionInhibition of CA1 hippocampal LTP may be implicated in cognitive dysfunction of epileptic rats.
ObjectiveTo investigate the relationship between admission serum potassium level and long-term prognosis in patients with unstable angina. MethodsWe studied the data of 1 412 patients with unstable angina who received coronary angiography examinations and completed the follow-up between July 2008 and September 2012. Serum potassium level within the first 24 hours after admission was collected. According to the serum potassium level, the patients were divided into three groups:those with a serum potassium level lower than 3.5 mmol/L, those with a level between 3.5 and 5.0 mmol/L and those with a level higher than 5.0 mmol/L. Then, we analyzed the relationship between admission serum potassium level and long-term prognosis in patients with unstable angina. ResultsThere was a U-shaped relationship between admission serum potassium level and long-term mortality that persisted after multivariable adjustment in patients with unstable angina. The all-cause mortality risk was the lowest in the group of patients with a potassium level of 3.5 to 5.0 mmol/L, whereas mortality was higher in patients with potassium level lower than 3.5 mmol/L and higher than 5.0 mmol/L [HR=1.89, 95%CI (1.13, 3.17), P=0.016; HR=1.64, 95%CI (0.40, 6.77), P=0.493]. Compared with patients with a serum potassium level between 3.5 and 5.0 mmol/L, the cardiovascular mortality risk was significantly higher in those patients with a potassium level lower than 3.5 mmol/L [HR=1.99, 95%CI (1.01, 3.94), P=0.048]. ConclusionThere is a U-shaped relationship between admission serum potassium level and long-term all-cause mortality rate, and the all-cause mortality rate and cardiovascular mortality risk was the lowest in patients with a potassium level between 3.5 and 5.0 mmol/L.
ObjectiveTo investigate the long-term effectiveness of microgenia treatment with natural coral, and the volume relationship between the implant and the new bone. MethodsA retrospective analysis was made on the cl inical data of 12 patients with microgenia treated by horizontal genioplasty with natural coral implantation between October 1998 and September 2004. There were 7 males and 5 females with the average age of 18.5 years (range, 15-28 years). The cephalometric data on the photo and X-ray films were collected at pre-operation, immediate after operation, and last follow-up. The vertical distance between lower lip point and inferior mental point, the vertical distance between inferior alveolar point and inferior mental point, the vertical distance of the osteotomic gap, and the distance between pogonion and the line between nasion and inferior alveolar point were measured, and the recurrence rates were caculated. ResultsAll incisions healed by first intention, and no complication occurred. All patients were followed up 8-12 years (mean, 9.2 years). X-ray films showed that the natural coral was replaced by new bone formation in the mental osteotomic gap; the new bone had good strength and firmly attached to the mentalis and periosteum. At last follow-up, the vertical distance between lower lip point and inferior mental point, the vertical distance between inferior alveolar point and inferior mental point, and the vertical distance of the osteotomic gap were decreased when compared with the ones at immediate after operation, and the mean recurrence rates were 6.1%, 22.9%, and 31.7%, respectively; and no obvious change was observed in the vertical distance between pogonion and the line between nasion and inferior alveolar point. Nine patients were satisfied with operation effectiveness; chin morphology was adjusted again in 3 patients. ConclusionNatural coral is a safe and effective bone substitute with enough stable new bone and good long-term effectiveness.
ObjectiveTo investigate influence factor of long-term survival of primary colorectal signet-ring cell carcinoma. MethodThe clinical data of 37 patients with primary colorectal signet-ring cell carcinoma from January 1990 to November 2010 in this hospital were analyzed retrospectively. ResultsThe cumulative survival rates of 1-, 2-, 3and 5-year after the initial surgery were 70.3%, 51.4%, 27.0%, and 10.8% respectively. The survival time of 37 patients was 26 months. The results of univariate analysis showed that the TNM stage, T stage, preoperative intestinal obstruction or not, operation mode, and postoperative chemotherapy or not were associated with the survival time of primary colorectal signet-ring cell carcinoma (P < 0.05). The results of multivariable analysis showed that TNM stage, T stage, and preoperative intestinal obstruction or not were the independent factors for the prognosis of patients with primary colorectal signetring cell carcinoma. ConclusionsThe survival rate of patients with primary colorectal signet-ring cell carcinoma is lower. TNM stage, T stage, and preoperative intestinal obstruction or not are independent factors of it. Chemotherapy after operation could prolong survival time of patients with primary colorectal signet-ring cell carcinoma.