ObjectiveTo investigate the difference of grant and aid systems for graduates of clinical medicine of "985" universities in China, in order to provide references for further advancing the system in West China. MethodsThree "985" universities were selected from each part of China including eastern China, central China and western China. A structured questionnaire was used to investigate the administrative departments of graduate study. The following data were included: grant extraction structure, academic scholarship coverage, living subsidies, three indexes of post allowance, etc. Excel software was used to summarize data, and then descriptive analysis was conducted to analyze the relevant data. ResultsThe grant systems for graduate students was mainly composed of three parts including financial allocation, social support and school aid in clinical medical colleges of "985" universities in China. The doctor scholarship coverage reached 100% in each region, while the coverage of academic scholarship for postgraduates, whole life subsidy levels of graduate students and "Three Helps" job coverage ratio were presented in the following trend: eastern China > central China > western China. ConclusionCompared with the grant and aid systems for graduate students of clinical medicine of "985" Universities in eastern and central China, the graduate grant in western China has the following problems, such as less coverage, lack of social support resources, imperfect grant systems without incentive mechanism. All these problems are needed to be further solved in future.
ObjectiveTo evaluate the reliability and validity of the Quality of Working Life Scale (QWL7-32). MethodsThe QWL7-32 scale was used to survey 487 drilling workers. The presence of chronic diseases was regarded as an effector for evaluating physical health, and the result of SCL-90 measurement was regarded as an effector for evaluating psychological health. The reliability and validity of the scale were statistically analyzed. ResultsThe results of the Pearson correlation coefficient was 0.713, the Cronbach's alpha coefficient was 0.920, and the Splithalf reliability coefficient was 0.942. The result of confirmatory factor analysis showed that the construct validity of scale was good, and the accumulative rate of 7 variances was 62.59%. The results of correlation analysis and t test showed that the validity of scale criterion was also good. In QWL7-32 scale, each dimension showed a good correlation with its relevant item but poor correlation with any other items. ConclusionThe QWL7-32 has a good reliability and validity.
ObjectiveTo explore necessity, safety, and clinical significance of pelvic floor reconstruction following laparoscopic abdominoperineal resection for low rectal cancer. MethodsThirty-seven patients with low rectal cancer admitted to our hospital from July 2013 to January 2016 were collected, who were divided into reconstruction group and non-reconstruction group according to the pelvic floor reconstruction or not. The complications were compared in two groups. ResultsThe laparoscopic abdominoperineal resections were successfully completed in all the patients with low rectal cancer, there was no case of conversion to open surgery. The operative time was (173.6±18.3) min, the suture time of pelvic floor peritoneal was (28.6±7.5) min. The postoperative following-up was 3-24 month. There were 5 cases (22.7%) of complications in the non-reconstruction group, included 2 cases of adhesive intestinal obstruction, 1 case of perineal incision hernia, 1 case of pelvic effusion and infection, 1 case of radiation enteritis caused by radiotherapy. There was 1 case (6.7%) of adhesive intestinal obstruction in the reconstruction group. Although the incidence of postoperative complications in the reconstruction group was lower than that in the non-reconstruction group, there was no significant difference between these two groups (χ2=2.367, P=0.096 1). ConclusionThe preliminary results of limited cases in this study show that it is not essential for pelvic floor reconstruction following laparoscopic abdominoperineal resection for rectal cancer, but it could obviously decrease difficulty of operation for postoperative reoperation, especially for postoperative radiotherapy patients, and prevent occurrence of radiation enteritis. It is still necessary because it is more consistent with principle of open surgery, Hem-o-lok 3-0 Angiotech Quilltm clip or barbed suture closure of pelvic peritoneum, it is technically safe and feasible.
ObjectiveTo determine the effects of different volume fluid resuscitation on intestinal injury and the permeability of intestine in hemorrhagic shock rats. MethodsSprague-Dawley male rats(n=72) were randomly equally divided into 4 groups after the model establishment of blood pressure-controlled hemorrhage, 45, 30, and 15 mL/(kg·h) of fluid resuscitation were performed in high dosage of resuscitation(HLR), moderate dosage of resuscitation(MLR), and low dosage of resuscitation(LLR) group respectively, but rats of Sham group didn't accept fluid resuscitation. After resuscitation, ten centimeters ileum was harvested for testing intestinal permeability. Then 6 rats of each group were sacrificed at 24, 48, and 72 hours after fluid resuscitation respectively. Over the specified time interval, blood was collected for testing levels of lactic acid and plasma tumor necrosis factor-α(TNF-α). The ileums of 3 resuscitation groups were obtained for testing the ratio of wet weight to dry weight and observing the histological changes. ResultsAfter resuscitation, the intestinal permeability was higher in HLR group(P<0.05). At 3-8 hours after resuscitation, rats of Sham group were all died, and the other rats of 3 groups were all alive. The level of plasma lactic acid was lower in LLR group than those of other 2 groups at 24 hours(P<0.05). The levels of TNF-α were higher in HLR group than those of other 2 groups at 24, 48, and 72 hours(P<0.05), and at 48 hours, level of TNF-α in LLR group was lower than MLR group(P<0.05). At 24 hours after resuscitation, ratio of intestinal wet weight to dry weight in LLR group was the lowest, and HLR group was the highest(P<0.05). According to the histopathology, intestinal injuries of the 3 groups were tend to be remission with the time, and at 48 and 72 hours after resuscitation, intestinal villus of LLR group appeared to be normal. ConclusionLimited fluid resuscitation of 15 mL/(kg·h) could not only decrease the levels of lactic acid and TNF-α, but also moderate the intestinal permeability and the intestinal injury in early stage after shock and surgery.
ObjectiveTo investigate the effect of Roux-en-Y gastric bypass (RYGB) on the composition of intestinal microbiota among the biliopancreatic limb, the Roux limb, and the common channel in normal Sprague-Dawley (SD) rats. MethodsSixteen SD rats were randomly divided into sham surgery group (Sham group) and RYGB group, each group enrolled 8 rats. Rats in Sham group underwent sham surgery of end to end anastomosis in situ after cutting off the stomach and jejunum, and rats in RYGB group underwent RYGB. Then quantitative real-time PCR (RT-PCR) method was used to detect the expression of total bacteria, Bifidobacterium, Bacteroides, and Lactobacillus mRNA at biliopancreatic limb, the Roux limb, and the common channel. At last the comparison of mRNA in 4 kinds of bacteria was performed. ResultsCompared with Sham group, the weight of rats in RYGB group was lower at 8 weeks after surgery (P<0.01). RT-PCR results showed that, expression levels of total bacteria, Bifidobacterium, and Bacteroides mRNA at the Roux limb and the common channel in RYGB group were higher than corresponding site of rats in Sham group (P<0.05), but there was no significant difference at biliopancreatic limb between the 2 groups (P>0.05). Expression level of Lactobacillus mRNA at the Roux limb in RYGB group was higher than corresponding site of rats in Sham group (P<0.05), but there was no significant difference at biliopancreatic limb and the common channel between the 2 groups (P>0.05). ConclusionRYGB can significantly improve expression levels of the total bacteria, Bifidobacterium, and Bacteroides mRNA at Roux limb and the common channel, increase the level of Lactobacillus mRNA at Roux limb, while has no influence on biliopancreatic limb.
ObjectiveTo systematically review the effectiveness and safety of anatomic landmarks positioning method (ALM) and real-time two-dimensional ultrasound (RTUS) guidance in the internal jugular vein cannulation. MethodsWe searched PubMed, EMbase, Web of Knowledge, CBM, WanFang Data and CNKI for randomized controlled trials (RCTs) concerning the effectiveness and safety of ALM and RTUS in the internal jugular vein catheterization up to May 1st, 2014. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assess methodological quality of included studies. Then meta-analysis was performed using RevMan 5.3 software. ResultsA total of 10 RCTs involving 1 973 cases were included in the metaanalysis. The results of meta-analysis showed that, compared with the ALM method, the RTUS method reduced puncture failure rate (OR=0.08, 95%CI 0.05 to 0.15, P<0.000 01). For safety, compared with the ALM method, the RTUS method was significantly lower in arterial injury rate (peto-OR=0.22, 95%CI 0.14 to 0.37, P<0.000 01), and the incidence of pneumothorax (peto-OR=0.13, 95%CI 0.04 to 0.40, P=0.000 3). ConclusionCompared to the ALM method, the RTUS method has characteristics such as causing fewer traumas, and having higher success rate and fewer complications. Due to limited quantity and quality of the included studies, the above conclusion still needs to be verified by conducting more studies.