Reflections on simulation-based medical education / 中华医学教育探索杂志

Simulation-based medical education can ensure medical safety, reduce medical errors and improve students' clinical skills. At present, the main problems in medical teaching are the conflict between doctors and patients, the contradiction between medical teaching and ethics, the shortage of teaching resources and the lack of a universal assessment standard. The advantages of simulation-based medical education are its safety, repeatability, standardization, controllability, relative authenticity, and the cultivation of humanistic spirit and teamwork for students. Simulation-based medical education has two major limits. First, its teaching effect relies on the function and quality of each model. Second, simulation cannot replace clinical practice. This article proposes the following ways and means for promoting the simulation-based medical education: training of faculty is the core, establishment of courses is the focus, cooperation and communication is an important way to promote development, and phased and refined development is the future direction.

Investigation of the surgical approach combined with frozen sections pathological features of papillary thyroid microcarcinoma / 国际外科学杂志

Objective Investigate the reasonable surgical approach combined with frozen sections pathological features of papillary thyroid microcarcinoma.Methods Clinical data of 96 cases papillary thyroid microcarcinoma nearly 5 years of follow-up in our clinic referral was retrospectively analyzed.Metastasis and recurrence rate were compared between group of ipsilateral lobe plus isthmus resection (unilateral group) and group of ipsilateral lobe plus isthmus resection and contralateral lobe subtotal (bilateral group).Metastasis and recurrence rate were compared between group of central lymph node dissection (dissection group) and non-dissection group (non-dissection group),and the injury rate of the recurrent laryngeal nerve was also compared between the two groups.Results The diagnosis of cancer by intraoperative frozen pathology were 53 cases (55％).Whether in high or low risk populations,the metastasis and recurrence between unilateral and bilateral groups showed no significant difference (P ＞ 0.05).Whether in high or low risk populations,the metastasis and recurrence between dissection group and non-dissection groups showed no significant difference (P ＞0.05).The temporary injury rate of recurrent laryngeal nerve in dissection group were higher than thatin non-dissection group both in high-risk populations (P =0.040,P ＜ 0.05) and low risk populations(P =0.037,P ＜ 0.05).Conclusions Intraoperative frozen pathological diagnosis of papillary thyroid microcarcinoma is difficult.The reasonable surgical approach for the first time is ipsilateral lobe plus isthmus resection.Preventive cervical dissections operation should not be carried out if the exploratory of lymph node showed no metastasis.

Effect of Puerarin on mechanism of endothelinin in biliary pancretitis with renal impairment / 国际外科学杂志

Objective To investigate the mechanism of endothelin (ET) in acute biliary pancretitis (ABP)with renal impairment, and examine the improvement of renal function by puerarin. Methods Thirty-two patients of ABP with renal impairment were selected and were randomly divided into group A and group B. Group A were given puerarin post-operatively, while group B were given common manegement postoperatively. Meanwhile, 16 ABP patients without renal impairment were selected as group C, and 16 nonABP patients who had common hepatic or biliary diseases were selected as group D. The levels of plsma ETand creatinine clearance rate(Ccr) of renal function in each group were observed pre-operation and 1 week post operation. Results In pre-operation the ET level in group A, B and C were higher than in group D(P ＜0.001), and the ET level in group A,B was higher than in group C(P＜0.001). Post operation after I week the ET level in group A was lower than in group B(P =0.014), while the Ccr level in group A was higher thanin group B ( P = 0.002). Conclusions The function of endothelin is an important mechanism in biliary pancretitis with renal impairment. Puerarin might reduce the ET level and increase the Ccr level in patients of ABP with renal impairment, improve the renal function of such patients.

Analysis of synchronous metastatic liver cancer of colorectal cancer for risk factors / 中国微创外科杂志

0.05). Metastasis of the liver of colorectal cancer occurred higher in the patients with serum CEA concentration ≥15ng/ml than that in those with serum CEA

The diagnosis and treatment of the sharp injury in the back / 中国实用外科杂志

Objective To improve the level of diagnosis and treatment of the sharp injury in the back. Methods 47 cases which were treated from Jan 1991 to May 2000 were reviewed. ResultsAmong 37 cases who underwent the exploration, 5 cases died. Among 10 cases who underwent conservative treatment, 2 cases died. ConclusionThe condition of sharp injury in the back is very complicated,it is easy to be misdiagnosed, the mortality is high. Saving should be equalled with the diagnosis and treatment. The application of wound exploration, abdominal puncture, ultrasound examination and X-ray checking is valuable to the diagnosis. The patients with operation indications should be operated at once,while the others should be observed for some time to prevent the delayed clinical manifestation.