Different from the general local hospital,the affiliated hospital of medical school plays double social roles that it not only serves as a teaching hospital but also a medical uniL Every medical staff in it shoulders the responsibility of teaching,researching and medical treatmenL According to the relative independence of affiliated hospital in comprehensive university,the particularity of professional and technical post,the multiplicity of post task,as well as problems existed in the current appraisal and appointment of professional and technical posts such as lacking objectivity and maneuverability in clinical skills examination and evaluation.the paper tries to put forward a new mode of clinical skills examination and evaluation system in accordance with the characteristics of affiliated hospital.

Objective To evaluate the efficacy and adverse events of oxcarbazepine(OXC) on the children with partial epilepsy.Met-hods Sixty-four children with partial epilepsy were divided into 2 groups.Forty-one newly diagnosed patients who had never accepted standard therapy entered monotherapy group,and 23 patients who had many anti-epileptic drug(AEDs) in turn with poor efficacy served as add-on therapy group.The initial dose was 4-8 mg/(kg?d).The dosage was increased by one time every 2 weeks,and should not exceed 10 mg/(kg?d) in each time.The maintenance dose was 28-40 mg/(kg?d).With open-label autocontrol method,the efficacy and adverse events of OXC were analyzed during the first 6 months of treatment both in 2 groups.Results The effective rates were 85.4%,69.6% and 79.7%,in monotherapy,add-on therapy and total groups.The seizure free rates were 53.7%,17.4% and 40.6%.It showed that the seizure frequencies between 2 groups at 6 months after therapy were significantly difference(P0.05).The common adverse events were dizziness,headache,fatigue and nausea.Six patients had dropped out because of rashes,however,they all recovered after drug withdrawal and nonspecific therapy.Conclusion The efficacy of OXC is sustained with good safety and tolerability profiles on the treatment of children patients with partial epilepsy.

Graves' ophthalmopathy (GO) is an autoimmune disorder representing the commonest and most important extrathyroidal manifestation of Graves' disease.GO can be a debilitating component of the disease,resulting in impaired quality of life.Although therapeutic methods appear to be widespread,the optimal treatment remains challenging.This article reviewes recent studies on therapy pattern and evidence-based medicine,to provide practical information for managing patients with GO.

Exendin-4,a peptide analogue of glucagon-like peptide-1(GLP-1),is presently in clinical trials as a therapy for type 2 diabetes mellitus.Exendin-4 selectively acts on GLP-1 receptors,which are coupled to the cAMP nucleotide second messenger pathway to enhance the survival and plasticity of neurons in the brain.Exendin-4 has potent effects on homeostasis of Ca2+,on multiple targets to block apoptotic signaling pathways,and on neuronal proliferation and differentiation.It has also been demonstrated to possess properties against oxidative stress and excitotoxicity.In this review the functions of exendin-4 on central nerve system and the potentia therapeutic effects on neurodegenerative diseases will be involved.

OBJECTIVE:To prepare glycyrrhetic acid derivatives-modified norcantharidin(NC)liposome(GDNL)and study its liver-targeting property.METHODS:Gal-GAOSt targeting molecules were synthesized to modify NC and prepare GDNL,with the parameters such as the entrapment efficiency and particle diameter,etc.investigated.Mice were enrolled to be injected with GDNL and NC water solution,respectively via vena caudalis followed by determination of NC concentration in different tissues to compute the targeting-index(TI)of GDNL in liver.RESULTS:The prepared GDNL had an entrapment efficiency of 56.29%,particle diameter of(210?20)nm and TI of 5.213 in liver.CONCLUSION:The prepared GDNL has high entrapment efficiency and remarkable liver-targeting property.

The capsule endoscope swallowed from the mouth into the digestive system can capture the images of important gastrointestinal tract regions. It can compensate for the blind spot of traditional endoscopic techniques. It enables inspection of the digestive system without discomfort or need for sedation. However, currently available clinical capsule endoscope has some limitations such as the diagnostic information being not able to correspond to the orientation in the body, since the doctor is unable to control the capsule motion and orientation. To solve the problem, it is significant to track the position and orientation of the capsule in the human body. This study presents an AC excitation wireless tracking method in the capsule endoscope, and the sensor embedded in the capsule can measure the magnetic field generated by excitation coil. And then the position and orientation of the capsule can be obtained by solving a magnetic field inverse problem. Since the magnetic field decays with distance dramatically, the dynamic range of the received signal spans three orders of magnitude, we designed an adjustable alternating magnetic field generating device. The device can adjust the strength of the alternating magnetic field automatically through the feedback signal from the sensor. The prototype experiment showed that the adjustable magnetic field generating device was feasible. It could realize the automatic adjustment of the magnetic field strength successfully, and improve the tracking accuracy.
Capsule Endoscopes ; Endoscopy ; Gastrointestinal Tract ; Humans ; Magnetic Fields

BACKGROUND:The assessment for long-term efficacy of chronic ischemic disease is more important than the short-term efficacy assessment, which associates with patient’s long-term quality of life and long-term survival rate. OBJECTIVE:To observe the 5-year folow-up outcomes of autologous bone marrow stem cel transplantation for the treatment of thromboangitis obliterans. METHODS:This study enroled 43 patients of thromboangitis obliterans who underwent autologous bone marrow stem cel transplantation from August 2007 to January 2010 in the Department of Thyroid Vascular Surgery, the First Affiliated Hospital of Xinjiang Medical University. At 1, 2, 3, 4 and 5 years after transplantation, pain, cold sensation, and intermittent claudication distance were folowed up by telephone; changes in limb ulcers were observed. At 1 year after transplantation, venous oxygen partial pressure and oxygen saturation of limbs were reviewed. RESULTS AND CONCLUSION:A total of 38 thromboangitis obliterans patients with complete folow-up data were included in the final analysis. Compared to the preoperation, pain, cold sensation, and intermittent claudication significantly improved. The difference was statisticaly significant (Z values:-4.277,-5.086,-3.574, P < 0.001). Compared with 1-5 years after operation, pain and cold sensation had no statisticaly difference (P >0.05). Intermittent claudication distance had increased. Differences in terms of intermittent claudication distance was statisticaly significant (Z=43.898,P < 0.001). Significant differences in venous oxygen partial pressure and oxygen saturation were detected between preoperation and 1-year posttransplantation (tvalues: 36.790, 43.964,P values: 0.040, 0.037). Above results suggest that autologous bone marrow stem cel transplantation for thromboangitis obliterans obtained stable long-term outcomes.

BACKGROUND: Cartilage stent materials were abundant. With the development of preparation technique, structure, and surface modification technique, performance of materials were improved remarkably; thus, Integrated-repaidng defects of articular cartilage and subchondral bone required high stability of cartilage replacement materials.OBJECTIVE: To evaluate the effect of polyurethane/nano-hydroxyapatite+polyamide66 (PU/n-HA+PA66) biological composite material on repairing articular cartilage and subchondral bone.METHODS: Twenty dog models were randomly divided into 4 groups: porous PU/n-HA+PA66 implant group, compact PU/n-HA+PA66 implant group, n-HA+PA66 implant group and blank control group. The macroscopic and histological evaluations were performed at 4, 12, and 24 weeks postoperatively. The interfaces of biomaterial implants with articular cartilage were observed by scanning electron microscope.RESULTS AND CONCLUSION: After 12 and 24 weeks, bone tissue grew into lower layer materials. Porous PU was well fused with peripheral cartilage. At 24 weeks postoperatively, the porous PU was closely connected with surrounding articular cartilage than the compact PU, and the articular cartilage surrounding the compact PU degenerated obviously. PU/n-HA+PA66 had a similar structure with normal cartilage and subchondral bone and had remarkable effects on repairing defects of articular cartilage and subchondral bone.

BACKGROUND: Polyvinyl alcohol hydrogel (PVA) has been generally considered as a good substitute material of articular cartilage. Polyamide 66 (PA66) polymer has achieved an extensive application in the fields of engineering and medicine owing to its high intensity, strong tenacity and good stability. Polyurethanes exhibit good histocompatibility and blood compatibility and show distinct advantages in repairing cartilage.OBJECTIVE: To compare the outcomes of repairing articular cartilage defects in rabbit knee joints with three materials and to find the best material.METHODS: Thirty-six healthy adult New Zealand rabbits were prepared for the models of articular cartilage defects by perforating on the patellofemoral joint and randomly divided into 4 groups, with 9 animals in each group. PVA, polyurethane, and PA66 were implanted into the into articular cartilage defects in rabbits of corresponding groups. There was no treatment in the control group.The macroscopic and histological evaluations of rabbit knee joints were performed at 4, 8 and 12 weeks postoperatively. The score of histology was used to evaluate the repairs of articular cartilage defects at 12 weeks postoperatively.RESULTS AND CONCLUSION: No infection was observed in all animals with good motion of joints. At 12 weeks postoperatively, the materials got well with surrounding cartilage, which did not degenerate obviously. The defects in the control group were filled with fibrous scar-like tissues that arranged in disorder. The histological score of the in the group implanted by PVA, as well as polyurethane, was higher than that in PA66 and the control groups (P < 0.05), but the difference between the two groups had no significance (P>0.05).The porous materials PVA and polyurathane have good function for replacing articular cartilage, with good biocompatibility.

Objective To investigate the value of peripheral blood for the prognosis of patients withbloodstream infection. Methods A retrospective analysis of patients with bloodstream infection was conducted inthe intensive care unit (ICU) of Mianyang Central Hospital of Sichuan from January 2012 to October 2016. Accordingto the 28-day survival, the patients were divided into survival group and death group. The white blood cell (WBC),neutrophils count (NEU), lymphocyte count (LYM), neutrophil/lymphocyte ratio (NLR), monocyte count (MO), eosinophilcount (EO), basophil count (BA), hemoglobin (Hb), platelet count (PLT) and procalcitonin (PCT) in peripheral bloodwere recorded when patients were diagnosed with blood infection. Receiver operating characteristic curve (ROC),Kaplan-Meier survival analysis and Cox regression were used to evaluate the value of these risk factors for predictingthe outcome. Results 305 patients were enrolled. 182 patients survived while 123 patients died during the 28-dayperiod. ① There was no significant difference in gender, age and comorbidities between the two groups. There was nosignificant difference in infection rate between the two groups except for fungal infection rate. The fungal infection ratein the death group was significantly higher than that in the survival group (9.8% vs. 3.3%, P = 0.019). ② The LYM,MO, EO and PLT in the death group were significantly lower than those in the survival group [LYM (×109/L):0.58 (0.29, 0.93) vs. 0.76 (0.44, 1.23), MO (×109/L): 0.47 (0.19, 0.80) vs. 0.58 (0.30, 0.94), EO (×109/L):0.00 (0.00, 0.01) vs. 0.03 (0.01, 0.09), PLT (×1012/L): 89 (47, 148) vs. 126 (82, 186), all P < 0.05]. The NLR in the death group was significantly higher than that in the survival group [17.09 (7.60, 33.51) vs. 12.86 (6.51, 24.85), P < 0.05]. There was no significant difference in the WBC, NEU, BA, Hb and PCT between the two groups. ③ It was shown by ROC curve analysis that the maximum area under the ROC curve (AUC) of EO was 0.755. When the best cut-off value was 0.015×109/L as a predictor of death in 28 days, the sensitivity was 80.3%, and specificity was 64.7%. ④ It was shown by survival analysis that the 28-day survival rate in the patients with EO < 0.015×109/L was significantly lower than that of patients with EO > 0.015×109/L [38.3% (62/162) vs. 83.9% (120/143), χ 2 = 56.999, P = 0.000]. ⑤ It was shown by Cox regression that EO was the independent factor for 28-day survival (β = 1.466, χ 2 = 39.535, P = 0.000). Risk of death was 4.331 times greater in patients with EO < 0.015×109/L than in those with EO > 0.015×109/L [hazard ratio (HR) = 4.331, 95% confidence interval (95%CI) = 2.743-6.840]. Conclusions Compared to other parameters in peripheral blood, EO has the best correlation with the prognosis of bloodstream infection. EO is the independent prognostic predictor for 28-day survival.