During years of managent practice of postgraduate training,it is found that great attention of leadership is a good foundation,that pre-service training is an essential part,that srtict implementation of the requirements on postgraduate,advisor-responsibility system unified instruction under subject,focusing on process-management of training and exploring actively effective incentive training methods is necessary.

Objective To understand the status of soil-transmitted nematode infections,as well as the awareness and healthy behavior on soil-transmitted nematodiasis in rural residents of Dezhou City. Methods Six villages were selected according to the stratified sampling method;the permanent resident population aged 3 years or above was determined as the investigation objects. The modified Kato-Katz technique was adopted to detect the eggs of Ascaris lumbricoides,hookworm and Trichuris trichiura in the feces of the residents,and the method of cellophane anal swab was used to detect the Enterobius vermicularis infection in children under 12 years old. More than 50 households in each investigated site were randomly selected to investigate the awareness status on nematodiasis prevention and treatment and the condition of healthy behavior formation. Results A total of 2 294 residents were detected by Kato-Katz methods,11 of them were positive,and the total infection rate of soil-transmitted nematodes was 0.48%. To-tally 260 children were detected and 40 were infected with E. vermicularis,and the infection rate was 15.38%. A total of 898 resi-dents were investigated in the household survey and the awareness rate of nematodiasis prevention and treatment was 44.99%,the proportion of residents with healthy behavior was above 70%. Conclusions The infection rate of soil-transmitted nematode is low in rural areas of Dezhou City,but the infection rate of E. vermicularis in children is higher. The condition of healthy behavior forma-tion is satisfying,but the awareness rate of nematodiasis prevention and treatment of the residents is low. Therefore,the control measures as well as healthy education still should be strengthened.

Objective To investigate the relationships between the level of heat shock protein (HSPs) 70 and severity of sepsis in order to find its effects on the status of sepsis and the prognosis of the patients. Methods In total, 120 patients diagnosed to be suffering from sepsis from the emergency department were selected as studying subjects. According to SAPS Ⅱ score, all of these patients were divided into mild, moderate and severe groups (n =40 in each group) , and at the same time, 40 healthy volunteers were studied as controls. The levels of intracellular HSPs70 in peripheral blood neutrophil cells in the mild, moderate and severe groups were determined by using flow cytometry, while serum levels of procalcitonin (PCT) and C-reactive protein ( CRP) were measured as well. Results ① The levels of heat shock proteins HSPs70 in neutrophil cells and PCT in patients with sepsis escalated gradually with the increase in SAPS Ⅱ score, and there were significant different among the mild, moderate, and severe sepsis groups(P<0.05). ② In all septic patients, the death happened only in the severe group. Compared other markers in the survivals , the level of heat shock protein HSPs70 was significantly higher in fatal patients. ③ In curve plot analysis in the patients with sepsis done by the curve of receiver operating characteristic (ROC) , the area of HSPs70 in neutrophil cells under the curve was significantly larger as compared with that of PCT and CRP. Conclusions Heat shock protein HSPs70 has a certain clinical value in determining the severity of disease and prognosis of patients suffering from sepsis.

Objective To study the changes in interleukin-32 (IL-32) in rats with Klebsiella bacillus pneumonia and approach its significance. Methods Seventy-two Sprague-Dawley(SD)rats were divide into control group,model group and experimental group by the method of random digits table,then the experimental group was subdivided into 4 hours and 1,3 and 5 days experimental subgroups(each n=6). The rat model of Klebsiella bacillus pneumonia was established by injection of 0.3 mL Klebsiella bacterial suspension into the trachea. Before the establishment of the model in the experimental group,IL-32 inhibitory agent,protease activated receptor-2(PAR2) was injected into the abdominal cavity. After model establishment,at different time points,blood was collected via tail vein to observe the changes in serum levels of IL-32,tumor necrosis factor-α(TNF-α),IL-6 and IL-8 in all the groups. The lungs were removed and stained with hematoxylin-eosin(HE)method to investigate the histopathological changes of the lung tissues under the light microscope. Results Compared to the control group, with the prolongation of time the levels of IL-32,TNF-α,IL-8 and IL-6 were increased gradually in the model group,and reached their peaks at 3 days〔IL-32(ng/L):84.40±28.24 vs. 18.57±3.86,t=5.544,P=0.002;TNF-α(ng/L):79.27±14.64 vs. 17.82±3.86, t=9.994, P=0.000;IL-8(ng/L):55.85±10.90 vs. 16.66±3.76,t=8.544, P=0.000;IL-6(ng/L):56.65±2.57 vs. 28.48±2.11,t=19.693,P=0.000〕;PAR2 could inhibit above indexes significantly,there was statistical difference at 3 days compared with the model group〔IL-32(ng/L):54.13±6.68 vs. 84.40±28.24,t=2.560,P=0.046;TNF-α(ng/L):49.12±3.56 vs. 79.27±14.64,t=4.901,P=0.003;IL-8 (ng/L):22.95±2.52 vs. 55.85±10.90,t=7.204,P=0.000;IL-6(ng/L):36.49±2.63 vs. 56.65±2.57,t=13.443, P=0.000〕. Under the light microscope,the inflammatory changes in the lung tissue in experimental group were milder than those in the model group. Conclusion As a pro-inflammatory cytokine,IL-32 can induce the production of TNF-α,IL-6 and IL-8,and the inhibition of IL-32 production may play a role in suppression of the development of Klebsiella bacillus pneumonia.

Objective To evaluate value of multi-indexes of real-time myocardial contrast echocardiography (RT-MCE) for the detection of coronary artery disease(CAD). Methods A total of 35 patients scheduled for coronary angiography underwent RT-MCE, and were undergone gated single photon emission computed tomography(gated-SPECT) after RT-MCE shortly. Coronary angiography was performed within one week of RT-MCE in all patients. All patients were divided CAD and no-CAD group. The observing indexes included: (1)The images of RT-MCE were analyzed quantitatively from microbubble replenishment curves for myocardial perfusion by using the Qlab software; A,β and A×β were compared between two groups. The sensitivity and specificity of RT-MCE for detection of CAD were performance by ROC curves Gensini score were calculated in 22 patients. Then the correlation analysis was used for comparing the value of A,β and A×β with Gensini score. (2) The sensitivity and specificity of gated-SPECT and RT-MCE for assessment of CAD were calculated by 4 score method. (3) RT-MCE for the detection of coronary artery stenosis with multi-indexes. Results (1) A,β and A×β were significant difference between two groups. The cutoff of A,β and A×β was 4. 58,0. 64 and 2. 73,then the sensitivity and specificity of RT-MCE for detection of CAD were 86. 0% , 80. 2% , 88. 9% and 84.1 % , 64. 6% , 79. 9 % , respectively. The correlation index was - 0. 79, - 0. 51 and - 0. 76 comparing the results of A, β and A ×β with Gensini. (2) The sensitivity and specificity of gated-SPECT for assessment of CAD were 84. 8 % and 82. 7% ,respectively. (3) The sensitivity of multi-indexes RT-MCE increased, the sensitivity was 89. l%,90. 4% and 96.3% when combinated A and β,A and A×β,and β and A×β, respectively. Conclusions RT-MCE with multi-indexes has a valuable application for assessment of CAD. The severity of CAD could be evaluated by RT-MCE.

AIM: To analyze the polymorphic expression of UDP-glucuronosyltransferase UGT1A gene locus in human colorectal epithelium. METHODS: Colorectal tissue samples were obtained from 40 patients with colorectal cancer and 20 normal controls. The levels of UGT1A transcriptions were detected by RT-PCR, exon-1 specific RT-PCR. UGT1A proteins were measured by Western blotting analysis. RESULTS: (1) UGT1A mRNA expression was found to be significantly down-regulated in colorectal cancer tissue as compared with the surrounding healthy tissues (P

Objective To investigate the effects of puerarin(Pur)on myocardial perfusion and ventricular wall motion in patients withacute coronary syndrome(ACS).Methods Thirty-seven patients with ACS were randomly divided into two groups:conventionaltreatment group(n=17,11 males,range of age:32-80 years,average age:60.9±4.9 years)and Purtreatment group(n=20,12 males,rangeof age:40-76 years.average age:62.7±3.5 years).Patients in the conventional treatment group received standard treatment according tothe current guidelines,while patients in the Pur treatment group received intravenous administration of Pur(500 mg/day)for 10 daysplus conventional treatment.Real-time myocardial contrast echocardiography (RT-MCE) was performed to evaluate the change inmyocardial perfusion index (MPI)and veiltricular wall motion index(VWMI)at admission and 10 days after treatment.Results At10 days after treatment,MPI was significantly higher(P＜0.01)and VWMI significantly lower(P＜0.01)in the Pur group comparingwith those in the conventional group.Conclusions Puerarin might improve myocardial microcirculation perfusion and ventricularwall motion in patients with ACS.

Objective To investigate the genotype and mutation frequency of thalassemia in child patients of Shenzhen region so as to provide evidences for the gene diagnosis and genetic counseling of thalassemia.Methods A total of 1 206 child patients suspected with thalassemia were retrospectively analyzed.The gene deletion of α-thalassemia was detected by Gap-PCR.The point mutations of α-thalassemia and β-thalassemia were determined by reverse dot blot(RDB)-PCR.The specimens suspected with HKαα and rare gene mutations were determined with nested PCR and gene sequencing,respectively.Results The detection rate of thalassemia was 76.9％ (927/ 1 206).Among them,α-thalassemia accounted for 40.5％ (489/1 206),and--SEA/αα was the most common gene mutation(75.1％);β-thalassemia accounted for 33.7％ (406/1 206),and the main IVS-2-654 (C→T) and CDM1-42 (-TCTT) heterozygous mutations accounted for 35％ and 32.5％,respectively.In addition,there were 32(2.7％) β-thalassemia patients with α-thalassemia mutation,1 patient with HKαα/ααQS,1 α-thalassemia patient with CD61 (AAG→TAG)/--SEA and 1 β-thalassemia patient with CD5 (CCT→C).Conclusion The are complicated gene mutation types and rare gene mutations of thalassemia in child patients of Shenzhen region.

AIM:To investigate the effects of Akt1 gene transfection into myocardium after ischemia-reperfusion (I/R) on mitochondrial permeability transition. METHODS:Forty adult male SD rats were divided randomly into five groups with 8 rats each:control group,I/R group,Ad-gene group,Ad-blank group and Ad-inhibitor group. The rats in Ad-gene group were injected with 30 μL Lipofectamine 2000 solution including Akt1 gene to the myocardium 48 h before ischemia while those in control group and I/R group were injected with PBS of the same volume. Rats in Ad-blank group were injected with Lipofectamine 2000 of the same volume into myocardium. In Ad-inhibitor group 30 μL Lipofectamine 2000 and gene complexes with LY294002 were injected. Hemodynamics,apoptotic index,the concentrations of lactate dehydrogenase,creatine kinase,the expression of Akt1,cytosolic,mitochondrial cytochrome C and MPT were also measured. RESULTS:The lowest level of Akt1 protein expression was observed in control group. The protein expression of Akt1 in Ad-gene group was higher than that in I/R group,Ad-blank group and Ad-inhibitor group. The AI,LDH and CK in Ad-gene group were significantly lower than those in other groups except control group. Transfection of Akt1 markedly reduced the loss of mitochondrial cytochome C after I/R injury. Ad-gene transfection led to a significant increase in absorbance at 540 nm compared to I/R group,Ad - black group and Ad-inhibitor group (P<0.05). CONCLUSION:Akt1 gene prevents myocardial apoptosis after I/R injury. Akt1 gene also inhibits the opening of mitochondria permeability transition and protects mitochondrial functions of myocardium in I/R injury.

Objective:To investigate the understanding of cancer pain by medical doctors and its therapeutic status in Shanghai. Methods:We recruited 1 982 medical physicians from 106 secondary and tertiary hospitals in Shanghai city from January to March in 2007. The understanding and the therapeutic status of cancer pain were investigated by conducting a questionnaire survey and the results were statistically analyzed.Rusults:There were 52.3% physicians who believed that they understand the treatment protocol of the Three-step Analgesic Ladder regimen. The rate increased by 21.6 percentage point compared with the results in 1999. The understanding degree of oncologists was significantly better than non-oncologists. There were 16.8% physicians giving the correct answers on the three main principles of the dosage titration in analgesic management. The correct rate of oncologists was significantly higher than that of non-oncologists. Opium with strong analgesic effect had become the first choice for severe cancer pain, and the use of pethidine (Dolantin) for severe cancer pain decreased significantly.The pain was significantly relieved in 74.8% patients. The pain-relieving rate increased by 25.4 percentage point compared with the results in 1999. There were 81.1% medical doctors confirming the effect of pain treatment and among them oncologists were more optimistic to therapeutic outcome than others. There were 93.3% physicians who agreed that it was necessary to carry out the standardized training of cancer pain treatment and the requirement of non-oncologists were much emergent. The over-strict controls by the hospitals and the regulations were the main obstacles for using analgesic drugs.Conclusion:The understanding of medical doctors and the diagnostic and therapeutic levels of cancer pain were improved significantly compared with those in 1999. But more training of cancer pain treatment are still required to publicize the standardized therapy and overcome the obstacles of using analgesic drug.