Clinical medicine is a practical discipline.Students combine theoretical knowledge with practical operation and develop clinical thinking at stage of clinical practice.From the perspective of education administration,a series of measures were carried out throughout the whole teaching in clinical internship in our university.Students were trained to gain the abilities of combing knowledge with practice,analyzing and solving issues individually and thinking logically and scientifically.Through years of research and practice,remarkable achievements were gained and both clinical skill and comprehensive quality of our students were greatly enhanced.

Objective To investigate the value of fasting plasma glucose (FPG) in 75 g oral glucose tolerance test (OGTT) on the diagnosis of gestational diabetes mellitus (GDM).Methods Data of 6516 pregnant women who accepted prenatal cares from Beijing Obstetrics and Gynecology Hospital,Capital Medical University between Jan.2010 and Dec.2010 were collected.All patients had normal FPG at first trimester,and accepted 75 g OGTT after abnormal 50 g glucose challenge test (≥7.8 mmol/L).According to the result of OGTT,they were divided into 12 groups,and Chisquare test was used to analyze the role of FPG of OGTT in GDM diagnosis.Results According to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria,15.0％ (980/ 6516) of this group of pregnant women was diagnosed with GDM by FPG (≥5.1 mmol/L) of OGTT in this study.Then,the rest 5536 pregnant women with normal FPG of OGTT were divided into 12 groups according to FPG level (FPG level interval 0.1 mmol/L).As FPG level rose,the incidence of GDM also rose (X2 =282.175,P =0.000).Similar results also appeared when the interval was 0.2 mmol/L and the FPG level was between 4.0 and 4.8 mmol/L (X2 =274.364,P=0.000).When FPG level was lower than 4.2 mmol/L(22.1％,1226/5536),the incidence of GDM diagnosed by OGTT was 3.6％ (44/1226).And when FPG level of OGTT was higher than 4.8 mmol/L,the incidence of GDM was 26.2％ (298/1138).Conclusions FPG screening is recommended between 24 and 28 gestational weeks before OGTT,and GDM low-risk women whose FPG ≤4.2 mmol/L do not need OGTT.

Objective To evaluate CT virtual cystoscopy (CTVC) in the diagnosis of bladder tumor. Methods 22 cases of bladder cancer were examined by spiral CTVC with intravenous injection of 60% urografin or omnipaque.The images obtained were compared with that observed on coventional cystoscopy and operation. Results Based on CTVC images and transverse section images of CT,tumors were classified as 3 catogories:(1)superficial papillary tumor.(2)tubercular mass papillary tumor.(3)infiltrated tumor.Of the 22 cases examined with CTVC,18 were papillomas,11 tubercalar mass papillomas and 1 infiltrated tumor.The smallest was 3.0 mm in diameter.CTVC findings have been similar to those observed on conventional cystoscopy and operation. Conclusions CTVC,a new,noninvasive,safe and useful technique,can correctly demonstrate the details of surface of bladder tumor when the latter was greater than 3.0 mm. It could show the normal or abnormal mucosal folds and the relationship of the tumor to the ureteral orifices and the bladder neck.CTVC my be helpful in the choosing of management,in the clinical staging and diagnosis of bladder tumor.

AIM: To establish an HPLC-MS for determining seven bioactive components,including vanillin ferulaic acid,ligustrazine,senkyunolid I,H,and A,and ligustilide in Ligusticum chuanxiong Hort. . METHODS: The bioactive components were extracted by ultrasonic method,and then were separated by reverse HPLC,and finally were determined by the multiple reaction mode of MS. RESULTS: The detected limits of the seven bioactive components such as vanillin were 40,20,80,20,10,60 and 50 ng/mL,respectively. Their linear range were 1450,4-490,1-625,2-360,2-700,1-244 and 21-210 ?g/mL,respectively. The average contents of the above components in Ligusticum chuanxiong Hort. were 0. 12,0. 25,0. 41,0. 99,0. 30,8. 96 and 11. 25 mg/g,respectively. CONCLUSION: The proposed method has the characteristic of simplicity,rapidty and high sensitivity. It could be used in analyzing the whole components of Ligusticum chuanxiong Hort. .

Objective To investigate the risk of heart failure to the mother and the neonate.Methods The clinical data of 30 pregnant womem with heart failure from January 1993 to December 2010 from Capital Medical University Tongren Hospital was retrospectively analyzed.Results Of the 30 patients,there were 12 affected with congenital heart disease (40％) ; 9 with rheumatic heart disease 30％,7 with heart failure in pregnancy-induced hypertension 23％.Heart failure appeared at the average of (34.20 ± 4.25) weeks in pregnancy.The average terminal time of pregnancy was (34.84 ± 2.17) weeks.The rate of early birth was 73.33％.The average birth weight was (2011 ±568) g,with 7 babies less than 2000 g.No death occurred in both new the mother and the neonate.Condusion The main causes of heart failure in pregnancy are congenital and rheumatic heart disease and pregnancy-induced hypertension.For those heart failure occurs before 30 weeks,it is the first selection that pregnancy shoud be terminated; For those occur after 30 weeks,active treatment should be performed to improve maternal heart function and promote fetal maturity.Apropriate threatment during per-cesarean section may decrease the case fatality of the mother and neonate.

Objective To study the effect of dexamethasone on pulmonary fibrosis model induced by bleomycin in rats and the expression of STAT1 and PDGF in lung tissue,and to discuss the possible mechanism.Methods Forty-five Wistar rats were randomly divided into three groups(15 in each group).They were dexamethasone group(DXM group),bleomycin group(BLM group) and control group(NS group):① The DEX group were intratracheally instilled with belomycin(BLM)(5mg/kg,in 1ml 0.9% NaCl solution),and then were treated with dexamethasone 3mg/kg via celiac injection daily;② BLM group were intratracheally instilled with BLM(5mg/kg),and then were treated with saline 3mg/kg via celiac injection daily;③ NS group were intratracheally instilled with saline(5mg/kg),and then were treated with saline 3mg/kg via celiac injection daily.Five rats in each group were sacrificed at 7,14,and 28 days after intratrachel instillation.Histological changes of the lungs were evaluated by HE stain.The bronchoalveolar lavage fluid(BALF) of right lung was gotten and the cells counting as well as differentiation were figured out.The expression of STAT1 and PDGF protein was assessed by immunohistochemistry.Results(1) The total number of inflammatory cells in BALF in BLM group was the highest at day 7 and diminished at day 14 and 28,which was significant different compared with that of the NS group(P

OBJECTIVE To ensure the lustration of atmosphere in the admixture room of pharmacy intravenous admixture service(PIVAS).METHODS We adopted strict nosocomial infection administration in PIVAS management and maintenance of the cleaning procedure.At the same time,we taken disinfection measurement and management of the staff,articles and operation criteria strictly.RESULTS Every supervision items had reached the government standards since the PIVAS was put into clinical use 3 years ago and the intravenous infusion reactions had not happened.CONCLUSIONS These administration measures can ensure the lustration of atmosphere to reach the standard effectively.

OBJECTIVE To save the acute radiation sickness patients by preventing nosocomial infection and implementing environment protection of the wards.METHODS The results of air and the object surface in the wards,the workers′ hands detecting and sampling after improving environment protection were compared with those four days before improving it.RESULTS The problems were solved by the improverent of the new systems,rigorous training of the workers,air disinfecting,object surface management and their working process.CONCLUSIONS Discovering problems,seeking causes and solutions and the standardized administration of the environment in the wards are important to save the acute radiation sickness patients by environment protecting and keep safety of patients.

OBJECTIVE To improve the quality of venous infusion and reduce the incidence of hospital infection.METHODS We analyzed the factors of hospital infection resulted from venous infusion.RESULTS The main factors were pollution or degeneration of the liquid,over standard of the bacterial number in prepared or infused environment,disobeying the operating instruction of venous infusion and unsuitable operating method.CONCLUSIONS The measures to prevent hospital infection are holding the key step of venous infusion,constructing and executing the management system of sterilization and isolation,reducing the chance of bacterium pollution,paying attention to the sterile operation through venous infusion,fostering the well working style and improving the links of infusing operation.We reduced the infusion reaction and the incidence of hospital infection effectively.

ObjectiveTo investigate the safety, efficacy and therapeutic mechanism of focused ultrasound surgery (FUS) on focal epilepsy of brain functional area in cat. MethodsThe focal epileptic models in the cats' motor cortex by penicillin were established. The different techniques were apphed in the animals epilepsy model. FUS, cortex thermocoagulation and multiple subpial transaction (MST) were compared in seizure control and functional preservation by observing behavior and electroencephalogram ( EEG), and the therapentic mechanism was compared by analysis of histopathology in the damaged cortex. ResultsIn seizure control and EEG changes, three kinds of techniques were similar without prominent difference in statistics (P ＞ 0.05). The same pathologic changes were showed in FUS group and cortex thermocoagulation group, ischemic change and coagulative necrosis of superficial layer nerval cells.The major pathologic change in MST group was an irregular crevice which was vertical with the surface of the cortex. The edema and mild gliosis were found around the crevice. ConclusionsThe focused ultrasound can effectively destroy and cut off the association of cortical horizontal fibre, meanwhile, the cortical function still to be reserved.Therefore, FUS is safe and effective as well as MST and cortex thermocoagulation on focal epilepsy in brain functional area.