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.

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 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.

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.

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.

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 establish a method to isolate and cultivate rat bone marrow mesenchymal stem cells (BMSCs),and explore the feasibility of labeling in vitro,and tracing in vivo,BMSCs with chloromethyl-benzamidodialkylcarbocyanine (CM-Dil). Methods BMSCs were obtained and subsequently cultured with whole bone marrow cell culture system,and the third generation of BMSCs was harvested. The positive rates of CD34,CD44 and CD29 were detected by flow cytometry. CM-Dil was used to label BMSCs in vitro and the efficiency of labeling after 24 hours and at day 21 and 30 were examined under fluorescent microscope. Moreover,the growth curves were sketched to determine the negative effects of CM-Dil on the vitality and proliferation of BMSCs cultured in vitro. Rat model of focal cerebral ischemia was reproduced,CM-Dil labeled BMSCs were implanted into corpus striatum of rats' brain with computer-guided stereotaxis thereafter. Brain tissues were obtained to prepare frozen sections at 7th,14th and 21st day post-implantation,and the survival and distribution of labeled cells were observed with fluorescent microscopy. Results The third generation passage of cultured BMSCs grew orderly,with shape of desmocytes,and homogeneous in morphology. The positive rates of CD34,CD44 and CD29 expressions in BMSCs were 1.71%,80.32% and 84.89%,respectively. Red fluorescence was observed in CM-Dil labeled BMSCs in vivo 24 hours after labeling,with a positive rate of 100%. The fluorescence intensity of passage cultured BMSCs observed on day 21 was similar to that observed at 24 hours after labeling,but diminished on day 30. The growth,proliferation and morphology of BMSCs,were not influenced by CM-Dil labeling. On day 7,14 and 21 post-implantation,BMSCs decreased in quantity,appearing in oval or irregular shapes,and most of the cells were found around the needle tract,with a tendency of diffusion to peripheral area. Conclusion High purity of BMSCs may be obtained with whole bone marrow cell culture system from bone marrow of rats. CM-Dil labeling is easy to handle and effective,with no cytotoxicity to cells. The latest labeling period of CM-Dil is 21 days in vitro,therefore it seems to be an effective method for in vivo tracing of BMSCs in brain after implantation.

Objective To do the environmental impact assessment for the water supply project of Mopan Mountain Reservoir in Harbin. Methods To collect the related data and to do the field-investigation and inspection in epidemiology, animals and insects, environmental quality sanitization and water quality, etc in the area of Mopan Mountain Reservoir and the surroundings. Results The main infectious disease in the development area of Mopan Mountain Reservoir was at the lower prevalence level and there was no fatal infectious disease such as plague , cholera in the recent ten years. Besides, there was no grievous public health emergency. There were no factories and collieries emitted poisonous chemical material in the catchment area. The results of water quality investigation showed that all the indexes were up to the related standards. Conclusion Monpan Mountain Reservoir project is not ease to cause the infectious diseases spread by water among the people. The water quality can meet the request for water source. The reservoir will not influence the ecological environment when the latent environment pollution factors are under control.