Research articles in the domestic bilingual teaching on the basis of the status, and presents a stratification analysis of thinking methods,to explore the notion of bilingual teach-ing,and the hierarchical structure of teacher,teaching materials,students,and evaluation of the bilingual teaching,and probe into the reform of bilingual teaching.

Objective To explore the diagnosis and treatment of endogenous adenoma of the duodenal papilla by endoscopy.Methods Between June 2005 and October 2008,eight patients who had dilated common and intrahepatic bile ducts with strictured opening of the papilla and lower segments shown by B-ultrasonography or MRCP,were enrolled in this study. The patients were assigned to receive ERCP and IDUS for diagnosis and treatment. Results In this series,three patients received pancreatico-duodenectomy because of tubulovillous adenoma (two cases) or tubular adenoma (one case) complicated with moderate atypical epithelial hyperplasia; one of the two cases with tubulovillous adenoma was confirmed as having local cancer by postoperative pathological examination,and then received interventional therapy and embolization because of liver metastasis in 3 months; the patient who had tubular adenoma was diagnosed with local signet ring cell cancer after the operation,and was followed up at 6 and 14 months afterwards by physical examination,which showed no abnormalities. Endoscopic snare papillectomy followed by bile duct stenting for drainage was performed on two patients,one of them was diagnosed with tubulo-papillary adenoma after the surgery and then showed recurrent tumor at 6 months,resulting death at 10 months; the other one was confirmed as having tubulovillous adenoma complicated with moderate atypical epithelial hyperplasia,this patient showed no abnormalities during follow-up at 6 and 12 months. Plastic bile duct stent was employed in one patient with severe atypical epithelial hyperplasia,but was replaced by metal stent because of repeated infection of the bile duct. One patient with papillary adenoma was lost to follow-up after bile duct stenting for intradrainage. One patient refused any treatment for the tubular adenoma; follow-up by phone showed no abnormality in this case in 12 months.Conclusions Endogenous adenoma of the duodenal papilla is rare detected. The tumor is very likely to turn to malignant. Multi-point biopsy is necessary for the patients with hyperplasia of the mucosal and muscle layers.

Objective To explore the endoscopic features and careinoembryonic antigen (CEA) ex-pressions of colorectal serrated adenomas (SA). Methods From June 2005 to July 2008, 27 patients with colorectal polyps and 26 cases of advanced colorectal cancer (ACC) were enrolled in the study. The pit pat-tern of the suspected lesions were observed with 0. 4% indigo carmine sodium stain and classified according to Kudo classification. The polyps were removed by biopsy, high-frequency electrical excision or endoscopic mucosa resection and the samples of ACC were collected with biopsy forceps. All specimens underwent rou-tine pathological examination and CEA expression was detected by immunohistochemistry. Results There were 47 SAs and 27 other types of polyps in polyp group. Most SAs located in left-side colon and were char-acterized by the bulge semipedunculation. The diameters of 45 serrated adenomas ranged from 3 to 8ram, and the maximal diameter of other 2 were more than 10ram. The most common type of pit pattern in SA was mixed type Ⅱ and ⅢL, with type Ⅱ predominant in a certain percentage. Expression of CEA in SA glands was significantly higher than that in proliferative polyps (P < 0. O1). Candnsion SA is an unique type of colorectal adenoma, which is capable of expressing CEA, and displays malignant potential and deserves great attention.

Objective To evaluate the effectiveness of autologous platelet-rich gel (APG)in the repair of diabetic foot ulcers.Methods This study was a single-center,prospective,randomized controlled trial.A total of 60 patients with diabetic foot ulcers (Wagner grade 2 - 3 )were randomly divided into autologous APG group (treatment group)and recombinant bovine basic fibroblast growth factor gel group (control group).After 8 weeks, we compared wound healing rate and wound healing time at five levels (overall ulcer,superficial ulcer,sinus ulcer, Wagner 2 and Wagner 3)in the two groups.Results In APG treatment group and control group,the healing rate of overall sample ulcer (93.33% vs .63.33%,P =0.005),sinus ulcer (84.62% vs .36.36%,P =0.033),Wagner 3 (81.82% vs .30%,P =0.030)differed significantly,but did not significantly differ in superficial ulcer (100%vs .78.95%,P =0.106)or Wagner 2 (100% vs .80%,P =0.106).Ulcer healing time was 31 d vs .41.5 d,23 d vs .32 d,32 d vs .56 d,25 d vs .32 d,38 d vs .56 d,with significant difference between the two groups (P <0.05). Conclusion Autologous platelet-rich gel can effectively increase the curative rate of diabetic foot and shorten healing time.

Objective To develop a method of detecting dry blood spot (DBS) samples collected in the filter paper by using Surface Enhanced Raman Spectroscopy (SERSp,also known as Raman molecular fingerprint spectrum) technology.The possibility and reliability of applying the technology to the newborn screening of congenital hypothyroidism (CH) was investigated.Methods The case-control study was used.The results of CH-hTSH screening test based on the DBS samples collected in the filter paper,and the clinical diagnosis were all provided by neonatal screening center of Shanghai Children's Hospital.The results of SERSp analysis were provided by Dalian University of Technology.Six positive and six negative samples,which were confirmed respectively by CH-hTSH screening using time resolved fluoroimmunoassay (TRFIA) were chosen.With the spectrum lines of 725 cm-1 as internal standard,the SERSp from the aqueous solution of these samples were analyzed.The specific spectrum line analysis,the principal component analysis (PCA) and the scatter diagram of PCA were used to compare the results of TSH test.Results With the spectrum lines of 725 cm-1 as internal standard,the CH specific spectrum lines of 1373 cm-1 and 1400 cm-1 were discovered.They showed the most significant difference of the peak height between the positive and negative samples of CH,while TSH specific spectrum lines of 785 cm-1,827 cm-1 and 853 cm-1 failed to distinguish positive from negative samples with distinct peak height.The consistency between the results of CH-Raman Screening and CH-hTSH Screening was 91.7％ (11/12),which was proven by PCA,the scatter diagram of PCA and the specific spectrum line analysis.The sensitivity of CH-Raman Screening was 100％ and the specificity was 83.3％.Conclusion There is a new CH-Raman Screening method using the SERSp analysis,which was proven to be a promising technology in the newborn screening of congenital hypothyroidism with the DBS in the filter paper.

Objective To investigate effect of sitagliptin ( SIT) on the expression of inducible nitric oxide synthase ( iNOS) and nitric oxide ( NO) in type 2 diabetic nephropathy.Methods 30 rats were randomly divided into normal group (NC group), diabetic nephropathy group (DN group) and sitagliptin treatment group (SIT group).The type 2 diabetes mellitus (T2DM) rats were induced by a high fat diet (HFD) plus repeated low dose streptozocin (STZ) injections.At the end of the 12th week in treatment,there were 6 rats in each group, the NO level was determined by Griess method.mRNA levels of iNOS RT-PCR was detect ed by.The expression of iNOS protein was detected by western blot and immunohistochemical method. ResuIts Compared with the NC group, the expression of iNOS and NO of DN group increased significantly.However, compared with DN group, the expression of iNOS and NO of SIT group decreased significantly.ConcIusion SIT can decrease the expression of iNOS and NO, which implies SIT may protect the type 2 diabetic kidney.

Objective This preliminary study aimed to investigate relevant factors of the metacognition of peri?menopausal women. Methods Total 66 perimenopausal women voluntarily participated in this study from October 2012 to July 2013. The Metacognitions Questionnaire 30-item version (MCQ-30) was used to assess metacognition from 5 di?mensions including cognitive confidence (F1), positive beliefs (F2), cognitive self-consciousness (F3), uncontrollability and danger (F4), and need to control thoughts (F5). Eysenck Personality Questionnaire was utilized to measure the person?ality characteristics such as the extraversion/introversion (E), neuroticism/stability (N), psychoticism/socialization (P), and lie (L). Depression and its 4 symptom components including core, cognitive, anxiety, and somatic symptoms were deter?mined by Zung Self-rating Depression Scale (SDS). The linear multiple stepwise regression were performed to analyze the relevant factors of each MCQ dimension. Results The education level (β’=-0.229, P=0.035), N score (β’=0.255, P=0.042), and L score (β’=-0.292, P=0.021) were related to F1. The education level (β’=-0.260, P=0.031) and N score (β’=0.248, P=0.039) were predictors of the dependent variable F2. The core depression symptom (β’=-0.251, P=0.037) and anxiety symptom (β’=-0.248, P=0.039) of SDS were negatively related to F3. Predictors of F4 were the body mass in?dex (β’=0.211, P=0.048) and L score (β’=0.511, P<0.0001). Only P score (β’=0.299, P=0.015) was related to F5. Con?clusion The metacognition level of perimenopausal women is affected by a variety of factors such as personality character?istics and education level, and low self-consciousness and lack of confidence to the cognitive process may be involved in the increased susceptibility to depression.

Objective To analyze the clinicopathological characteristics and prognosis of different subtypes of breast cancer patients with bone metastasis.Methods For this study, we recruited 300 primary breast cancer patients with bone metastasis treated at the Department of Oncology, the First Affiliated Hospital of Xi`an Jiaotong University, between September 1, 2007 and September 1, 2011.We also retrospectively analyzed their clinical and follow-up data.Results The percentage of Luminal A, Luminal B, human epidermal growth factor receptor-2 (HER-2) overexpression and triple negative subtypes in all the bone metastatic breast cancer patients was 59.0％, 16.0％, 13.7％ and 11.3％, respectively.Age, tumor size and histologic grade significantly differed among the four subtypes (P<0.05).However, there were no significant differences in menopausal status, lymph node metastasis, histological type or lymphovascular invasion among different subtypes (P>0.05).The median survival time of Luminal A breast cancer patients with bone metastasis was 28.6 months, longer than Luminal B (26.9 months), HER-2 overexpression (20.9 months) and triple negative breast cancer patients (12.0 months) with bone metastasis.The overall survival significantly differed among the patients with four subtypes of breast cancer.Conclusion Different subtypes of breast cancer patients with bone metastasis have different clinical characteristics and prognosis.Luminal A breast cancer patients with bone metastasis have better prognosis whereas triple negative subtype has poorer prognosis.

Aim To study the effects of Free Anthra-quinone from Rhubarb (FAR)on myocardial CTGF and collagen expression and interstitial fibrosis in dia-betic rats.Methods The male SD rats were randomly divided into normal group (CON),diabetic cardiomy-opathy group (DCM) and FAR treatment group (FAR).Streptozocin was intraperitoneally injected in-to the animals in the latter 2 groups to induce diabetic rat model.The model was expected to be stable for 2 weeks before the treatment.At the end of the 8th week in treatment,fasting plasma glucose and heart mass in-dex were measured.Masson staining was used to ob-serve the myocardial fibrosis.RT-PCR was used to de-tect the mRNA levels of CTGF,procollagen type Ⅰand collagen type Ⅲ.Immunohistochemical method was used to detect the content of CTGF.ELISA was used to detect the depositions of collagen type I and collagen type Ⅲ. Results Compared with CON group,fasting plasma glucose,heart mass index,the degree of myocardial fibrosis,and the expressions of CTGF,collagen type I and collagen type Ⅲ in left ven-tricular myocardial tissue of DCM group were signifi-cantly increased. However, compared with DCM group,fasting plasma glucose,heart mass index,the degree of myocardial fibrosis,and the expressions of CTGF,collagen type I and collagen type Ⅲ in left ven-tricular myocardial tissue of FAR-treated rats were sig-nificantly decreased.Conclusion FAR retards the process of myocardial fibrosis in diabetic rats by down-regulating the expression of CTGF,reducing the syn-thesis and depositions of collagen type I and collagen type Ⅲ.

Objective To understand the status quo of stressors and mental health of undergradu-ates of local medical colleges in internship and provide relevant countermeasures so as to provide scientific reference for psychological health counseling for them. Methods The stress source scale and mental health symptom self-rating scale for medical students in internship (SCL-90) coded by Chang Lirong et al was adopted to investigate. The questionnaire survey was conducted on the stress and mental health status of 390 interns in Binzhou Medical College, and 384 valid questionnaires were collected, with the effective rate of recovery as 98.46%. The questionnaire results were analyzed by sample t test, variance analysis and Pearson correlation analysis. Results A total of 24.1% of students in local medical schools were under moderate pressure (1.17±0.63). The highest pressure source was examination and employment (1.58±0.74), and the other followed were knowledge and skills (1.43 ±0.68), interpersonal relationships (1.11 ±0.54), patients (1.06±0.53), medical conditions (1.00±0.53) and work load (0.95±0.52) respectively. The scores of various stressors were significantly and positively correlated with most of the mental health factors. Conclusion The undergraduates of local medical colleges and universities are generally under stress in internship, which would affect their mental health. It is suggested that the interns should be guided from the aspects of employment, study and psychology so as to help them relieve their stress and develop good psychological qualities.