Objective To analyze risk factors of vascular disease in the lower limbs in type 2 diabetes patients.Meth- ods Investigating the lower limb vein of 80 type 2 diabetes patients with Siemens G-50 color Doppler ultrasonograph, and recording their age,sex,course of disease,and blood pressure,at the same time,take some tests as follows: FBG,P2hBG,FIN,C-peptide HbA_1c,Tch,UAE.Results Compared to the control group,blood pressure, FBG,P2hBG,Tch,TG,HbA_1c,Tch,UAE of the type 2 diabetes patients with lower limb vascular disease,are all increased significantly(P

Objective　To evaluate the efficiency of low molecular weight heparin(LMWH, fraxiparine) given as a single predialysis bolus injection with reused dialyzers in comparison with standard heparin(SH) administered with a continuous infusion. Methods　30 hemodialysis patients were studied in a radomized crossover fashion. Dialyzers fibrer bundle volumes(FBV), predialysis hemocrit and 2 h clearance of urea, creatinine were observed in the first, the fourth dialysis. The plasma heparin activities(anti-Fxa levels) were measured by the chromogenic substrate assay in 0 h, 2 h, 4 h of dialysis. Results　Significant increase (P<0.05) was seen in the number of dialyzer reuse in LMWH group compared with SH group; there was not significant decrease in dialysis FBV as well as 2 h clearance of urea, creatinine (P>0.05); in addition, the plasma heparin activity(anti-Fxa levels) were comparable in both groups after 2 h of dialysis, however, they were significantly higher after 4 h in the LMWH than those in the SH group (P<0.05). Conclusion　LMWH as a single bolus dose can prevent decrease in dialyzer clearance. It is clinically worthy of further popularity.

Background and purpose:The skeleton is one of the most common sites of metastasis in patients with lung cancer.Bone metastases often cause poor prognosis.It is important to early detect bone metastases.Therefore,we planned a retrospective study to investigate the role of radionuclide bone scanning with 99mTc-MDP in detecting bone metastases in lung cancer patients.Methods:It was a retrospective analysis.400 patients with lung cancer diagnosed in our hospital from 2005.5 to 2007.5 were recruited.Using 99mTc-MDP bone scanning,we analyzed the symptoms,sites,numbers,pathological types and TNM stages of bone metastases.Results:Ostealgia was the most frequent symptom in lung cancer patients with bone metastases.The sites of bone metastases were:thoracic bones(41.52%),vertebras(32.31%),pelvic bones(15.89%),extremities(8.68%),skull(1.60%).126 patients had multiple bone metastases(80.25%).There was a statistical significance of bone metastases in adenocarcinoma patients(48.09%)compared with in squamous cell carcinoma patients(33.33%)(P

Objective To probe into application of clinical pathway on clinical practice teach-ing in thoracic surgery , and evaluate its effect . Methods 76 students were randomized into two groups: 35 students who accepted clinical pathway teaching were the experimental group, they were asked to carry out clinical practice in accordance with the teaching pathway;and the other 41 students were control group. The final examination included four parts: ①theoretical examination account for 20%of the total score. The test paper was randomly combined from the standardized question bank of Xinjiang Medical University, and this test included single choice questions and fill-in questions; ②clinical operational skills test account for 30%of the total score. This part included pleural puncture, dressing change, stitches remove, incision disinfection and surgical draping, and all of these opera-tions were carried out on medical patient simulators; ③clinical case analysis account for 50% of the total score. This part involved history collection, physical examination, humanistic care, case writing, diagnosis and treatment planning for new admission patients. T-test of independent samples was used to analyze all the scores of the two groups. Results The clinical case analysis score and the total score in experimental group [(42.26 ±3.93) points and (81.69 ±6.16) points, respectively]were obviously higher than that in control group[(38.88±4.76) points and(77.39±6.83) points, respectively];There were significant differences between the two groups(P values was 0.001 and 0.006, respectively). Conclusion Application of clinical pathway in clinical practice teaching may improve the effect of clinical teaching. The pathway contents and evaluation methods should be constantly improved accord-ing to teaching practice.

Objective:The study aims to screen chemosensitivity-associated proteins in colorectal carcinoma tissues by using two-dimensional gel electrophoresis (2-DE) and mass spectrometry,then identify some differentially-expressed proteins. Methods:The patients with advanced colorectal carcinoma were confirmed by clinical diagnosis. Fresh carcinoma specimens were collected by biopsy and preserved in liquid N2. The tissues were classified into two groups: high sensitivity group (HS) and low sensitivity group (LS) based on drug sensitivity test. The total proteins were extracted and separated by 2-DE. The images were composed, compared, and differentially analyzed to identify the proteins with differential expression in HS and LS groups. Then the differentially-expressed protein spots were incised from the gels and digested by trypsin. The peptide mass fingerprintings (PMF) was acquired after matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) and the proteins were identified by data searching in the Mascot database. Two proteins with differential expression were detected by Western blotting.Results:The 2-DE spectrum of HS and LS groups were established. Most protein spots were distributed in the area with pH 4-8 and relative molecular weight of (20-100)×10~3. The average number of the protein spots was 842±23 in HS group and 793±19 in LS group,respectively. The mean matching rate was 90.7%. The number of differentially-expressed dots between HS and LS group was 79.00±13.56. Thirty protein dots were selected for mass spectrum and bioinformatic analysis, and 9 proteins were identified. Conclusion:Colorectal carcinoma with different chemosensitivity had differential protein expression profiles. The differentially expressed proteins may be associated with chemosensitivity and could be used for prediction of chemosensitivity of colorectal carcinoma.

The First Affiliated Hospital of Nanjing Medical University has adopted a strategy of brand development in the process of continuing medical education.Given the different recipients,the First Affiliated Hospital of Nanjing Medical University has established four types of brand-based education modes,namely Jinling high-level forum of clinical medicine,hospital management school,management salon,and clinical case discussion in English.The influence and competitiveness of the brand of hospital continuing education should be elevated through the following methods:adhering to the brand development orientation-to fulfill the public responsibility and cultivate medical talents; establishing appraisal mechanism of continuing medical education; transforming thinking of management department; relying on new media propaganda and expanding domestic and international communication.

Objective:To establish the method validation of microbial limit tests for hospital paste preparations, including com-pound salicylic acid paste, zinc oxide paste and compound pine tar paste. Methods:According to the microbial limit test described in China pharmacopoeia 2010 edition, the method validation of count of bacteria, fungi and yeasts and tests for specified microorganisms was established. Results:Medium dilution method could be used in bacteria, fungi and yeasts count and specified microorganisms ex-amination for compound salicylic acid paste and zinc oxide paste. For compound pine tar paste, bacteria, fungi and yeasts count and the pseudomonas aeruginosa examination could use medium dilution method, while the staphylococcus aureus examination should employ membrane filtration method. Conclusion:The methods of microbial limit tests for the three hospital paste preparations are established, which can be used to control the quality of hospital preparations effectively.

Objective To evaluate the interstital MR lymphography using positive lymphotropic contrast agent for differentiation of metastatic lymph nodes from inflammatory lymph nodes hyperplasm.Methods Eighteen New Zealand white rabbits weighted at 2.0-2.5 kg were used.Inflammatory hyperplastic popliteal lymph node model was established in 9 rabbits by injection of complete freund adjuvant into the interdigitial skin of the dorsal aspect of one hind leg,and tumor-bearing popliteal lymph node model was established in another 9 rabbits by injection of VX~2 tumor cell suspension.The popliteal lymph nodes of another hind leg of all 18 rabbits were assigned to the normal contral group.In each group,every rabbit underwent MR lymphography examination before and after the inoculation.Volumes of 0.2 ml of Gd[DTPA-bis(2-aminoethoxy)ethane]polymeric contrast agent(Gd-poly-DTPA-EOEA)injection were injected subcutaneously into the dorsal feet of both hind legs of two groups of rabbits.T_1-weighted 3D gradient-echo images were obtained,and source images were used to reconstruct images of MIP before and after the administration of agent.The maximum short-axis diameter(MSAD)of each popliteal lymph node was measured on the enhanced 3D MIP images,and the signal-to-noise ratio(SNR)measurement was performed in the largest popliteal node of each rabbit at each time point in delayed scan.Independentsamples t test was used to compare the sizes of popliteal nodes in MSADs between inflammatorily hyperplastic and tumor-bearing nodes after the inoculation,and the values of SNRs of popliteal nodes at each time point between inflammatorily hyperplastic,tumor-bearing and normal popliteal lymph nodes.Imaging results of the popliteal nodes were analyzed and correlated with pathological findings.Results All of the rabbits were successfully inoculated except of the 2 rabbits in tumor-bearing nodal group.The size in MSAD of 13 inflammatorily hyperplastic and 11 tumor-bearing nodes was(1.32±0.14)and(1.33±0.12)cm,respectively.There was no significant statistical difference between the sizes of the two groups(t=0.186,P＞0.05).At the time of 5,15,30,60,90,120 minutes after the injection of the agent,the value of SNR of 9 inflammatorily hyperplastic and 9 contralateral normal nodes was 17.31±0.37 and 17.19±0.29,27.42±0.50 and 27.39±0.48,38.44±0.47 and 38.19±0.27,37.10±0.09 and 36.97±0.10,36.32±0.61 and 36.20±0.80,34.60±0.44 and 34.71±0.32,respectively.There was no significant statistical difference between the values of the two groups(t=0.78,0.14,1.43,1.00,0.36,-0.62,respectively,P＞0.05).The value of SNR of seven tumor-bearing and seven contralateral normal nodes was 6.00±0.22 and 17.21±0.28,7.87±0.16 and 27.17±0.23,8.14±0.24 and 38.16±0.19,8.09±0.28 and 36.94±0.30,7.59±0.20 and 35.96±0.72,7.50±0.14 and 34.81±0.27,respectively.There was significant statistical difference between the values of the two groups(t=-84.00,-182.72,-261.27,-186.48,-100.22,-239.00,respectively,P＜0.01).At each time point,inflammatorily hyperplastic nodes had significantly higher values of SNRs compared to tumor-bearing nodes(t=83.97,174.07,158.49,152.71,96.06,154.57,respectively,P＜0.01).A complete or part signal filling defect occurred in the tumor-bearing lymph node on the MR lymphographic images.Conclusions The internal anatomy and function of the lymph nodes were effectively visualized by interstitial MR lymphography with positive lymphotropic contrast agent,which provide a sensitively diagnostic way for the differentiation of benign lymph nodes from malignant ones.

Objective To study the function of emotional capital theory in activating the nursing human resources. Methods We used emotional capital theory together with the use of incentives and humane management of emotional exchange to meet the individual demands of nurses, in order to accumulate good for the intrinsic emotional capital of the hospital. At the same time, attention was paid to detail services and vigorously carried out the moving services to accumulate external emotional capital for the hospital. Results After the implementation of emotional capital management, the satisfaction rate of the nurse improved 3.6% than before, and the satisfaction rate of the patients increased from 94.2% to 98.4%.In addition,the nursing complaints redueed from six down to two, the written recognition received from patients increased from 3 to 8, the quality of the care integrated service score increased from 93.3 points to 97.8 points on average, and the nursing errors reduced from 16 to 8. Condusions Use of emotional capital management theory was conducive to activate the nursing human resources, improve the quality of the nursing service and the efficiency of management.

Objective To study the biological characteristics of dendritic cells (DCs) derived from peripheral blood mononuclear cells (PBMCs) of patients diagnosed with syphilis. Methods PBMCs were isolated from 16 patients clinically and serologically diagnosed with syphilis, and from 16 healthy human controls, then cultured with GM-CSF and IL-4. On day 10, the monocyte-derived dendritic cells (MoDCs)of the patients and controls were collected and subjected to the detection of surface molecules by flow cytometry; TpN17 was used to stimulate MoDCs from the controls, the expression of phosphorylated ERK was detected by Westem blotting 20 minutes following the stimulation. Results The positivity rate of CD80 was significantly increased in the patients with syphilis than that in the controls (51.90% vs 33.67,P ＜ 0.05), while no significant difference was observed in the expressions of CD83, CD86 or HLA-DR be tween the two groups (16.53% vs 15.99%, 66.13% vs 59.32%, 91.29% vs 90.51%, all P 0.05). The ex pressions of CD80 and CD83 on the surface of MoDCs were enhanced in a dose-dependent manner after ex-posure to TpN17. The expression of cytoplasmic phosphorylated ERK was observed in MoDC stimulated by TpN17, but not in those without the treatment. Conclusions Antigenic stimulation with Treponema pal-lidum may be a reason for phenotypic abnormality of MoDCs derived from patients with syphilis. TpN17 may stimulate the maturation of DCs through the ERK signal transduction pathway.