Clinical teaching quality directly affects the training of medical talents.It is of great significance for improving the quality of clinical teaching and training medical talents to strengthen clinical teaching management and to carry out clinical teaching research.On the basis of investigation and analysis of clinical teachers, interns and teaching activities in the hospital, the author introduced the PDCA method of the total quality management into the teaching management, and analyzed the effect of its dynamic circulation, to explore a suitable scientific management mode of clinical teaching for the hospital, so as to realizing the continuous optimization of teaching quality.

Aged ; Aged, 80 and over ; Antibodies, Bacterial ; blood ; Coal Mining ; Humans ; Male ; Middle Aged ; Mycobacterium tuberculosis ; immunology ; Pneumoconiosis ; complications ; Sensitivity and Specificity ; Tuberculosis, Pulmonary ; complications ; diagnosis

Objective To explore the alterations, relationship and clinical significance of CD4 +CD25 +CD127 low/ -
regulatory T cells ( Treg ) and lymphocyte subsets in peripheral blood of patients with acute myelocytic leukemia ( AML) . Methods The level of peripheral blood lymphocyte subsets and Treg of untreated AML patients and com-plete remission( CR) patients were tested by flow cytometry,and were compared with that of 30 normal controls. Re-sults The proportions of Treg were much higher in untreated AML patients and CR patients than in normal con-trols, while the mean proportion of Treg in untreated AML patients was higher than that in CR patients(P<0. 05). The proportions of NK( CD3 -CD16 +CD56 +) cells in untreated AML patients and CR patients were both decreased compared with normal controls,and the mean proportion of NK cells in untreated AML patients was lower than that in CR patients(P<0. 05). Compared with the normal controls,the proportions of CD3 +T cell, CD4 +T cell,and the ratio of CD4 +/CD8 + decreased in untreated AML patients ( P <0. 05 ) , but the proportions of CD8 +T cell was higher than in normal controls;the proportions of CD3 +T cell, CD4 + T cell, CD8 +T cell and the ratio of CD4 +/CD8 + in CR patients were close to the proportions in normal controls, but there was significant difference between CR patients and untreated AML patients(P<0. 05). Conclusion The increase of Treg, CD8 +T cell and decrease of NK cells, CD3 +T cell, CD4 +T cell, and the ratio of CD4 +/CD8 + in peripheral blood of patients with AML in-dicate that the immune function of patients with AML is depressed. Treg control the immune response of CD8 +T cells,at the same time inhibit the natural immune response of NK cells, playing a major role in the disorders of CD4 +T cells and CD8 +T cell balance,and closely relate with the development of AML. The immune treatment of patients with AML will be optimised by reducing the amount of Treg or removing the suppression function.

To evaluate the effect of rosiglitazone on the Angiotensin Ⅱreceptor 1(AT1) and explore its mechanisms of lowering the blood pressure and protecting the organs. The spontaneously hypertensive rats(SHR) 24(SHR)rats were divided into 2 groups:12 were given rosiglitazone,12 were in the control gronp without any treatment. The duration of observation was 8 weeks. The tail blood pressure was measured indirectly.The in situ hybridization and the immunohistochemical methods were used to estimate the expression of the AT1 mRNA and AT1 receptors of heart.In rosiglitazone group,the blood pressure was reduced significantly,and the expressions of AT1 mRNA and AT1 receptor of heart were inhibited.The effect of rosiglitazone on the expressions of AT1 mRNA and AT1 receptor might be one of the reasons why insulin sensilizers reduce the blood pressure and prevent the organ injuries of hypertension.

Objective To explore the clinical significance of urine transferrin testing in the diagnosis of early pregnancy-induced hypertension syndrome (PIH).Methods Sixty-eight PIH patients (PIH group) who received treatment from January 2012 to October 2013 were enrolled in this study.Mild PIH was 21 patients,midrange PIH was 24 patients and severe PIH was 23 patients.Meanwhile,68 cases of healthy person were selected as control group.The level of urine transferrin,urea and creatinine were compared between two groups.Results The level of urine transferrin,urea and creatinine in PIH group were significantly higher than those in control group[(3.01 ± 1.82) mg/L vs.(1.29 ± 0.88) mg/L,(13.12 ± 5.51) mmol/L vs.(6.23 ± 3.68) mmol/L,(135.5 ± 62.3) μ mol/L vs.(85.1 ± 38.2) μ mol/L] (P ＜ 0.05).The sensitivity of urine transferrin,urea and creatinine in mild PIH was 76.19％,61.90％,57.14％.In midrange PIH was 75.00％,79.17％,75.00％.In severe PIH was 78.26％,86.96％,73.91％.The specificity of urine transferrin,urea and creatinine was 80.65％,56.45％,58.06％.The sensitivity of different degree of PIH was exceeded 75.00％.The sensitivity of urine transferrin in mild PIH was significantly higher than urea and creatinine (P ＜ 0.05).But the sensitivity of urine transferrin in midrange PIH and severe PIH had no significant difference (P ＞ 0.05).The specificity of urine transferrin was significantly higher than urea and creatinine (P ＜ 0.05).Conclusions Urine transferrin is a good index in diagnosis of early PIH,which can reflect the early injury degree of the renal tubular and glomerular.It has active and important significance for the clinical diagnosis and treatment of PIH.

Objective To evaluate the clinical application of segmental RAE for treating renal arteriovenous malformation(RAVM) and fistula (RAVF).Methods 4 cases of RAVM or RAVF were treated by segmental RAE,Embolic material was permanent embolism.Results 4 cases RAE operations were performed successfully,After 12～14 months follow-up,3 cases were no evidence of recurrence,1 case clinical symptom was relieved.Conclusion Segmental RAE is an effective and safe approach to the treating RAVM and RAVF.

Objective To sum up the experience of embolization uterine aterial to treat uterine leiomyoma and to discuss how to prevent and manage the complications.Methods 103 patients with uterine leiomyoma have treated by uterine aterial embolized.Postembolization syndrome and 18 accidents out of 16 patients were reviewed.Results Postembolization syndrome were treated by conservation therapy,among the 18 accidents,there were 6 aterial rupture,after embolization the rupture aterial,no serious complications occurred;6 uterine aterial spasm,4 were cured after treated,1 aterial false embolized,1 embolized uterine aterial with Gelfoam particle;3 patients fibroids extrusion,the fibroids was detached easily,all were cured after conservation treated;1 had amenorrheal after embolization;1 case urine bladder aterial was embolized,there was not complication after conservation treat;1 case had uterine infection,no serious complications occurred after hysterectomy.Conclusion The correct management of the complications may helpful to increase the cure rate.

No abstract available.

Objective To retrospectively investigate the impact of postoperative radiotherapy ( RT) on the relationship between molecular subtype and survival in patients with breast cancer ( BC ) . Methods A total of 716 women who were admitted to our hospital in 2008 and newly received unilateral mastectomy were divided into Luminal A ( LA ) , Luminal B?HER?2?negative ( LB1 ) , Luminal B?HER?2?positive ( LB2) , HER?2 overexpression ( HER?2+) , triple?negative ( TN) , and unassigned subtypes according to the 2011 St. Gallen Consensus. The Cox model was used to analyze the differences in overall survival ( OS) and disease?free survival ( DFS ) rates between subtypes in all patients, RT group, or non?RT group. The Kaplan?Meier method was used to calculate OS and DFS rates. The Cox model was used to perform the factor analysis. Results In all patients, the median follow?up time was 71?4 months;the overall mortality rate was 10?5%;the incidence of treatment failure ( death+relapse+metastasis) was 14?9%;217 patients ( 30?3%) received RT. The multivariate analysis showed that there was no significant difference in OS between subtypes in any group ( all P>0?05 ) . In all patients, patients with LB1 subtype or unassigned subtype had significantly poorer DFS rates than those with LA subtype ( HR= 1?881, P= 0?035;HR= 1?907, P=0?049) . In the non?RT group, patients with LB1 subtype had significantly poorer DFS rates than those with LA subtype (HR=3?324, P=0?01). In the RT group, there was no significant difference in DFS rate between subtypes ( all P>0?05) . The two?dimensional cross analyses of RT and subtype demonstrated that patients with LB1 subtype in the non?RT group had lower OS and DFS rates than patients with LA subtype in the RT group ( P=0?09,0?06) . Conclusions Patients with LB1 subtype have lower OS and DFS rates than patients with LA subtype, especially in the non?RT patients. RT has no impact on the relationship between subtype and prognosis.

Child ; Graft Survival ; HLA Antigens ; genetics ; immunology ; Hematopoietic Stem Cell Transplantation ; Humans ; Polymerase Chain Reaction ; Tissue Donors ; Transplantation Chimera ; genetics ; Transplantation Conditioning ; methods ; Transplantation, Homologous ; immunology