In view of the current situation of the teaching of diagnostics, this paper analyzes the ex-isting problems and deficiencies , and puts forward the teaching reform of the National Medical College Students' clinical skills competition. Through the construction of experimental teaching demonstration center of clinical skills, we set up theclinical skills associationamong the students, boldly try innovative training, strengthen humanistic education and take other measures to improve the quality of clinical practice teaching of diagnostics, so as to achieve the purpose of the competition focusing on promote teaching, learning and using by competition.

Objective To investigate the level of self-perceived burden(SPB) and analyze the influencing factors in continuous ambulatory peritoneal dialysis(CAPD) patients.Methods One hundred and ten CAPD patients were investigated by a self-designed demographic questionnaire and Self-Perceived Burden Scale (SPBS).Results The total score of SPBS was (30.27±7.88) points,being in a middle level,and 85.45％ of the patients showed different levels of burden.Single factor analysis showed the influencing factors of self-perceived burden were marital status,family per capita income,the main caregivers and selfcare ability.Conclusions Most CAPD patients have obvious self-perceived burden,nursing staff should use the relevant nursing measures to reduce the SPB with CAPD patients and improve their quality of life.

Objective:Study the effect of Acanthopanax gracilistylus extract(Age) on monocyte,and reveal the anti trmor mechanism.Methods:The content of TNF ?,IL 12 were examined by using biological method and ELISA,respectively.The expression of monocytic cytokine mRNA are investigated by RT PCR.The effect of Age on the phagocytosis of monocytes is studied using TdR incorporation method.Results:After cultured with Age,the production of cytokines by monocytes such as TNF ?,IL 12 are markedly increased with good dose dependent manner.After monocytes cultured with LPS in the presence or absence of Age,Age markedly enhances LPS induced TNF ? production.Treatment with Age,the production of cytokines and the expression of their mRNA are increased simultaneously.The results in vivo also show:Age can enhance the productions and the expressions of TNF ? and IL 12.Conclusion:The anti tumor active component of Age has obvious stimulative activity on monocytes, increasing the production of cytokines, enhancing the phagocytosis.These results product the scientific evidence for the study of anti tumor mechanism and clinical ultilization.

AIM: To prepare ethosomes and study on transdermal resorption of tanshinone ethosomes in vitro. METHODS: Tanshinone ethosomes were prepared by thin-film ultrasonic method.The different dosage regimens and volume on the transdermal resorption of tanshinone were evaluated through excised mice skin in vitro using modified Franz-diffustion cells. RESULTS: The mean particle diameter of ethosomes was 79.7 nm,and the encapsulation efficiency was about 81.2%.Cumulative penetration amount of tanshinone from ethosomes was 1024? 104.0 ng/cm2 and skin residual amount was 345.2?58.0 ng/cm2.Cumulative penetration amount increased with ethosomes volume.Liposomes failed to promote the penetration of tanshinone,and its skin residual amount was 625.3 ?124.5 ng/cm2,water-ethanolic suspension also could not promote the penetration of tanshinone,and skin residual amount was 765.0?60.00 ng/cm2. CONCLUSION:Ethosomes can improve significantly the transdermal delivery of tanshinone.

Objective To investigate the relationship between HBV genotypes and YMDD motif mutations or BCP mutations in Xiangtan of Hunan Province. Methods HBV genotypes, YMDD motif mutations and BCP mutations were analyzed in 952 HBV infected patients. Results HBV genotyping showed that 698 HBV type B patients and 115 HBV type C patients accounted for 73.32% and 12.08% respectively of all the participants. The rest 139( 14.60% )were genotype B and C mixed infection( B + C ). The analysis of YMDD motif mutations showed that 844 YMDD wild-type which accounted for 88.66% of all the subjects and the remainder were YMDD mutation types, of which 54( 5.67% ) carried YVDD, 53( 5.57% ) YIDD,and 1 YVDD and YIDD mixed infection. Basic Core Promoter mutations showed that 1762A/1764G ( wild type )accounted for 70.59% and 1762T/1764A( mutant ) accounted for 19.75%. The rest 92 patients were 1762T/1764A and 1762A/1764G mixed infection. This study showed no significant difference in the rate of YMDD mutation( 10.04% vs 10.43% ,χ2 =0.017,P＞0.05 ) ,but a significant difference in the types of YMDD mutation(χ2 = 4.836, P ＜ 0.05 )between HBV types B and C. The YVDD mutation was more commonly seen in genotype C( 9.57% ) than in genotype B( 5.88% ). The BCP mutation rate showed a significant difference( 27.36% vs 46.09%, χ2 = 16.478, P ＜ 0.01 ). Genotype C was more frequent than genotype B. The BCP mutation rate showed no significant difference between YMDD Wild-type and YMDD mutation types( 28.67% vs 35.51%, χ2 = 2.139, P ＞ 0.05 ), but most of BCP mutations happened in YVDD mutant type( 61.11% ). Conclusions ( 1 ) The predominant HBV genotypes in Xiangtan were genotype B and genotype C, the major genotype was type B, which display the characteristics of epidemiology in Southern China. ( 2 ) Determination of HBV genotypes before lamivudine therapy was probably not an important pretreatment investigation to predict antiviral responses. ( 3 ) Detection of HBV genotypes, YMDD motif mutations and BCP mutations will contribute to the correct evaluation of prognosis and timely proper management of HBV patients.

Objective To study the effects of abiotic elicitors methyl jasmonate (MeJA) and salicylic acid (SA) on the alkaloids accumulation and related enzymes metabolism inPinellia ternata suspension cell cultures. Methods Using the leaf petioles-derived suspension cell cultures as the study object, the culture duration, concentrations of MeJA and SA were determined to get the optimal alkaloids accumulation, and the activities of metabolic enzymes IMP dehydrogenase and sAMP synthase were also measured.Results A 9-fold of dried biomass and a 3-fold of alkaloids accumulation were observed inP. ternata suspension cell cultures after culture for 21 d. Both MeJA and SA could significantly promote the accumulation of alkaloids inP. ternata suspension cells. 150 μmol/L MeJA enhanced alkaloids content (4.7 mg/gDW) by 3.6 folds in comparison with control group, whereas 50 μmol/L SA showed a 2.5-fold increase. Meanwhile, 100 μmol/L MeJA and 50 μmol/L SA promoted the increase in IMP dehydrogenase activity by 3.0 and 3.7 fold respectively, and 150 μmol/L MeJA and 100 μmol/L SA showed the increase by 2.6 and 4.4 fold respectively.Conclusion Proper adding exogenous MeJA and SA can promote the accumulation of alkaloids inPinellia ternata suspension cell cultures.

Objective To comparative study the effect on colorectal cleansing of CT colonography with gulping down 10 mg bisacodyl before or 1 h after oral taking 2 liter polyethylene glycol .Methods Forty participants with informed consent were appor‐tioned to group A ,group B randomly ,20 cases in each group .On the day before CT colonography ,participants in group A oral took 20 mL of 40% W/V barium sulfate prior to 3 mealtime ,and 20 mL of 60% diatrizoate meglumine diluted in 250 mL of water after supper ,then gulped down 10 mg bisacodyl enteric‐coated tablets 1 hour before oral taking 2 liter polyethylene glycol electrolyte so‐lution .Participants in group B were the same as that in group A ,with the exception of gulping down 10 mg bisacodyl enteric‐coated tablets 1 hour after oral taking 2 liter polyethylene glycol electrolyte solution .Cleansing efficacy of stool and fluid ,and attenuation value of remainder fluid between the two groups were analyzed statistically .Results In group A ,score of cleansing efficacy of stool (1 .96 ± 0 .11) was lower than that in group B (2 .01 ± 0 .12) ,segments with good cleansing efficacy of stool (87/120 segments , 72 .50% ) was higher than that in group B (83/120 segments ,69 .17% ) ,the difference was not statistically significant (P>0 .05) .In group A ,score of cleansing efficacy of fluid (1 .50 ± 0 .06) was lower than that in group B (1 .53 ± 0 .06) ,segments with good cleansing efficacy of fluid(113/120 segments ,94 .17% ) was higher than that in group B (111/120 segments ,92 .50% ) ,the differ‐ence was not statistically significant (P>0 .05) .Attenuation value of remainder fluid [(729 ± 29)HU ] in group A was higher than that in group B[(653 ± 25)HU] ,the difference was statistically significant(P<0 .05) .Conclusion Gulping down 10 mg Bisacodyl before or after oral taking 2 liter polyethylene glycol has no effect on cleansing of stool and fluid ,with good cleansing efficacy .The former has better cleansing efficacy of fluid ,is beneficial to detecting polyps for CT colonography .

Objective To discuss the problems of using high pressure injector in the 16-detector-row CT. Methods Reviewed and analyzed the courses of using high pressure injector in the 16-detector-row CT for 799 patients. Results 774 patients obtained successful infusion,contrast medium hydrops were occurred in 20 patients,2 patients were infusion failure and 3 patients were redid for misoperation. Conclusion Master the details of operating high pressure injector can alleviate the pain of patients,and then obtain the satisfactory effect.

Objective To explore the relationship between the interleukin-6 (IL-6) RS1800796 gene polymorphism and susceptibility of Enterovirus 71 (EV71) infection.Methods One hundred and twenty-three children with EV71 infection were selected as infection experimental group from March 2012 to December 2014 in the Central Hospital of Xiangtan,and they were divided into mild EV71 infection group (62 cases) and severe EV71 infection group (61 cases).And 52 age-and gender-matched healthy children were selected as the healthy control group.Two mL blood samples were collected from all subjects,and DNA was extracted by Beijing Optimal Boland Gene Technology LTD.The SNaPshot was used to determine the genotype for G/C polymorphism at RS1800796 position of IL-6 gene.Results The genotype frequency of IL-6 RS1800796 GG in the infection experimental group [73.2％ (90/123 cases)]was significantly higher than that in the healthy control group[48.1％ (25/52 cases)],and the difference was statistically significant (x2 =10o 215,P =0.002,OR =2.945,95 ％ CI:1.500-5.782).No significant difference was found in the distribution of genotype frequency of the IL-6 RS1800796 GG between the mild EV71 infection group and the severe EV71 infection group[71.0％ (44/62 cases)vs.75.4％ (46/61 cases),x2 =0.309,P =0.685].The G allele in IL-6 RS1800796 G/C was more frequent in the infection group (85.0％)than that in the control group (70.2％),and the difference was statistically significant (x2 =10.183,P =0.002,OR =2.399,95％ CI:1.389-4.143).No significant difference was found in allele frequency of the IL-6 RS1800796 G between the mild EV71 infection group and the severe EV71 infection group (83.1％ vs.86.9％,x2 =0.703,P =0.477).Conclusion The G allele of IL-6 RS1800796 confers susceptibility to infection of EV71.But G allele carrier will not increase the risk of severity after infection.

han that in the control one (t=3.94, P<0.01).Conclusion Social skills training can effectively improve subjective satisfactions of the long-terra hospitalized patients with chronic schizophrenia.