Objective To study the outcome of pregnancy with lupus nephritis. Methods The clinical data of 9 pregnancies with lupus nephritis were retrospectively malyzed. Results Hypertension,proteinuria,injured renal function and abnormal serological marker were complicated with nine patients with lupus nephritis in pregnancy. The outcome of pregnancy was as following:abortion 2 cases,stillbirth 1 case,premature delivery 4 cases,term delivery 2 cases. All neonate survived without malformation. There was no postpartum hemorrhage or death. Patients with active SLE had very high fetal mortality( 100% ). And SLE got worsen in 50% of them. However,fetal mortality rate in pa-tients with controlled or quiescent SLE was 11.1% ,which was much lower than it in other patients(P<0.05). Con-clusion Lupus nephritis should be controlled before pregnancy. Pregnancy outcome could be improved by careful multidisciplinary monitoring and proper usage of adrenal cortical hormone.

Objective To evaluate the infection of high-risk human papillomavirus (HPV) and the expression of tumor metastasis suppressor protein KAI1 in cervical cancer.Methods The expression of KAH,HPV16/18E6 and HPV16E7 proteins were analyzed by immunohistochemistry SP assay in 117 cases of paraffin-embedded cervical tissue,including 20 normal cerival tissue as control,58 intraepithelial neoplasia (CIN) and 39 cervical cancer.Results In normal cervical tissue,CIN and cervical cancer,the positive rate of KAI1 protein were respectively 90.0 ％ (18/20),72.4 ％ (42/58),25.6 ％ (10/39).There was significant differience among three gruop (P ＜ 0.01).The positive rate of HPV16/18E6 and HPV16E7 proteins were respectively 0 (0/20),31.0 ％ (18/58),41.0 ％ (16/39); 0 (0/20),34.5 ％ (20/58),64.1％ (25/39).There were significant differience among three gruops (P ＜ 0.01).There was no correlation between the expression of KAI1 and the infection of HPV (P =0.429).Expression of KAI1 was correlated to grade of differentiation,clinical stage and lymph node metastasis (P ＜ 0.05),but was not correlated to age (P ＞ 0.05).HPV infection was not correlated to the age,clinical stage,cell differentiation and lymph node metastasis (P ＞ 0.05).Conclusion The expression of KAI1 protein is down-regulated in cervical cancer,which is not associated with the infection of HPV.

The clinical skills competitions for national medical students in China have been well organized for five times.Experience has been accumulated,and much has been emphasized on the low assessment efficacy throughout the competitions.However,few solutions has been brought about to conquer such problem.This article mainly focused on introducing a computerized clinical skill assessment system based on current clinical skills competition assessment.The system realizes functions such as team management,online marking,score calculation,data analysis,and real-time result presentation.Such appliance of computer,internet and information technology on conventional clinical skills evaluation could hopefully replace the traditional manual calculating procedures,improving the efficiency of the future competitions,to ensure their openness,impartiality,and equitability,as well as to deliver observatory appeal among audience.

This paper analyzed the system,methods,content,scope and standards of last two competition in order to further improve the clinical skills competition for national medical students in China.According to the characteristics of medical education,the paper proposed several opinions and suggestions as follows:repechage should be cancelled in competition system and objective structured clinical examination should be used in competition; the content,scope and criteria of the competition should take the actual ability of the medical students at graduation into consideration.

Objective To summarize the clinical experience of thoracic injury.Methods Analyze 778 cases of thoracic injury,including soft tissue injury,rib fracture,hemothorax and pneumothorax,pulmonary contusion,cardiovascular injury,et al.The causes of the injury including traffic accident,injury suffered from the job and dispute,et al.Results 774 cases were cured among all the 778 cases with the recovery rate of 99.35％.There were 5 cases died with the death rate of 0.65％,including 1 case of heart rupture,1 case of large vessle rupture,2 cases of brain combining injury,1 case of spleen combining injury.Conclusion Thoracic injury arise new characteristic in recent years.The main causes of the injury are traffic accident,injury suffered form the job and dispute.Most cases may be cured by rapid treatment.The main causes of death are haemorrage shock due to cardiovascular or spleen rupture and combination of severe brain injury.

Objective To study the expression of p27kip1 and Ki67 proteins in various types of gastric polyp and the relationship be-tween gastric polyp and gastric carcinoma (CA:). Methods The expression of p27kip1 and Ki67 proteins were detected in normal gastric mu-cosa, hyperplasie polyp, adenomatons polyp, and carcinoma by S-P immunohistochemical staining. Results In the normal gastric mucosa,hyperplasie polyp, adenomatous polyp and gastric carcinoma, the expression rate of the p27kip1 protein was 90. 00% ,70. 00% ,65.00% and 30. 43%, respectively. The positive rate of p27kip1 protein in gastric cancer was significantly lower than that in other tissues. The rate of Ki67 protein expression in those tissues was 10. 00%, 15.00%, 45.00%, and 73.33%, respectively. The positive rate of Ki67 protein in gastric cancer was significantly higher than that in other tissues. And the positive rate of Ki67 in adenomatous polyp was significantly higher than that in the normal gnstric mucosa and hyperplasic polyp. There were significant differences among them(P <0.05). There was no correlation between the expression of p27kip1 and Ki67 proteins in gastric polyp(rs=-0. 093, P >0. 05). Conclusion Detection of p27kip1 and Ki67 proteins in gastric polyp was very helpful in early diagnosis and prognosis of GC.

The article has analyzed the policy co-ordination, Industry coverage and technical experience of the global medical device nomenclature (GMDN) to our country, argued the feasibility on the application of GMDN in our medical device administration system, provided some reference on building the naming system of medical device in our country.
Equipment and Supplies ; Feasibility Studies ; Industry ; Terminology as Topic

ObjectiveTo explore and analyze the effect of simulation-based learning combined with debriefing in neonatal resuscitation training.MethodsA total of 114 clinical medical staffs attended the neonatal resuscitation training course hold by Department of Neonatology, Quzhou Maternal and Child Health Hospital from November 2014 to May 2015, and were randomly assigned to observation (n=60) and control group (n=84) by coin tossing. Staffs in the observation group adopted to training skills with simulation-based learning combined with debriefing,while those in the control group were educated with traditional method. The examinations on theoretical knowledge were taken before and after the training. Operational exam and self-confident questionnaire for all staffs on each procedure taught in the course were taken at last. Scores of the exams and self-confident questionnaire were compared between the two groups witht-test and Mann-WhitneyU test.ResultsThe mean score of theoretical test rose up significantly after the training in both observation and control group (25.19±2.62 vs 20.17±3.71,t=7.725,P<0.01; 25.44±2.64 vs 18.90±4.27,t=11.170,P<0.01), but no difference was found in this score after the training between the two groups (t=0.492,P=0.624). The practical operation examination score in the observation group was higher than that in the control (34.05±1.34 vs 31.32±4.10,t=4.183,P<0.01). All questionnaires sent to the staffs were retrieved (100%), and the total values after the training in the observation group were higher than in the control (mean rank: 92.81 vs 57.99; rank sum:5 569 vs 4 872,Z=-4.96,P<0.01).ConclusionsSimulation-based learning combined with debriefing is a much more effective teaching methods for neonatal resuscitation training, which might quickly improve the resuscitation skills of clinical staffs.

Phosphorylation is the most common way of p 53 post-translational modifications .However , gaps still exist in our knowledge regarding the role and mechanism of phosphorylation of p 53 at Ser392 in carcinogenesis and cancer prevention.In the present study, we summarized the effect of phos-p53-Ser392 to wild-type and mutant p53, the regulation by DNA damage agents and protein kinase , and the significance of phosphorylation of p 53-Ser392 in cancer treatment .

Objective To investigate the effect of geographical differences on human serum metabolic profiles .Methods A total of 169 serum samples were collected from healthy individuals from 9 provinces in China and divided into four groups according to the geographical location .The nuclear magnetic resonance ( NMR) data of these samples were segmentally inte-grated, normalized,and analyzed with multivariate statistical methods using SIMCA-P 10.0 software to investigate the differ-ence in serum metabolites between eastern and western populations or between northern and southern populations .Results There were differences in a variety of small molecule metabolites in serum between eastern and western populations or be -tween northern and southern,including glucose,lipoproteins,amino acids,ketones,creatine and choline.Conclusion The geographical differences in a variety of factors (temperature,precipitation,folk culture, living habits,etc) result in the differences in human serum metabolic profiles ,which can provide appropriate reference for epidemiological studies and nu -tritional metabonomics .