Using registration information on candidates for the written examination in medical synthesis, a part of the doctor qualification examination, from 1999 to 2001 as processing data, the authors made a comparative study on the composition of the candidates in the eastern, middle and western regions of the country from 7 aspects, viz. total number, category of registration for the examination, educational background, time of graduation, age, organization and rank of organization. It was found that the educational background of the candidates was on the whole very low and the number and quality of health personnel in the western region and at the grass roots level was in dire need of enhancement.

Objective To evaluate endoscopic ultrasound for preoperative staging of ampullar tumors.Methods A total of 31 patients with ampullar tumors who underwent surgery from 2010 to 2015 were retrospectively reviewed.B-US,CT,MRCP and EUS were performed in all patients.The diagnostic rates of EUS and other imaging technology,and the diagnostic accuracy of preoperative staging and postoperative pathological staging were compared.Results Diagoses of 31 patients of ampullar tumors patients undergoing preoperative endoscopic ultrasonography assessment T staging were as the following:uT1,4 cases; uT2,15 cases; uT3,10 cases; uT4,2 cases.Compared with the postoperative pathological diagnosis,the T staging accuracy was 90.3％ (28/31),anong which 1 case was overestimated,2 cases were underestimated.The accuracy of endoscopic ultrasound in preoperative diagnosis of ampullar lesions was superior to other detection technology.Conclusion EUS is a valuable diagnostic tool for patients with suspected ampullar tumors.

Objective To investigate the clinical outcomes of microwave heliotherapy in situ on the primary or metastatic malignant tumors of the pelvis.Methods From February 2000 to April 2009,18 patients with primary or metastatic malignant tumors of the pelvis were treated with microwave heliotherapy in situ,and followed a total or partial tumor resection.There were 11 males and 7 females with an average age of 45 years(range,16-72).Twelve cases were diagnosed as primary malignant tumor and 6 as metastases.Locations of tumors involved:the Ⅰ region 6 cases.the Ⅱ region 10 cases.and the Ⅲ region 2 cases.The exposures of all tumors were via aTtype or ilioinguinal approach.The lesions were heated at 50℃ for 20 min by 2450 MHz microwave,with surrounding soft tissue protected by copper.mesh.The necrotic tumor tissues were total or partial excised after treatment,with preservation of the anatomical continuity of the pelvic ring.Results The duration of surgery was 60-180 min (110 min on average).The blood loss was 400-800ml(480 ml on average).All patients were followed-up for 0.5-7 years(3.5 years on average).Tumor local recurred in 1 case with chondrosarcoma,and was survival in tumor-bearing after 6 months follow up.One case with malignant fibrous histiocytoma died due to brain,pulmonary,and all body metastases.One case with osteosarcoma died due to pulmonary metastases.Five cases with the metastases died due to non-pelvis metastases.Functions of hip joint in 18 patients were as follows:flexion 80°-130°,extension 0°-10°,abduction 25°-35°,and adduction 18°-23°.Conclusion The clinical result demonstrated that the advantages of microwave heliotherapy in situ were quick increase of temperature,sensitive responses,easy control of temperature,and effective inactivation of tumor cells in the malignant bone tumors of pelvis.

Objective To explore the biomechanical mechanism of non-erosive reflux disease(NERD).MethodsFrom October 4,2014 to September 30,2015,17 NERD patients and 17 healthy controls were recruited from the outpatients department of China-Japan Friendship Hospital.The cross-sectional area(CSA), intra-balloon pressure (IBP)and compliance(Δv/Δp)of each were measured by endoscopy in combination with EndoFlip.ResultsWith the increase of balloon volume,the compliance of gastroesophageal junction in NERD group was significantly higher than that of control group(P<0.01) while the cross sectional area and intra-balloon pressure were similar.Conclusions Increased compliance of the gastroesophageal junction may be involved in the pathogenesis of non-erosive reflux disease.

Objective To research on treament of femoral head of patients with osteoneerosis of the femoral head fracture.Methods Twenty-six patients half of femaoral head of patients with osteonecrosis of the femoral head fracture who treated with vascularzed bone graft were determined.Twenty-one hips treated with internal fixation unloaded and vascularzed bone graft after selective digital subtraction angiography (DSA) was performed to confirm the blood supply of femoral head.one case underwent total hip replacement after internal fixation unloaded.Results All patients were followed up for a mean of 23 months (range,12-38months)and were assessed clinically and radiologically according to Harris scoring.Selective digital subtraction angiography (DSA) was performed in 15 cases to confirm the blood reconstruction of femoral head.Two cases underwent total hip replacement postoperatively.Preoperative and postoperative Harris score were 54 and 86.2,clinical success rate was 92.0% and radiological success rate was 84.0%.DSA demonstrated blood supply was found reconstruction in the necrotic femoral head.Conclusion Femoral head of patients with osteonecrosis of the femoral head fracture was very much (recent 40%).Taking out of internal fixation,treatment of osteonecrosis of the femoral head by using vascularzed bone graft was confirmed,early clinical results were satisfied.

The characteristics of glucose dysbolism in ectopic ACTH syndrome (EAS) were investigated by analysing the clinical data of 117 patients with Cushing syndrome (CS). The patients with CS were divided into 3 groups : EAS group (n = 9) , Cushing's disease (CD) group (n = 67) and adrenocortical adenoma (AA) group (n =41). Retrospective analysis of the data covered the prevalence of secondary diabetes, blood glucose, HbAlc, blood potassium, and blood ACTH and 24 h urinary-free cortisol (UFC) levels. Compared with CD and AA groups, the prevalence of secondary diabetes and blood glucose level were higher in EAS group, while HbAlc level was lower. Blood glucose level in patients with ectopic ACTH syndrome decreased to normal after tumor removal.

OBJECTIVE:To systematically review the efficacy and safety of Deproteinised calf blood serum injection in the treatment of cerebral infarction,and to provide evidence-based reference for clinical treatment.METHODS:Retrieved from Co-chrane Library,EMBase,Medline,CBM,CJFD,VIP and Wanfan database,randomized controlled trials(RCT)about theeffica-cy and safety ofDeproteinised calf blood serum injection(test group)based on basic treatment(control group)in the treatment of cerebral infarction were collected.Meta-analysis was performed by using Rev Man 5.2 software after data extraction and quality eval-uation with Cochrane system evaluation manual 5.1.0.RESULTS:A total of 18 RCTs were included,involving 2 111 patients.Re-sults of Meta-analysis showed the total effective rate [OR=3.30,95%CI(2.48,4.39),P<0.001],National Institutes of Health Stroke Scale (NIHSS) score[MD=-1.47,95%CI(-2.06,-0.88),P<0.001] and activities of daily living(ADL) score[MD=9.09,95%CI(6.46,11.72),P<0.001] in test group were significantly better than control group,there were significant differences be-tween the 2 groups;and there was no obvious adverse reactions during treatment. CONCLUSIONS:Both efficacy and safety of De-proteinised calf blood serum injectionin the treatment of cerebral infarction are good.

Objective:To have an experimental investigation on teaching reform of Orthopedics of TCM based on network resources.Method:Two comparison groups were set and observed when we were teaching the orthopedics students of 2003 grade.One was taught by traditional problem-based learning(PBL) method,the other was taught by PBL method based on network resources.Results:The creative thought and research ability of the students who had been taught by PBL method based on network resources were greatly improved.Conclusion:The teaching method based on network resources has so many advantages such as students being able to self-learn and research without time and space limit that it can be used more in medical students teaching.

Background: Helicobacter pylori (Hp) is a Gram-negative bacterium that colonized the human gastric mucosa. Hp infection is closely related with a variety of digestive diseases and there is the possibility of recurrence after eradication. Aims: To investigate the recurrence of Hp infection after eradication and its influencing factors. Methods: Clinical data of 317 patients with Hp infection from January 2015 to July 2018 at Daping Hospital, Army Military Medical University were retrospectively analyzed. The recurrence of Hp infection after eradication was recorded. The influencing factors of recurrence were analyzed by univariate analysis and multivariate Logistic regression analysis. Results: Twenty-five patients had recurrence of Hp infection, the recurrence rate was 7.9%. Among them, 10 patients relapsed in the first year, 11 patients in two years, and 4 patients relapsed after more than two years. The recurrence rate of clarithromycin+tinidazole-containing regimen was the highest (37.5%), while the recurrence rate of amoxicillin+PPI-containing modified dual regimen was the lowest (3.4%). Univariate and multivariate Logistic regression analysis showed that more family members, peptic ulcer and receiving gastroscopy examination after eradication were the independent risk factors for Hp infection recurrence (P<0.05). Conclusions: More family members, peptic ulcer and receiving gastroscopy examination after eradication are the risk factors for recurrence of Hp infection. For patients with high risk of Hp recurrence, regimen with high eradication rate should be carefully selected and the follow-up examination should be strengthened.

Objective: To investigate the effect of atorvastatin on plasma microRNA-143/145 expression in patients with stable angina pectoris (SAP).
Methods: A total of 74 SAP patients taken atorvastatin at ifrst time were enrolled in this study, the patients were assigned into 2 groups by the dose of medication:Low dose group, the patients received atorvastatin 20 mg/day, n=36 and Moderate dose group, the patients received atorvastatin 40 mg/day, n=38. Plasma levels of LDL-C and microRNA-143/145 were examined before medication and at 1 month, 12 months after medication respectively. The patients were further divided into another 2 groups by plasma levels of LDL-C:Reach the standard group, plasma LDL-C<2.60 mmol/L and Not reach the standard group, plasma LDL-C≥2.60 mmol/L. Plasma levels of microRNA-143/145 were measured and compared between 2 groups.
Results: ① Compared with baseline condition, plasma levels of microRNA-143/145 were increased in both groups after medication, P<0.001 the levels in Moderate dose group were higher than those in Low dose group at both 1 month and 12 months of time points.②Plasma levels of LDL-C were decreased with medication in both groups, P<0.05. Micro RNA-143/145 expression was similar between Reach the standard group and Not reach the standard group, P>0.05.
Conclusion: Atorvastatin could up-regulate plasma microRNA-143/145 expression, which was not related to lipid-decreasing effect.