Through approaching the mixed ability training of clinical post-graduates, the following conclusions were drawn: necessity to take turns in the clinical specialties, establishment of its program, the details and contents were pointed out, meanwhile, it is necessary to guarantee progression of the plan and its training effects, and to improve the cultivation quality.

Through developing resident standardization training,we established programs of resident standardization training,defined training aims,standardized training items,and established guarantee system,evaluation system,quality-monitoring system and encouragement system,which guaranteed the quality of residency training,and acquired satisfactory effects.

This study reviewed the reasons for encounter (RFE),diagnoses and the diagnostic categories of patients aged 0-14 y in general practice clinic affiliated to a tertiary hospital from June 2011 to May 2012.The results showed that the most frequent RFE was cough,at a rate of 29.6 per 100 encounters;the second one was fever (21.4％) and the third was nasal problems (9.5％).Medical examinations,skin rashes and follow-up encounters occurred at equal rates (5.2％).The most frequent diagnosis was acute upper respiratory tract infection (41％).Medical examination (6.3％),other viral diseases (5.1％),pneumonia (3.6％) and no detected disease (3.6％) were also common diagnoses.The diagnostic categories included all systems,and the problems of the respiratory system (56.4％) were most common.The results suggest that pediatric care comprises a very important part of primary care.

Objective: To explore the influence factors of the degenerate oligonucleotide primered PCR(DOP-PCR). Methods: Genome DNA template from the mouse single oocyte or liver tissue were used to perform DOP-PCR. DOP-PCR was carried out with templates of different origin, different gradient dilution, with or without low melting point gel purified to wipe off the small fragment that might interfere with the following analysis, and then PCR of gene FTCD and CBS were carried out to evaluate the influence of these factors on the amplification efficiency and specificity. Results: Compared with genome DNA template from mouse liver, the template from single oocyte had the same efficiency and specificity but a minor yield and different gradient dilution of DNA template had no effect on the efficiency and specificity. Furthermore, there was a higher specificity in the low melting point gel-purified DOP-PCR product than in untreated ones. Conclusion: We have got a satisfactory result and increased specificity from DOP-PCR product purified with the low melting point gel. Single oocyte of mice could be used for further investigation of special genes detection by DOP-PCR and of an optimization in the yield of the products.

Objective To analyze the differences of biochemical and immunological indicators in gender or Lee′s classification of IgA nephropathy ( IgAN) to provide laboratory evidence for clinical diagnosis and treatment of IgAN.Methods Retrospective cohort study.The information of biochemical and immunological indicators of 213 in-hospital patients which were admitted in Chinese PLA General Hospital in June to December, 2012.The data were collected and analyzed with t-test, non-parameter analysis, Pearson correlation analysis, ROC curves analysis and Logistic regression analysis according to gender or Lee′s classification ( Lee′s≤3 group and Lee′s>3 group).Results In this study, the average age and sex ratio of patients with IgAN was ( 35.0 ±10.6 ) years old and 2.04∶1.00.T-test and non-parameter analysis indicated homocysteine(HCY), immunoglobulin E (IgE), immunoglobulin M (IgM), prealbumin (PA), ceruloplasmin ( CP) ,α1-acidoglycoprotein(α1-AGP) , albumin ( Alb) ,α2-globulin(α2-G) andγ-globulin (γ-G) had significant difference in gender (P<0.05).And cystantin-C (CYS-C), HCY, complement 4 (C4),β2-microglobulin(β2-MG), PA, α1-AGP, α1-globulin(α1-G), immunoglobulin G (IgG), IgM and transferrin ( TF ) had significantly different in Lee′s classification ( P<0.05 ).ROC curves analysis showed that the areas under curves of CYS-C andβ2-MG were 0.891 and 0.839 respectively;the sensitivity was 90.2%and specificity was 75.3% when cutoff value of CYS-C was 1.56 mg/L; the sensitivity was 80.3%and specificity was 78.8% when cutoff value of β2-MG was 0.275 mg/dl.Logistic regression analysis showed that CYS-C ( OR: 31.380, 95% CI: 10.808 -91.113, P=0.000 ) and HCY ( OR:1.035, 95%CI:1.002-1.069, P=0.040) were introduced into the model after twice variable selections.ROC curve of CYS-C combined with HCY for classifying Lee′s classification showed that the sensitivity, specificity, Jorden index and AUC were 0.843, 0.862, 0.705 and 0.894 ( P=0.000 ) , respectively.Conclusions CYS-C,β2-MG, PA and HCY were valuable indicators for Lee′s classification.CYS-C andβ2-MG had high correlation with Lee′s classification, which indicated that these two tests were related to the severity of IgAN.CYS-C combined with HCY could improve the diagnostic efficiency of IgAN Lee′s classification.Combination of biochemical and immunological indicators could improve the accuracy of Lee′s classification and provide effective laboratory evidence for clinical treatment of IgAN.

Objective To evaluate the inhibitory effects of shRNAs targeting genes encoding viral capsomeres VP1-VP4 on enterovirus 71 (EV71) replication when used alone or in combination.Methods Short hairpin RNAs (shRNAs) targeting genes encoding VP1-VP4 protein of EV71 were designed and then respectively inserted into lentiviral vector pLKD-CMV-GFP-U6 to construct the recombinant plasmids.The expression plasmids together with psPAX2 and pMD2.G were transfected into 293T cells to induce the expression of recombinant lentiviruses,which were collected on the third day after transfection.The titers of recombined lentiviruses were determined by real-time PCR.The effects of shRNAs used alone or in combination on the expression of EV71 at mRNA and protein levels were respectively detected by real-time PCR and Western blot.Results The inhibitory effects of shRNAs on EV71 replication showed no significant differences among various strains (isolated from fatal cases,severe cases,mild cases and FY0805) (P＞0.05).Their inhibition rates were 51.6％ (sh-VP1-1),85.1％ (sh-VP1-2),76.4％ (sh-VP1-3),57.5％ (sh-VP2-1),81.4％ (sh-VP2-2),79.5％ (sh-VP2-3),68.9％ (sh-VP3) and 56.7％ (sh-VP4) respectively,and they were in a dosage dependent manner.sh-VP1-2 in combination with sh-VP2-2 showed the highest inhibition rate reaching up to 96.6％.Moreover,shRNAs used in combination showed better effects than any one used alone even at double dosage.Conclusion All shRNAs targeting viral capsid VP1-VP4 genes showed inhibitory effects on EV71 replication with inhibition rates over 50％ and the effects could be strengthened when using shRNAs in combination.

Job-transfer training for general practitioner is the important channel of primary medical talents team construction.This article elaborated on existing problems in the general practitioner job-transfer training in our country from several aspects,such as training base,teachers,teaching materials,actual work need and discipline construction,etc.Based on the existing problems and combined with practical work requirements of general practitioner job-transfer training in our country,the article put forward corresponding suggestions and countermeasures including strengthening teachers' construction,textbook construction and speeding up general medical discipline construction,etc.

Objective: To clone a novel gene and explore its expression patterns in tissues and cells,so as to find its role in the process of encephalopathy in DS.Methods: On the base of our previous microarray's result together with the tissue type,we chose EST AI480014 to carry out RACE,then analyzed its expression profiles in liver,spleen,kidney,heart,brain by multi-tissues Northern blot,after that semi-quantitive RT-PCR was used to reexamine the expression profiles.Furthermore,we used ISH to find whether aim gene expressed in neuroglial cells cultured in vitro.Finally we performed semi-quantitive RT-PCR to explore whether it expressed differently between DS and normal.Results: We gained a 682 bp new cDNA fragment(DQ275636)which expressed in all the tissues examined and had no alternative splices in them.It expressed highly in brain especially in frontal lobe and hippocampus.According to the ISH result we convinced that it expressed in neuroglial cells.Using bioinformatics we mapped DQ275636 to chromosome 5q14.Conclusion: We have obtained a new gene fragment based on the(above) results.According to its expression character and tissue type,it can be suggested that this gene has a probable role in the process of encephalopathy in DS.

Objective To promote professional training aid on healthcare talents in western China,this paper aims to explore methods and to evaluate the effectiveness of a new training system for underprivileged medical professionals from hospitals of western China.Methods Questionnaires and interviews were conducted to 115 trainees and their employers took part in the Counterpart Support Project.A retrospective analysis was done to evaluate key indicators of the trainees' professional competence.Results More than 90％ of the trainees have seen great improvement on basic healthcare knowledge,clinical skills,and diagnosis and treatment practice.About 80％ the participating hospitals have enjoyed varied degrees of growth in outpatient visits,surgical volume,number of inpatient and operational efficiency.(Increase level from 0％ to 50％) Conclusions Within the frist 3 years of implementation,this new model has been proven effective to enhance participants' overall professional competence,and by tapping into the significant resource of first class hospitals,this model will help greatly promoting the development of healthcare talents in Western China.

Objective: To investigate the expression level of genes located in chromosome 21 in the brain tissues of Down syndrome(DS). Methods: An optimized semi-quantitative RT-PCR method was used to evaluate the expression levels of seven genes encoded in chromosome 21 in fetal cortex brain and cerebellum of DS and the control at the end of 20 weeks of gestation. B2M was used as internal reference to normalize cell loss. Results: The expression levels of 6 genes in cortex and cerebellum, including DYRK1A, SYNJ1, PCP4, C21orf5, C21orf2 and C21orf106, were comparable between DS and the control. ANA, a cell-cycle negative regulatory gene, was over-expressed dramatically in the cortex but not in the cerebellum of DS. Conclusion: Over-expression of ANA may contribute to the reduction of neuronal density in DS brain.