To improve the quality of clinical practice education,questionnaires were distributed to the medical interns. Corresponding responses were proposed based on humanities quality,quality of clinical practice and its factors,views on after-department examination and training for clinical skill. The result shows most of students realized the importance of clinical practice. After reformation for clinical education,after-department examination could efficiently improve interns’ability to resolve practical problems. Management of teachers,development of students’clinical thinking and ability of communication between doctor and patient should be enhanced .

Objective To study the relation along p53, p21 protein, p21 gene and their clinical significances in 40 gastric comparing with normal gastric tissues.Methods In this study, the p53 and p21 protein were investigated in 40 gastric carcinomas using IHC(Immunohistochemistry). At the same time, the possible presence of p21 gene mutation was also analyzed by silver staining PCR-SSCP method.Results The abnormal expression of p53 and p21 protein occurs only in gastric carcinoma; The expression of p53 protein and p21 is not related to the clinico pathological features. There was relationship between the expression of p53 protein and p21 protein. In 40 cases of gastric carcinoma, single strand conformational polymorphism of PCR product for p21 gene in tumor tissue shows no altered band or mobility shifting.Conclusion The abnormal expression of p53 and p21 protein occurs only in gastric carcinoma and is not related to the clinicopathological features. The expression of p21 protein is related to that of p53 protein. The mutation of p21 gene was not found in all of 40 tumor specimens. This suggests that p21 alteration in gastric carcinoma is caused through the inactivation of p53 protein rather than through intragenic mutation of the p21 gene itself.Using drugs which can stimulate p21 gene is a new method to cure gastric cancer with mutation-p53 protein.

Objective To evaluate the reliability of autologous blood withdrawal during cesarean section. Methods Fifteen patients preoperatively diagnosed with pernicious placenta previa and∕or accrete by using ultrasound and magnetic resonance imaging, aged 20-35 yr, weighing 55-75 kg, at≥36 weeks of gestation, were enrolled in the study. Blood containing amniotic fluid from the surgical field was collected, and the washed blood was processed using cell?salvage machine and then filtered using a leukocyte depletion filter during cesarean section. The 20 ml blood samples collected included maternal central venous blood after delivery of fetus, unwashed blood, washed blood and filtered blood. The fetal squamous cells were counted using papanicolaou staining. The concentrations of a?fetoprotein, tissue factor, endothelin?1 and histamine were measured by enzyme linked immunosorbent assay. The fetal red blood cells were counted using the acid elution method and HE staining. Results Compared with unwashed samples, the tissue factor concentrations were significantly increased, and the fetal squamous cell count, concentrations of a?fetoprotein and endothelial?1, and fetal red blood cells were decreased in the washed samples. Compared with washed samples, the fetal squamous cell count, concentrations of a?fetoprotein and fetal red blood cells were significantly decreased in filtered samples. Compared with maternal venous blood samples, the tissue factor concentrations were significantly increased, and the fetal squamous cell count and concentrations of a?fetoprotein and endothelial?1 were decreased in filtered samples. Conclusion Autologous blood withdrawn during cesarean section can be used for reinfusion in cesarean section.

Objective To study the different expressions of neurotensin (NT) at gene and protein level in orthotopic model of prostate cancer . Methods The animal models of androgen dependent prostate cancer(ADPC,castrated for 3 days) and androgen independent prostate cancer(AIPC) were established by planting tumor tissue or undergoing surgical castra-tion. Affymetrix microarray technology was carried out to compare the gene expressions of NT. The result was verified by qRT-PCR. HE staining was used to observe the change of pathology. ELSIA and immunohistochemistry technology were fi-nally performed to detect protein expression of prostate-specific antigen(PSA) and NT in three different groups of prostate cancer tumor tissues. Results The expression of NT was 5.10 times higher in AIPC group than that in ADPC group. The ex-pression of NT was 0.33 times lower in castrated 3-day group than that in ADPC group. Results of RT-PCR and qRT-PCR showed that the expression levels of NT gene were 1.41 and 7.27 times respectively higher in AIPC group than that in ADPC group,but the expression levels of NT gene were 0.78 and 0.46 times respectively lower in castrated 3-day group than that in ADPC group (P<0.05). HE results showed that nuclear atypia and tumor structure in three groups. Immunohistochemistry and ELISA results showed that the values of PSA and NT were (0.48±0.03) and (0.031±0.008)μg/L in ADPC group;(0.17± 0.03) and (0.021±0.004)μg/L in castrated 3-day group,and (0.87±0.02) and (0.042±0.010)μg/L in AIPC group. There were significantly lower expressions of NT and PSA in castrated 3-day group that those of ADPC group (P<0.01). Conclusion In the transition from ADPC to AIPC, the over-expression of NT suggested that NT may be associated with prostate cancer progression. NT may be used as a new therapeutic target and specific diagnostic method of AIPC.

Cultivating Clinical thinking ability is an important tache of clinical medical education. Teachers'guidance, the charateristics that suit teaching, the organic combination of the active methods which can mobilize clinical medical interns' learning enthusiasm, such as problem-based learning, and humanity education are effective approaches to enhancing interns' clinical thinking ability.

In order to study the effect of seed soaking with different aluminum solution on seed germination and seedling physiological characteristics of Platycondon grandiflorum, two P. grandiflorum varieties'seed (the white flower and the purple flower) were soaked in Al3+ solution with different concentrations (0, 10, 100, 250, 500, 750 and 1000 mg x L) for 24 h, then germinated in illumination incubator. Results showed that the aluminum toxicity on the trends of the germination rate, germination index and vigor index was positive associated with its concentration, and the Al tolerance of the purple was slightly greater than that of the white. There were some relationships between the physiological indices, which were the leakage rate of electrolyte, the malonaldehyde (MDA) content, the activities of peroxidase (POD) and superoxide dismutase (SOD) , the free praline(Pro) and the soluble sugar contents, with the concentrations of Al. It was suggested that there was Al tolerance difference between the two P. grandiflorum varieties: the purple flower was greater than the white.
Aluminum ; pharmacology ; Dose-Response Relationship, Drug ; Germination ; drug effects ; Immersion ; Platycodon ; drug effects ; growth & development ; physiology ; Seedlings ; drug effects ; physiology ; Seeds ; drug effects ; growth & development

Objective:To test the relative response of a detector matrix used for measuring of the dose distribution in radiotherapy in order to ensure the accuracy and reliability of dose distribution measurement result.Methods:The two adjacent detectors can be irradiated at the same radiation dose by translating the detector matrix. The relative response of each detector to the reference detector can be obtained by combining the recursive algorithm. At the same time, the measurement data at different test steps are corrected to the reference step by setting the reference step, which correct the influence on the relative response result caused by the variation of the radiation condition and the detector response.Results:Based on the actual test of a 32 × 32 detector matrix, the relative response of each detector of the detected detector matrix to the reference detector varied from 0.896 to 1.077, with the expanded uncertainty of the relative response result being 0.8% ( k=2). Conclusions:On the premise of no known distribution of a radiation field, the relative response relationship of each detector of a detector matrix can be obtained by this method accurately and expediently, which provides a basic method for the performance evaluation of the detector matrix. The same idea can also be used to determine the relative response relationship of other detector matrices for different measurement purposes.

Objective:To establish a scientific, sensitive and practical sensitive index system for nutritional screening and nursing quality evaluation of maintenance hemodialysis patients, so as to provide reference for objective evaluation of nutritional screening and nursing quality evaluation of MHD patients.Methods:Based on Donabedian three-dimensional quality structure theory of "structure-process-result", the first draft of the index system was constructed through literature review and semi-structured interview. From September to October 2022, a total of 20 clinical nursing and nursing management experts from the field of hemodialysis in 12 Class Ⅲ Grade A hospitals were selected for two rounds of expert letter consultation to revise and confirm the indicator system.Results:The positive coefficient of the two rounds of expert correspondence were 95.00% and 100.00%, the expert authority coefficient were 0.813 and 0.818, the Kendall's harmony coefficients were 0.121-0.257 (all P<0.05), and the coefficient of variation of each index was less than 0.30. After 2 rounds of expert letter consultation, the sensitive index system for nutritional screening and evaluation of nursing quality for maintenance hemodialysis patients was finally constructed, including 1 structural index, 7 process index and 2 outcome index. Conclusions:In this study, a sensitive index system of nutritional screening and evaluation of nursing quality for maintenance hemodialysis patients with 10 indicators is established, which was scientific, practical and specialized and could be used to standardize the nutritional screening and evaluation nursing work in blood purification centers and promote the continuous improvement of nursing quality.

Objective To determine the applicable conditions and the film reading time of Gafchromic EBT3 film dosimeter through the research and test of the measurement performance such as blackening time,dosimetry range,dosimetry resolution and dose response non-uniformity.Methods Three Gafchromic films were exposure to different doses,and the optical densities were read at different moments after irradiation for analyzing and confirming the effects of blackening time on dose measurement and different doses on blackening time.The absorbed dose-optical density curve was used to determine Gafchromic film dosimetry range.The Gafchromic film dosimetry resolution was obtained by calculating the average optical densities of two groups with a dose difference of 0.01 Gy.The dose response non-uniformity of Gafchromic film was evaluated by irradiating the whole film and the cutting film.Results Relative to the optical density at the termination moment of irradiation,the optical density changes at 4 h were 1.69%(2 Gy),2.53%(4 Gy)and 2.13%(8 Gy);the changes at 24 h were 2.91%(2 Gy),3.31%(4 Gy)and 3.20%(8 Gy);and the changes at 48 h were 2.91%(2 Gy),3.31%(4 Gy)and 3.96%(8 Gy).The optical density given by Gafchromic film dosimeter within 0.1 to 10.0 Gy had a linear relationship with the absorbed dose,while the optical density of Gafchromic film dosimeter within 10.0 to 30.0 Gy had a nonlinear relationship with the absorbed dose,but there was still a one-to-one correspondence.The difference of the average optical densities of two groups was 0.004 when the inter-group dose difference was 0.01 Gy.The non-uniformity was 2.2%for the whole film and 2.8%for the cutting film.Conclusion Gafchromic EBT3 film reading time can be set at 24 h after irradiation,and the dose is independent of blackening time.Gafchromic film dosimeter can be used for point dosimetry and dose distribution measurement within 0.1 to 10.0 Gy,and point dosimetry within 10.0 to 30.0 Gy.The dosimetry resolution of the Gafchromic film dosimeter is better than 0.01 Gy.To avoid the effect of scattered rays,the cutting film is recommended for testing dose response non-uniformity.

Normal tension glaucoma (NTG) is almost the most difficult type of glaucoma to diagnose.The difficulty lies in the lack of specificity of the symptoms and signs of glaucomatous optic neuropathy (GON), so the reevaluation of NTG is a new understanding of GON.As a subtype of primary open-angle glaucoma (POAG), NTG is difficult to accurately conceptualize.One of the reasons is that the intraocular pressure (IOP) is closely linked to the occurrence of GON in POAG but not in NTG.GON seems to be secondary to a number of local or systemic disorders, including vascular dysfunction in the optic nerve head induced by compression (elevated IOP) or ischemia, hypoxia, migraine, Flammer syndrome, intracranial hypotension, low body mass index, low estrogen levels, nocturnal hypotension, obstructive sleep apnea-hypopnea syndrome, Alzheimer disease, Parkinson disease, and genetic background, which may influence the flow in the radial peripapillary capillaries (RPCs) and the underfilling of RPCs causing retinal ganglion cell damage.In some cases, GON does not progress with systemic diseases under control, and these systemic diseases are not risk factors for NTG but may be the cause of GON (or GON is one of the manifestations of these diseases). If these causes are not excluded and NTG is diagnosed only on the basis of GON, chamber angle opening, and normal IOP, it is easy to cause misdiagnosis, and the complete exclusion of these diseases is short of clinical significance in practice.In conclusion, the diagnosis of NTG may not be made before the other ocular or systemic disorders capable of presenting with GON are ruled out, and the concept and diagnostic criteria of NTG should be reconsidered.