The application of continuous quality improvement program in standardized residency training examination in the central Hospital of Shanghai Jiading was introduced to inquire into the way to improve the quality of standardized training of resident doctors. Through the steps of FOCUS-PDCA, we continuously improved the examination content and quality compliance training personnel, and developed the examination process including test, training, supervision, learning and using. After the implementation of the project, the percentage of the departments that meet the residency training examination requirements has been increased from 33.3%to 100%in our hospital. The percentage of the students that passed the licensed medical skills examination was 96.6%in that year. 100%of the students passed the graduation comprehen-sive examination. Year-end evaluation showed that the students' satisfaction degree to the teachers increased from 94.5%to 98.2%. Thus, through the implementation of CQI project, we achieved the goal of promoting teaching and promoting learning.

OBJECTIVE:To probe into the status quo and problems of the prescriptions of rural clinics in a national level poverty-stricken county so as to provide reference for standardizing rural physicians' drug use behavior and facilitating a smooth development of new rural cooperative medical care.METHODS:A total of 962 prescriptions from June 2007 to June 2008 in rural clinics of a county in Chongqing municipality collected by sociological investigation were described and analyzed in respect of the structure of patients,diagnoses of diseases and drug use by descriptive statistical method.RESULTS:The patients visiting rural clinics were mainly young adults and patients with common diseases;the use of Chinese traditional medicine was on the low side;the writing of some prescriptions were nonstandard;and abuse of antibiotics,hormones and injections were widespread.CONCLUSION:Prescription management and the training of rural physicians should be strengthened to promote the rational drug use in rural poverty-stricken area.

ObjectiveTo evaluate the effectiveness of the interventional treatment for portal vein stenosis in patients who had undergone liver transplantation.MethodsFromApr.2004 to Oct.2011,30 patients with portal vein stenosis after liver transplantation were referred for angiographic analysis and interventional treatment. All patients had typical clinical signs and symptoms or surveillance by imaging.After percutaneous transhepatic portography and balloon angioplasty,stents were deployed.Embolization was performed on patients with varices or portal vein flow changes.The therapeutic results were monitored by the follow-up on clinical symptoms,laboratory tests and imaging examinations.ResultsAngiography was performed successfully on all patients.Twenty-four patients received balloon dilation and 26 stents were deployed subsequently.The guide-wire cannot pass through the lesion of portal trunk in 1patient.Four patients received balloon angioplasty only.The technical success rate was 96.7％ (29/30).Stainless steel coils were applied in 7 patients for varices embolization.The complication related to interventional treatment was bleeding in thoracic cavity which happened in 2 patients.Portal vein patency was maintained in all the patients who received interventional treatment for 1-72 months (mean 21.5 months).No re-stenosis was identified.ConclusionInterventional therapy is an effective method for the treatment of portal vein stenosis after liver transplantation and excellent patency can be achieved by this method.

A highly sensitive and selective method for specific DNA sequence detection is developed using a non-labeled molecular beacon (MB) and a nucleic acid dye Hoechst 33258. It is demonstrated by a specific DNA sequence of wild-type HBV as a model system. In this strategy, the stem of MB is completely designed as C/G base pairs. In the absence of target DNA, the interaction between Hoechst 33258 and the MBs is very weak,and the fluorescence signals of Hoechst 33258 is very low. In the presence of target DNA, the MBs hybridize with the target DNA and form double-stranded structure. Hoechst 33258 binds to dsDNA, and the fluorescence intensity is significantly enhanced. Under the optimum conditions, the fluorescence intensity of Hoechst 33258 exhibits good linear dependence on target DNA concentration in the range of 2 × 10-10-2 × 10-8 mol/L. The fitted regression equation is △I=3. 3439C(10-10 mol/L) ﹢18. 6949(R2=0. 9982) with a correlation coefficient of 0. 9982 (R2), and the detection limit is 9 × 10-11 mol/L (3σ). The proposed method has good precision, simple operation, fast detection speed, low detection limit, high accuracy and high sensitivity.

OBJECTIVE: To investigate the effects on the differentiation and maturation of rat osteoblast (ROB) by naringin and it's metabolite-naringenin. METHODS: Primary ROB were obtained from new born SD rat skull after dissected and digested many times by type II collagenase during sterile condition. Serial subcultivation were proceeded when cells covered 80% culture dish. Cell proliferation was detected by MTT, while the alkaline phosphatase (ALP) activity was adopted as osteogenic differentiation marker to screen the best concentration of naringin and naringenin. The secretion of osteocalcin, bone morphogenetic protein-2 (BMP-2), oes-teopontin(OPN) and collagen I, the bone mineralized nodulus, even the gene expression of bFGF, IGF-1, Runx-2, Osterix, OPG and RANKL all were compared among the naringin-supplemented group, naringenin-supplemented group and the control. RESULTS: Both naringin and naringenin can significantly improved ALP activity, the secretion of osteocalcin, BMP-2, OPN and collagen I, the bone mineralized nodulus also were raised. Besides, these two drugs also stimulated the expression of genes which related to the osteogenesis of ROB. However, naringenin is stronger than naringin in above markers significantly. CONCLUSION: The osteoprotective effects of naringenin is stronger than naringin at enhancing the osteogenic differentiation of ROB, suggesting that naringin can be administered via oral and its metabolites developed higher activity to prevent osteoporosis. These results may provide a guide for the new drug develop and dosage forms design during osteoporosis therapy.

Objective To investigate clinic value of real-time shear wave elastography (SWE) in indentifying benign salivary gland mass through measuring tissue elastic properties of the benign mass in salivary gland.Methods Seventy-four patients with benign salivary gland mass were enrolled.All of them have been obtained the average elasticity modulus of the mass by SWE before surgery,including parotid mixed tumor (22),parotid adenolymphoma (13) and sub maxillary gland mixed tumor (6),adenolymphoma (33).Statistical analysis was done between groups.Results The average elasticity modulus in parotid mixed tumor group and sub maxillary gland mixed tumor group exhibited (133.53 ± 3.35)kPa and (125.57 ± 2.89)kPa respectively.The average elasticity modulus in parotid aden lymphoma group and sub maxillary gland adenolymphoma group exhibited (65.60 ± 2.33)kPa and (64.60 ± 1.93)kPa respectively.There was no significant difference between mixed tumor group and there was no significant difference between adenolymphoma group.There were significant differences between mixed tumor group and adenolymphoma group.ConcLusions The SWE can distinguish salivary gland benign mass from different originates,which can provide more evidence for clinical diagnosis.

Objective To explore the biological basis of TCM syndromes from a biomolecules network perspective with qi deficiency syndrome as the breakthrough point. Methods A data dictionary of neuro-endocrine-immune (NEI) related genes and qi deficiency syndrome characterization terminology thesaurus were established. Literature about qi deficiency syndrome characterization was retrieved by using Genclip, to excavate the characteristic NEI gene, thereby to explore different bioactive substances of syndromes. Results The analysis of the genetic data, showed qi deficiency related cluster with the relevance of endocrine, signal transduction, hematopoietic cell and immune deficiencies etc. It is confirmed that the intrinsic biological features of TCM syndrome can effectively identify in the NEI level. Conclusion Literature mining method as a new way to discover syndromes biological indicators has certain feasibility, and it is recommended to be further expanded into other studies on syndromes to validate the universality and reliability of this method.

Objective To explore the lesion types of renal branches and evaluate the clinical results of endovascular treatment for renal artery branch lesions associated with fibromuscular dysplasia (FMD).Methods Eight cases with renal artery branch lesions due to FMD from June 2014 to December 2015 in Department of Vascular and Endovascnlar Surgery,Henan Provincial People's Hospital were retrospectively reviewed.The computed tomography angiography was routinely performed to ascertain the property of renal artery lesion,and digital-subtraction angiography was further performed to confirm FMD diagnosis and analyze lesion characteristics.The renal artery branch lesion types,blood pressure (BP),renin activity,glomerular filtration rate (GFR) and restenosis after operation were observed,and the outcomes were recorded.Results In 8 patients,6 patients were found with the second grade renal branch lesions and 2 patients were found with tertiary branch lesions,involving 2 and more branch arteries for 4 cases and 1 branch for 4 cases.Five cases with branch-type cystic dilatation or aneurysms with coexisting stenosis including 1 case with dissecting aneurysm and renal local infarction,and 1 case with aneurysm located in the bifurcations of branches,and 3 cases with only branch stenosis were found.The angiography showed the small branch lesions of renal artery indicating FMD-mediated focal (5 cases) and multiple stenosis (3 cases).The branch stenosis was not operated in 1 case with dissecting aneurysm and renal local infarction,as BP could be controlled by antihypertensive treatment.Other 7 cases underwent endovascular angioplasties and the technical successful rate was 100％ without complications.After 1 week of operation,BP was improved,renal function remained normal,plasma renin activity was reduced and GFR was recovered for all patients.During the follow-up period (3 to 12 months),BP improvement was observed in 3 cases,and cure were found in 4 cases,and patient's GFR and plasma renin activity were improved in all patients.There were 2 cases with re-intervention during the follow-up period due to restenosis,and the involved branches were unobstructed without obvious stenosis after 1-year follow-up.Conclusions FMD can affect the renal branch artery with different lesions types and endovascular treatment is the first choice for the renal branch lesion of FMD.

Objective To investigate the curative effect of percutaneous transhepatic cholangial drainage(PTCD) on patients with non-anastomotic stricture after liver transplantation when treated with endoscopic retrograde cholangio-pancreatography(ERCP) unsuccessfully.Method The clinical data of 29 patients with non-anastomotic biliary stricture after liver transplantation were retrospectively analyzed,who failed to respond to ERCP and underwent PTCD from January 2005 to December 2007.Result All patients were performed PTCD successfully including cholangiography in 141 cases,drainage tube replacement in 115 cases,and balloon dilation of bile duct stricture in 39cases.The intubation time ranged from 2 months to 65 months.The mean levels (x ± SD) of alanine aminotransferase,aspartate aminotransferase and total bilirubin were 68.0 ± 29.1 U/L,52.6 ± 34.8 U/L,63.2 ± 33.3 μmol/L after treatment in comparison to 178.3 ± 63.3 U/L,144.0 ± 59.1 U/L,154.2 ± 92.0 μmol/L before treatment.Conclusion PTCD,which could improve the symptoms and prolong the survival time of both grafts and patients in spite of inconvenience of intubation,is suggested for patients with non-anastomotic biliary stricture if they are not suitable for liver retransplantation.

Objective To research the method of Chronic hepatic injury modeling in mice induced by D -galactosamine and lipopolysaccharide combination . Methods Injected D-galactosamine ( 30 mg/mL ) and lipopolysaccharide ( 2μg/mL ) combination by intraperitoneal injection , two days at a time for 8 weeks .Monitored variation of diet and weight; detected serum level of alanine aminotransferase ( ALT ) and aspartate aminotransferase (AST), been put to death in mice and removed the liver tissue .strained hepatic tissue by the HE and Masoon dye to observe Liver tissue structure and cellular morphology and the degree of fibrosis .Results Lipopolysaccharide and D-galactosamine combination resulted in ALT rise , hepatocyte degeneration and necrosis ,collagen fiber hyperplasia obviously . Conclusion D-galactosamine and Lipopolysaccharide combination could induce mice chronic hepatic injury modeling .