Medical examination is an important measurement of evaluating the teaching effect and studying results,and also is the main method and content of teaching quality evaluation in universities and colleges.During the teaching evaluation we found that many problems of medical examination need to be solved and improved.This paper deals with three major aspects closely related to teachers including the standardization of programming test paper,rating the test scores,and statistical analysis of the examination papers.

Objective To investigate the roles of aberrant expression of c-myc,c-myb,and c-erbB-2 in the development of breast cancer and its clinical significance.Methods Immunohistochimical technique (S-P method)was used to detect the expression of c-myb,c-myc and c-erbB-2 protein in 150 cases of breast cancer and 30 cases of benign proliferative lesions.heir relation to clinical pathological parameters were analyzed.Results The protein expression levels of c-myc,c-myb,and c-erbB-2 in breast cancer were higher than those in benign proliferative lesions and the difference was significant(all P ＜0.05).Expression of c-myc protein had obvious relationship to histological grade,lymph nodes metastasis and pathological types(all P ＜ 0.05).Expression of c-myb protein related significantly to histological grade (P ＜ 0.05).c-erbB-2 was associated with the tumor size,grading,PR expression (all P ＜ 0.05).The association among the three kinds of genetic proteins was observed.Conclusion Expressions of oncogenes c-myc,c-myb,and c-erbB-2 proteins are higher in breast cancer and lower in benign proliferative lesions.The difference is significant.They are related to the grading and some other prognostic factors such as tumor size,pathologic types,PR expression and lymph node metastasis.The results suggest that these oncogenes are activated in the development of breast cancer and provoke cancerous cells multiplication.Expressions of oncogenes c-myc,c-myb and c-erbB-2 mightbe considered to be the prognostic indicators of breast cancer.

Objective To summarize the experience in diagnosis,prention and management of right accessory hepatic duct(AHD)injury during laparoscopic cholecystectomy(LC).Method The clini-cal data of 8 patients with AHD injury during LC diagnosed and managed retrospectively analyzed. Results Of the 8 patients, 5 patients were found during LC,3 patients were found after LC.Management were ad follow:5 patients with the diameter of the AHD smaller than 3.0 mm were ligated,1 patient with the diameter of 5.0 mm were reconstructed,1 patient with the diameter of 3.0 mm,but the AHD connected with other bile duct in vicinal epaticlobes,were ligated.These 7 patients,with the injured AHD ligated or re-constructed,were followed up for 6 months to 5 years and showed good results.The another who did not be found during LC and not be managed appropriately,arose serious bile leakage and infection for a long time,underwent drainage operations for 3 times,cured after haft year.No death in all patients.Conclusions Correct operative rules should be obeyed strictly in LC,and keep the exist of AHD under close guard,if AHD injury occurred,LC should turn to open surgery immediately,early finding of the injury and managing appropriately is the key to achieve successful result.

Objective To understand the incidence and the clinicopathological characteristics of breast cancer in Bengbu area.Methods The clinicopathological datas of 446 cases of breast cancer were analyzed retrospectively,which included the clinical profile,tumor size,pathological grading,lymphatic metastasis,pTNM staging,hormonal receptor status and oncogene C-erbB-2 protein expression of some cases.Results Female was found in 99.6% of the patients.The average age was 49.76 years old.Most patients presented firstly by breast masses.The average time was 11.58 months from discovering the mass to final pathological diagnosis.The average longest diameter was 3.06cm.Invasive ductal carcinoma was found in 92.8%.Metastasis was found in 58.8%.Lymphatic metastasis rate was higher in extrinstic and posterior pectoralis monor.ER expression rate was 45.3% and PR,44.2%.The positive rate of C-erbB-2 was 81.4%.C-erbB-2 protein expression was found to be related to the status of ER and PR.Conclusion Breast cancer is more commonly found in middle and old women.Early discovery rate is lower and invasive carcinoma is diagnosed in most cases while metastasis is found in halof the cases.Carrying out breast cancer census is of important significance for prevention and treatment of breast cancer.

[Objective]To evaluate the accuracy and influenceing factors of somatosensory evoked potential in spinal cord monitoring during cervical and thoracic spinal surgery and intraoperative nerve root monitoring in lumbar surgery.[Method]The somatosensory evoked potential(SEP) were used during arvical and thoracic spinal surgery and evaluated the accuracy of SEP according to the record of different stages and spinal cord function after surgery.The EMG were used to monitor the nerve root function in lumber operation to estimate whether nerve root being stimulated or tensioned.In addition,affected fators of SEP and EMG during operation were observed.[Result]Of 128 cases of cervical and thoracic surgery,116 cases did not reach the warning standards(amplitude decreasing 50% or diappearing) and showed no postoperative enhancement of symptom of nerve roots injury.12 cases reached the warning standards intraoperatively and the surgeon were warned to take some steps to finish the operations,only in one case incompletely transient paralysis occurred due to the time of amplitude decreasing of intraoperative SEP more than 10 minutes.Effect of other factors such as anaesthesia and low blood pressure did not reach the warning standards.There were 3 artifical negative cases.Only 1 was artifical positive case.of 40 cases of lumbar surgery,12 cases were found myoelectic responses,which warning the surgeon at any time to avoid nerve roots injury,no nerve roots injury were found after operation.[Conclusion]During cervical and thoracic spinal operation,the somatosensory evoked potential can reflect the physiological and pathological conditions of spinal cord after ruling out the interfering factors.Intraoperative spontaneous electromyography can reflect the nerve roots function promptly and accurately and assure the safety of lumbar surgery.

Nude mouse bearing human bladder cancer exhibits similar growth characteristics as human bladder cancer and therfore is a good simulation model in the research of the biological behaviors of human bladder cancer. To explore the initiation, development, prognosis and biological behavior of human bladder cancer,and to develop intravesical biological agents and antitumor drugs with improved strategies for prevention and treatment of bladder cancer, it is essential to establish human bladder tumor-bearing nude mice for basic and clinical researches. This is a review of the current status of the application of human bladder tumor-bearing nude mice.

Objective To explore the relationship between self-management behaviors and family function among elderly pa-tients with diabetes in community in order to provide evidence for community nursing of diabetes.Methods A total of 670 elderly patients with diabetes were selected with convenience sampling household survey method and investigated with the family Adapta-tion,Partnership,Growth,Affection,and Resolve(APGAR)and the Summary of Diabetes Self-Care Activities(SDSCA).Results The family functions total score of the elderly patients with diabetes in community was (6.95±2.91),the self-management behav-iors total score was (20.06±5.80),among the self-management behaviors the score for exercise was the highest and blood glucose monitoring was the lowest;family function had remarkable positive relation with the total score of self-management behaviors a-mong elderly patients with diabetes in community(r=0.156,P <0.05).Conclusion There is a correlation between the self-man-agement behaviors and family function,good family function is conducive to the improvement of self-management behaviors for the elderly patients with diabetes.

BACKGROUND:Basic research demonstrated that type Ⅰ collagen exhibited prominent effect on osteogenesis,bone mass and bone fracture,which also participated in the bone fusion.However,few reports concerning the polymorphism of type Ⅰ collagen gene and spinal fusion.OBJECTIVE:To investigate the polymorphism of type Ⅰ collagen and to explore its relationship with the spinal fusion rate following metal implant or autogenous bone transplantation.METHODS:A total of 200 volunteers who need to receive spinal fusion in the Affiliated Hospital of Qingdao University Medical College were selected,including 102 cases received anterior cervical subcorpectomy combined with lilac bone implantation fusion following decompression,and 98 cases received posterior laminectomy for decompression combined with intertransverse process fusion.Meantime,223 normal adults were served as the control group.The peripheral blood was drawn-off and genomic DNA was extracted from white blood cells.The specific fragment which includes the objective gene was amplified by polymerase chain reaction (PCR),with length of 293 bp.The genotypes of Pcol2 site in type Ⅰ collagen were detected by PCR-restriction fragment length polymorphism (PCR-RFLP) method.The PCR product was digested with restriction endonuclease Eco311 and the result was observed by agarose gel electrophoresis.The G gene represented for the presence of the restriction endonuclease site,while the T gene for the absence of the restriction endonuclease site.The fusion rate of the bone graft was evaluated by x-ray film prior to and at months 3,6 and 12 after operation,and the results were compared by stages including quick (＜3 months),middle (3-6 months) and slow (6-12 months).RESULT AND CONCLUSION:There were the-1997G/T polymorphisms of the type Ⅰ collagen gene in 423 cases,including 166cases with GG,232 cases with GT,and 25 cases with TT,in addition,there was some correlation between the GG genotype and the lilac bone implantation fusion (P =0.004).The GG genotype accounted for 50% in the fast group,which was obviously greater than that of the middle and slow groups (33.3% and 16.7%,respectively).However,the-1997G/T polymorphisms had no correlation with the bone graft fusions inter transverse process of lumbar vertebra (P=0.831).The GG genotype in the-1997G/T polymophsim of the type Ⅰ collagen gene may be the essential factor which can promote the C-spine auto-ilium graft fusion.

Objective To investigate the relationship between a functional single nucleotide polymorphisms(SNP) in the core promoter region of GDF5 gene(+104T＞c ;rs143383) and spinal fusion in Qingdao Han people. Methods This study included 201 patients who needed to be treated with spinal fusion and 200 healthy controls. They were all out of tuberculosis, tumor, infection, and long time of related medicine using. Their operation regions were similar, containing L4.5, C4.5, C5.6, and C6.7. The SNP was defined in all people, using PCR-restriction fragment length polymorphism (RFLP) and gene sequencing. The patients were followed-up 3,6, 12 months after operation. The conditions of bone graft fusion were carried out into different grades according to imaging. According to the common used fusion criterion, to analyze the relationship between this SNP and spinal fusion. Results The results obtained from PCR-RFLP were confirmed by gene sequencing. The patients and the healthy control all showed the SNP in this site. There were no relationship between the spinal fusion patients and the healthy control in the SNP (x2=0.304, P=0.859). But it showed correlation (x2=4.752, P=0.023) with fusing or not in the spine and the speed of fusion (x2=9.864, P=0.007)in Qingdao Han people. In the fusion group, the site rs143383 showed more C allele than the non-fusion group. T allele may affect the transcription of GDF5, thus reduce the expression of GDF5. Patients with the genotype TC+CC showed larger proportion stable fusion and faster speed than the patients with TT. Conclusion SNP in the core promoter region of GDF5 (+104T＞C) is associated with spinal fusion in Qingdao Han people. The allele C may be an important factor to promote spinal fusion. Detect the TT genotype early and intervene, the spinal fusion effect may be improved. Or, the genotype may be changed by gene technology,making the efficient fusion.

Objective The purpose of this study is to investigate the influence of comprehensive intervention on the family and social functions in patients with schizophrenia. Methods The stratified randomization, controlled experiment was designed for this study. 300 cases were diagnosed as schizophrenia in accordance with the Chinese classification and diagnostic criteria of mental disorder-3 (CCMD-3) diagnosis standard, and they were randomly divided into intervention group and control group. All the cases were followed up for three years after hospital discharge. Comprehensive interventions were only taken in intervention group, but not in control group. All of the cases were e-valuated by family assessment device (FAD) and social disability screening schedule ( SDSS) at the time of pre - therapy, hospital discharge and the end of 1st, 2nd and 3rd year after hospital discharge. Results In the 3rd year after hospital discharge, the scores of PANSS, FAD and SDSS of intervention group were significantly lower than those of control group ( P < 0.05 ). Conclusion Comprehensive intervention can significantly improve the family and social functions in the patients with schizophrenia.