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 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.

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.

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 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 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:At present, spleen tyrosine kinase is the new target of studying and treating rheumatoid arthritis. OBJECTIVE:To study the influence of smal molecule tyrosine kinase inhibitor HL131078 on the inflammatory cel infiltration and cartilage destruction of the knee joint of mice with col agen-induced arthritis. METHODS:Forty DBA/1 mice were randomly and evenly divided into blank, model, positive and experimental groups. Col agen type II (CII) solution and Freund’s complete adjuvant (including mycobacterium tuberculosis) were injected into the mice of the latter three groups through the tail to establish mouse models of col agen-induced arthritis. At 2 weeks after the the first immunization with CII, the mice in the positive group were intragastrical y given R406 (10 mg/kg), once a day, for 28 consecutive days. The mice in the experimental group were intragastrical y given HL131078 (10 mg/kg), once per day, for 28 consecutive days. RESULTS AND CONCLUSION:Compared with the model group, the mean arthritis indexes of mice in the experimental and positive groups started to decline at 29 and 26 days. In the experimental group, the cartilage destruction of mouse knee joint was obviously reduced and the inflammatory cel infiltration in the knee joints was obviously reduced, which was close to that in the positive group. The results demonstrate that the smal molecule tyrosine kinase inhibitor HL131078 can effectively reduce inflammatory cel infiltration and cartilage destruction in the knee joints of mice with col agen-induced arthritis.

Objective To study the prevention,diagnosis and treatment of the pulmonary embolism after abdominal surgery.Methods The clinical data of patients with acute pulmonary embolism(PE) after abdominal surgery between July 2008 and June 2012 were analyzed retrospectively.The high-risk patients received D-dimer,deep venous ultrasound and pulmonary CT examination to confirm the diagnosis postoperatively.Anticoagulation,thrombolysis,inferior vena cava filter placement were carried out in these patients.The high-risk patients received low molecular weight heparin(LMWH) to prevent PE from January 2010.Results 5 patients with PE survived and 3 patients died.The incidence of venous thromboembolism event was 0.43％ (13/3012) before January 2010 and PE was 0.20％ (6/3012).The incidence of venous thromboembolism event was 0.15％ (7/4803) after taking preventive measures and PE was 0.04％ (2/4803).There was no PE within 1 week since using LMWH after 2010.Lower limb DVT was found in 7 patients including 2 patients with PE after LMWH discontinuance within 2-3 weeks postoperatively.Conclusions Early prevention,diagnosis and treatment of postoperative PE are important for high-risk patients.

Objective: To investigate the efficacy of specific point acupuncture and manipulative adjustment on muscle strength of the knee osteoarthritis. Method: One hundred and five patients were randomly allocated to two groups. Sixty-eight cases in the treatment group were treated by specific point acupuncture and manipulative adjustment on muscle strength of the knee joint. While 37 cases in the control group were treated with specific point acupuncture alone. Result: The total effective rate was significantly higher in the treatment group than in the control group (P＜0.05). Conclusion: Specific point acupuncture and manipulative adjustment on muscle strength of the knee joint has a satisfactory curative effect on knee osteoarthritis.