Objective: To evaluate the satisfaction degree of non-medical students in medical school,and to investigate the factors that influence satisfaction degree. Method: Selfcompile scale is administered to 430 nonmedical students from 6 medical colleges,in which 5 is in Guangdong province and 1 is in Ha’erbin city. Result:The satisfaction of nonmedical students is low,significant diferences are found between grades,and between students with medicine as the first choice major and those whose first choice major is not medicine. Conclusion:Medical colleges should pay more attention to nonmedical majors,improve the quality of teaching,and so on in order to improve the nonmedical students’satisfaction degree.

Objective To compare CT perfusion changes of patients 1 month after living liver transplantation with healthy volunteers. Methods Twenty perioperative patients without complications and 25 healthy volunteers underwent dynamic multi-slice CT scan. On each targeted slice, liver was divided into 3 regions of interest (ROI) according to hepatic venous drainage, i.e. anterior segment area drained by middle hepatic veins (MHV) which was most likely congested, risk area drained by both MHV and RHV which was posterior to anterior segment, reference area drained by RHV. Perfusion parameters and relative perfusion difference were calculated.Results The relative perfusion differences of anterior segment and risk area in study group were as follows: BF 44.56±43.19 vs 25.41±27.49 ［ml/(min〖DK〗·100 g)］; BV 3.91±2.45 vs 2.15±1.86(ml/100 g); PVP 41.50±39.15 vs 22.66±23.82 ［ml/(min·100 g)］. Significant differences of RPDs of BF, BV and PVP were found in anterior segment (P<0.0001) and risk area (P＜0.01) compared with control group.Conclusion In perioperative period, there are hemodynamic differences in hepatic segments drained by RHV and MHV. BF, BV, PVP of anterior segment decreases obviously.

Objective To study the clinicopathological characteristics and prognosis of asymptomatie IgA nephropathy (IgAN) children with pmteinuria and/or microscope haematuria .Methods Clinical and pathological characteristics of 54 children with IgA nephropathy confirmed by renal biopsy were analyzed . These children with IgAN were divided into two groups according to their clinical characteristics at the first onset: asymptomatic IgAN group (AsIgAN) and symptomatic IgAN group (SIgAN) . Histologic changes were classified by Lee SM and Katafuchi semiquantitative scoring system . Results Eighteen children were in AslgAN group and 36 children were in SIgAN group . The degree of proteinuria in SIgAN group [(2 .3±2 .2) g/d] was higher than that in AslgAN group [(0 .4±0 .3) g/d] at the time of biopsy (P＜0 .05) . Although asymptomatic IgAN children were mainly of Lee's type Ⅰ ～Ⅱ, 2 children (11%) were of Lee's type Ⅳ～Ⅴ and 5 cases (27%) presented interstitial injury . Symptomatic IgAN children were mainly of Lee's type Ⅱ ～Ⅲ, there was no significant difference between two groups (P＞0 .05) . Urine micrealbumin was increased in 87% children presented with microscope haematuria . After an average of (26 .9±8 .8)months follow-up, only one case of Lee's Ⅴ progressed into renal failure and the others maintained normal renal function . Conclusions Although children with asymptomatic IgAN have minor clinical symptoms, severe renal pathological lesion and poor prognosis also occur . Urine screening helps to detect renal diseases and renal biopsy should be performed in the patients with increased urine microalbumin .

Objective To describe the real experience of nurses from different grade hospitals during further study in the three-level hospital.And to provide the basis to make plans,improve the effect of fustther study and ensure the realization of further study aim.Methods In-depth interviews were canied out with 28 nurses by using Hidegerian phenomenological method.The acquired data were reorganized,analyzed and extracted themes.Results Different grade hospital nurses had different psychological experience such as aims,willingness,effects,obtainment and stress.Condusions Further study should be based on subjective willingness and definite goals.Hospitals should strictly select nursing teachers,give differential treatment in education,fully understand the pressure source and provide corresponding measures to reduce stress of nurses.

Objective To explore the effect of Toll-like receptor 4 (TLR4) on the peripheral blood mononuclear cells(PBMCs) in the development of rheumatoid arthritis (RA) by inducing the differentiation of Th17 cells.Methods Forty two subjects were recruited to the study,including 22 patients with RA and 20 healthy controls (HC).The percentage of circulating Th17 cells were analyzed using flow cytometry.PBMCs were stimulated with LPS for two days.TLR4 mRNA of the PBMCs and the concentration of IL-6 and TNF-α in the supernatants were analyzed with the real-time qPCR and ELISA respectively.Supematants was then used for CD4+ cord blood mononuclear cells (CBMCs) culture,and IL-17 in the supernatants and the expression of IL-17 mRNA in cells were detected by ELISA and real-time qPCR respectively.The statistical analysis was carried out with t-test.Results The TLR4 mRNA expression in the PBMCs and the percentage of circulating Th17 ceils of RA patients were significantly higher than that of the HC group (P＜0.01).Stimulated by LPS,the expression of TLR4 mRNA increased 3.5 times in the RA group but decreased 0.11 times in the HC group.LPS also increased cytokines production in both groups,while PBMCs from RA patients produced more IL-6 and TNF-α than the cells from healthy subjects (P＜0.01).Compared to the HC group,the IL-17 mRNA expression and IL-17 secretion of CD4+ CBMCs induced by the supematants of RA patients' PBMCs stimulated with LPS was significantly higher(P＜0.01 ); but there was no significant difference between the RA group and the HC group without LPS stimulation (P＞0.05).Conclusion The expression of TLR4 on PBMCs from patients with RA and its response to LPS stimulation are increased,and it has demonstrated high capability in inducing the differentiation of Th 17 cells.

Objective:To optimize the formula of 5-aminosalicylic acid enema in situ gel. Methods:5-Aminosalicylic acid ene-mas in situ gel was prepared using a cold dissolution method with carbomer as the gel matrix and xanthan gum as the thickener. A 32 full factorial design was used to investigate the effects of the concentrations of carbomer and xanthan gum on the viscosity before and af-ter the gelling, duration of inversion tube and sedimentation rate. Response surface methodology was used to optimize the formula. Re-sults:The quantitative relationships between the two factors and the four evaluation indices were obtained. The optimum formula was as follows:the concentration of carbopol and xanthan gum in the enema was 0. 7% and 0. 15%, respectively. The viscosity before and af-ter the gelling was 500-1 000 mPa·s and 2 200-2 700 mPa·s, respectively. The duration of inversion tube test was 40-80 min and the sedimentation rate was more than 98. 5%. Conclusion:The multi-objective simultaneous optimization of the formula of 5-aminosal-icylic acid enema in situ gel is accomplished by factorial design and response surface methodology.

Objective To explore the clinical characteristics of infratentorial primary angiitis in central nervous system (PACNS).Methods A total of 5 cases diagnosed as infratentorial PACNS in the neurology department of Navy General Hospital of PLA in 2015 were enrolled in the study.The clinical,imaging and pathological data were collected and analyzed.Results All the 5 cases were male with the median onset age of thirty-four.Five cases presented with dizziness,two with headache,three with walking unstable,two with facial numbness and one with dysarthria.Rising pressure of cerebrospinal fluid (CSF) (190-245 cmH2O,1 cmH2O =0.098 kPa) was found in 4 cases by the lumbar puncture,mildly increased number of leukocyte in 2 cases [(12-28) × 106/L],increased CSF protein in 3 cases(540-979 mg/L) and increased IgG index in 3 cases (0.84-1.45).Pons lesions were revealed by magnetic resonance imaging(MRI) in 4 cases,brachium pontis lesions in 2 cases,cerebellum lesions in 2 cases,one with midbrain lesion in 1 case,unilateral lesions in 4 cases and bilateral lesion in 1 case.Different degree of edema and mass effect were shown in all lesions by MRI.Patch like enhancement was found by contrast MRI in 5 cases and meningeal enhancement in 2 cases.Elevation of choline (Cho) peak was found by magnetic resonance spectroscopy (MRS) in 4 cases,reduction of N-acetyl aspartate (NAA) peak in 3 cases,appearance of lactate peak in 1 case and lipid peak in another case.Arterial spin labeling (ASL) was performed in 4 cases and no hyperperfusion was found.Susceptibility weighted imaging(SWI) was performed in 3 cases and microhemorrhage in the lesions was found in 2 cases and normal in 1 case.Magnetic resonance arteriography(MRA) was performed in 1 case and no stenosis was found.Digital subtraction arteriography(DSA) was performed in 1 case and multiple stenosis of the intracranial arteries was showed.Two cases had taken the stereotactic brain biopsy and the histopathologic diagnosis was angiitis.Five cases were treated with methylprednisolone and cyclophosphamide was added on in 1 case.Good prognosis was found in all cases.Conclusions Infratentorial PACNS mostly attacks middle-aged males.The lesions tend to locate in unilateral pons,brachium pontis,cerebellum and midbrain.Hemorrhage or microhemorrhage in lesions is often found by SWI and no hyperperfusion is shown by ASL,which would be useful to distinguish PACNS from malignant tumors.Given the limitations of brain biopsy in clinical practice,clinical and imaging features would be helpful to diagnose PACNS.

Objective To explore the correlation of minimal residual disease ( MRD) and ABC genes expression in acute myeloid leukemia ( AML) .Methods 52 de novo AML bone marrow samples were used to detect the expres-sion of ABCB1,ABCC1,ABCC4 andABCG2 by real-time PCR at diagnosis.Meanwhile, followed up these patients to monitor MRD with MFC at the points of finishing the first induction cause as well as the third ,the sixth and the ninth month after chemotherapy .Results The expression level of 4 ABC transporters among three MRD level de-tected after induction cause are correlated significantly with ABCB1(P<0.01), ABCC1(P<0.01), ABCC4(P<0.01) and ABCG2(P<0.01).Further more, after nine months follow-up, the patients whose MRD turned into positive again were detected a high ABC transports expression level , comparing with those MRD remained negative for nine months,which was of a statistically significance for ABCB1(P<0.05), ABCC1(P<0.05), ABCC4(P<0.01) and ABCG2(P<0.01).Conclusions A positive correlation of MRD and ABC transporters level in AML is found.

Objective To analyse the pathological features in 12 patients demonstrated with demyelination lesions of peripheral nerves Methods Twelve abnormaly cases were screened with EMG from 60 cases of multiple sclerosis (MS) Sural nerve biopsy was done in 12 patients and specimens were analyzed by HE and Loyez,and by electronic microscopy Results Myelinated fibers was reduced in sural nerve biopsy in 8 cases and most striking demyelination seen in 11 cases In electronic microscopy,11 cases specimens were shown myelinated losses,regeneration of myelinated fibers,vacuoate,hyperplasia of Schwann cell and typical onion bulb formation 8 cases of the large thickened fibers showed increased members of myelin lamellae Conclusion MS is charaterized by inflammatory demyelinating disorder limited to the CNS And some patients' peripheral neves are also shown sectionally demyelinated injury.