Medical students participating in chnieal medical early is one of the good ways to cultivate students'all-around qualities From freshman year medical students begin to enter chnical medical service system and make clinical practice in spare time,They are also trained to link theory with practice to caltivate clinical thinking ability,strengthen its humanistic care idea and doctor-patient communication ability so that medical students will know the sacred profession of being adatov and from the idea of sewing patients work of the sacred doctor,set up'professional service to patients'concept.

Objective:To fathom the disposition and drug resistance of the common pathogenic bacteria,separated from various kinds of samples of in-patients and out-patients in hospitals of the western areas in 2006.Method:The assay and analysis of drug resistance in accordance with the sceptor microbiological manual system set by BD company,or with Biomerieux Vitek-32 manual system.Results:In 2006,1 900 strains of pathogenic bacteria were separated,1 210 of which were negative bacilli (63.68%);585 out of 1 900 strains were positive coccobacteria(30.79%).Imipenem has natural drug resistance against Stenotrophmomas maltophilia,and among all of the tested antibacterials,There were 105 strains of fungi.it has the most powerful antibacterial activity against other negative bacilli.There were a remarkable distinction(P

Objective To investigate the changes of serum cytokines IL-2,IL-8,IL-10 and IFN-? in infants with cytomegalovirus hepatitis before and after ganciclovir treatment,and explore the underlying mechanisms of ganciclovir and the immunological changes in the development and progression of cytomegalovirus(CMV) infection.Methods CMV-IgM in the serum samples of 72 infants with identified cytomegalovirus infection were measured by enzyme-linked immunosorbent assay(ELISA).CMV DNA in blood was measured by quantitative PCR.CMV-IgM(+) and CMV DNA(+) were as observed group 1(35 cases,without hepatitis).Those with abnormality of ALT were regarded as observed group 2(37 cases,with hepatitis).Another 30 matched healthy infants were enrolled as healthy control group.Levels of serum IL-2,IL-10,IL-8 and IFN-? of each group were examined by ELISA,and CMV masculine hepatitis group were cured with ganciclovir(5mg/kg,i.v.,twice per day for 14 d,and then once per day for 14 d after a 7 days'interval),then the levels of above factors were examined again.Results The levels of IL-8 and IL-10 in observed group 1 were significantly higher than those in healthy control group(t=3.74,9.56;P0.05).After ganciclovir treatment,the level of IL-2 in observed group 2 was significantly higher than that in observed group 1(t=3.41,P0.05).The levels of IL-8,IL-10 and IFN-? were decreased significantly(t=6.52,7.24,14.23;P

Objective To investigate the relationship of peroxisome proliferator activated receptor gamma ( PPAR?)C161T gene polymorphism with related diseases of metabolic syndrome. To disscuss the mechanism of the elderly diseases from gene level and the relation between the gene polymorphism and lipid metabolism. Methods Three hundred seventy one non-sibship subjects of Han nationality were investigated in this study, including 69 old healthy subjects, 302 elderly cases diagnosed as metabolic syndrome. PPAR? C161T gene polymorphism was determined by polymerase chain reaction and restriction fragment length polymorphism, and radioimmunoassay was used to detect serum insulin. The insulin resistance was obtained from homeostasis model assessment (HOMA), and blood glucose, blood lipoprotein, height, weight and so on were tested. The frequencies of PPAR? C161T genotypes and the allele were compared with the clinical data. Results (1) In the groups of old normal health and metabolic syndrome, "T" allele frequency was 0.217,0.201, and "C" allele frequency was 0.783, 0.798 . There was no significant difference between the groups. (2)The triglyceride in CC genotypes of the metabolic syndrome was significantly higher than that in "T" allele carriers. Conclusions (1) The distributing trend of PPAR ? C161T gene polymorphism of the Han nationality in Wuhan in the elderly normal healthy group was in accord with that in the group of the elderly metabolic syndrome. (2) PPAR ? C161T substitution can influence metabolic syndrome, especially in liporprotain metabolism. "T" allele is associated with lower level of triglyceride.

The experience in diagnosis and treatment of bleeding complications in severe acute pancreatitis (SAP) by transcatheter arterial embolization was summarized. The clinical data of 19 SAP patients complicated with intra-abdominal bleeding in our hospital from Jan. 2000 to Jan. 2003 were analyzed retrospectively and the therapeutic outcome of TAE was evaluated statistically. The results showed that the short-term successful rate of hemostasis by TAE was 89.5% (17/19), the incidence of re-bleeding after TAE was 36.8% (7/19) and the successful rate of hemostatis by second TAE was 71.4% (5/7). It was concluded that the intra-abdominal bleeding in SAP was mainly caused by the rupture of erosive/infected pseudoaneurysm. Mostly, the broken vessels were splenic artery and gastroduodenal artery; In terms of emergence hemostatis, TAE is the most effective method. Surgical hemostasis is necessary if hemostasis by TAE is failed or re-bleeding occurs after TAE.
Aneurysm, False/diagnosis ; Aneurysm, False/etiology ; Aneurysm, False/therapy ; *Embolization, Therapeutic/methods ; Hemoperitoneum/diagnosis ; Hemoperitoneum/etiology ; Hemoperitoneum/*therapy ; Pancreatic Pseudocyst/diagnosis ; Pancreatic Pseudocyst/etiology ; Pancreatic Pseudocyst/therapy ; Pancreatitis, Acute Necrotizing/*complications ; Pancreatitis, Acute Necrotizing/therapy ; Retrospective Studies

The proliferation and differentiation of pancreatic duct epithelial cells in remnant pancreas during regeneration after partial pancreatectomy in rats were studied, and the source of pancreatic stem cells was characterized. Partial (90 %) pancreatectomy was performed on 4- to 5-week-old Sprague-Dawley rats, and different duct epithelial cells and acinar cells were detected by immunohistrochemical stain method and scored using 5-bromo-2'-deoxyuridine (BrdU) labeling index (LI) at various time points after partial pancreatectomy. It was found that at 24 h after partial pancreatectomy proliferation started in the main, large and small duct cells, and persisted in small duct cells to day 5. There was significant difference between the experimental group and the control group (P<0.001). Acinar cells positive for BrdU were greatly increased and reached the peak LI on day 5. The destroyed lobular architecture almost totally recovered on day 7, and the newly islet cells appeared around the pancreatic ducts. These results suggest that regeneration after partial pancreatectomy is involved in proliferation and differentiation of pancreatic stem cells, and pancreatic stem cells may locate in the pancreatic ductules.

ObjectiveTo investigate the effect of percutaneous coronary intervention (PCI) treatment on quality of life and prediction in patients with chronic total occlusion.Methods87 patients with chronic total occlusion who had underwent PCI to revascularization were studied. 57 cases had successfully revascularized and implanted stenting. 30 cases failed to revascularize. Their activity of living, quality of life and long prediction were observed.ResultsAfter 6～60 months follow-up, the quality of life in patients with successful revascularization was much better than that in patients who failed to revascularize. Mortality between these two groups showed no significant difference. ConclusionSuccesful revascularization by PCI on chronic total occlusion can improve quality of life.

Objective To evaluate the efficacy and safety of lamivudine combined with thymosin α1 therapy for patients with chronic hepatitis B.Methods Sixty-eight eligible patients with chronic hepatitis B were enrolled in this multi-center randomized controlled rlinical trial.Patients were randomized into the trial group and the control group(n=34 for each).Patients in trial group received thymosin α1 for 6 months and lamivudine for 12 menths:patients in control group received lamivudine for 12 months only.The rates of serum HBV DNA clearance.HBeAg loss,HBeAg seroconversion,ALT normalization and the safety of thymosin α1 were observed at 3rd.6th,12th and 18th month during and after the treatment.Results At 12th month of the treatment,there were significant differences in the rates of serum HBV DNA clearance,HBeAg loss and ALT normalization between two groups(χ2=31.17,7.17 and 5.92,P＜0.05);at 6th month after the treatment.there were significant differences in the rates of sernm HBV DNA clearance and HBeAg loss between two groups(χ2=4.53 and 7.17,P＜0.05).HBV DNA was not detected in 2 patients during 6-month follow-up study and no sever side effect was observed throughout the study.Conclusion The conlbination of lamivudine and thymosin α1 is safe and has better effect than the monotherapy of lamivudine in patients with chronic hepatitis B.

OBJECTIVE:To optimize the matrix formula of Lanlian ertong qingre cataplasm. METHODS:Taking adhesion force,peel strength and sensory description as index,the ratio of matrix framework material(sodium polyacrylate-gan hydroxyl alu-minum-tartaric acid-glycerin) was optimized with orthogonal test. The single factor test was adopted to select adhesive and filler;the amount of penetrating agent azone was screened using the in vitro penetration amount of phillyrin. RESULTS:The best matrix ratio of Lanlian ertong qingre cataplasm was sodium polyacrylate-gan hydroxyl aluminum-tartaric acid-glycerin(4.0:0.8:0.4:15);PVP K-90 was used as adhesive,and bolus alba as filler;penetration enhancers azone accounted for 2.0%. Validation test showed, prepared cataplasm had good appearance,could stick on the 5th or the 6th ball;it's peel strength was 7.5 N;all RSDs of score were lower than 4%(n=3). CONCLUSIONS:The optimized matrix formula of Lanlian ertong qingre cataplasm is simple,stable and good in molding.

Objective To evaluate the efficacy of ultrasound-guided laryngeal mask airway (LMA) in children.Methods ASA Ⅰ and Ⅱ children (aged 1 to 6 years) scheduled for orthopedic surgery of limbs were recruited in this study.ALMA was inserted after induction of general anesthesia.After mechanical ventilation for 5 minutes,the air-filled cuff was deflated and then inflated with saline.Ultrasonography was then performed by a high frequency linear-array transducer to confirm the correct placement of the LMA.Results The LMA can be easily recognized on the transverse view of the thyroid cartilage notch,appearing as a circle around the glottis,which was called the dumbbell sign.On the sagittal view of the thyroid cartilage,the LMA has an archlike appearance which ended below the thyroid cartilage.Oblique scan over the cricoid cartilage shows the tip of LMA is located at the upper portion of the esophagus.Conclusions Filling the LMA cuff with saline instead of air allows better LMA visualization by ultrasound.This method enhances correct positioning of the LMA,which is crucial to ensure safe ventilation.