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

Purpose To evaluate the value of imaging on the diagnosis and treatment of human-infected H10N8 virus. Materials and Methods The chest X-ray and CT features of one case of human infected H10N8 virus were retrospectively studied. Results A 73-year-old female patient was admitted to the third affiliated hospital of Nanchang University on November 30, 2013 due to cough, sputum for 3 days and fever for 1 day. The patient was diagnosed with severe pulmonary infection and underwent chest CT on December 1, which showed large opacities with air bronchograms were in the lower lobe of her right lung and ground-glass exudative lesions in the lower lobe of the left lung;the next 24 h, 48 h and 72 h review tracking chest X-ray showed the chest lesions developed rapidly which involved more lobes with more areas, integration of lesions and plenty of pleural effusion in a very short time. This was a typical white lung sign of acute respiratory distress syndrome. The patient died later on December 6, which was reported as the case of human-infected avian influenza (H10N8 virus) by Chinese Center for Disease Control and Prevention. Conclusion The chest imaging features found in human infected H10N8 virus present as progressive opacities and exudative lesions.

Objective: To investigate the effect of hydrogen sulifde (H2S) on the expression of CSE, NF-κB, and IL-8 mRNA in GES-1 cells withHelicobacter pylori (H. pylori) infection and to explore its mechanism on gastric mucosa inlfammation caused byH. pylori.
Methods: GES-1 cells were cultured for 24 h and divided into a control group (neitherH. pylori nor NaHS), anH. pylori group, a NaHS group (which was further divided into 4 groups at 50, 100, 200, or 400 μmol/L NaHS), andH. pylori + NaHS group (which was further divided into 4 groups at 50, 100, 200, or 400 μmol/L NaHS). Each group was then cultured for 3, 6, or 12 h. The expression of CSE, NF-κB, and IL-8 mRNA was measured by RT-PCR, and their correlation was analyzed. Results: The expression of CSE, NF-κB, and IL-8 mRNA in GES-1 cells in theH. pylori group was higher than that in the control group. The expression of CSE in the 200 μmol/L NaHS group and 400 μmol/L NaHS group was lower than that of the control group (P<0.05), whereas the expression of NF-κB and IL-8 in all NaHS groups had no statistical differences compared with the control group (P>0.05). The expression of CSE, NF-κB, and IL-8 mRNA in all groups of NaHS,H. pylori + 200 μmol/L NaHS group, andH. pylori + 400 μmol/L NaHS group was lower than that in theH. pylori group (P<0.05). There was positive correlation among the expressions of CSE, NF-κB, and IL-8 mRNA in theH. pylori group, theH. pylori + 200 μmol/L NaHS group, and theH. pylori +400 μmol/L NaHS group (P<0.05).
Conclusion:H. pylori can induce NF-κB and IL-8 mRNA expression and upregulate CSE mRNA expression. At 200 and 400 μmol/L, NaHS can suppressH. pylori-induced NF-κB and IL-8 mRNA expression and ameliorate the morphology ofH. pylori-induced GES-1 injury, which may protect gastric epithelial cells byH. pylori infection.

Objective To investigate the changes of serum cytokines and explore their role in infants with cytomegalovirus (CMV) infection. Methods We recruited 41 positive CMV-IgM plus normal ALT infants (other disease group), 30 positive CMV-IgM plus abnormal ALT infants (hepatitis group) and 30 healthy infants (control group) in the study. The levels of tumor necrosis factor-?(TNF-?), interferon-?(IFN-?) and interleukin-4 (IL-4) in serum were measured with ELISA. The association between TNF-? and ALT was analyzed. Results The levels of TNF-?, IFN-?, IL-4 were higher, and IFN-?/IL-4 was significantly lower in the two CMV infection groups than the control group. Compared with other disease group, the changes of TNF-?, IL-4, and IFN-?/IL-4 showed significance in hepatitis group. The level of TNF-? showed a positive association with ALT in hepatitis group(r=0.76,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.

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.

OBJECTIVE To study the existence of integron and metallo-?-lactamase in Stenotrophomonas maltophilia in our hospital.METHODS The antibiotic susceptibility was tested by K-B method.The genomic DNA and their plasmids were extracted.The integron and metallo-?-lactamase gene were amplified by polymerase chain reaction(PCR).RESULTS L1 and L2 genes were amplified in chromosomes and plasmids.Integrons Ⅰ and Ⅱ were detected in genomic DNA.CONCLUSIONS Existence of metallo-?-lactamase is one of reasons of multi-drug resistance in S.maltophilia.S.maltophilia can receive integrons and gain its multi-drug resistance from other strains.

Objective To sum up the experience on diagnosis and treatment of intraabdominal bleeding in severe acute pancreatitis (SAP). Methods The clinical data of 37 SAP patients with bleeding complications from Jan 1999 to Jan 2003 were analyzed retrospectively. The causes of bleeding were of erosive (5 cases), infected (20 cases), intra operative/postoperative (10 cases) and coagulopathy (2 cases). Results The mortality was 10% (2/19) for transcatheter arterial embolization (TAE), 30% (7/23) for laparotomy, 50% (2/4) for conservative thepary. The cause related mortality was 0 (0/5), 30% (6/20), 40% (4/10) and 50% (1/2) for erosive, infection, intra/post operative, and coagulopathy respectively. Conclusion In SAP most intra abdominal bleedings are from erosive/infective pseudoaneurysms of splenic artery or/and gastroduodenal artery. The preferred diagnosis methods were CT and selective angiography which often give definite diagnosis. TAE is most effective therapy, when it fails, a surgery is necessary.