ObjectiveTo study the diagnostic value of serum type IV collagen(IV-C) in hepatic fibrosis. MethodsSerum IV-C levels were detected by using radioimmunoassay(RIA) and were compared with serum type Ⅲ procollagen(PCⅢ ) levels in normal controls(NC) and patients with chronic liver diseases. ResultsSerum IV-C and PCⅢ levels in patients with chronic liver diseases were all much higher than those in NC(P < 0.01, totally). Serum IV-C level in severe chronic hepa titis(CH) group was significantly higher than those in mild and median CH groups (P<0.01 total ly), and that in active liver cirrhosis(LC) group was significantly higher than that in static LC group (P＜0.05). There were significant positive correlation between serum IV-C level and serum PcⅢ level both in CH group and in LC group ( in CH γ=0.7023, in LC γ=0. 5878, P＜0. 001).Conclusion Serum IV-C level could reflect the activity of hepatic fibrogenesis.

Objective To investigate the role of IgG determination in diagnosis of early renal damage in children with Henoch-schonlein purpura(HSP). Methods Urine IgG was determined in 188 children with HSP (HSP group), 99 patients with Henoch-schonlein purpura nephritis (HSPN group) and 26 healthy controls (healthy control group). Simultaneously, qualitative detection of urine protein was carried out in HSP group. Results The abnormality rate of urine IgG was significantly higher than that of urine protein in HSP group (P<0. 05). The level of urine IgG was significantly higher in HSP group than that in healthy control group (P<0. 05), while the level of urine IgG in group than that in HSP group (P<0. 05). Conclusion Urine IgG determination is simple and nonin-vasive, which if high clinical value in diagnosis of early renal damage in children with Henoch-schonlein purpura(HSP).

Objective To study the effect of small diameter graft (0.8 cm) splenocaval or mesocaval shunts combined with pericardial devascularization in the treatment of portal hypertensive variceal bleeding. Methods Splenocaval shunts were performed in 14 patients and mesocaval shunts were done in 24 patients, in combination with pericardial devascularization. Results The average decrease of free portal pressure was 6.6±1.2 cm. There was no significant changes in liver function postoperatively (P>0.05). Platelet counts and leukocyte counts were back to normal in splenocaval shunt patients postoperatively (P< 0.05). Operative mortality was 3%. Pyrexia developed in 4 patients, intractable ascites in 1 patient, chylons ascites in 1 patient, hepatic encephalopathy in 1 patient, intraabdominal infection in 1 patient and stress ulceration in 1 patient. All patients recovered after expectant treatment except one who died from severe intraabdominal infection. 35 patients received follow-up between 6 months and 3 years, total effective rate was 89%, 2 patients died from recurrent variceal bleeding, the shunt potency rate was 80% in 1 year and 75% in 3 years. Esophagogastric varices disappeared or alleviated as shown by endoscopy in 25 patients on 6 months postoperatively. Conclusions Small diameter portosystemic graft shunts combined with poricardial devascularization is an effective therapy for bleeding esophagogastric varices with a low rate of hepatic encephalopathy. Splenocaval shunt alleviates hypersplenism concurrently.

American medical colleges attach great importance to the humanistic education.The rich humanities curriculum is fully integrated into the teaching practice thus the mutual penetration of medicine and the humanities is achieved.They have specific and detailed examination evaluation system and the teaching method was more practical and participatory.By contrast,nost of the medical colleges in our country neglect the humanities construction and the cultivation of medical students' humanistic spirit.The coverage of the humanities curriculum is relatively narrow and the faculty is insufficient.We should promote the development of humanistic cducation,attach importance to the construction of medical humanities,set up appropriate curriculum system,increase the investment in faculty and reform the teaching method and examination method.

Objective Through investigating the current situation of first national Standardized Medical Resident Training Bases construction in Xinjiang to provide the basis for the administrative department of public health to improve their resident training bases.Methods Selecting standardized training related personnel 133 people of 20 base hospital to conduct a questionnaire survey,and selecting the base hospit.al leaders,the management staff of functional departments,teachers and residents,a total of 254 people were given in-depth interviews.We conducted data collection mainly around the basic situation of the base hospitals and departments,to understand the basic situation,difficulties and problems of the standardized training of resident doctors in the base hospitals,and suggestions and opinions on the training work.We used x2 test,Wilcoxon rank test to make statistical analysis.Results Basic conditions of the hospital was not balanced,70％ of the base hospital library number was 10 thousand ～5 million,75％ of the base hospital computer had a volume of less than or equal to 30.There was statistical significance in the difference of the rate of operation between the cases and the skills in the southem/northeru region teaching/non professional teaching base hospital.Teacher level was not balanced,and only 5 hospital teacher training rate was greater than or equal to 80％,which met the national requirements.Enrollment of each department had a rising trend,including the department of pediatrics,psychiatry and other major shortage of profes-sional year by year,the increase in the proportion of 1 ～2 times.National financial aid was implemented,but lacked local financial input.Conclusion The balanced development of base construction,the continuous improvement of system construction and organization management,the improvement of the teachers' teaching and training quality,the improvement of the resident treatment and striving for more national and local financial allocation will be the focus of the construction and development of Xinjiang resident standardized training base.

Objective:To investigate the changes and clinical implications of serum procalcitonin in exacerbation of chronic obstructive pulmonary disease(COPD).Methods:We have evaluated PCT measurement in 45 patients with an exacerbation of COPD(group A) and 25 patients with stable COPD(group B),quantitative sputum culture was performed,too.PPMs were only regarded as significant if they reached a growth of ≥10~7cfu/mL,indicating the presence of bacterial infection.Results:In patients with an exacerbation,15 patients,sputum yielded a high(≥10~7cfu/mL) bacterial load(group A_1),30 patients,sputum yielded a low(0.05).Using a cut-off point of 0.155?g/L for PCT,the sensitivities and specificities for bacterial infection in patients with an exacerbation of COPD were 93.3% and 60% respectively.Conclusion: Serum procalcitonin measurements in patients of an exacerbation of chronic obstructive pulmonary disease play a role in the diagnosis of bacterial infection.

Objective To explore the expression and clinical relevance of metastasis-associated colon cancer-1 (MACC1) and C-MET proteins in hepatocellular carcinoma (HCC) tissue.Methods The expressions of MACC1 and C-MET were detected in 51 specimens of HCC and paraneoplastic liver tissue,normal liver tissue in 13 healthy cases using immunohistochemistry and Western blotting.The correlations of the expressions of MACC1 and C-MET proteins were evaluated,survival rates were observed,the relationship between the expression of MACC1,C-MET proteins and the clinicopathologic features of HCC were analyzed.Results The positive rate of MACC1 and C-MET proteins was 80.4％ and 76.5％ in HCC tissue,the relative expressions were 0.645 ± 0.047 and 0.504 ± 0.023 respectively,which was significantly different from those in paraneoplastic liver tissue and normal liver tissue (respectively F =173.308,252.817,all P =0.000).The survival analysis showed that the three-year survival rate in patients with positive MACC1 and C-MET expressions was significantly lower than that in patients with negative expressions (respectively x2 =3.934,4.439,all P ＜ 0.05),the positive rate and relative expressions of MACC1 and C-MET were significantly correlated with TNM stage,portal vein cancer thrombus and pathology typing (P ＜ 0.05).Conclusions The expression of MACC1 and C-MET is associated with the malignant progression of HCC.MACC1 may serve as a independent prognostic factor for advanced HCC and a possible therapy target for the treatment of HCC.

Objective To construct evaluation system of residents standardization training's effect in Xinjiang. Methods According to the principles of combinations of comprehensiveness and direction, sci-entificity and operability, initial questionnaire regarding for residents' attitude, knowledge and ability was modified to form the final questionnaire through the first round of the survey using literature research and expert interviews. Internal consistency check was carried out for all valid questionnaires by SPSS 18.0, the reliability coefficient was calculated by Alpha test and the analytic hierarchy process was used to determine the indicators' weights of evaluation system of residents standardization training's effect in Xinjiang. Results The cronbach coefficient of the questionnaire was 0.894, with a higher reliability. Evaluation system of resi-dents standardization training's effect in Xinjiang included 6 first-level indicators and 23 second-level indi-cators, and calculated their respective weight coefficients. Conclusion Evaluation system of residents stan-dardization training's effect which was constructed and was in accordance with the reality of Xinjiang was more reasonable. It is of guiding significance to comprehensively and objectively measure the training effect of trainees and to strengthen and improve residents' standardization training in Xinjiang.

A serious complication of penile girth enhancement with acellular dermal matrix(ADM) patch is large area penile skin necrosis. Since the penile skin has characteristics such as thin, elasticity, pliability, and durability to withstand erection and friction, the repair surgery is often difficult to achieve good results. Furthermore, the implantation of ADM patch increases the difficulty of surgery. From March 2014 to August 2019, a total of 13 patients with skin necrosis after penile girth enhancement with ADM patch were treated in our center.The debridement and change dressing, according to the condition of the necrotic skin of penis, were performed in all patients. 7 patients used the repairing method of scrotal skin flap via one side scrotal artery, 6 patients used the repairing method of full thickness skin graft. The penile function was not affected with 6 to 12 months′ follow-up after surgery and the curative effect was satisfactory.

Little is known about the distribution of Rhodococcus equi in the soil environment of native horses in China. One hundred and eight soil samples were collected from native-horse farms in the Hulun Beier grasslands of eastern Mongolia, the Xilin Goler grasslands of southern Mongolia, and Tongliao city in Inner Mongolia of China for investigating the distribution of R. equi in these regions. The isolation rates of R. equi from soil samples from the Hulun Beier and Xilin Goler grasslands ranged from 25.9% to 30.0%. In contrast, isolation rates from soil samples from Tongliao city was as high as 82.3% and the mean number of R. equi in soil samples from Tongliao city was 10 times more than those of samples from the grasslands. The 488 isolates were examined using PCR for the presence of genes that encode virulence-associated 15 000-17 000 antigen protein (VapA) and the 20 000 antigen protein (VapB). All isolates were negative for virulence-associated proteins. Plasmid profiles of these avirulent isolates showed that cryptic plasmids of various sizes were present with an incidence of 13.3% to 21.5%. The results of the present study contrast with those of our recent study, in which we reported that R. equi was absent from Mongolian horses in Ulaanbaatar, Mongolia. It is suggested that the difference between the results of these two studies is due to the mobile pasturing system in Mongolia and nonmobile pasturing system in Inner Mongolia.