Under the new situation of rapidly expanded medical education scale and its great development,combined with the characteristics and position of higher medical education, and keeping the quality of teaching in this school lifeline,we explore the specific measures and methods to improve the quality of medical education, from the quality monitoring system of classroom teaching,clinical teaching and teaching management.

Objective To compare the diagnostic values of 3D CT and 2D CT imaging for tibial plateau fractures. Methods A retrospective study was performed to evaluate 21 tibial plateau fractures. Four experienced orthopaedists were asked To make assessmem of fracture classifications and characteristics using 3D CT and 2D CT images.Agreement test Was performed to evaluate interobserver and intraobserver reliability for fracture classification and criteria validity for fracture characteristics(intraoperative findings were taken as the golden standard).Furthermore,MeNemar test was used to compare the agreement of 3D CT results and 2D CT results respectively with the golden standard for fracture characteristics.Results When 3D CT images were used.interobserver reliability and intraobserver reliability for fracture elassiftcation increased to"almost perfect agreement".The agreement of golden standard with 3D CT results for fracture characteristics Was significantly higher than that with 2D CT results. Condmiou Since 3D CT imaging can improve the reliability and accuracy of preoperative assessment oftibial plateau fractures,it is helpful and valuable for tibial plateau fractures.

Objective To investigate the cause and related factors of hospitalization in patients with diabetic nephropathy with maintenance hemodialysis.Methods Fifty-six patients of diabetic nephropathy were enrolled in current study who hospitalized in Beijing Tongren Hospital affiliated to Capital Medical University from March 2009 to February 2012.All subjects were divided into hospitalized group (n =29) and non hospitalized group (n =27).The information including age,dialysis age,blood pressure,hemoglobin,blood glucose,serum creatinine,serum potassium,plasma albumin,serum calcium,serum phosphorus,albumin,intact parathyroid hormone (iPTH) and hemodialysis sufficienc (KT/V) were collected.Stepwise multiple regression analysis was applied to explore the main causes and related risk factor.Results Twenty-nine out of 56 patients were hospitalized and they had 56 hospitalization records during 24 months of observed period.Average hospitalization was 1.0 times per patient and hospitalized days were (29.62 ± 14.30) days per hospitalized patients.The main causes of hospitalization were cardiac vascular diseases (35.7％),vascular access stenosis (30.4％),and pulmonary infection (17.8％).Compare with non-hospitalization group,age of patient hospitalization group was older((66.97 ± 9.94) vs.(57.42 ± 11.77),t =2.917,P =0.02) and the level of albumin and Kt/V were lower(albumin:(34.02 ± 4.76) vs.(38.93 ± 3.82),t =-4.573,P =0.000 ; Kt/V:(1.16 ± 0.09) vs.(1.39 ± 0.18),t =6.503,P =0.000).Stepwise multivariate regression analysis showed plasma albumin and KT/V were risk factors to influence the hospitalization in diabetic patients undergoing maintenance hemodialysis (β =-1.724,-0.040 respectively,P =0.00,0.02 respectively) Conclusion Cardiovascular disease,vascular access stenosis and pulmonary infection were the important factors for hospitalization in hemodialysis patients with diabetic mellitus.Cardiovascular disease was the top reason of hospitalization in diabetic patients with maintenance hemodialysis.Hypoalbuminia and inadequacy dialysis were risk factors to influence the hospitalization in diabetic patients undergoing maintenance hemodialysis.

OBJECTIVE:To establish a method for the content determination of paeoniflorin in Bazhen pill(concentrated pill). METHODS:HPLC was performed on the column of wondasil C18 with mobile phase of acetonitrile-1% phosphoric acid(15∶85, V/V)at a flow rate of 1.0 ml/min,the detection wavelength was 230 nm,and column temperature was 30 ℃. RESULTS:The lin-ear range of paeoniflorin was 0219-1.32 μg(r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 1%;recovery was 95.82%-101.82%(RSD=2.13%,n=6). CONCLUSIONS:The method is simple,stable and reproducible, and can be used for the content determination of Bazhen pill(concentrated pill).

Objective To summarize the effect of predictive nursing combined with high-quality nursing in patients with pulmonary embolism or having risk factors of pulmonary embolism (PE).Methods A retrospective analysis of nursing in 57 PE patients was camied out,Nursing flow chart was established.For patients with high risk factors of PE,predictive nursingwas administered,including analysis of risk factors,health education,general nursing and pertinent nursing.For PE patients,holistic nursing was administered,including emergeney nursing,basic nursing,observation of illness,nursing of thrombolytic therapy,psychological nursing and rehabilitation nursing, Results All patients accorded with thrombolysis indication and received thrombolysis treatment. Conclusions Predictive and high-quality nursing should be used in PE patients in order to improve treatment effect.

Objective To investigate the role of r-aminobutyric acid B receptor in the development of liver fibrosis.Methods Thirty-two Sprague-Dawley (SD) rats were divided into four groups including a control group,a model group,a baclofen group,and a CGP35348 group.Liver fibrosis was then induced by carbon tetrachloride (CCl4).Baclofen and CGP35348 treatment were carried out after the formation of liver fibrosis,followed by complete extraction of the eyeball to obtain blood sample to test liver function.Liver tissue specimens were cut and stored for histological staining,histochemistry,real-time polymerase chain-reaction (RT-PCR),and western blot analysis.Results Histological staining indicated that the degree of liver fibrosis was more severe in the CGP35348 group than in the baclofen group (P＜0.001).The levels of alanine transaminase (ALT),aspartate aminotransferase (AST),gamma-glutamyl transferase (GGT),total bilirubin (TBil),and direct bilirubin (DBil) were significantly lower in the baclofen group than in the CGP35348 group (P＜0.01).The levels of ALT,AST,GGT,TBil,and DBil were significantly higher in the CGP35348 group than in the model group (P＜0.05).Immunofluorescence results show that the hepatic cell migration was inhibited in the baclofen group.Western blot results showed that the expression levels of α-SMA protein were significantly lowered in the baclofen group when compared to that of the CGP35348 group and model group (P＜0.01).Conclusion GABAB receptor might play a role in the liver protection by inhibition of migration of hepatic cells in liver fibrosis.Further studies into the mechanism behind this function are further needed and may be a potential source of future anti-fibrotic treatment.

Objective To explore the significance of using cytologic and RT-PCR methods to examine(peritoneal) washings and peritoneal tissues of gastric cancer patients in prediction of peritoneal micrometastasis.Methods The peritoneal washings of 38 patients with gastric cancer and 5 patients with benign gastric(lesions) were collected and,at the same time,a small amount of omentum and peritoneum were removed for control.CEAmRNA expression of free cells in peritoneal washings were detected by RT-PCR method and(also) cytology of the washings were performed.Results The CEAmRNA expression rate of peritoneal washings and peritoneal tissues were 36.8%(14/38) and 39.5%(15/38)respectively.Both were more(sensitive) than that of cytologic examination 26.3%(10/38).TNM staging,depth of invasion,lymph node metastasis,and serosal involvement were related to the expression rate of CEAmRNA.Conclusions mRNA of CEA is more sensitive and specific than cytologic examination for detecting free cancer cells in peritoneal cavity.It is an effective method for detecting peritoneal micrometastases in gastric cancer patient.

Objective To evaluate the potential value of IgG antibodies against recombinant PPE65 protein (rPPE65) of Mycobacterium tuberculosis in serodiagnosis of tuberculosis.Methods The gene encoding PPE65 protein of M.tuberculosis was cloned into the PET-28a vector and then expressed in Escherichia coli.The rPPE65 was purified with Ni-NTA affinity and ion exchange chromatography.After dialysis renaturation, the concentration of rPPE65 was determined using Lowry assay.ELISA was used to detect the levels of specific IgG against rPPE65 and recombinant PstS1 protein (rPstS1) in sera from 144 patients with pulmonary tuberculosis (PTB patients), 144 health controls, and 56 patients with non-tuberculosis pulmonary diseases.ROC curves were used to determine cut-off values with the results of IgG antibodies against rPPE65 and rPstS1 for 144 PTB patients and 97 controls with negative PPD skin test.The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of rPPE65 and the combination of rPPE65 and rPstS1 were counted.Results The PPE65 protein of M.tuberculosis was successfully expressed in E.coli. The purity and concentration of rPPE65 were 95% and 0.5 mg/ml, respectively.ROC analysis showed that the cut-off of ELISA using rPPE65 was 0.64.The sensitivity, specificity, PPV, NPV, and accuracy of rPPE65 were 34.7%(50/144), 93.5%(187/200), 79.4%(50/63), 66.5%(187/287), and 68.9%(237/344), respectively.The sensitivity, specificity, PPV, NPV, and accuracy of the combination of rPPE65 and rPstS1 were 59.0%, 91.0%, 82.5%, 75.5%, 77.6%, respectively.Conclusions The rPPE65 of M.tuberculosis appears to be a candidate antigen for serodiagnosis of tuberculosis.Detection of IgG antibodies against the combination of rPPE65 and rPstS1 can increase the sensitivity of serological test for tuberculosis.

Objective To study the correlation of HLA-G levels with acute rejection and CMV active infection post-kidney transplantation.Methods A total of 132 initial kidney transplantation recipients were divided into kidney function stable group (F),acute rejection group (AR),CMV group according to whether they had active CMV infection and acute rejection.Forty-one healthy donors served as control group (H).HLA-G levels and mRNA expression were analyzed by using flow cytometry,ELISA,RT-PCR and Western blotting.Immunohistochemical staining was used to detect the HLA-G expression in kidney biopsies.Results The expression levels of mHLA-G1 were low in all 4 groups pre-transplantation.Only CMV group had significantly more CD14+ mHLA-G1+ cells post-transplantation (P＜0.05).sHLA-G5 levels were higher in F group than in H group (P＜0.05),but there was no significant difference among other groups pre-transplantation (P＞0.05).sHLA-G5 levels were increased significantly in CMV group as compared with F group (P＜0.05),and those in F group were higher than in H and AR groups (P＜0.05).Renal tissue biopsies from 21 renal transplantation recipients with AR indicated that HLA-G5 was expressed negatively in 17 patients,positively in 3 patients and 1 weakly positively.HLA-G was positive in the kidney tissue of 9 patients out of 9 patients with active CMV infection.In total 132 recipients,AR incidence was significantly lower in CMV ( + ) group (7.1 ％,2/28) than that in CMV ( - ) group (24.0 ％,25/104).Conclusion The sHLA-G5 may contribute to predict AR and CMV active infection; AR and CMV active infection may be correlation with immune balance in kidney transplantation recipients.

Objective To measure the cytokines levels in peripheral blood from kidney transplantation recipients by using cytometric bead array and to analyze their change and the clinical significance in pre- and post- kidney transplantation, inducting with basiliximab and graft rejection. Methods A total of 72 renal transplantation recipients were divided into two groups, kidney function stable group(n =53) and acute rejection group (n = 19). And they were also grouped by induction with basiliximab or not,32 in basiliximab group and 40 in without basilixmab group. The levels of IFN-γ, TNF-α, IL-10, IL-5,IL-4, IL-2 were measured by cytometric bead array in peripheral blood of 72 kidney transplantation recipients and 30 healthy donors at differential time. The data was analyzed according to the following grouping:donors and recipients, kidney function stable group and acute rejection group post transplantation and with or without basiliximab group. Results The levels of TNF-α, IL-10, IL-5, IL-4, IL-2 in recipients before transplantation were ( 1.65 ±0. 10) ,(2. 55 ±0. 19) ,( 1.88 ±0. 14) ,(1.85 ±0. 12) ,(2. 12 ±0. 09) ng/L,respectively. While they were (3.04 ±0. 17), (3.33 ±0. 26), (4.03 ±0.25), (2.73 ±0. 16), (4.03 ±0. 26) ng/L respectively in healthy donors. There was statistical significance between the two groups ( t =6. 890, 2. 375, 7. 851,3.955,7.153, P<0. 01, <0. 05, <0.01, <0.01, <0.01). While the level of IFN-γ in recipients before transplantation was (2. 50 ±0. 18) ng/L,compared with (3. 00 ±0. 24) ng/L in healthy donors. There was no statistical significance between the two groups( t = 1. 625, P > 0. 05 ). The levels of IFN-γ and IL-10 in kidney function stable group were (2. 71 ± 0. 11 ) ng/L and (3.91 ± 0. 52) ng/L,while they were ( 3.30 ± 0. 36 ) ng/L and ( 12. 01 ± 5.35 ) ng/L in acute rejection group. There were statistical dirrerences between the two groups ( t = 5. 061, 11. 465, P < 0. 01, < 0. 05 ). Before induction with basiliximab, the levels of IFN-γ, TNF-α, IL-10 in recipients were (2.90 ±0. 21 ), ( 1.67 ±0. 12),(2. 45 ± 0. 16) ng/L respectively. But they were ( 2. 78 ± 0. 17 ), ( 1.58 ± 0. 07 ), ( 2. 77 ± 0. 24 ) ng/L respectively after induction with basiliximab, which showed significantly different ( t = 5. 605, 6.011,4. 126, P <0. 01, <0. 01, <0. 05). Four weeks after kidney transplantation in recipients with basiliximab,the levels of IFN-γ, IL-10, IL-4 were (2. 90 ± 0. 31 ), (9. 08 ± 0. 16), (2. 73 ± 0. 11 ) ng/L. While they were (3.28 ±0. 11 ), (4. 17 ±0. 21 ), (2. 11 ±0. 20) ng/L respectively in recipients without basiliximab induction, which were significantly different from those with basiliximab induction (t = 4. 268,4. 263,3.762, P <0. 01, <0. 01, < 0. 05 ). Conclusions Six kinds of cytokines can be measured by cytometric bead array simultaneously and accurately. The data suggests that the detection of multiple cytokines in kidney transplantation recipients by cytometric bead array can provide more guidance for clinical diagnosis and therapy.