The part-time graduate student education is the important part of the graduate student system in Chinese medicine education.Developing and regulating the part-time graduate student education in Chinese medicine is helpful to the consummation of Chinese medicine graduate student system,the cultivation of the high lever talents in Chinese medicine,and keeping up with international graduate student educational system.

Objective To explore the applicability of different clinical staging systems in chronic lymphocytic leukemia(CLL) for Chinese patients. Methods 218 cases of CLL patients from the Institute of Hematology and Blood Diseases Hospital during the year 2000 to 2007 were staged according to different clinical staging systems retrospectively,and the applicability of these systems was analysed. Results The 5-year overall survival(OS) rates of Rai 0, Ⅰ,Ⅱ, Ⅲ and Ⅳ group were (80.5±8.0) %, (79.7±6.7) %, (82.6±7.3) %, (46.1±19.7) % and (48.4±7.3) % respectively, being statistically different between stage 0 and Ⅲ/Ⅳ, Ⅰ and Ⅳ groups(P <0.05). For modified Rai staging system, the 5-year OS rates of low-, intermediate-and high-risk group were (80.5±8.0) %, (80.9±5.0) % and (49.6±6.5) % respectively, being statistically different between high-risk and intermediate/low-risk groups (P <0.05). The 5-year OS rates of Binet A, B and C group were (79.9±5.3) %, (71.7±7.7) % and (51.6±6.8) % respectively, being statistically different between A and B/C groups(P <0.05). The 5-year OS rates of GIMEMA Ⅰ , Ⅱ, Ⅲ and Ⅳ group were (85.1±4.5) %,(59.4±8.6) %, (64.3±9.5) % and (48.9±14.0) % respectively, being statistically different between Ⅰ and Ⅱ/Ⅲ /Ⅳ groups (P <0.05). By the definition of smouldering CLL according to Montserrat et al, or French Group criteria, the Binet A patients were divided into two groups:the smouldering group and the active group. No matter what criteria was used,there was no statistically difference in OS between the two groups (P >0.05). Conclusion There are limitations to some extent in the prognostic evaluation of available staging systems for Chinese CLL patients.A more suitable risk stratification system for Chinese CLL patients is required.

Objective:To compare the compressive strength of porcelain crown with Co-Cr,CAD/CAMpure titanium and CAD/CAM zirconia respectively.Methods:Metal models of simulating crown core of the ideal premolar were manufactured,digital data of the met-al model were obtained by CAD/CAMsystem,the basement crowns of Co-Cr,CAD/CAMpure titanium and CAD/CAMzirconia were respectively made(n =5),size of each crown was kept the same and the spcimens were set as group A,B and C respectively.Then masking porcelain and body porcelain were fired on basement crowns according to the instructions.The thickness of the porcelain was kept the same.All of the porcelain crowns were located on the Instron testing machine,the compression strength force values were measured.Data were statistically analysed by SPSS 1 3.0 software.The bonding surface of basement material and porcelain was observed by SEMafter compressive failure.Results:The compressive strength(N)of group A,B and C was 2 990 ±1 88,2 305 ±1 57,2 1 50 ± 1 31 ,A vs B or C,P <0.05,B vs C,P >0.05.Conclusion:All the 3 base materials with porcelain crown satisfy the clinical require-ments.The compressive strength of Co-Cr porcelain crown is stronger than that of CAD/CAMpure titanium porcelain crown and CAD/CAMzirconia porcelain crown.

Objective:To explore the influence of the veneering porcelain thickness on the compressive strength of zirconia all-ceramic crown.Methods:25 zirconia basement crowns with the thickness of 0.5 mm were made by CAD-CAMsystem,and then were divided into 5 groups randomly with the veneering porcelain thickness of 0.5(A),1.0(B),1.5(C),2.0(D)and 2.5 mm(E)respectively. The compressive strength of the samples was measured by a testing machine.Statistical analysis was conducted by SPSS13.0 software. The microstructure of the fractured bonding interface of the specimens was observed by scanning electron microscope(SEM).Results:The compressive strength in group A,B,C,D and E were:(1 279.96 ±42.85)N,(2 235.44 ±50.14)N,(2 216.38 ±48.97)N, (2 169.22 ±60.40)N and (2 028.70 ±47.37)N respectively(A or E vs B,C or D,P <0.01;A vs E,P <0.01;B vs C or D,P >0.05;C vs D,P >0.05).SEMobservation found that in group A and E the bonding interface was uneven and loose,the cracks and spores in veneering porcelain appeared more and larger,and had a more intensive distribution.Conclusion:When the veneering porce-lain is too thick or too thin,the compressive strength of zirconia all-ceramic crown decreases,the thickness of the veneering porcelain should be controled in an appropriate range.

Objective To identify the clinical and pathological features of aggressive natural killercell leukemia (ANKL). Methods 9 cases of ANKL fulfilling the criteria defined by the World Health Organization classification were retrospectively analyzed with literature review, Results Systemic symptoms, hepatomegaly, splenomegaly, lymphadenopathy were frequently observed. Liver dysfunction, neutropenia, anemia and thrombocytopenia were often seen during the course of the disease. Most of the bone marrow shows focal or subtle infiltration by the neoplastic cells. The immunophenotype of cells was characteristic for CD+56, sCD-36, and variable expression of CD2, CD7, CD8 and CD11b. T-cell receptor (TCR) genes rearrangement were in germline configuration. Median survival time was 9 weeks. Conclusion ANKL is an entity of mature cytotoxic NK-cell neoplasms with distinct phenotype and disease presentations. The disease often has a fulminant course with a poor response to chemotherapy and a short survival time. Patients achieving CR showed significantly longer survival time, but the remission did not translate into cure of the disease.

Objective To summarize the common complications of chronic lymphocytic leukemia (CLL). Methods 203 cases of CLL patients from the Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, were retrospectively reviewed and followed up.The common complications of CLL were also summarized. Survival analysis was used to analyze the prognostic value of these common complications. Results 40 (19.7 %) patients sustained infectious complications,and the respiratory tract infections were the most common type (75.6 %). 15 (7.4 %) patients complicated with autoimmune diseases (AID), and the autoimmune hemolytic anemia(AIHA) were the most common type(31.3%). 8(3.94 %) patients suffered from secondary cancers, including lung cancer, etc.3(1.48 %) patients developed other high-grade lymphomas, 2 of them transformed to prolymphocytic leukemia (PLL), 1 of them transformed to diffuse large B cell lymphoma (DLBCL) which was called Richter syndrome. Complicating infections and secondary cancers or transformations were associated with poor prognosis.Complicating AIDs was not an adverse prognostic factor. Conclusion Infections, AIDs and secondary cancers or transformations are common complications of CLL patients.Lung is the most common infectious site, and AIHA is the most common AID type,none secondary cancer s incidence rate is specifically higher than the others. Infections and secondary cancers or transformations indicate poor prognosis.

Objective To improve the recognition of precursor T- lymphoblastic lymphoma (T-LBL)of the breast. Methods One case of breast T- LBL was reported, the development of breast non-Hodgkin lymphoma and T-LBL presenting as breast masses was reviewed. Results One case of breast T-LBL was diagnosed, the patient with a high leukocyte count, breast mass and peripheral lymph nodes was treated with Hyper-CVAD regimen after active therapy and achieved complete remission (CR). Followed by maintenance therapy with Hyper-CVAD regimen for three times, disease free survival had been obtained five month.Conclusion Lymphoma of the brest is a rare malignancy. T-LBL is a highly aggressive disease with adverse prognosis, it is very uncommon for presenting as lymphoma of breast. Initiation of intensive muhiagent chemotherapy can improve the free survival and the prognosis.

Objective To review the efficacy of bisphosphonates in reducing skeletal events in patients with multiple myeloma. Methods Two hundred and five patients with newly diagnosed MM were enrolled in this retrospective study,with bisphosphonates or not.Skeletal-related events,therapeutic reaction of myeloma bone disease and patient survival were analyzed. Results The occurrence of skeletal-related events (SRE) per patient year (P＜0.01) and the time to first SRE (P＜0.05)were significantly lower in the reatment group than in the untreated group. After 6 cycles of treatment, a significant higher percentage of effective and marked effect patients were observed through X ray in the treatment group (80.0 ％) compared to the untreated group (48.7 ％), P＜0.001. There was no overall significant difference in the level of serum calcium between the two groups (P=0.278). After 6 cycles of treatment, the patients who received bisphosphonates had significant decreases in bone pain and lower ECOG score (ECOG≤2) compared to the untreated group (P＜0.05). Bisphosphonates were tolerated well, and the common adverse reaction including gastrointestinal reaction (3 cases,3.3 ％),fever (lcase,1.1％) and skin rash (2 cases,2.2 ％).There was no significant difference in overall survival between the two treatment groups,(P=0.580).Conclusion Infusions of Bisphosphonates could reduce the occurrence of skeletal- related events (SRE), prolong the time to first SRE and improve the quality of life of patients with multiple myeloma. Bisphosphonates could not prolong survival time of myeloma patients.

Medical ethics is the standard ofbehavior toadjust the relationship between medical personnel and patients,medical personnel,medical personnel and society.It is a general social morality in medical field in special performance.Teachers should carry through the ethics education to the end,making students smoothly enter society from the school,cultivating good ethics during the process of learning basic knowledge of oral cavity,and developing high-quality oral physicians for our country.

Objective To observe the effects of rosuvastatin on the homocysteine (Hcy)-induced expression of matrix metalloproteinase 2 (MMP 2) and cell migration in rat vascular smooth muscle cells (VSMCs), and to explore the possible mechanism of Hcy-induced atherosclerosis and the role of statins in reversing atherosclerosis. Methods In one cell culture plate, the cultured rat VSMCs were incubated with different concentrations of Hcy (0, 50, 100, 500, 1000 μmol/L and 5000 μmol/L) in vitro for 24 h, 48 h and 72 h. And in another cell culture plate, the different concentrations of rosuvastatin (10-9, 10-8, 10-7, 10-6, 10-5 mol/L and 0 mol/L) were added to the cultured rat VSMCs (while the concentration of Hcy was 1000 μmol/L). The MMP 2 expression and enzyme activity were determined by gelatin zymography and Western blotting. The effects of Hcy and rosuvastatin on cell migration and invasiveness of VSMCs were observed. Results Hcy (50-5000 μmol/L) increased the protein expression, and Hcy (50-1000 μmol/L) increased enzyme activity of MMP 2 significantly. But Hcy (5000 μmol/L) inhibited activity of MMP 2 (F=9.31, 6.44 and 5.97, all P＜0.05). Rosuvastatin (10-9-10-5 mol/L) inhibited Hcy-induced expression and enzyme activity increasing of MMP 2. The counts of cell migration of VSMCs were 18.32±2.17, 32.68±4.34, 44.75±4.08, 61.39±5.21, 79.74±5.54 and 90.78±5.83, while the concentration of Hcy was 0, 50, 100, 500, 1000 μmol/L and 5000 μmol/L respectively (F=5.31, P＜0.05). The counts of cell migration of VSMCs were 79.74±5.54, 62.53±6.41, 48.37±5.66, 31.41±4.79, 19.27±3.62 and 11.17±2.33, while the concentration of rosuvastatin was 10-9, 10-8, 10-7, 10-6 and 10-5 mol/L respectively (F=4.99, P＜0.05). Rosuvastatin could decrease the stimulation of Hcy-induced migration of VSMCs. Conclusions Hcy can influence the MMP 2 protein expression/activity in VSMCs, and rosuvastatin can inhibit augmentation of Hcy-induced MMP 2 expression/activity and migration of VSMCs. It may be one of the multiple-effects of rosuvastatin reducing atherosclerosis.