This thesis mainly expounds the design ideas and the realization methods of medical statistics question database management system.Specifically speaking,the function modules,data structure and business processes of the system are designed based on the analysis of questions,test papers and the needs of system functions.We choose Visual Basic 6.0 to develop the system interface,establish the question database with Access 2003,and make use of Word 2003 to output documents.This system can achieve the separation of teaching and testing effectively which can make examinations more normal and scientific.

Objective To analyze the demands and to evaluate training effect on the knowledge and technology of prevention and treatment about hypertension among doctors in county and countryside hospitals of Xinjiang.Methods 336 doctors were trained about knowledge of prevention and treatment of hypertension and technology of useful therapeutic regimen,and were investigated for demands of the knowledge and technology and self-evaluation of training effect by questionnaire.Results The knowledge of prevention and treatment about hypertension and the technology of useful therapeutic regimen were needed urgently by 94.8％ subjects.91.3％ trained doctors thought that the technology suited practically in county and countryside hospitals,and 96.7％ hospitals had condition of carrying out the technology.97.9％ trained doctors expected this kind of technology on hypertension prevention and treatment to be trained again.74.1％ trained doctors comprehended the technology,and the percent of doctor practically using the technology increased from pre-training 12.3％ to post training 62.1％.Conclusion The knowledge of prevention and treatment about hypertension and technology of useful therapeutic regimen were needed urgently and were comprehended with training for the most doctors in county and countryside hospitals of Xinjiang.

The effects on frozen-thawed sperm survival rate of 16 different cryoprotective media containing different ratio of glycerol (0%, 2.5%, 5% and 7%) and sucrose (0,25,50 and 100 mmol/L) were compared. The results showed that glycerol-sucrose cryoprotective media had better effect on cryoprotection of spermatozoa than that of traditional glycerol protective medium, and appropriately increasing the concentration of sucrose and decreasing the concentration of glycerol could improve sperm motility, and especially benefit to preserve sperm linear motility at 12h postthawed. Using 5% glycerol combined with 50 mmol/L sucrose as cryoprotective medium, the sperm survival rate at 0, 6, 12h postthawed was 85.38%, 51.22%, 33.38%, respectively, the linear moving sperm survival rate was 83.74%, 33.33%, 18.38% respectively.

Objective To investigate the effect on bioeffects such as sonoporation and cell killing that induced by domestic ultrasound contrast agent(perfluoropropane-albumin microsphere)and diagnostic ultrasound by microbubble concentration.Methods Suspensions of hepatocyte with microbubbules in different concentrations were exposed to diagnostic ultrasound.The study included blank contrast group(no microbubble,no ultrasound),exposed group(no microbubble,exposed to ultrasound)and 6 microbubble groups in different concentration(with different microbubbule/cell ratios for 1,5,10,50,100 and 200,exposed to ultrasound for 10min).The uptake of fluorescein isothiocyanatedextran(FD500)by hepatocyte was observed and the percentages of sonoporation cells were counted,the cell viability was determined by trypan blue stain immediately after exposure,and apoptosis of ceils were detected by flow cytometry,with double staining of fluorescein isothiocyanate(FITC)-labeled Annexin V/propidium iodide(PI).Results Fluorescence stain results:compared with blank contrast group or exposed group,the sonoporatin of groups with microbubble/cell ratio of 5 to 200 increased significantly(P＜0.05).Cell killing effects:compared with the blank contrast group,only the cell death percentages of microbubble groups with microbubble/cell ratio of 50,100 and 200 increased significantly(P＜0.05).Compared with the exposed group,only that of groups with microbubble/cell ratio of 100 and 200 increased significantly(P＜0.05).There was no significant different between blank contrast group and exposed group for all these results.Conclusions Sonoporation and cell killing effect can be induced by diagnostic ultrasound in HL-7702 with domestic ultrasound contrast agent(perfluoropropane-albumin microsphere).For diagnosis,the ratio of microbubbule/cell should better be under 10.While for gene transfection,the ratio should better be 50 and could be 100 if it is necessary.

Objective To explore the hierarchical chain management model in blood glucose control and its influence factors in patients with diabetes mellitus.Methods Health management database of diabetic patients was established in 2007 and managed by hierarchical chain management.The number of the patients reached to 1010 till 2011.The blood glucose control of diabetic patients was analyzed and its influence factors were analyzed by multivariate unconditional Logistic regression method.Results The concentration of glycosylated hemoglobin( HbA1c ) of 1010 patients with type 2 diabetes was (8.21 ±:2.70)％.Four hundred and eighty-seven cases (48.22％) reached the blood glucose standard,303 cases (30.00％)reached the blood pressure standard,245 cases (24.26％) reached the blood lipids standard,and 76 cases (7.52％) reached all three standards.Multivariate analysis showed that occupation (OR =2.521,95％ CI:1.871 - 3.397),education level (OR =1.890,95％ CI:1.642 - 2.174),disease course (OR =1.035,95％CI:1.016 -1.055),systolic pressure (OR =1.016,95％ CI:1.007 -1.025) and triglyceride (OR =1.204,95％CI:1.063 - 1.365) were the risk factors of blood glucose control (P ＜0.01).Conclusions Hierarchical chain management model is helpful for the blood glucose control in patients with type 2 diabetes.The comprehensive control and treatment of type 2 diabetes should be taken combined with related risk factors,such as blood pressure,blood lipids and diabetes disease course.

Objective To evaluate the diagnostic and therapeutic strategy of traumatic pulmonary pseudocyst (TPP).Methods Fifteen patients who were diagnosed and treated as TPP between January 2000 and November 2011 were studied retrospectively.Results Nonpenetrating chest trauma was the underlying cause in all cases.A typical sign shown on chest radiograph was a thin-walled cavitary lesion in 9 patients,6 patients accompanied by traumatic wet lung,with or without an air-fluid level.Serial radiological images of CT showed high resolution of the above lesions.Single TPP lesion occurred in 9 patients,and multiple TPP lesions in 6 patients.The size of the lesions was 5 -75 (32 ± 17) mm.The pseudocyst was located in the left lung in 5 patients(33％),located in the right lung in 7 patients (47％),located in bilateral lung in 3 patients (20％).All TPP patients were treated conservatively with no occurrence of complications.Conclusions TPP is an uncommon benign lesion secondary to thoracic trauma.CT scan is an optimal option for diagnosis and evaluation of TPP.Uncomplicated cases can take conservative treatment.For complicated patients,theraneutic strategy should be made individually.

Objective To explore the hierarchical chain management model of type 2 diabetes and determine its evaluation.Method Based on the hierarchical chain management of the three community health service institutions and Dahua hospital in Shanghai Xuhui district,215 cases of type 2 diabetes had been involved in the study.Results Compared with the baseline before management,lasting blood glucose (FBG),2 h postprandial glucose (2hPBG),glycosylated hemoglobin (HbA1c),low density lipoprotein cholesterol (LDL-C),systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the diabetes after 12 months' management declined [(8.50 ±2.81) mmol/L,(11.09 ±4.01) mmol/L,(8.56 ±2.41)% ,(3.31 ± 1.06) mmol/L,(139.06 ±20.68) mm Hg (1 mm Hg = 0.133 kPa),(78.20 ± 12.11) mm Hg vs.(7.41 ±2.04) mmol/L,(9.03 ±2.46) mmol/L,(7.34 ± 1.59)% ,(3.00 ± 1.06) mmol/L,(135.48 ± 17.82) mm Hg,(77.27 ±11.83) mm Hg],and the differences were statistically significant(P＜0.01 );control rate of FBG,2hPBG,HbA1c,LDLC,SBP,DBP had improved significantly [19.5% (42/215),20.9% (45/215),24.7%(53/215),20.0%(43/215),27.4%(59/215),30.2%(65/215) vs.50.7%(109/215),53.0% (114/215),54.0%(ll6/215),42.3%(91/215),47.0%(101/215),45.6%(98/215)](P＜0.01).Conclusion Primary and secondary-care hospital based hierarchical chain management model is valid and can be implemented for type 2 diabetes.

Objective To investigate the relationship and mechanism of the heme oxygenase-1 expression in peripheral blood mononuclear cells (PBMC) and the oxidative stress in diabetic nephropathy. Methods Two groups of diabetic patients with or without diabetic nephropathy and a normal control group were enrolled in this study. Fasting blood glucose (FBG), HbA1c, serum MDA level, ROS level, HO-1 mRNA level and HO-1 protein expression in PBMC were determined. Results In control group, diabetic group and diabetic nephropathy group , the MDA levels significantly increased[(14.23±5.07)nmol/ml vs (24.90±7.12)nmol/ml vs (43.83±16.97)nmol/ml](F＝37.022,P＜0.01), the ROS levels significantly increased (113.18±58.59 vs 364.54±88.67 vs 524.35±162.51)(F＝68.369,P＜0.01) and the HO-1 protein expression also increased significantly (22.84±9.98 vs 36.72±15.85 vs 58.1±15.93)(F＝31.302,P＜0.01). There was a positive correlation among the HO-1 mRNA, protein expression and MDA level(r＝0.407,0.429,P＜0.05). Conclusions There existed a severer oxidative stress condition in patients with diabetic nephropathy compared with the patients without diabetic nephropathy. HO-1 could be a potential pathway to ameliorate oxidative stress in diabetic kidney disease patients.

The study aims to establish a method for simultaneous determination of repaglinide and pravastatin sodium in rat plasma by LC-MS/MS and to study its pharmacokinetic interactions. Eighteen male SD rats were divided into repaglinide group, pravastatin sodium group and co-administration group. Blood samples were collected at different times after oral administration. Repaglinide and pravastatin sodium in rat plasma were separated by Agilent HC-C18 with the mobile phase consisting of methanol-0.1% formic acid (80 : 20). Detection and quantification were performed by using ESI-MS. The detector was operated in selected Reaction-monitoring mode at m/z 453.3-->230.1 for repaglinide, m/z 447.2-->327.4 for pravastatin sodium and m/z 285.1-->192.9 for diazepam as the internal standard. The calibration curve obtained was linear (R2>0.99) over the concentration range of 9.77-10,000 ng.mL-1 for repaglinide and 4.88-625 ng.mL-1 for pravastatin sodium. Compared with the single administration group, Cmax and AUC0-6h of repaglinide increased significantly (P<0.05) and tmax of pravastatin sodium prolonged (P<0.05) in co-administration group. The method is found to be simple, sensitive and accurate for determining the concentration of repaglinide and pravastatin sodium in rat plasma. There exists pharmacokinetic interactions in the co-administration of repaglinide and pravastatin sodium.

Objective This study is about to detect the KCNJ5 gene variations in aldosterone-producing adenoma (APA) with primary hyperaldosteronism (PA),and to investigate the association of the KCNJ5 gene missense mutations with APA and PA.Methods A total of 46 APA tumors and their clinical characteristics were collected from Hypertension Center of the People's Hospital of Xinjiang Uygur Autonomous Region,and all the tumors were confirmed by pathology.All the samples of the coding region segments of KCNJ5 were detected by PCR and direct DNA sequencing to compare the different missense mutations in the tumor cells and peripheral blood cells and to analyze the association between the genotype and phenotype.Results Three missense mutations were found in 46 patients with APA:c.451G ＞ C/A (p.G151R) (5/46),c.503T ＞ G (p.L168R) (4/46),c.830T ＞ A (p.S209T) (12/46).S209T,as an unreported somatic mutation was observed.There were no missense mutations detected in the peripheral blood.Sex,age,systolic blood pressure,diastolic blood pressure,duration of hypertension,plasma potassium,urine potassium,aldosterone,plasma renin activity,aldosterone,and plasma renin activity ratio,as well as the rate of positive family history were compared between the mutants and wild-types.Systolic blood pressure and plasma potassium level among G151 R,L168R,and S209T had statistical differences.Systolic blood pressure in G151R was significantly higher than the other two groups,while the plasma potassium level was significantly lower than the other groups.Conclusions Three missense mutations were found in 46 patients with APA.The subjects with mutations had more serious condition than those without mutations after comparing their clinical phenotype.Besides,other different subtypes may exist in PA.