Objective To understand the clinical medicine graduates competency status of Kunming Medical University in the past 5 years and provide important reference for cultivating students in medical university. Methods The questionnaire results in the relevant departments responsible person of Yunnan provincial municipal and district 26 hospitals were system analyzed by fuzzy comprehensive evaluation method. Results In the past 5 years, the graduates occupation competence of clinical medicine in Kunming Medical University is good. Among them, the graduates’core competency gets the lowest score, but the graduates’post competency gets the highest score. Conclusion The graduates’core competency should be strengthened in training of doctor-patient communication skills and quality evaluation of clinical practice for medical students.

Objective To observe the clinical efficacy of low-dose erythromycin combined with salmeterol-fluticasone in the treatment of stable COPD, focus on the quality of life and respiratory function of patients.Methods 87 patients with stable COPD admitted to Hangzhou Red Cross Hospital from January 2014 to January 2016 were selected.Patients were divided into two groups by therapeutic methods, observation group ( salmeterol-fluticasone+erythromycin) 46 cases and control group (salmeterol-fluticasone) 41 cases.Six months of treatment, the quality of life of two groups of respiratory function assessment, acute COPD and peripheral inflammatory factor and other indicators of change.Results After treatment, both of the two groups got significantly decreased in SGRQ and MMRC scores, while the observation group was significantly lower than the control group, the difference was statistically significant(P<0.05).After treatment, FEV1/FVC%levels were significantly increased in both groups, but the observation group was significantly higher than the control group, the difference was statistically significant(P <0.05).The cumulative incidence of acute exacerbation of COPD was 10.87%(5/46) in the observation group, which was significantly lower than that in the control group 29.27%(12/41), the difference was statistically significant(Log-rankχ2 =4.833, P=0.028).After treatment, the levels of IL-1βand TNF-αin the peripheral blood of the patients in the observation group were significantly lower than those in the control group, the difference was statistically significant (P <0.05).Conclusion In the treatment of stable COPD, low-dose erythromycin could significantly improve the clinical efficacy, improve the quality of life and respiratory function.

Group B Streptococcus ( GBS) is a conditional pathogenic bacteria related to late-term abortion, premature delivery, premature rupture of membranes, perinatal infection, neonatal sepsis and other diseases.Prevention and treatment guidelines by the US Centers for Disease Control and Prevention ( CDC) suggest that all the pregnant women at 35-37 gestational weeks should screen for GBS .The detection methods for GBS include microbiology , immunology, molecular biology, etc.The appropriate method should be chosen depending on circumstances .Penicillin is recommended for the preventive treatment of GBS , and the treatment for the insensitive should base on the antibiotic susceptibility results .No vaccine against GBS is currently available for clinical use .

Objective:To discuss the applicative value of 1.5TMR-diffusion weighted imaging (DWI) sequence and apparent diffusion coefficient (ADC) measurement in the diagnosis and differential diagnosis of endometrial carcinoma.Methods: Thirty seven cases were collected in endometrial carcinoma group, 11 cases were selected in benign group and other 20 normal volunteers. Data of the DWI and ADC value, common-MRI(c-MRI) sequence in the 48 patients and 20 normal volunteers was contrasted and analyzed.Results: The differences between endometrial malignant tumors, benign lesions and the normal have statistical significance.Conclusion: 1.5 T MR-DWI sequence and ADC value has a superior ability in detecting endometrial lesions. It can be used to differentiate the endometrial carcinoma from either benign or normal cases, it can provide reliable assistance in the clinical cure.

A total of 65 patients of condyloma acuminatum (CA) received cryotherapy plus 5-aminolevulinic acid-photodynamic therapy (ALA-PDT) or ALA-PDT alone.During cryotherapy,handling was gentle with a moderate depth.The nursing of PDT was both meticulous and comprehensive.Patients with adverse reactions received Kangfuxin liquid for wet packing and topical antibiotic ointment.The combination group received cryotherapy for 2 sessions and then PDT for 1-3 sessions while PDT was administered for 1-4 sessions in single PDT group.Then all patients received PDT once for consolidation therapy.For groups 1 and 2,the effective rates were 83％ and 70％ and the recurrent rates 17％ and 30％ respectively.Cryotherapy plus ALA-PDT is feasible for CA and it offers better efficacies and lower recurrent rates.And comprehensive,meticulous and comfortable nursing may achieve clinical efficacies,reduce the recurrent rate and minimize discomforts during treatment.

Circulating tumor DNA (ctDNA) is emerging as a novel biomarker for tumor evaluation, offering advantages such as high sensitivity and specificity, minimal invasiveness, and absence of radiation. Currently, various techniques including gene sequencing and PCR are employed for ctDNA detection. The utilization of ctDNA for monitoring minimal residual disease (MRD) enables comprehensive assessment of tumor status and early identification of tumor recurrence, achieving a remarkable detection sensitivity of 0.01%. Therefore, ctDNA holds promise as a biomarker for early diagnosis, treatment response monitoring, and prognosis prediction in solid tumors. This article reviews the commonly used methods for detecting ctDNA and their advantages in evaluating tumor MRD and guiding clinical diagnosis and treatment.
Humans ; Circulating Tumor DNA/genetics* ; Neoplasm, Residual/genetics* ; Biomarkers, Tumor/genetics* ; Neoplasm Recurrence, Local ; Prognosis

Objective:To investigate the efficacy of dipeptidyl peptidase 4 inhibitor combined with insulin detemir (ID) in the treatment of type 2 diabetes mellitus with poor blood glucose control and its effects on blood glucose and oxidative stress indicators.Methods:A total of 105 patients with poor blood glucose control after taking oral hypoglycemic drugs who received treatment between August 2017 and September 2019 were included in this study. They were randomly assigned to receive treatment with either ID and compound vitamins (control group, n = 53) or dipeptidyl peptidase 4 inhibitor sitagliptin and ID (study group, n = 52). After 3 months of treatment, the clinical efficacy was compared between the control and study groups. Before and after 3 months of treatment, blood glucose indexes [fasting plasma glucose, 2-hour postprandial blood glucose], glycosylated hemoglobin, islet β-cell function [homeostasis model assessment-beta and homeostasis model assessment of insulin resistance)], oxidative stress index [superoxide dismutase, glutathione peroxidase, lipid hydroperoxides, malondialdehyde were compared between the two groups. The incidence of hypoglycemia was also recorded in each group. Results:After 3 months of treatment, total effective rate in the study group was significantly higher than that in the control group [92.31% (48/52) vs. 77.36% (41/53), χ2 = 4.541, P < 0.05]. After 3 months of treatment, fasting plasma glucose, 2-hour postprandial blood glucose, glycosylated hemoglobin, homeostasis model assessment of insulin resistance, lipid hydroperoxide and malondialdehyde levels in each group were significantly decreased, homeostasis model assessment-beta, superoxide dismutase and glutathione peroxidase levels were significantly increased compared with before treatment (all P < 0.05). There were significant significances in these indexes measured concurrently between the study and control groups ( t = 2.902, 3.539, 5.215, 7.313, 6.269, 4.475, 6.050, 3.323, 5.375, all P < 0.05). During the treatment, the incidence of hypoglycemia in the study group was significantly lower than that in the control group [0.00% (0/52) vs. 11.54% (6/53), χ2 = 4.319, P < 0.05]. Conclusion:Dipeptidyl peptidase 4 inhibitor combined with insulin detemir is highly effective for type 2 diabetes mellitus with poor blood glucose control. It can effectively control blood glucose level, improve oxidative stress reaction and is highly safe. Therefore, this treatment method is of good application value.

Objective To characterize the capsid proteins of recombinant adeno-associated virus 6(rAAV6)vectors by reversed phase liquid chromatography-mass spectrometry(RPLC-MS),including primary structure and post-translational modification(PTM).Methods The mobile phase A consisted of 0. 1% aqueous solution of difluoroacetic acid(DFA),while the mobile phase B was 0. 1% DFA acetonitrile solution. The column temperature was maintained at 80 ℃,and the gradient elution lasted for 10 min(0→10 min,mobile phase B 15%→45%). The ESI-Q-TOF mass spectrometry detection operated in positive ion mode with the scanning range of 400-4 000 m/z,the scanning frequency of 2 Hz,the cone voltage at 80 V,the capillary voltage at 3. 0 kV,and the ion source temperature at 120 ℃.Results The measured relative molecular mass of the AAV capsid proteins VP1,VP2,and VP3 was 81 255. 9,66 062. 9,and 59 488. 6,respectively. The deviations from the theoretical values were 8. 1 ppm for VP1,3. 8 ppm for VP2,and 36 ppm for VP3. Mass peptide profile analysis of the enzymatically digested rAAV6 sample indicated a sequence coverage of about 89% with detected PTMs mainly including deamidation,N-terminal acetylation,ubiquitination,and phosphorylation;no glycosylation modification sites were found. Tandem mass spectrometry confirmed the N-terminal and C-terminal sequences of the rAAV6 capsid protein as well as the N-terminal PTM.Conclusion The complete relative molecular mass of rAAV6 capsid protein was analyzed by RPLCMS technique,and the PTM of rAAV6 capsid protein was analyzed by tandem mass spectrometry at the peptide level,which has a certain significance for the quality control of AAV gene therapy products and the improvement of production process.

ObjectiveTo investigate the effect of nutritional status on the parameters of pulmonary function, respiratory muscle strength and drive in patients with chronic obstructive pulmonary disease (COPD).MethodsThe nutritional status of 79 COPD patients at stable period was evaluated regularly, and their pulmonary function and parameters of respiratory muscle strength and drive were examined routinely, and the results were compared with 53 healthy subjects (control group) of the same age and gender.ResultsThe indexes of nutritional status in the COPD patients were all obviously lower than those in the control group (P<0.05～0.01). The parameters of pulmonary function including FEV1, FVC, FEV1%, FVC% and FEV1%/FVC% in the control group were all markedly higher than those in the common nutritional status group and bad nutritional status group, and those were higher in the common nutritional status group than in the bad nutritional status group (P<0.05～0.01). The parameters of respiratory muscle strength including maximal mouth inspiratory pressure (Pmip) and maximal mouth expiratory pressure (PmEp) in the control group were obviously higher than those in the common nutritional status group and bad nutritional status group, but the drive parameter of P0.1 was markedly lower than those in the latter two groups, the Pmip and PmEp in the bad nutritional status group were obviously lower than those in the common nutritional status group, but the P0.1 was obviously higher than that in the common nutritional status group (P<0.05～0.01).ConclusionCOPD patients at stable period are often accompanied by malnutrition, and the nutritional status is decisive to the declined degrees of the parameters of pulmonary function, respiratory muscle strength and drive.

ObjectiveTo understand the influenza vaccination rate and influencing factors of children aged 6 months to 5 years in Shunyi District,Beijing in June from 2016 to 2021,and analyze the surveillance status of suspected adverse events following immunization(AEFI)after vaccination.MethodsThe data of influenza vaccination and AEFI report of children,influenza vaccination status and follow-up observation of children with underlying diseases after the trial implementation of“Vaccination Recommendations”in Shunyi District of Beijing from 2016 to 2021 were collected to analyze the coverage rate and AEFI report.ResultsFrom 2016 to 2021,a total of 11 996 children aged 6 months to 5 years were vaccinated with influenza vaccine in Shunyi District of Beijing,and the vaccination rate increased year by year(χ2=11 921. 129,P < 0. 01；χ2=11 921. 129,P < 0. 01；χ2_(trend)= 8 881. 396,P < 0. 01);With age,the influenza vaccination rate showed a rising trend(χ2_(trend)= 8 881. 396,P < 0. 01);With age,the influenza vaccination rate showed a rising trend(χ2= 4 073. 395,P < 0. 01；χ2= 4 073. 395,P < 0. 01；χ2_(trend)= 3 495. 611,P < 0. 01);The vaccination rate of children in urban areas was higher than that in rural areas(χ2_(trend)= 3 495. 611,P < 0. 01);The vaccination rate of children in urban areas was higher than that in rural areas(χ2= 497. 153,P < 0. 01). 9 children with underlying diseases who met the “Proposal of Vaccination Experts” were followed up and no adverse reaction was observed after being vaccinated with influenza vaccine.Conclusion In Shunyi District of Beijing,the influenza vaccination rate for children aged 6 months to 5 years was relatively low,and no adverse reactions different from other vaccines have been detected. It was safe and reliable to vaccinate children suffering from basic diseases under the guidance of“Vaccination Recommendations”.