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 investigate the distribution and resistance of non-fermenting bacteria isolated from our hospital and offer a basis for the treatment of bacterial infection.Methods 236 strains of non-fermenting bacteria were isolated from clinical samples between May.2004 and Dec.2006were identified with API identified test (API Inc.France) and Kirby-Bauer (K-B) test used for the antibiotics susceptivity test. Results Totally 236 strains of non-fermenting bacteria were isolated from the 1303 pathogenic strains. The most common bacteria were Pseudomonas auruginosa(57.6%),followed by Acinetobacter baumannii(7.6%)and Pseudomonas putida(6.4%).64%of non-fermenting bacteria were isolated from the sputum. these bacteria had various resistance to all detected antibiotics. Conclusions non-fermenting bacteria had high isolated rate and multi-antibiotic resistance,so antibiotics should be correctly under the guidance of antibiotic susceptibility testing.

Objective To explore the changes and clinical significance of gestational diabetes mellitus in late pregnancy with fetal ductus venosus blood flow waveform parameters.Methods 23 cases of 24-40 gestational weeks gestational diabetes and 60 cases of normal fetus were selected,color Doppler ultrasonography in the venous catheter into the subarachnoid catheter blood flow waveform was applied to record,including the determination of blood flow parameters:ventricular peak systolic velocity ( DVS) ,left ventricular diastolic peak flow velocity ( DVD) ,atrial systol-ic peak velocity (DVA),and DVRI=(DVS-DVA)/DVS.Results DVS(42.72 ±3.63)cm/s,DVA (12.34 ± 3.11)cm/s and DVRI(0.49 ±0.08) of fetal ductus venosus gestational diabetes group and normal pregnancy group had significant difference (t=3.232,9.664,2.470,all P<0.05),especially the difference between the two groups of DVRI had statistically significant.Conclusion Color Doppler flow spectrum curve of ultrasonic detection of fetal duc-tus venosus have clinical significance in gestational diabetes mellitus.

Extrauterine growth restriction (EUGR) is common in very low birth weight infants (VLBWI) during early postnatal life.Parenteral nutrition (PN) management can meet the requirement for these very preterm infants.How to keep the balance between the needs of the catch-up growth and the risks of the metabolism disorder has become a hot topic.This article reviews some issues about PN that are involved in the studies in recent years,such as the initial time and doses,the individual formulation and the tolerance of the amino acids intake,and emphasizes that high dose amino acids is necessary and security for VLBWI used within 24 h (even 2 h) after birth.

Objective The purpose of this study is to understand students' awareness of education quality and provide an important reference for teaching quality assurance and improvement in universities of Yunnan. Methods By using questionnaire, a survey to 1069 students in 5 grades of 5 Yunnan universities was conducted. Results Students have strong sense on awareness of education quality in Yunnan universities, but it is still necessary to increase the propaganda of education quality among students. Conclusion Focus on the idled teaching evaluation results in 5 universities of Yunnan. Clear and definite the importance of establishing improvement mechanism after teaching evaluation.Focus on the problem of low satisfaction from students. Pay more attention to teaching effect and add it as the important indicator in the teachers' performance assessment.

Objective To investigate the superiority of augmentation rhinoplasty by using ear cartilage.Methods We excised ear cartilage from patient's unilateral ear.106 cases were performed through suitable ear cartilage that was carved to some shape and then transplanted to nasal tip and columella,and two alar cartilages were sutured and implant was used for rhinoplasty.Results All cases were followed up for one year after operation without implant slipping and malposition of implant,with better figure after enhancing and lengthening nasal tip.Conclusions This method of augmentation rhinoplasty using ear cartilage can avoid complications such as slipping,malposition and exposure of implant.Therefore,it is deserved to recommend clinical application.

Objective To establish monitoring indicators to predict the pregnancy outcome of threatened abortion. Methods In one hundred and five pregnancy patients, normal pregnancy was 35 cases ( normal pregnancy group), continued pregnancy was 35 cases(continued pregnancy group ), failure abortion was 35 cases (failure abortion group).The levels of cancer antigen 125(CA125),progesterone,estradiol, β -hunan chorionie gonadotrophin( β -hCG) were monitored and compared among three groups. Results The levels of progesterone,estradiol, β-hCG were lower in failure abortion group than those in normal pregnancy group and continued pregnancy group (P＜ 0.05); CA125 in failure abortion group was higher than that in normal pregnancy group and continued pregnancy group (P ＜0.05). The accuracy of combination progesterone,CA125,estradiol and β-hCG was 100.00% (28/28). Conclusion The integrated method which combination monitoring CA125, progesterone, estradiol, β -hCG can improve the prediction accuracy of the early outcome of abortion.

Objective To investigate the clinical effect and complications of candesartan in the treatment of stress-induced hypertension.Methods 60 patients with stress-induced hypertension were randomly divided into experimental group and control group.Experimental group was treated with candesartan,the control group was treated with benazepril.The efficacy of the two groups was compared.Results After the treatment for 4 weeks,8 weeks,SBP/DBP in the two groups had significant differences compared with before treatment (t =5.32/3.76,5.94/3.99,8.61/5.83,2.34/5.67,all P ＜ 0.05).The incidence rate of complications in the experimental group was 6.7％,which was significantly lower than 25.0％ in the control group (x2 =4.32,P ＜ 0.05).Conclusion Candesartan in the treatment of stress-induced hypertension has significant effect,the incidence of complications is lower.

Objective To observe the curative effects of traditional Chinese plus western medicine and west ern medicine on patients with nephropathy(IgAN).Methods 45 cases of IgAN were randondy allocated to two groups.22 cases(control group)were treated with routine western medicine and 23 cages(treatment group)were trea ted based on syndrome differentiation.on a course of treatment.The changes of urine routine;24h urine protein;serum creatinine and BUN were observed in patients with IgAN.Results The total effective rate(91.3%)was significantly higher(65.2%)(x2=6.02,P＜0.05);Treatment after 24h urine protein(0.48±0.32)g,urine BBC count(25.7±13.6)104/ml was significantly lower than before treatment(1.62±1.05)g,(64.4±30.1)104/ml(t=2.889,t=2.945,P＜0.01);two groups after treatment Scr,BUN has dropped,and before treatment had no significant difference (t=1.752,P＞0.05).Conclusion The curative effect of traditional Chinese plus western medicine exerts a better effect than the sole western medicine in patients with IgAN.

Recently,staging,chemoradiotherapy schedule,new chemotherapy agents and application of targeted therapy drugs are widely investigated in small cell lung cancer(SCLC).Some progresses are achieved in prophylactic cranial irradiation of extensive stage and some new chemotherapy agents such as irinotecan,oral topotecan and pemetrexed etc are widely investigated.There are still some disputes about staging,the timing of chemoradiotherapy in localized SCLC and so on.