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 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.

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 .

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.

Objective To investigate the infection statue of new drug experimenters with hepatitis B,as well as liver fuction in 6 kind of infection modes of serum HBV,and to provide evidence for clinical therapy of hepatitis B.Methods 5 immunological HBV markers were measured with ELISA in serum sample of 550 patients before new drug test. Velocity method was applied to detecting serum TBiL,ALT,AST,γ-GT and GLO.Results New drug experimenters with hepatitis B mainly suffered from "small three positive" [HBsAg (+),anti-HBe (+) and anti-HBc (+)] (52.9%),followed by "big three positive" [HBsAg (+),HBeAg (+) and anti-HBc (+)] (28.2%). The rate of hepatic function abnormality was significantly higher in "small three positive" group than that of the other groups (P<0.01),while the rate of hepatic function abnormality was much higher in "big three positive" group than that of the other groups except "big three positive" group (P<0.05).Conclusion In 550 cases of new drug experimenters,HBV are all positive,mostly in "small three positive" or "big three positive" mode. The rate of hepatic function abnormality is markedly elevated in 6 kind of infected modes,in which "big three positive" mode is the highest,followed by "1,3" mode and"small three positive" mode.

The rise in childhood obesity has lead to an increased number of children with lipid abnormalities,and the predominance of a combined dyslipidemic pattern characterized by a moderate-to-severe elevation in triglycerides,normal-to-mild elevation in low density lipoprotein cholesterol and reduced high density lipoprotein cholesterol.Most of the published guidelines focus on managing primary dyslipidemia in pediatric patients,there is still no general consensus regarding the treatment of obesity-related lipid abnormalities in children.This article reviews screening,diagnosis and management of dyslipidemia associated with obesity in children,and emphasize lifestyle change is critical,in the rare child for whom diet and exercise interventions are insufficient,there are medication options that can be considered.

Objective To investigate the effective dose of dexmedetomidine on reducing agitation after sevoflurane anesthesia in patients undergoing repair of indirect inguinal hernia .Methods 105 patients ( ASAⅠ-Ⅱ) were randomly assigned into three groups ,35 cases in each group .In the observation group 1 and observation group 2, the patients received intravenous injection of dexmedetomidine 0.15μg/kg and 0.30μg/kg respectively.In the control group,the patients received intravenous injection of 0.9% normal saline solution 2mL before surgery.All patients were induced by 3%sevoflurane and maitained by 1.2%sevoflurane and hiatus sacralis block .During the operation, the BP,HR,SpO2,RR were recorded.At the end of anesthesia,the time to eyes opening (TEO) and agitation of emer-gence were recorded.Results The TEO of the control group,observation group 1,observation group 2 was (8.45 ± 4.02)min,(9.23 ±5.03)min,(10.81 ±4.06)min,respectively,and there were no significant differences among the three groups(all P>0.05).The incidence rate of agitation of the observation group 1 was 20.00%,which was signifi-cantly lower than that in the control group (42.86%) (χ2 =31.42,P<0.05 ),and that of the observation group 2(8.57%) was significantly lower than the control group and observation group 1(χ2 =24.37,7.53,all P<0.05). Conclusion The dose of dexmedetomidine 0.3μg/kg administered after induction of anesthesia can reduce the post-sevoflurane agitation in children and with no adverse effects .

Moxibustion therapy is a commonly used external treatment method for numerous conditions and general health care. Besides the effects of the drugs, infrared-heat and radiation spectrum are also the manner of action. By collecting the literature about thermal radiation and infrared spectrum features of moxibustion, the author reported the novel studies on the thermal effect of moxibustion including factors that impacted the temperature, infrared spectrum features, apparatus based on infrared technology employed in clinic for moxibusiton and characteristics of temperature sensitivity. The author also identified some existing problems and provided advice for future application and research.

Objective To explore the clinical effect of refractory atelectasis treated with high dose ambroxol.Methods 112 patients with refractory atelectasis were selected as research subjects.All the patients were divided into two groups with each group 56 patients according to admission order.The control group received symptom treatment,physics treatment and routine dosage ambroxol,while the observation group received high dose ambroxol.The clinical effect and safe between two groups were compared.Results The excellence rate and total effective rate of the observation group were 71.43％ (40/56) and 100.00％ (56/56),respectively,which were higher than 51.79％ (29/56) and 83.93％ (47/56) of the control group (x2 =4.57,9.79,all P ＜ 0.05).There were no statistical difference on the total adverse effect incidence rates between the two groups(x2 =0.15,P ＞0.05).No other sever adverse effects happened in both groups.Conclusion Compared with routine dosage ambroxol,the clinical effect of refractory atelectasis treated with high dose ambroxol was better.The treatment was also safe.It was worth generalizing on the treatment of refractory atelectasis.