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 explore the impact of intrapartum mild asphyxia on motor development in infants. Methods 30 infants with any of the following were as asphyxia group: heart rate more than 160 beats/min in the process of childbirth, and then down to 70-80 beats/ min, no cyanose; Apgar score 1 min more than 8. Other 30 normal infants were as control group. They were assessed with Neuropsychological Development Scale for 0-6 Years Old 3, 6 and 9 months after birth. Results Opisthotonos was more frequent in the asphyxia group than in the control group (P<0.01) 3 months after birth, but there was no significant difference in total score (P>0.05). Sitting forward was more frequent in the asphyxia group 6 months after birth, and the score of motor was less in the asphyxia group than in the control group (P< 0.05). More of the asphyxia group couldn't stand with help, and with poor motor score 9 months after birth (P<0.05). Conclusion Intrapartum mild asphyxia may infulence the motor development of infant in long-term.

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.

Allergic conjunctivitis is a very common pathology and its incidence has increased in developing countries with the development of industrialization.At present,the therapy of allergic conjunctivitis is mainly the use of topical eyedrops to eliminate causative factors,relieve symptoms and prevent complications.The drugs used in allergic conjunctivitis have 6 groups,including antihistamine,mastocyte stabilizer,drugs with dual effects (antihistamine and mastocyte stabilizer),non-steroidal anti-inflammatory drugs (NSAIDs),glucocorticoids and immunosuppressors.The goals of topical use of antihistamine,mastocyte stabilizer and drugs of dual effects are to remove the itching and hyperaemia of eye or to treat the patients with acute allergic conjunctivitis; while NSAIDs,glucocorticoids and immunosuppressors are used for the patients with severe or chronic allergic conjunctivitis.The glucocorticoid drugs are more effective because of their arresting effects in several links of the allergic response.Nevertheless,the long-term use of glucocorticoids probably results in ocular hypertension or posterior subcapsular cataract,furthermore,glucocorticoid drugs should be more cautionary in the application of the patients with corneal ulcer.Immunosuppressors inhibit abnormal immune responses,but these drugs should not be used for a long term because of higher cost and adverse effects.NSAIDs have a good anti-inflammatory effect and less irritant,so the topical use of NSAIDs for allergic conjunctivitis appears to be a better choice nowadays.

Recent researches showed the incidence of filtering blebs leakage after anti-glaucoma surgery was 3％-25％.The affecting factors include the usage of antimetabolite medicine.Pathogenesis of filtering blebs leakage is the basement membrane of conjunctival cells fracture,reduced conjunctival cells and subconjunctival cells.It may cause hypotony,bleb infection and even endoophthalmitis.The treatments mainly include conservative therapy and surgery.Conservative therapy methods include package,autoserum or fibrin injection or eye drops and tissue glue.Surgery methods include conjunctival transposition,repair with conjunctival,corneal,scleral,amniotic membrane and biomechanical materials.Filtering blebs leakage may induce severve complications without timely treatments.Conservative therapy and surgery have their own limitations,which need to be considered intently and followed up closely.

Uveitis is one of the leading causes of visual impairment.The method of evaluate to visual function include visual acuity,visual field,contrast sensitivity,color vision and visual electrophysiology.Among these methods,the most direct and common one is visual acuity.The visual outcomes are various because of the differences of cause of disease,severity of inflammation,location of lesion and complications.Visual impairment is most common in panuveitis.The risk of serious visual impairment is increased with aging.Bilateral inflammation is more serious and difficult to cure.Of varied causes of disease,the visual outcomes in sarcoid-related uveitis,Behcet' s disease and juvenile arthritis-related uveitis are poor.The complications of uveitis can cause visual impairment directly as well.Cystoid macular edema is the most common complication of uveitis,and which to bring up to visual impairment.There are abnormalities left in contrast sensitivity,visual field and electroretinogram.This article mainly summarize the visual function outcomes of uveitis and factors affecting the visual function.