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.

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 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 .

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.

Objective To investigate the effects of Nicergoline on swallowing function,substance P level and cognitive function in stroke patients.Methods A total of 60 patients developing stroke within 1-3 months with swallowing and mild to moderate cognitive impairments were selected and randomly divided into Nicergoline group (n=30,patients taking Nicergoline 20 mg,tid,for 4 weeks) and control group (n=30,patients taking placebo for 4 weeks).The swallowing function was evaluated,change of serum P substance level and the improvement of cognitive function were observed after 4 weeks of treatment.Results The swallowing function was improved in Nicergoline group after 4 weeks of treatment as compared with pre-treatment [(7.15 ± 1.76) scores vs.(5.42±1.89) scores,t=3.669,P=0.001],while it had no significant difference in the control group before versus after treatment (t=0.115,P=0.909).The substance P level was increased in Nicergoline group after 4 weeks of treatment as compared with pre-treatment [(189.6 ± 41.3) ng/L vs.(112.3±38.5) ng/L,P＜0.01],and it was slightly increased in control group after treatment,but there was no significant difference (t=0.933,P=0.355).In Nicergoline group,MMSE and MoCA scores were higher after treatment than before treatment [(24.77±5.75) vs.(19.22±2.36),(18.53±5.42) vs.(14.02±3.52),t=4.891 and 3.822,both P=0.000],while they had no significant differences in control group before versus after treatment (both P＞0.05).Conclusions Nicergoline can improve swallowing function and reduce the incidence of aspiration pneumonitis as well as improve the cognitive function in stroke patients.

Objective: To explore the pharmaceutical care mode for drug treatment and interactions through participating in the treatment of patients using cyclosporine A combined with anti-tuberculosis ( TB) drugs. Methods: The clinical questions were pro-posed and refined, the literature evidence was retrieved in the electronic databases, the questions were answered and the procedure and mode of pharmaceutical care for the similar clinical problems was established. Results:For the patients with cyclosporine A treatment, strong anti-TB drugs should be chosen to ensure the effectiveness and decrease the drug interactions, and the concentration monitoring of cyclosporine A should be paid more attention. Conclusion: Clinical pharmacists can implement the pharmaceutical care for the pa-tients with immunosuppression and TB infection through developing anti-TB regimen, avoiding the drug interactions, improving the drug safety and so on.

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.

The drug and medical consumables management center in Wuhu features the operational mechanism separating the decision-making power of drug purchasing,the executive power and the supervision power.This practice terminates the interest chain previously found between medicine suppliers with hospitals,pharmacies and doctors,creating the Wuhu Model of drug and medical service separation at public hospitals.The drug zero-profit policy reshapes the drug supply system and the existing compensation mechanism of public hospitals,further defining the Wuhu Model.This model is paving the way for the same reform to be carried out nationwide.