Aiming at status of training the rural order directed free medical educational talents, we should improve the understanding of training the free medical students, perfect the relevant management system, strengthen medical ethics education of students, pay attention to humanistic care of students,strengthen the continuing education of students, standardize the access system of students, reform the medical distribution system, to ensure the quality of training free medical students.

OBJECTIVE To investigate the distribution and the antimicrobial resistance of nonfermenters Gram-negative bacilli causing nosocomial infection.METHODS Routine method was used to isolate and identify,antibiotics susceptibility was tested by the Kirby-Bauer on the NCCLS criterion of 2001.RESULTS Among 321 strains nonfermenters Gram-negative bacilli,Pseudomonas aeruginoa was 53.9%,Acinetobacter were 17.4%,and Stenotrophomonas maltophilia was 12.5%,Three kinds added up to 83.8%.CONCLUSIONS P.aeruginosea,Acinetobacter and S.maltophilia are important nonfermenters Gram-negative bacilli causing nosocomial infection and their drug resistant rate is very high.The matter is horrible in clinics,we should enforce monitoring.

Aim Toinvestigatetheeffectofhigh,me-dium and low doses of Mahuang decoction on the re-lease amount of rat hippocampal neural transmitter (Glu,Gly,Asp,GABA),then compare Mahuang de-contion with ephedra alkaloids and ephedra.Methods Ratswererandomlydividedinto6groupsandgiven orally with Mahuang decoction of high dose (calculated by ephedra 4 g·kg-1 ),medium dose (calculated by ephedra 2 g·kg-1 ),low dose (calculated by ephedra 1 g · kg-1 ),ephedra (calculated by ephedra 2 g · kg-1 ),ephedra alkaloids (ephedrine 7 mg · kg-1 , pseudoephedrine 2. 4 mg · kg-1 , methylephedrine 1. 12 mg · kg-1 )and blank control group.Samples were obtained from the hippocampus of conscious rat by microdialysis sampling technique.The content of ami-no acid neurotransmitters in dialysates was detected u-sing the established HPLC-ECD with OPA pre-column derivationmethod.Results Fouraminoacidneuro-transmitters could be well separated in 28 min.High, medium and low doses of Mahuang decoction,ephedra and ephedra alkaloids significantly increased the con-tent of these four amino acid neurotransmitters,com-pared with blank control group (P<0. 05 ).Ephedra alkaloids significantly reduced the levels of inhibitoryamino acid neurotransmitters GABA and Gly in 90 min,compared with the medium dose of Mahuang de-coction.Excitatory neurotransmitters of ASP and Glu in hippocampus showed the trend of increase first and then decrease after oral administration of Mahuang de-coction and ephedra. The levels of Glu and Asp reached peaks from 90 min to 120 min after treatment with Mahuang decoction,and also increased along with dose increase of Mahuang decoction.In comparison with the medium dose of Mahuang decoction group,the level of Glu reached peak at 90 min and 150 min in ephedra alkaloids group and ephedra group respective-ly,and the content of Glu significantly increased at peaktime.Conclusions Increasedcontentofexcita-tory amino acid neurotransmitters (Asp and Glu ) shows positive correlation with the dose of Mahuang de-coction.Other components in Mahuang decoction in-hibits the up-regulation effect of ephedra and ephedra alkaloids on Glu,and promotes the up-regulation effect of ephedra alkaloids on GABA and Gly.

A method for the determination of decabrominated diphenyl ether(decaBDE) in sediment samples at trace level using dispersive liquid-liquid microextraction based on the solidification of floating organic drop (DLLME-SFO) and high performance liquid chromatography-ultraviolet detector (HPLC-UV) has developed.Based on the data of interactive orthogonal array design, the optimization experimental conditions were obtained with BP artificial neural network model: 1.00 mL methanol as dispersive solvent, 35.0 μL dodecanol as extractive solvent, 10.00% NaCl, pH 5, and extraction in 10 min.The extraction recovery (ER) was 62.22% at the extraction conditions.The proposed method exhibited a wide linear range(3.5-1400 ng/g) with R~2 =0.9921.The limit of detection (LOD) and the limit of quantification (LOQ) of this method were 2.3 pg/g(S/N =2) and 5.6 pg/g(S/N = 5), respectively.The recoveries of real samples at different spiking levels of decaBDE were 104.2%, 98.4% and 97.7%, respectively.Extraction, concentration and separation procedures for decaBDE from the sediment sample were carried out by one step, and hence, the process of DLLME-SFO for decaBDE was shortened.

Objective To investigate the effect of in vitro high glucose stimulation on the expression of adiponectin receptor (adipoR) in human kidney proximal tubular cells.Methods The HK-2 cells were cultured in the low glucose DMEM culture medium containing 10% fetal bovine serum until the cells were adherent and 80% confluence. After cultured in the serum-free DMEM for 24 hours, these cells were stimulated with glucose-containing 1mg/ml, 2mg/ml, 4mg / ml, 6mg/ml, 8mg/ml serum-free DMEM for 48 hours. Then RT-PCR and western blot were used to analyze adipoR ( R1, R2) expression levels. The HK-2 cells were cultured respectively in high glucose (4mg/ml) , low glucose (1mg/ml) DMEM culture medium containing 10% fetal bovine serum to cultivate 0h, 12h, 24h, 48h, 72h, 96h, then RT - PCR was applied to analyze adipoR (R1, R2) mRNA expression levels semi-quantitatively. Results Two kinds of adiponectin receptor gene were both expressed in HK-2 cells, and the quantity of gene expression of adipoR1 (0. 63 ±0. 12) was 3. 9 times to adipoR2 (0. 16 ±0.03) , the difference was statistically significant ( P<0. 01). The different concentrations of glucose and different time of high glucose on HK-2 cells had no significant effect ( P>0. 05 ) on adipoR gene expression. Expression of adipoR 1 protein in HK-2 cells was detected by western blot, and it was not affected by glucose concentration ( P>0. 05).Conclusion adi-poR1 and adipoR2 gene were both expressed in HK-2 cells, and the adipoR1 was the major one, which suggested that adipoR1 played a more significant role in kidney disease. The expression of adipoRl/R2 of HK-2 cells was not affected by high glucose concentration.

Objective: To investigate the relationship between prognosis and alteration of oxygen(utilization) coefficient(O_2UC) in patients with sepsis.Methods: Sixty critically ill patients were divided into(sepsis)(n=30) and nonsepsis(n=30) groups,and 30 healthy controls were selected as normal control group.Gas analysis of arterial blood and central venous blood and calculation of O_2UC(O_2UC=arterial oxygen(saturation-venous) oxygen saturation/arterial oxygen saturation) were carried out at 8 o′clock in sepsis and(non-sepsis) groups on admission and 1,2,3,5,7 and 10 days after admission,and gas analysis of arterial blood and central venous blood was carried out only once in the controls.Results: On admission and 1 day(after) admission,O_2UCs in sepsis and non-sepsis groups were significantly higher than that of control group(both P0.05)).When O_2UC in critically ill patients persisted higher than 55% for 12-24 hours,the prognosis of the patients was poor and had a tendency to die in a short time.From the 2 nd day after admission,O_2UCs in sepsis and non-sepsis groups were lower than that in control group,and O_2UC in sepsis group was obviously lower than that in non-sepsis group(all P0.05),but from the 2 nd day after admission,O_2UC in sepsis group remained at a lower level compared with that in control group(all P

0.05). Conclusion The defecation function was similar between CPP group and CJP group. Therefore, the coloplasty pouch seems to be superior because of feasibility, simplicity, and effectiveness.

Objective To establish CT image-based, three-dimensional finite element models of healthy tibiae and plateau-fracture tibiae, and to calculate the displacement and stress distribution of the tibial models .Methods Continuous-time tomographic images of knee joints of a healthy adult and a patient with tibial plateau fractures were obtained using multi-slice spiral CT scan , and inputed to Mimics to establish three-dimensional surface mesh models of tibiae .The models underwent global meshing procedures and material properties assignment to construct finite element models of normal and plateau-fracture tibiae in ANSYS , and the newly established models were analyzed and calculated .Results In case of applied load on the tibial plateau , the peak strains of the load-contact sites in the healthy subject and the patient presented divergent directions , with peak strains on the medial tibia in the healthy subject and lateral tibia in the patient , respectively . Equivalent stress decreased gradually down the tibiae and concentrated in the one -third of the upper and middle regions in both types of tibiae .Moreover, concentration of stress was also present in the locus of the fractured tibia .The deformation displacement gradients were more evident in the healthy tibia than in the fractured tibiae .There was significant difference in overall stress distribution between the two types of tibiae .Conclusion Three-dimensional finite element models of tibiae have been established that can demonstrate the differences in biomechanical properties between healthy and plateau -fracture tibiae, which might provide reference and guidance for orthopedic regimens .

Objective To evaluate the influence of orthokeratology lenses on vision,intraocular pressure and biometric measurement parameters in adolescent myopia.Methods A total of 72 adolescent myopia patients (136 eyes) with orthokeratology lens,aged 8-16 years old,in Hebei Provincial Eye Hospital from Junuary 2013 to December 2015 were randomly selected.The vision,intraocular pressure,axial length,corneal topography,corneal thickness and anterior chamber depth were observed before wearing glasses,at 1 week,1,3,6 months after wearing glasses.Results After orthokeratology wearing,the uncorrected visual acuity was obviously improved (P＜0.05),the average refraction diopter was declined (P＞0.05) and the non-contact intraocular pressure was decreased (P＜0.05).The axial length after orthokeratology wearing had little change (P＞0.05).The curvature of the patient's cornea at one week after wearing glasses was deceased (P＜0.05) and the posterior corneal curvature tended towards stability.The corneal thickness at 1 week after wearing glasses had no obvious change compared with before wearing glasses(P＞0.05),which at 1 month after wearing glasses was decreased(P＜0.05) and which at 3,6 months after wearing glasses trended to be stabilized.The anterior chamber depth after wearing glasses had no obvious change.Conclusion Orthkeratology lens can decrease the myopia degree,increases the uncorrected visual acuity and has obvious effect for controlling adolescent myopia.The intraocular pressure and biometric measurement parameters have corresponding change after wearing orthkeratology lens.

Objective To meet the needs of the development of modern medicine and train health technical talent for basic level. Methods Using heuristic approach,and multi-form discussions,case teaching method,reform teaching methods,optimizing teaching content. Result Survey results showed that the satisfaction degree was high and it effectively enhanced the concept of preventive medicine and the actual working capacity. Conclusion Through teaching reform,the students’ ability to prevente and cure diseases,to analyze and solve problem has been markedly enhanced,and this approach can be widely used.