Quality consciousness is the guidelines of the graduate cultivation.The perfection of organization and management as well as the strength of innovation and reform also immediately influence the training quality of graduates.Today the graduate scale expands,so we should use scientific development concept to guide the graduate cultivation and to develop postgraduate education quickly and soundly.

Objective To establish the hyperinsulinemic-euglycemic clamp(HEC) technique in conscious rats, and to explore the effect of acute infusion of lipid on glucose infusion rate (GIR) in rats. Methods Ten SD rats were random-ly divided into two groups, 5 rats for each group. The right jugular vein and left carotid artery were catheterized and under-went a HEC with infusion of lipid (intralipid group) for 6 hours, and with continuing infusion of 5%glucose (control group). The plasma levels of free fatty acid(FFA) and GIR were measured by HEC method. Results The level of FFA concentration increased by 17.6-fold, and GIR was reduced by 27%in the intralipid group compared to those of control group (P＜0.001). Conclusion The rat model of HEC has been successfully established by intravenous intralipid infusion, which can be con-firmed by HEC technique.

Objective To investigate the psychological status and related factors in patients with mainte-nance hemodialysis in Huzhou city.Methods 376 cases of maintenance hemodialysis were selected as the research subjects in Huzhou First People's Hospital.The anxiety and depression status in maintenance hemodialysis patients were investigated by issuing questionnaires.To study the relationship between anxiety and depression,gender,age, social support,nutritional status,complications,and in maintenance hemodialysis patients.At the same time,the quality of life was evaluated by SF -36 scale.Results Issuing 376 questionnaires,a total of 373 points,the effective recovery rate was 99.20%.In 373 patients,there were 182 patients (48.79%)with no depression,mild depression in 78 cases (20.91%),moderate depression in 59 cases (15.82%),severe depression in 54 cases (14.48%). 51.21% patients had different degree of depression.Of the 373 patients,there were 123 patients (32.97%)with no anxiety,mild anxiety in 141 cases (37.80%),mild and moderate anxiety in 55 cases (14.75%),moderate anxiety in 33 cases (8.85%),severe anxiety in 21 cases (5.63%).A total of 67.03% patients had different degrees of anx-iety.Huzhou city maintenance hemodialysis,female patients had depression rate of 80.70%,anxiety rate of 65.50%, which were significantly higher than the rate of depression 55.45%,anxiety rate 39.11% in male patients,the differ-ences were statistically significant (P <0.01 -0.05).In maintenance hemodialysis patients,the anxiety and depres-sion status gradually increased with age.Severe malnutrition in maintenance hemodialysis patients,the rate of depres-sion,anxiety rates were 80.65%,90.32%,the rates of depression,anxiety were 44.49%,61.81% in normal and mild malnutrition patients,the differences were statistically significant (all P <0.01).SF -36 scale showed that most of the patients with maintenance hemodialysis patients had poor quality of life,and the function was limited. Conclusion Maintenance hemodialysis patients,the general existence of anxiety and depression in the mental state in Huzhou city.Moreover,the psychological state of the patients is influenced by sex,age,nutrition status,and other factors.In clinical,it is needed to provide effective psychological intervention for patients to improve the quality of life,according to the psychological status and related factors of maintenance hemodialysis patients.

Objective To explore the pathogenesis of syringoma in order to cure this disease. Methods The clinical manifestation was observed in 39 cases of syringoma. The serum level of estradiol (E 2), progesterone (Pro), luteinizing hormone(LH) and follicle stimulating hormone (FSH) were detected with radioimmunoassay in all the 30 female cases and 25 normal controls. The expression of estrogen and progesterone receptor (ER and PR) was determined in syringoma tissues using ABC method and anti ER and anti PR monoclonal antibodies. Results Syringoma mainly involved middle aged women. The average level of serum E 2 in female patients was (73?28) ng/ml and its control group, (42?19) ng/ml ( P

Clinical symptoms,multi screeming characters and pathological features of 15 cases of FNH were analysed retrospectively.11 cases were treated by operation.The results showed that three quarters(12/15) of the patients were male.Only one third(5/15) of the patients were diagnosed as FNH according to multi screeming of B US,CT and MRI.There were no complications for the 11 cases after operation.The results indicated it is difficult to diagnose FNH only by multi screeming methods.Operation is the best option for the treatment of FNH.

Purpose To explore the multislice spiral CT (MSCT) features of renal chromophobe carcinoma, and to improve the understanding and diagnosis of the disease. Materials and Methods MSCT features of 17 patients with renal chromophobe carcinoma confirmed by surgical pathology were retrospectively analyzed, plain MSCT and multi-phase dynamic contrast-enhanced scan were applied to these patients. Results Single substantive round or oval-shaped soft tissue mass was demonstrated in 17 cases. The lesions were all uniform density on plain MSCT, and mild to moderate homogeneous enhancement in 11 cases on enhanced MSCT, including 9 cases with significant enhancement above the renal medulla and below the renal cortex, and 2 cases with similar enhancement to renal medulla in corticomedullary phase. On nephrographic phase the lesion showed significant lower density than renal medulla. Heterogeneous enhancement presented in 6 cased, including 1 case with small necrosis and 1 case with stellate scar lesion in low-density. Conclusion Renal chromophobe carcinoma demonstrates a round solid mass of uniform density on plain MSCT, and mild to moderate homogeneous and heterogeneous, which can provide the reference value for preoperative diagnosis.

Objective To detect and analyze nuclear factor kappa B (NF-κB),Helicobacter pylori (HP),Helicobacter pylori cytotoxin associated protein A (CagA),platelet (PLT) and platelet associated IgG (PA IgG) in 224 patients with idiopathic thrombocytopenic purpur(ITP) from three urban hospitals of Shaoxing,in order to explore the role of NF-κB and CagA in the pathogenesis of ITP,then to improve the prognosis of ITP.Methods SABC method was used to detect the NF-κB,13C breath test for the determination of the Hp infection.CagA and PA-IgG were tested by enzyme linked immunosorbent assay.Automatic blood cell analyzer was used to measure PLT.According to the test results,the patients were divided into Hp+cagA+NF-κB+,Hp+cagA+NF-κB-,Hp+cagA-NF-κB+,Hp+cagA-NF-κB-,Hp-NF-κB+,Hp-NF-κB-PLT groups,and PA-IgG,PLT of the six groups were statistically analyzed.Results Of 224 cases with ITP,175 cases of HP positive,the positive rate was 78.13%.CagA+ 91 cases in 175 cases of Hp+,accounting for 52%,overall 43.63%.NF-kappa B+ 108 cases,the positive rate was 46.21%,78 cases were found in Hp+cagA+,accounting for 85.71% in cagA+.In 84 cases of Hp+cagA-,there were 21 cases NF-κB+,the positive rate was 25%.In 49 of HP-,9 cases with NF-kappa B+,accounting for 18.37%.PLT and PA-IgG were compared among the groups.The count of PLT of group Hp+,group Hp+cagA+ and group NF-κB+ was lower than group Hp-,group Hp+cagA- and group NF-κB-.However,the level of PA-IgG of group Hp+,group Hp+cagA+ and group NF-κB+ was higher than group Hp-,group Hp+cagA- and group NF-κB-,the difference was statistically significant(P<0.05).Conclusion CagA maybe directly or through the activation of NF-kappa B take part in the immune response of ITP,cause PA-IgG increased and thrombocytopenia.

Objective To study the effects of endolymphatic sac decompression and on semicircular canal plugging in treating intractable Meniere's disease.Methods A total of 14 cases of intractable Meniere's disease were included in this study.The age was from 33~67 years old and the history was from 1 to 40 years.The hearing level of bone was from 35 to 65 dB for the speech frequencies.All cases received the treatments according to the pre-op-erative design.The endolymphatic sac was decompressed and the three semicircular canal bones were drilled to cre-ate a fenestra followed by soft tissue plugging into the canal.The vertigo,hearing level and tinnitus were included in the following up.Results All cases had no facial palsy,no cerebrospinal leak,and no vertical after surgery.In the period of 3 to 18 months following up,the attack of Meniere's disease was completely controlled for 13 cases excep-tion of one lost case.For five cases,the hearing level descended 10 to 15 dB compared to pre-operation.Conclusion Although the endolymphatic sac decompression can relieve endolymphatic pressure,this may not adequately pro-tect the hearing caused by the semicircular canal plugging.The surgical technique is reliable and safe;however fur-ther clinical data should be gathered.

Objective To explore the effect of Shenshuaining capsule on nutritional status and blood rheology in patients with chronic renal failure.Methods 150 cases of chronic renal failure were randomly selected and were randomly divided into observation group and control group, 75 cases in each group.The control group were given hemodialysis for treatment,and the observation group was treated with Shenshuaining capsule one week after dialysis.The clinical effect,nutritional status and biochemical indicators in the two groups were observed.Results The total effective rate in the observation group was 86.67%, which was higher than 72.00% in the control group,the difference was statistically significant(x2=4.920,P<0.05).After treatment,the nutrition indicators of HBG,ALB,IgG,IgA and IgM in the observation group were (135.7±16.4)g/L,(34.5±2.9)g/L,(10.8±0.7)g/L,(2.1±0.4)g/L and (1.7±0.3)g/L respectively, which were higher than those in the control group[(113.8±16.9)g/L,(28.4±2.5)g/L,(7.6±0.8)g/L,(1.3±0.3)g/L and (1.2±0.2)g/L], the differences were statistically significant(t=8.054,13.797,26.070,13.856,12.010,all P<0.01).In the observation group,the incidence rate of undernutrition was 25.33%, which was lower than 46.67% in the control group, the difference was statistically significant(x2=45.905,P<0.05).After treatment,the blood urea nitrogen and blood urea in the observation group were (349±64)μmol/L and (10.4±3.7)mmol/L respectively,which were lower than those in the control group[(462±51)mol/L and (14.2±4.5)mmol/L], the differences were statistically significant(t=11.958,5.649,all P<0.05).After treatment,the creatinine clearance rate and concentration of hemoglobin in the observation group were (25.1±6.1)mL/min and (92.1±21.1)g/L respectively, which were higher than those in the control group[(21.7±5.4)mL/min and (84.7±15.3)g/L], the differences were statistically significant(t=3.614,2.459,all P<0.01).After treatment, the high blood viscosity,low blood viscosity,plasma viscosity and hematocrit in the observation group were (3.59±0.94)m/Pas,(7.84±0.97)mPa/s,(1.31±0.15)mPa/s and (0.33±0.07) respectively, which were lower than those in the control group[(4.41±1.13)mPa/s,(8.72±1.05)mPa/s,(1.43±0.24)mPa/s and (0.42±0.05)], the differences were statistically significant(t=11.958,5.649,2.459,all P<0.01).Conclusion For patients with chronic renal failure,Shenshuaining capsule combined with hemodialysis can improve the nutritional status and blood rheology.

Object To optimize the best extraction of the total saponins in the root of Ophiopogon japonicus (Thunb.) Ker-Gawl. (RO). Methods The extract condition of total saponins in RO was observed by orthogonal design with ophiopogonis D as index. Results The optimum extract condition of RO was established. The more effective way was to smash RO to 5-10 mesh and extract total saponins in RO with ten times amount of 80% alcohol thrice by refluxing, one hour each time. Conclusion The total saponins in RO could be fully extracted in this condition.