With the size of graduate education continues to expand,deepening the reform of graduate education to improve the quality of graduate education has become the core of graduate education.This paper introduces the common problems and solution of graduate education in cilinical medicine professional degree.

Objective To explore the relationship between obesity phenotypes and adipocytokines in children.Methods Based on the Beijing child and adolescent metabolic syndrome (BCAMS) study,3 508 children (1 788 boys and 1 720 girls) aged 6-18 were recruited.In this study,participants were categorized into four groups:226 cases in general obese group,192 cases in abdominal obese group,1 004 cases in combined obese group and 2 086 cases in non-obese group,according to the sex,age,specific body mass index(BMI),and waist circumference (WC) equal to or greater than the 90th percentile for age and gender of school children in Beijing in 2004.The levels of plasma insulin,serum leptin,resistin and adiponectin were measured by sensitive,specific double-antibody sandwich enzyme-linked immunosorbent assays (ELISA).Analysis of covariance,multivariate linear regression and binary logistic regression analysis were performed.Results There were highest plasma insulin and serum leptin,and lowest adiponectin levels in combined obese group than those in other obese groups and non-obese group and resistin level in abdominal obese group was highest than those in other obese groups or non-obese group.Among subjects with general obesity and conbined obesity,WC was more important factor than BMI for plasma insulin[?(WC)=0.158 P0.05].With covariates adjusted,the odds ratios(OR)and 95% confidence intervals of general obesity,abdominal obesity and combined obesity were 3.46(2.44-4.91),5.41(3.87-7.57) and 10.10(8.26-12.35) for predicting hyperinsulinemia,respectively,5.83(4.02-8.45),7.07(4.97-10.05)and 20.82(16.49-26.28) for hyperleptinaemia,respectively,1.47(1.05-2.07),2.0(1.42-2.80) and 2.66(2.23-3.18) for hypoadiponectinaemia,respectively.Serum resistin was highest in abdominal obesity.Conclusion The levels of adipocytokines in children were correlated with the phenotypes of obesity,especially for abdominal obesity.

OBJECTIVETo explore the performance patterns of reaction point Jingtong in balance acupuncture through multi-center and big-sample clinical investigation. Methods The Jingtong points of balance acupuncture on healthy side and affected side were observed among 230 cases of cervical spondylosis and scores of self-discomfort in reaction point, color of skin, changes of skin, morphology of subcutaneous tissue and abnormal pressing pain were recorded. The software SPSS 15.0 was applied to statistically analyze the recorded scores.

RESULTSAmong 230 cases, the reaction point appeared in 226 cases, accounting for 98. 3%. Among the 226 cases who had reaction point, the total score of symptom and sign was (1.08+/-1.09) on the healthy side and (0. 84+/-1. 36) on the affected side, which had statistical significance (P<0. 01); score of self-discomfort in reaction point was (0. 76 +/-0. 83) on the healthy side and (0. 40+/-0.80) on the affected side, which had statistical significance (P<0.01); the score of skin color was (0.10+/-0.36) on the healthy side and (0. 03+/- 0. 19) on the affected side, which had statistical significance (P<0. 05); the score of abnormal pressing pain was (2. 47+/-2. 46) on the healthy side and (1. 39+/-2. 37) on the affected side, which had statistical significance (P<0. 01).

CONCLUSIONThe total score of symptom and sign of reaction point Jingtong on the healthy side is higher than that on the affected side, indicating positive reaction of Jingtong on the healthy side has specificity for cervical spondylosis. When patient has cervical spondylosis on either side of neck, the other side will have anomaly in Jingtong.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Neck Pain ; therapy ; Spondylosis ; therapy ; Young Adult

Forensic Medicine ; Humans ; Kidney Transplantation ; Polycystic Kidney Diseases

Objective To explore the dynamic changes of hydrogen sulfide(H2S)in the pathological course in cortical tissues at diffe-rent times of hypoxia-ischemia brain damage(HIBD).Methods Fifty-six healthy 7-day-old Sprague-Dawley newborn rats were randomly assigned into 7 groups(n=8):normal group,sham-operated group,HIBD 12 h group,HIBD 24 h group,HIBD 48 h group,HIBD 72 h group,and HIBD 7 d group.HIBD rat models were established by ligating the left common carotid artery,after 2-4 h,followed by exposuring to hypoxia(80 mL/L oxygen and 920 mL/L nitrogen)for 2 h.The achievement of HIBD model was determined by the change on behaviour of neonatal rats.There were no treatment on the normal group,and the left common carotid artery was only separated in the sham group.The left cortical tissues in the experimental group were removed at 12,24,48,72 h,and 7 d after HIBD.H2S amounts in cortical tissues at different times after HIBD were measured by biochemical methods.Results H2S level in cortical tissues in HIBD 12 h group increased significantly compared with sham-operated group(P

OBJECTIVETo apply the single cell nested multiplex polymerase chain reaction (PCR) to HLA typing, and analyze the influence factors on the amplification results.

METHODSSingle cell DNA templates were prepared with different methods. The exon 2, 3 and intron 2 of HLA-A, B, and exon 2 of DRBI were amplified using multiplex PCR. The second round of SSP-PCR HLA typing was carried out according to the large scale routine HLA typing results.

RESULTSEnzyme lysis method was the most efficient procedure for preparing the single cell DNA template, with a success rate (SR) of 93.3%, while the SRs of alkali lysis and freezing-thaw lysis methods were 83.3% and 73.3%, respectively. The second round amplification using enzyme lysis and SSP-PCR in 20 samples obtained a 95% success rate and a 15% allele drop out rate. The time for performing the whole procedure was less than 6 hours.

CONCLUSIONThe modified nested multiplex PCR technique is efficient for single cell HLA typing and might be applied to clinical preimplantation genetic diagnosis.

Histocompatibility Testing ; methods ; Humans ; Polymerase Chain Reaction ; methods

OBJECTIVETo examine the association between Ponderal index (PI) at birth and metabolic syndrome during middle age.

METHODSTotally, 975 adults (494 men and 481 women) aged 41-52 from the study cohort of Fetal Origin of Adult Disease were recruited in the study for clinic examinations, involving anthropometry and measurements of blood pressure, fasting and 2 hr plasma levels of glucose and insulin, serum lipid profile. Their HOMA-insulin resistance (IR) index was estimated. Metabolic syndrome (MS) was diagnosed according to 1999 WHO definition. Multivariate logistic regression analysis was used to estimate the effect of PI on MS and the interaction between PI at birth and body mass index (BMI) in adulthood.

RESULTSPrevalence of MS was 18.7% in this mid-aged population, 24.8%, 19.4%, 16.3% and 14.0% in those with less than the 25th percentile, the 25th to less than the 50th percentile, the 50th to less than the 75th percentile and more than 75th percentile of PI at birth, respectively, in a decreasing trend (chi2 M-H for trend=9.938 adjusted for gender, P=0.002). Logistic regression analysis showed that both PI at birth and BMI during adulthood could influence their occurrence of MS (beta=-0.125, P=0.002, for PI; and beta=0.430, P=0.000, for BMI). A synergistic effect between PI at birth and BMI in adulthood was observed in this population. Persons who were thin at birth with PI less than the 25th percentile, and became overweight with BMI greater than or equal to 24 kg/m2 later in their life, were at higher risk of suffering from metabolic syndrome (OR=29.1, 95% CI=13.6-62.1), in comparison with those who became overweight during adulthood from a higher PI at birth (OR=16.0, 95% CI=7.9-32.3) and those who were thin at birth and remained a appropriate BMI during their adulthood (OR=2.0, 95% CI=0.7-5.7). Attributable fraction of the interaction to MS was 34.6%.

CONCLUSIONSThin at birth was a predictor for later occurrence of metabolic syndrome, as well as an effect modifier for the association between of later BMI and metabolic syndrome, i.e., overweight later in his life was most deleterious for a person with growth retardation at birth.

Adult ; Birth Weight ; Blood Glucose ; metabolism ; Body Mass Index ; China ; epidemiology ; Cohort Studies ; Female ; Humans ; Insulin Resistance ; physiology ; Lipids ; blood ; Logistic Models ; Male ; Metabolic Syndrome ; epidemiology ; Middle Aged ; Prevalence ; Risk Factors

Aneurysm, False ; etiology ; surgery ; Blood Loss, Surgical ; Carcinoma ; Carotid Arteries ; Carotid Artery Diseases ; etiology ; surgery ; Humans ; Nasopharyngeal Neoplasms ; radiotherapy ; Rupture

Aged ; Angioplasty, Balloon, Coronary ; instrumentation ; methods ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; pathology ; therapy

OBJECTIVETo explore the relationship between serum level of leptin and the components of metabolic syndrome in a group of mid-aged Chinese population.

METHODS345 adults (184 men and 161 women) aged 46 - 53 were enrolled from Fetal Origin of Adult Disease (FOAD) cohort to participate the clinic examination including anthropometry, measurements of blood pressure, fasting and 2 hr plasma levels of glucose and insulin, serum levels of lipid and leptin. HOMA-IR index was calculated to estimate individual insulin resistance. Metabolic syndrome (MS) was diagnosed according to the definition criteria issued by the International Diabetes Federation (IDF) in 2005.

RESULTSThe prevalences of central obesity, higher serum level of triglyceride (TG), lower serum level of high-density lipoprotein (HDL-C), IFG, higher blood pressure and MS were 53.0%, 47.5%, 34.2%, 26.7%, 33.9%, 31.9% in this mid-aged population, respectively. Serum geometric mean level of leptin was higher in females than in males. Serum level of leptin increased with the prevalence of MS and components of abnormal metabolism. The serum level of leptin compared with central obesity, higher blood pressure, higher serum level of triglyceride (TG), lower serum level of high-density lipoprotein cholesterol (HDL-C), IFG and MS was significantly higher respectively (P < 0.05) without HDL-C in males. The serum level of leptin increased with the number of components of abnormal metabolism subjects had (P < 0.001).

CONCLUSIONThe serum level of leptin in this population is significantly associated with MS and components of MS. Hyperleptinemia could be a new component of metabolic syndrome. It might be a target in selection of MS and relative diseases.

China ; epidemiology ; Cholesterol, HDL ; blood ; Cohort Studies ; Female ; Humans ; Hyperinsulinism ; blood ; Insulin ; metabolism ; Insulin Resistance ; Leptin ; blood ; Male ; Metabolic Syndrome ; blood ; epidemiology ; Middle Aged ; Obesity ; blood