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.

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 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.

Objective To investigate the clinical features of pregnancy complicated severe hepatitis and summarize experience in diagnosis and treatment so as to decrease maternal mortality.Methods Forty-two cases of pregnant women with severe hepatitis in the hospital were retrospectively analyzed.According to the outcome,all subjects were divided into death group(27 cased) and survival group(15 cases).Clinical data including viral markers,clinical manifestations,blood biochemistry,clinical treatment and pregnancy outcomes were recorded.Results (1) Pathogen examination showed that the major infection was hepatitis B virus (HBV),accounting for 64.29％ (27/42).(2) The first symptoms was gastrointestinal symptoms,accounting for 73.81％ (31/42).(3) The level of serum albumin,cholesterin (CH) and cholinesterase (CHE) in survival group were (29.91 ± 6.78) g/L,(2.80 ± 1.02) μmol/L and (5 399.4 ± 1 096.5) U/L respectively,significantly higher than that in death group((25.14 ± 7.36) g/L,(1.73 ± 0.77) μmol/L,(3423.6 ± 1102.7) U/L respectively).The serum creatinine(SCr) and prothrombin time (PT) levels in survival group were (83.06 ± 47.23) μ mol/L,(18.98 ± 6.72) s,lower than that in death group ((231.54 ± 58.90) μmol/L,(44.16 ± 5.38) s).The differences were statistically significant (t =2.07,3.84,5.57,8.37,13.29 ; P ＜ 0.05 or P ＜ 0.001).(4) The mortality rate of patients who chose pregnancy termination was 31.58％ (6/19),lower than the overall average mortality rate 64.29％ (27/42) and the difference was statistically significant (x2 =5.636,P =0.018).Conclusion HBV infection is the main reason for pregnant women with severe hepatitis.Gastrointestinal symptoms is the main symptom.Serum albumin,SCr,PT,serum CH and CHE can be regarded as prognostic indicators of the disease.Active comprehensive treatment and timely pregnancy termination can reduce maternal mortality.

Psychiatric nurses are subjected to a high rate of assault by patients.The stress of exposure to assault or potential assault appears to impact nurses emotional states in the form of post-traumatic stress disorder (PTSD).This study analyzed and summarized from the aspects of non somatization influence of patients' assault on psychiatric nurses and the risk factors and coping styles of PTSD in psychiatric nurses in order to supply reference for psychiatric nurses to cope with PTSD effectively.

X-linked hypophosphatemic rickets is the most common hereditary rickets and easy to misdiagnosis or missed.The treatment is more complicated compared with the general rickets.In this paper,the clinical features,genes and treatment of X-linked hypophosphatemic rickets are reviewed.

Intestine is one of the fastest cellular renewal tissues and organs in the body cells,and intestinal mucosal epithelial cells keep self-renewal constantly all the life.Its effect relys on stem cells continued proliferation,differentiation and replaces the outer terminal differentiated cells.Under the stimulation after injury,the repairment of stem cells is initiated,the proliferation and differentiation of intestinal stem cells are stimulated throughout molecular mechanisms.Studys found that intestinal stem cells involve in the repairment of the gut during stress,trauma,anoxia,radioactive damage,inflammatory bowel disease and short bowel syndrome.In this paper,we briefly overviewed the definition,location,and differentiated regulation stem cells,and influence factors in the intestinal repairment.

Thyroid nodules in childhood are less prevalent but more often to be malignant than those in adulthood. The evaluation of thyroid nodules includes history collection, physical examination, laboratory examination, imaging and ifne-needle aspiration biopsy (FNAB). A history of neck irradiation, previous thyroid diseases and thyroid neoplasms in the family are high risk factors of malignant nodules. Thyroid ultrasonography is the ifrst choice of thyroid nodules assessment. FNAB is the best way to discriminate between benign and malignant lesions. Treatment option for benign thyroid nodules is follow-up. Surgery is the most effective treatment option for malignant or suspicious thyroid nodules.