Objective To understand the status quo of continuing medical education in different levels of hospitals in primary health technical personnel,and provide suggestions for the development of continuing medical education.Methods Questionnaire survey,Statistical analysis and Interview.Results Health technical personne of medical institutions at all levels in primary health technical personnel were generally more emphasis on continuing medical education,but the management system,input and the need are different in the different levels of hospital.Continuing medical education in the basic level hospitals is much lower than the high level hospitals.Conclusions We should strengthen the transformation of continuing education mode,put forward the practical development strategy,improve the level of medical education,and narrow the gap between different levels of hospitals,so as to achieve the purpose of common progress.

Objective To study the expressions and prognostic significance of high mobility group protein A1 (HMGA1) and high mobility group protein A.2 (HMGA2) in pancreatic carcinoma.Methods The expressions of HMGA1 and HMGA2 were examined by immunohistochemical SP method in 60 cases of pancreatic carcinoma and 30 cases of normal pancreatic tissues.The relationship between the expression and prognosis was also analyzed.Results The expressions of HMGA1 and HMGA2 in pancreatic carcinoma were significantly higher than those in normal tissues,and the positive expression rates were 70.0％ vs.6.7％ (x2 =32.105,P =0.000) and 73.3％ vs.3.3％ (x2 =39.200,P =0.000).The expression of HMGA1 in pancreatic carcinoma was correlated with histological grade (x2 =6.774,P =0.034),TNM stage (x2 =4.776,P =0.029) and lymphatic metastasis (x2 =12.614,P =0.000).The expression of HMGA2 in pancreatic carcinoma was correlated with histological grade (x2 =8.200,P =0.017) and TNM stage (x2 =7.253,P =0.007).The expression of HMGA1 was positively associated with HMGA2 expression (r =0.393,P =0.001).Kaplan-Meier analysis showed that the median survival time of HMGA1 and HMGA2 positive patients were shorter than those patients with HMGA1 negative and HMGA2 negative (14.0 months vs.24.0 months,x2 =14.568,P =0.000;15.0 months vs.21.0 months,x2 =7.270,P =0.007).Conclusion HMGA1 and HMGA2 are highly expressed in pancreatic carcinoma,and play synergistic roles in the generation and progress of pancreatic carcinoma.There is certain value of combined detection of HMGA1 and HMGA2 to predict the prognosis of pancreatic carcinoma.

Objective To explore the construction and application effects of extended care form for children with epilepsy based on Omaha System.Methods Based on Omaha System,the form was established by referring medical records,literature review and three rounds of focus group discussion.From February to June,2016,48 children with epilepsy were selected as the observation group and received routine care as well as management using the form based on Omaha System;from August to December,2015,48 children with epilepsy were selected as the control group and received routine care and follow-up.The effects of intervention and scores of Family Management Measure were compared between two groups.Results Nursing issues in all domains for the observation group 3 months after intervention were lower than those during hospitalization except financial situation (P＜0.05);there was statistically significant difference in scores of knowledge-behavior-status of main nursing issues before and after intervention except cognition and mental health items (P＜0.05).Duration of hospitalization,expenditure,readmission rate,EEG results and scores of FAMM in the observation group were better than those in the control group (P＜0.05).Conclusion The construction and application of the form based on Omaha System can provide references for longterm management for children.

Objective To analyze the prognostic factors for patients with hepatic encephalopathy (HE) in acute-on-chronic liver failure(ACLF).Methods A retrospective analysis was performed on 159 ACLF patients with HE.The hepatic encephalopathy was determined to baseline,the patients were divided into survivors(n =13) and nonsurvivors(n =146),The 32 factors affecting the prognosis were analyzed by Cox proportional hazard model with SPSS.Results One-month,three-month,and six-month survival rates were 20.13％,10.06％ and 8.18％,respectively.Cox regression analysis of prognostic factors showed that it could the stage of hepatic encephalopathy and HRS significantly improve the survival rate of the patients with HE in acute-on-chronic liver failure.The stage of hepatic encephalopathy and HRS could significantly decrease the survival rate of the patients(x2 =18.344,11.368,all P ＜ 0.05),elevated the levels of hepatic encephalopathy (relative risk (RR) =1.591) and HRS (RR =1.809) indicate worse prognosis with hepatic encephalopathy in acute-on-chronic failure.Conclusion The stage of hepatic encephalopathy and HRS were independent risk factor sof prognosis in acute-on-chronic liver failure.

Female ; Hamartoma ; Humans ; Infant, Newborn ; Mouth Diseases ; Palate, Soft

Objective: To explore senior high school students' knowledge, behavior and attitude toward sex and reproductive health issues. Methods: Questionnaire surveys were carried out in 6 high senior schools in Harbin, the questionnaire was provided by YRH (youth reproductive health) Project Team. Results: The after-school life of our sample included reading, watching movies and television, Internet exploring and playing with partners; 30%-40% of the people had never explore sex topic with their parents. Most of the students had appropriate understanding of adolescent knowledge, but they had less knowledge about reproductive health and contraception; About 30% of students had fallen in lover, only 4.3% of students had intercourse with their partners, and they were lack of awareness and ability to protect themselves from unsafe sex. 31.6% of students think that the main sources of knowledge of adolescent health education in schools. Conclusion: Students in senior high school have showed a more positive and stable attitudes toward life. They have some knowledge about YRH but not systematic.

OBJECTIVE: To investigate the protective effect of celastrol on allergic rhinitis rats and its possible mechanism. METHOD: Allergic rhinitis (AR) model of rats was established by OVA. The behavioural characteris tics were observed at the 1st, 4th and 7th dayafter stimulation treatment. The levels of superoxide dismutase (SOD), malondialdehyde (MDA), glutathione (GSH) and glutathione peroxidase (GSH-PX) in the nasal mucosa breathing zone were measured. The expression of the nuclear factor erythroid 2 related factor 2 (NRF2) nuclear protein and the catalytic submit of glutamylcysteine ligase (GCLC) cytoplasmic protein in the nasal mucosa breath ing zone were determined. RESULT: We observed obvious behaviour changes related with allergic rhinitis in AR rats, together with decrease of SOD, GSH and GSH-PX and increase of MDA in the nasal mucosa breathing zone. Moreover, NRF2 nuclear protein expression and GCLC cytoplasmic expression were suppressed in the nasal mucosa. The changes above were alleviated in celastrol pretreatment group. The potential mechanism may be related to the upregulation of NRF2 nuclear protein expression and GCLC cytoplasmic expression after celastrol pretreatment. CONCLUSION Celastrol can significantly relieve the allergic symptoms in AR rats. The mechanism of this protective effects may relate to the upregulation of NRF2 nuclear protein expression and GCLC cytoplasmic expression in the nasal mucosa breathing zone.
Animals ; Disease Models, Animal ; Glutamate-Cysteine Ligase ; metabolism ; Male ; NF-E2-Related Factor 2 ; metabolism ; Nasal Mucosa ; metabolism ; Rats ; Rats, Sprague-Dawley ; Rhinitis, Allergic ; drug therapy ; Triterpenes ; therapeutic use

Objective To investigate the surgical correction of alar deformity and repairing function of unilateral cleft lip in infant. Methods Millards procedure was used to incise skin, muscle and mucosa, correct the nasal deformity through lip. At the normal side, ophthalmic scissors was applied to incise lips muscle and skin, and reach the deep level of the base of nasal pillor, cut the abnormal attachment between the orbicular muscle of mouth and anterior nasal spina, and sharp dissect cartilage and skin in nasal wing through deep level of nasal pillor. At the cleft side, the abnormal muscle branch was cut that attached at the down side of the base of nose and pyriform aperture, the tissue between nasal base and lip, maxilla relaxed, and the cartilage and skin in the nasal wing at the same side dissected. The deform cartilage was repairied as the same of normal side. After the rehabilitation of cartilage of nasal wing, the soft tissue at deep level was moved to normal location, but the deep level structure of nasal wing cartilage, nasal septum cartilage and nasal bone did not dissected. After the dissection of orbicular muscle of mouth, the muscle in nose and lip must be relaxed in illous side. The orbicular muscle of mouth was sewed under the condition of tensionless. The repairing of orbicular muscle of mouth will improve the balance of muscular strength around the nose. Thus, the deviation of nasal pillor was corrected and the base of nose repaired. Results Eighty cases of infant with unilateral cleft lip at the age of 3 months ～12 months, in which 11 cases were Ⅰ?,16 Ⅱ, and 3 Ⅲ?. Eighty cases were low grade alar deformity, and 13 middle grade deformity. After operation, 52 cases were better, 17 cases were good, and 11 cases were worse. The postoperational result was good. Conclusion While performing the cleft lip operation or Millard operation, the authors can correct the nasal deformity through lip. So, it is recommended that cleft lip and the alar deformity can be repaired at the same time.

[Objective]To investigate the long-term result of total hip replacement with a Ribbed hydroxyapatite-coated proximally femoral stem and cup component.[Method]From June 1999 to May 2002,24 cases (26 hips) with hip joint disease received cementless total hip replacement with a Ribbed hydroxyapatite-coated proximally femoral stem and cup component. There were 14 males and 10 females with the average age of 59.4 years. The disorders included avascular necrosis of the femoral head in 13 cases,femoral neck fractures in 9 cases,hip dysplasia in 2 cases. X-ray scans were recorded at 7~10 days,6 month,and every 1 year after operation respectively. Harris score was evaluated at last follow-up for hip joint function evaluation.[Result]According to Harris evaluation,16 cases (18 hips) received 85-100 points,8 cases (8 hips) received 75-84 points. Mild thigh pain happed in 1 case. Slight bone absorption was found in 1 case. No case needed second revision. Six month-3 year postoperative X-ray showed bone absorption in Gruen zone 5,6 and 2,3 near HA coating in 1 case (1 hip). Bone density increase was found in both cancellous and cortical bone,which revealed good prosthesis-bone fixation.[Conclusion]A Ribbed proximally hydroxyapatite-coated femoral stem and cup implant are able to enhance the initial fixation of implants,to accelerate bone in-growth and osseous fixation of the femoral stem and cup component,to seal the interface between the implant and osseous,and to prevent ingress of polyethylene particles which lead to thigh pain and bone absorption. It has showed good long-term results.

The microvasculature of the rabbit right ventricle was studied by the method of vascular corrosion cast and scanning electron microscopy. In the endocardium could be seen thin and sparse capillary network i. e. subendothelial capillary network formed by the branches of the arterioles passing through myocardium. In the myocardium, arteriole and its branches distributed in certain area. Sphincters could be seen in the beginning of the arterioles. Capillaries of the papillary muscle in right ventricle were parallel to muscle bundle and were thinner and sparser than those of the papillary muscle in left ventricle. Venous system in right ventricle wall was similar in architecture to that in left ventricle, postcapillary venule joined its corresponding venule in a "turnip root" like pattern. No A-V anastomosis could be seen, yet thebesian vessels and myocardial sinusoids directly opened into ventrical chamber could be found.