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 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.

Not only calmodulin (CAM) with Ca2+ regulates the activity of many enzymes and proteins, but also free-CaM (no Ca2+bound) and Ca2+-independent CaM-binding proteins play roles in plant and animal cells. There is no in vivo method to identify the interaction between free-CaM and Ca2+-independent CaM-binding protein (CaMBP). Using site-directed mutagenesis by polymerase chain reaction (PCR), 5 mutant Arabidopsis calmodulin isoform 2 (AtCaM2) genes, mCaM21, mCoM212,mCaM2123, mCaM2124 and mCaM21234 were obtained. The mutant mCaM2 encoded glutamine in place of glutamate (E32Q; E68Q; E105Q; E141Q) in one or more EF-hand Ca2+-binding motifs of AtCaM2. The recombinant mCaM2 proteins were produced in Escherichia coli, and subsequently separated on SDS-PAGE in the presence of Ca2+ or EGTA, their electrophoresis mobilities were related with that of mutant EF-hand motifs. 45Ca2+ overlay analysis indicated that the more glutamate replaced by glutamine, the lower affinity with Ca2+ in the mCaM2 proteins. The mCaM21234 mutant protein (E32Q; E68Q; E105Q;E141Q) was unable to bind Ca2+. Using yeast two-hybrid technique with mCaM21234 as bait, it was possible to see interaction in Arabidopsis of AtCaM2 with IQD26, a calcium-independent CaM-binding protein. Site-directed mutation of AtCaM2 will aid the research of Ca2+, CaM and Ca2+-independent CaMBPs in plant biological processes.

AIM　To study the effect of lidamycin on the expression of genes involved in invasion regulation in HCT-8 human colon cancer cells. METHODS　HCT-8 human colon cancer cells were treated with lidamycin (10 nmol*L-1) for 8 h. The effect of lidamycin on the expression of genes were detected by cDNA arrays, Northern blot and RT-PCR. RESULTS　Hybridization of the entire cDNA populations to Atlas Arrays showed that lidamycin down-regulated the expression level of MMP-9 and up-regulated the expression level of TIMP-1. These changes were confirmed by Northern blot and RT-PCR. CONCLUSION　The results indicate that lidamycin may exhibit its anti-invasive activity by inhibitting the production of type IV collagenase whilst enhancing the production of tissue inhibitor metalloproteinase.

[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.

Objective To investigate the main predisposing factors of hematoma enlargement in spontaneous intracerebral hemorrhage,reduce the early mortality,and improve clinical outcomes.Methods By a retrospective study of 268 patients,all patients underwent their first computed tomography (CT)scan within 24 hours of arrival and a second CT scan within 72 hours of admission.These predisposing factors were analyzed by means of univariate and multivariate logistic regression analyses.Results The patients occurred early hematoma enlargement were accounted for 27.99％ (75/268).Univariate analyses indicated that hematoma shape,midline shift,breaking into the ventricle,thrombin clotting time (TT),white blood cells,neutrophil percentage,serum creatinine,fasting plasma glucose (FPG),and Glasgow coma scale (GCS) were significantly different between the patients with or without hematoma enlargement (P ＜0.05).Furthermore,multivariate logistic regression analyses revealed that the following four factors were independently associated with hematoma enlargement:the midline shift [OR (95％ CI) =3.356 (1.251-8.999),P =0.000],the GCS score [OR (95 ％ CI) =0.745 (0.671-0.827),P =0.023],the FPG [OR (95％ CI) =3.022 (1.232-7.408),P =0.016],and the breaking into the ventricles [OR (95％ CI) =2.851(1.158-7.019),P =0.005].Conclusions The midline shift of brain CT scan,the GCS score,the FPG,and the breaking into the ventricles maybe the independent predisposing factors of hematoma enlargement.Therefore,timely review of CT scan and dynamic monitoring of peripheral blood biochemical indicators should be very important for further therapy.