Objective To find out the weak points of students through analyzing the scores of medical licensing examination, to explore the causes and to put forwards some advices. Methods Excel 2007 was used to statistically analyze the average scores, average passing rate and the mastering rate of 3 060 candidates who took the exam from 2006 to 2011. Literatures were reviewed to find out reforming measures taken by other schools. Results The average scores changed lightly. The master-ing rate changed differently. The average passing rate declined from 83.6% in 2006 to 71.65% in 2011. Conclusions Score of medical licensing examination is an important index of the teaching quality of medical universities, which should be emphasized on. Some practicable methods are put forward taken into all related factors:adjusting course setting, strengthening teaching of practical skills, reforming teaching methods and examination systems, placing more emphasis on examination work.

Objective To assess the application value of REP-PCR in genotyping of candida glabrata strains in clinical pratice. MethodsFrom 2009 to 2010, thirty-eight candida glabrata strains were isolated from Shanghai Ruijin Hospitals, Shanghai Renji Hospital, Shanghai Huashan Hospital, Anhui Medical University Hospital, Shenzhen People's Hospital. Six loci in housekeeping genes (FKS, LEU2,NMT1, TRP1, UGP1 and URA3 ) were amplified and sequenced. The sequences were compared with the MIST database and allele profile and sequence type (ST) were obtained. With primers Ca21, Ca22 and Com21 used to amplify the adjacent variable gene regions,the amplicons were analyzed through electrophoresis to generate different REP-PCR types. Finally, the results of these two genotyping methods were compared. ResultsFor REP-PCR, Ca22-Com21 has the best genotyping effect. REP-PCR and MLST have the same genotyping results. Five REP-PCR types were found in 38 candida glabrsta isolates. Type A,B, C, D and E strains from REP-PCR were genotyped as ST 7, 3, 19, 45 and new type respectively byMIST. REP-PCR saves time compared with MIST. Conclusions REP-PCR offers a simple and rapid method for molecular typing, with similar discriminatory power with MIST. Therefore, REP-PCR can be the preferred choice in laboratory, especially for a large number of isolates.

Objective To investigate the mechanisms of fluconazole resistance in clinical and experimental induced isolates of C.glabrata.Methods Efflux of rhodamine 6G was performed to evaluate the effects of efflux pumps.The expression levels of transporter genes CDR1,CDR2,SNQ2 and ERG11 were examined by real-time RT-PCR.Meanwhile,sequence of PDR1 was determined by PCR based DNA sequencing.Results Efflux pumps of all fluconazole-resistant isolates had stronger effects than that of susceptible isolates,consistently with significant upregulation of CDR1,but no obvious difference was found in CDR2 or SNQ2.Also,no notable change in the expression level of ERG11 between susceptible and resistant isolates.PDR1 mutations existed in both clinical and experimental induced isolates of C.glabrata,among which P927S,L543P and S947L haven't been reported previously.Conclusion Mutations of PDR1 were induced by fluconazole both in vivo andin vitro,which will result in overexpression of CDR1 and strengthen the effect of efflux pump.

Objective To investigate the role of PDR1 gene in azole-resistant Candida glabrata (C.glabrata).Methods Thirty-eight clinical isolates of C.glabrata were collected from five different hospitals.The minimal inhibitory concentrations (MIC) of azole antifungals including fluconazole,itraconazole and voriconazole against C.glabrata were determined by broth microdilution.Sequencing and amplification of PDR1 gene was achieved by real-time quantitative polymerase chain reaction (PCR).The mutation was cloned into an expression plasmid and then transferred into C.glabrata.The efflux of rhodamine 6G and drug sensitivity test were performed,and expressions of CDR1 and CDR2 were examined to verify function of mutation.Results Among these 38 isolates of C.glabrata,17 were resistant to at least one of azole antifungals.Moreover,mutations of PDR1 gene existed in every resistant isolates.Results of phenotyping test showed that in the isolate that expressed PDR1P927S,the expression of CDR1 and CDR2 were increased by 20.53 and 4.03 fold,respectively.And the fluorescence intensity of rhodamine 6G was decreased to 0.62 in efflux experiment.Conclusion P927S mutation of PDR1 gene could induce azole resistance of C.glabrata by increasing the expressions of CDR1 and CDR2,which results in drug resistance due to enhanced effect of efflux pump.

OBJECTIVE: To analyze the pathological characteristics and the death reasons due to postpartum hemorrhage, and to help to deal with the obstetrical medical tangles. METHODS: Thirty-two cases of death caused by postpartum hemorrhage encountered in our department since 1995 had been collected and retrospectively analyzed. RESULTS: Death caused by postpartum hemorrhage could be divided into single factor and multi-factor, with 81.25% due to single factor, 12.50% multi-factor, and 6.25% unknown reason. The single factors included uterine atony, retained placenta, placenta increta, laceration of the lower genital tract, and coagulation defects. The multi-factor included a combination of two or more factors mentioned above. CONCLUSION The causes of death due to postpartum hemorrhage should be analyzed according to the clinical characteristics of the postpartum hemorrhage and the autopsy examination.
Autopsy ; Blood Coagulation Disorders/complications* ; Cause of Death ; Female ; Forensic Pathology ; Humans ; Placenta, Retained ; Postpartum Hemorrhage/etiology* ; Pregnancy ; Retrospective Studies ; Uterine Inertia

Objective To detect quantitatively hepatocyte growth factor(HGF)mRNA expressions of bone marrow mononuclear cells(MNCs)in acute leukemia(AL)and investigate its clinical significance.Methods Total mRNA of quantitated bone marrow MNCs isolated from 67 de novo AL cases was extrated and then cDNA was synthesized.Expression of HGF mRNA was quantified absolutely using real-time fluorescence quantification PCR(FQ-PCR).Results Expressions of HGF mRNA in a group of AL were higher significantiv than these in a control group(6.936 ±1.613,0.407 ±0.170,P<0.001),but there was similafitv between a group of acute myeloid leukemia(AMI,)and group of acute lymphoblastic leukemia (ALL)(7.127±1.911,6.635±0.934,P>0.05).In AL subtypes,the expression of M5(9.998 4±1.454)was higher than that of M2,M3,M4,L1,L2 and L3(P<0.001),but there ware no differences among the latters(P>0.05). Meanwhile,there was no statistical significance on the expressions of HGF mRNA between different age and sex(P>0.05).In addition,expressions of HGF mRNA in the remission group were lower than these in the non.remission group(6.393±1.165,8.041±1.848,P<0.005).Conclusions There are statistical significances of the expressions of bone marrow MNCs HGF mRNA among the AL group and control group.As to AL subtypes,there are no statistically significant differences between AML and ALL as well as between different age and sex.Besides,lower HGF mRNA level is correlated with better curative effect.It is suggested that HGF mRNA is a suitable index for AL diagnosis and treatment.

Objective To construct quantitative standard for quantification of hepatocyte growth factor (HGF) mRNA and establish its real-time fluorescence quantitative(FQ)-PCR assay to estimate its clinical relevance in lymphoma.Methods Recombinant plasmid Was constructed with target cDNA obtained from isolated total RNA by RT-PCR After PCR products were identified and purified,recombined plasmids were quantitated and then acted as quantitative standard.A new real time FQ-PCR analysis system Was established with the second pair of primers and the probe after amplification condition and the concentrations of components were optimized.HGF mRNA expressions in 47 lymohoma cases[11 Hodgkin disease(HD) cases,36 non-Hodgkin lyphoma(NHL)cases.among these patients,36 patients in remission while 11 patients without remission ] were analyzed quantitatively,and its specificity and sensitivity for lymphoma diagnosis were evaluated by receiptor operation character(ROC)curve method.Results HGF mRNA quantitative standard was constructed successfully.and its real time FO.PCR analysis system Was established combined with hot.start PCR and down.touch PCR technique. According to slope of standard curve (-3.513)and correlation cofficient(0.999),amplification efficiency of the system was 92.6%.Coefficient variation of intra-assay,intra-day and inter-day-assay were 2.1%,4.0% and 6.8%,respectively.Sensitivity of FQ-PCR Was 2 eopies/μl.Expressions of HGF mRNA in lymphoma group Was higher than that in control group(6.425±2.172 and 0.317±0.192,respectively,t=15.883,P<0.001),and its expressions in remission group was lower than no remission group(6.157±1.712 and 7.59l ±1.184,respectively,t=2.768,P<0.05).However,there Was not difference of HGF mRNA level between group HD and group NHL(P>0.05).According to ROC analysis,its sensitivity and specificity were 93.6% and 100% when cutoff value for lymphoma clinical diagnosis Was 3.136.Conclusion HGF mRNA'8 quantitative standard and its real time F9-PCR analysis system have been successfully constructed,and it can be used for quantitative detection of its mRNA expression in lymphoma.

Objective To investigate the point mutations within the adenosine triphosphate-binding region of BCR/ABL in patients with chronic myeloid leukemia who develop imatinib resistance.Methods We collected a total of 17 bone marrow samples obtained from 11 patients who showed hematology resistance (n = 7)or cytogenetic refractoriness(n = 4).A long semi-nest PCR method was used to amplify the ABL kinase domain of the BCR/ABL allele.After two rounds of PCR reactions,we got a fragment of 863 bases The PCR products were purified and followed by sequencing.Results In total,we find three point mutations presented in all patients tested G250E,E255K and T315I.The mutation rate of hematology resistance is 4/ 7,and 95% confidence interval was 8%-90%,while mutation rate of cytogenetic refractoriness 1/4,95% confidence interval 1%-81%.For those patients whose samples were available,no single mutation were determined before imatinib resistance emerged.Conclusions There is high frequency of point mutations clustered within the adenosine triphosphate-binding region of BCR/ABL in patients with chronic myeloid leukemia.It's good for patients to switch to another therapeutic strategy when the mutations are detected.

Objective To observe the effects of scutellaria barbata extract (ESB) on proliferation, apoptosis and telomerase activity of human malignant glioma U251 cells in vitro.Methods Different concentrations of ESB (50, 25, 12.5, 6.25, 3.125 and 1.5625 mg/mL) were added into the medium cultured human malignant glioma U251 cells for 24, 48 and 72 h, respectively. And blank control group was also established. MTT assay was employed to detect the proliferation of U251cells. AnnexinV/PI staining and low cytometry (FCM) were used to detect the changes of apoptotic rate.And the telomerase activity of the cells was observed under the examination of telomeric repeat amplification protocol-PCR (TRAP-PCR)-ELISA.Results ESB inhibited the proliferation and induced the apoptosis of U251 cells. Interaction effect was found between the concentration of ESB and the treatment time of ESB by MTT assay (F=59.908, P=0.000); 50 mg/mL ESB for 72 h could most significantly inhibit the proliferation of U251 cells. Interaction effect was found between the concentration of ESB and the treatment time of ESB by AnnexinV/PI staining (F=6.548, P=0.000); 25mg/mL ESB for 72 h could most significantly induce the apoptosis of U251 cells. Interaction effect was also found between the concentration of ESB and the treatment time of ESB by TRAP-PCR-ELISA(F=138.433, P=0.000); the telomerase activity of the cells was the lowest by treatment with 50 mg/mL ESB for 72 h; negative correlation was noted between the telomerase activity of the cells and the apoptosis rate (r=-0.785, P=0.037); so as the telomerase activity of the cells and the inhibition effect (r=-0.278, P=0.042) Conclusion ESB may inhibit the proliferation and induces the apoptosis of U251 cells through down-regulating the telomerase activity.

Drugs for the treatment of premature ejaculation (PE) are divided to two categories: oral drugs and local drugs. Oral drugs include antidepressive drugs, alpha-adrenoceptor blocking drugs, phosphodiesterase type V blocking drugs and Chinese herbal medicine. Local drugs include local surface drugs, intracavernosal injective drugs and local urethra drugs. Antidepressive drugs are extensively used, which have moderate efficacy, relatively more side effects and high recurrence rate; alpha-adrenoceptor blocking drugs are seldom used and are less effective than antidepressive drugs; phosphodiesterase type V blocking drugs like sildenafil have good efficacy and few side-effects and are worthy to be studied further. Local surface drugs like SS-Cream have good efficacy and few side-effects and are worthy to be applied and promoted; local urethral drugs like MUSE and Befar may become a new method to treat PE after being further studied. Medication for premature ejaculation shall be made specific and suitable as much as for each individual patient.
Adrenergic alpha-Antagonists ; therapeutic use ; Antidepressive Agents ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Ejaculation ; drug effects ; Humans ; Male ; Phosphodiesterase Inhibitors ; therapeutic use