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.

Forensic Medicine ; Humans ; Kidney Transplantation ; Polycystic Kidney Diseases

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

ZM-1 tissue microarrayer designed by our group is manufactured in stainless steel and brass. It features an easier and faster preparation for tissue microarrays. By means of it, a group of biopsy needles are used to punch the donor tissue specimens respectively, and all the needles with the punched specimen cylinders are arranged into the array-board, where small holes have been digged to fit the needles. All the specimen cylinders arraying and the tissue microarray block's shaping are finished simultaneously. ZM-1 tissue microarrayer with a lower cost of manufacture, is capable of preparing the tissue microarrays conveniently, efficiently and quality-controllably.
Equipment Design ; Tissue Array Analysis ; instrumentation

OBJECTIVETo determine the current prevalence of overweight and obesity among children and adolescents (2-18 years) in Beijing and its distribution by age, gender and urban-rural residence.

METHODSAs part of the Beijing Child and Adolescent Metabolic Syndrome Study, a stratified cluster representative sample of 23,422 children aged 0-18 years was selected. Anthropometric measures including weight and height were collected from 21,198 subjects aged 2-18 years from April to October in 2004. Overweight and obesity were defined according to body mass index [BMI, weight(kg)/height(m2)] cutpoints. For national and international comparisons, three sex-age-specific BMI criteria were used:1) The BMI cutoffs recommended by the Chinese Working Group on Obesity for Children (WGOC) aged 7-18 years; 2) The US 2000 CDC Growth Charts (CDC 2000) frac 34, the 85th and 95th percentiles; 3) The International Obesity Task Force (IOTF) reference.

RESULTSThe overall combined prevalence of overweight and obesity was 18.6% with obesity as 8.1% based on the CDC 2000 criteria, The figures were 17.4% and 5.1% based on the IOTF criteria. According to the WGOC criteria, the combined prevalence of obesity was 20.9% and 8.9% in children aged 7-18 years. The combined prevalence was higher in school-age children (6-18 years) than in preschool-age children (19.8% vs. 14.8%, based on the CDC 2000 criteria). Among school-age children, the prevalence was higher in boys than in girls (26.7% vs. 16.5%), in urban than in rural areas (27.0% vs. 15.9%). However, these differences were not observed in preschool-age children. It was estimated that approximately 450 000 children from 2 through 18 years of age,were overweight or obesity in Beijing.

CONCLUSIONData from our study indicated that one fifth of the children and adolescents in Beijing were under overweight or obesity situation which was the highest in the nation. Obesity among children and adolescents in Beijing had already become a serious public health problem which deserved greater attention.

Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Humans ; Infant ; Obesity ; epidemiology ; Overweight ; epidemiology ; Prevalence

Objective To explore the association between histories of hypertension in parents and level of blood pressure in their children so as to provide strategy for early intervention. Methods 19 088 children aged 6-17 years were selected in Beijing with stratified random cluster sampling method,and data on influencing factors including parental history of hypertension and other related environmental factors were collected.Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were examined.SPSS 13.0 was used for data analyses.Results The average prevalence of high blood pressure in children and adolescents was 9.13%based on the blood pressure criteria Beijing Children and Adolescents Metabolic Syndrome (BCAMS) set in 2004.Familial aggregation of hypertension in children and adolescents was observed (P＜0.001).There were positive associations between the numbers of parents with history of hypertension and both SBP and DBP of their offspring.Partial regression coefficients appeared to be 0.980 (95%CI:0.524-1.437) and 0.832 (95%CI:0.463-1.201) respectively,after controlling for con founding variables including gender,age,residential regions,body mass index (BMI),pubertal development,histories of smoking and drinking alcohol,fat intakes,physical exercises,parents' education level etc.Results from multiple factor logistic regression analysis showed that when compared with children whose parents did not have hypertension,the odds ratios of children having high blood pressure with only paternal history,only maternal history or with both parental histories were 1.688 (1.385-2.059),1.559 (1.164-2.087) and 1.273 (0.673-2.406),respectively,after adjustment for confounding factors.Conclusion Parental history of hypertension seemed to be an important independent risk factor for high blood pressure to their offspring.Heredity factors should be emphasized in the development of prevention and intervention on hypertension in children and adolescents.

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

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

OBJECTIVETo compare the optimal references of waist circumference (WC) between Beijing and China in detecting cardiovascular risk factors in school-age children.

METHODSPercentile curves for WC were drawn by sex using LMS method based on 21 787 children and adolescents aged 7 - 18 from Beijing Child and Adolescent Metabolic Syndrome Study. The 75(th) and the 90(th) percentiles by age and by gender of WC percentile curves were chosen as the optimal WC reference for 3 - 18 years old children and adolescents in Beijing. The sensitivities (Se) and specificities (Sp) were compared between Beijing and China WC references based on the evaluation of cardiovascular risk factors including hypertension, dyslipidemia, impaired fasting glucose and non-alcoholic fatty liver disease (NAFLD) in the test population being composed of 4927 school children aged 7 - 18 years. The predictive values for those cardiovascular risk factors were compared between the two optimal thresholds through comparison of the odds ratio (OR) in regression analysis.

RESULTSThe optimal reference for Beijing children and adolescents aged 3 - 18 years ranged from 51.8 to 78.2 cm for the 75(th) percentile in boys and 50.8 to 72.1 cm in girls, and the 90(th) percentile increased from 54.0 to 86.0 cm in boys and 53.3 to 77.3 cm in girls. The Ses of Beijing and China WC references in detecting hypertension were 0.74 and 0.82 in boys and 0.68 and 0.73 in girls; the Ses were 0.69 and 0.80 in detecting low-high density lipoprotein in boys and 0.64 and 0.71 in girls; and they were 0.98 and 1.00 in boys and both were 0.93 in girls for NAFLD. The Sps of Beijing and China WC references in screening hypertension were 0.62 and 0.53 in boys and 0.68 and 0.63 in girls, respectively. In predicting low-high density lipoprotein, the Sps were 0.59 and 0.50 in boys and 0.66 and 0.61 in girls, the Sps were 0.60 and 0.50 in boys and 0.56 and 0.51 in girls for predicting NAFLD. After adjustment for age and gender, ORs and their 95% credibility intervals (CI) of the 90(th) WC percentiles of Beijing and China school children were 6.3 (5.2 - 7.7) and 6.0 (4.9 - 7.4) in predicting hypertension. Both predictive ORs and their 95%CIs were 1.3 (1.1 - 1.5) in predicting impaired fasting glucose and the both were 2.9 (2.5 - 3.4) for dyslipidemia. In predicting NAFLD the ORs and their 95%CIs were 49.1 (12.0 - 201.6) and 69.8 (9.7 - 504.2) for Beijing and China WC optimal references, separately.

CONCLUSIONCompared with Chinese WC reference, WC reference of Beijing had high Sps in screening cardiovascular risk factors in 7 - 18 years old children. The predictive values were not significant different between Beijing and China WC references for almost all cardiovascular risk factors except NAFLD. The WC reference in Beijing was more practical and handy for reference in Beijing and other north developed metropolises.

Adolescent ; Cardiovascular Diseases ; epidemiology ; etiology ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Reference Values ; Risk Factors ; Waist Circumference ; Waist-Hip Ratio