Based on the study of theory research and teaching practice, Nanjing University of Aeronautics & Astronautics has tentatively put forward the concept of “teaching force”. At the same time, Nanjing University of Aeronautics&Astronautics has integrated various resources and systemat-ically constructed the teaching force cultivation mechanism focusing on “fanning out from point and line to area, two stage financing, internal and external drive”, which has effectively promoted the all-round development of young teachers in the teaching, personal, professional and organizational aspects.

Objective To explore the applied value of thyroid imaging reporting and data system (TI-RADS) strati?fication in diagnosing thyroid nodules in patients with different ages.Methods A total of 527 patients with thyroid nod?ules (aged 26-65) were divided into four groups:aged 26-35 group, aged 36-45 group, aged 46-55 group and aged 56-65 group. TI-RADS was used to evaluate patients in four groups. The results of TI-RADS were compared with the pathologic di?agnostic analysis. Results For the low aged groups (aged 26-35 group and aged 36-45 group), the positive predictive val?ue, the negative predictive value and accuracy rate were more than 90%. With regard to the patients aged 46-55, the positive and negative predictive values and accuracy rate were 81.5%, 87.5%, and 81.9%, respectively. The positive and negative predictive values, accuracy rate were 76.6%,88.8%and 77.9%for patients aged 56-65 group. The diagnostic rate of TI-RADS in patients with thyroid lesions was lower in aged 56-65 group than that of other groups. Conclusion TI-RADS method is affected by age. The diagnostic rate is lower in the high age group than that of the low age group.

Objective To investigate the characteristics of coronary's pathological changes in patients with impaired glucose tolerance. Methods Four-hundred and ninety patients who were suspected with ischemic chest pain were divided into three groups according to their OGTT results: (1) IGT group: n = 161,(2) 12DM group:n = 159, (3) NGT group: n = 170. Serum levels of triglyceride (TG) , total cholesterol (TC) , highdensity lipoprotein cholesterol (HDL-C) , low-density lipoprotein cholesterol (LDL-C) and high sensitive Creactive protein (hs-CRP) were detected, their body mass indexes (BMI) were calculated. General clinical information (including gender, age, history of smoking, history of hypertension) were collected. All the CAG results were analyzed and Gensini scores were assessed as well. Results The TG levels in the T2DM group and IGT group ([2. 41 ± 1.70] mmol/L and [2. 26 ± 1. 20] mmol/L) were significantly higher than that of the NGT group (1.95 ± 1.14) mmol/L, the differences were significant (t=0.4610,0.3124, P<0. 01 and 0.05,respectively),whereas there was no significant difference between the IGT group and T2DM group (P >0.05);No significant difference was found among the three groups about TC, HDL-C, LDL-C levels (either P > 0.05). The levels of hs-CRP in T2DM group ([2. 38 ± 1. 76] mg/L and IGT group [2. 33 ± 2. 03] mg/L) were higher compared with the NGT group ([1. 54 ± 1. 32] mg/L), the differences were significant (t = 0. 8391,0. 7815, Ps < 0. 01), whereas there was no significant difference between the IGT group and T2 DM group (P >0.05). BMIs of the IGT group ([25.50 ± 3.04]kg/m2) and T2DM group ([26.09 ± 2.86]kg/m2) were higher than that of the NGT group ([24. 70 ± 3. 27] kg/m2), the differences were significant (t = 0. 8063,1. 3947, P<0. 05 and <0.01, respectively),whereas no significant difference was found between the T2DM group and IGT group (P > 0. 05). The incidence of single coronary pathological changes was 44.7% in the NGT group,it was higher than that of the IGT group (23. 6%) and T2DM group (18. 9%) (x2 = 16. 310,25. 116,Ps < 0. 05), whereas there was no significant difference between the IGT group' and T2DM group (P > 0. 05);The incidences of 2 branches pathological changes in the T2DM group (37. 1%) and IGT group (39. 8%) were higher compared with NGT group (23. 5%) ,the differences were significant (x2 =1. 200,10. 099,Ps <0. 05),whereas there was no significant difference between the IGT group and T2DM group (P >0. 05) ;The incidences of 3 vessels pathological changes in the T2DM group (40.9%) and IGT group (33. 5%) were higher than that of the NGT group (20. 0%) , the differences were significant (x2 = 7. 767,17. 028, Ps < 0.05), there was no significant difference between the IGT group and T2DM group (P > 0. 05). The incidence of subtotal or total occlusion of the T2DM group and IGT group were 22. 6% and 18.0% respectively,both were higher than that of the NGT group(7. 6%) (x2 = 14. 573,8. 019 ,Pa < 0.05) , whereas no significant difference was found between the T2DM group and IGT group (P > 0. 05). The incidences of vascular diffusing pathological change in the IGT group (24. 8%) and T2DM group (30. 8%) were higher compared with the NGT group (12.4%) (x2 =8.583,16.724, Ps < 0.05), whereas there was no significant difference between the IGT group and T2DM group (P >0.05). The Gensini scores in the IGT group (55. 05 ± 22. 99) and T2DM group(56. 15 ± 24. 87) were significnatly higher than that of the NGT group (38. 03 ± 17. 38), the differences were significant ((t =17.0142,18. 1186,Ps <0.01),whereas there was no significant difference between the IGT group and T2DM group (P>0.05). Conclusion The incidences of 2 and 3 vessels pathological changes increase significantly in patients with IGT. Moreover, the incidences of occlusion and diffuse stenosis increase significantly. This is similar to the coronary artery pathological charactersitics in patients with diabetes, which indicates that IGT is closely related to the pathological severity of coronary artery. We should pay much attention to those patients with IGT in the clinical work.

Objective As members of CNEDERT, we were trusted to take the mission of medical rescue in April of this year in Yushu area of Qinghai province. As soon as we heard of the news of earthquake with shock of 7.1 on Richter scale happened on 14th April 2010, our team of 32 members from the General Hospital of Armed Police Force rapidly rushed to get there at 19 o'clock on 14th April. It is a cold plateau with 4000 meters in average above sea level. Of course, they would face many difficult problems and some of them could not be figured out in advance. It was really a new and big challenge. First of all, we had to bear the very low barometric pressure,threatening lives of team members. In order to fulfill the mission of medical rescue, and to prevent the acute mountain sickness (AMS) ,we monitored the physiological changes of every member. Method A total of 32 members aged from 27 - 42 years old with average age of (33.26 + 12.54) years, 6 male and 6 female, gathered at Peking, 50 meters above sea level, 6 hours ahead of getting to Yushu and received physical examination with measurements of SaO2, HR, Hb and breath holding test. The team worked in Yushu area for 13 days and returned back to Peking on 27th April at 13 o'clock. The measurements of SaO2, HR and He were kept on from 14th April to 4th May, 21 days in total. The occurrence of AMS was surveyed by questionnaire from 18 to 48 hours after arrival,and the AMSA was diagnosed and scored according to the Lake Louise consensus on the definition and quantification of altitude illness. When the score was equal or above 3, it was considered to be AMS. Our work activities included searching the victims under the collapsed building, carrying out treatment and operation as soon as possible in the mobile hospital, doing medical round visiting, public health and disease prevention, work of joint rescue of multiple professions and psychological counseling. Results Of them 26 (81.25%) members suffered from AMS of various severities and few of them had pulmonary edema and hematuria, and those with SaO2 below 60% were sent down to the plain of low level above sea. The average level of SaO2 at Peking was ( 98.21 + 2.63) %, and it suddenly dropped to (66.31 ± 4.24)% on the first day of entering Yushu area, and from the 2nd day on, it gradually increased to (84.80 ± 4.20)% on the 13th day of stay in Yushu. On the 14th day, we returned back to Peking, the average SaO2 gradually went up from ( 85.57 + 2.73) % to (85.70 + 3.11 ) % on the 15th day,(87.93±2.63)% on the 17th day, (92.21 ±3.62)% on the 18th day, and (98.2333 ± 1.78)% On the 21st day (5th May ). At plain the average HR was (78 ± 11 ) beats/min, and it went up abruptly to ( 121 ± 18) beats/min on the first day of arrival to Yushu, and from the 2nd day on, it slowly lowered down to (99± 12) beats/min at the end day of stay in Yushu area. When we got back to Peking, the average HR gradually normalized from (91± 18) beats/min to (77 + 16) beats on the 5th May. The average Hb in Peking was ( 118 ± 32) g/L, and it gradually increased to ( 137 ± 18) g/L on the 5th day and to ( 161 ± 27) g/L on the 11th day after arrival, and it gradually dropped to (127:± 13) g/L on the 17th day and to (120± 13) g/L on the 21st day. Various measures were taken to treat and prevent the AMS with Chinese herbal medicines such as hongjingtian (Rholiola sacra [Prain ex Hamet] Fu), droplet-sized pill of danshen (salva miltiorrhiza Bge), slice of xiyangshen (Panax quinquefolium L)for lozenge which had some effect of minimizing the symptoms of AMS, and with easily digestible diet catered for in less amount of food in each meal and more meals every day, and diet was composed of mainly carbohydrate and vitamins. Large amount of fluid was required at least 4000 - 6000 mL daily guided by the number of urination at least once or twice a day. For the severe case with shortness of breath and sense of oppression over chest, the oxygen inhalation and intravenous glucose saline with small dose of hydrocortisone were given. Conclusions There were great changes in SaO2, HR and Hb of individuals rushed into high altitude area from plain of low level above sea in a short length of time. But those individuals had the capability of adaptation to ameliorate bit by bit those changes day by day until 13 days of stay, the end of stay at high altitude. On that day, the levels of SaO2, HR and He were still far away from normal. And those changes took 6 days to resume the original levels after the members retumed to the plain. Of them, 81.25% (26/32) members suffered from AMS of various severities. Various measures taken to treat and prevent the AMS are very important. In addition, working at high altitude area, the medical equipment and facilities should be miniaturized for easy portability on the rugged and narrow footpath in order to preserve the energy of medical members.

Objective: To evaluate the diagnostic value of fluorine-18 fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography ( PET/CT) in fever of unknown origin ( FUO) in a Chinese hospital .Methods:The records of 51 patients with FUO (32 men and 19 women;mean age 54 years with a range between 3 and 81 years) were analyzed retrospectively .All the patients were examined by 18 F-FDG PET/CT scan and the results were compared with the final diagnosis which was established by additional procedures including pathology , laboratory examination , and clinical follow-up for more than 3 months.The t test was used for statistical analysis .Results: A final diagnosis was established for 48 patients , including 32 patients with infectious diseases , 9 with malignancies , and 7 with non-infectious inflammatory diseases .By FDG PET scan alone , the rates of true positive , false positive , false negative, and true negative were 52.9%, 27.5%, 17.6%, and 2.0%, respectively.By FDG PET/CT scan, the rates of true positive, false positive, false negative, and true negative were 70.6%, 27.5%, 2.0%, and 0, respectively.18F-PET/CT had a sensitivity of 97.3%(36/37), specificity of 0 (0/14), and accuracy of 70.6%(36/51) in FUO, especially a high sensitivity and accuracy of 100%(9/9) in the diagnosis of malignant tumor .Moreover , the maximum standardized uptake value ( SUVmax ) in tumor was significant higher than that in infection (3.7 ±2.7 vs.7.7 ±3.5, P=0.001, t=3.6), which implied that SUVmax might be useful in differential diagnosis in FUO .Conclusion:FDG PET/CT is a valuable imaging tool for the identification and location of the potential lesion in FUO and is helpful for the etiological diagnosis , especially in the diagnosis of malignant lesions .

Objective To understand the status quo of ICU nurses career situations and its influencing factors in Shandong province. Methods A total of 247 ICU nurses were investigated by questionnaires on career condition. Results The career condition score was 79.19 ± 11.63. In addition, statistical significances were revealed by occupational career questionnaire of ICU nurses in different aspect of the scores with age, gender, working years in the ICU, access years to ICU nurses specialist, whether to participate in career training. The scores of career condition and career identity ICU nurses were different, the 40-years-older group was higher than 31-40 years group (P=0.007, P=0.005). The dimension scores of male nurses organizational commitment was higher than that of female nurses(P=0.002). The scores of career condition whose ICU working life more than 16 years were higher than those of within 5 years(P=0.013). The career condition scores of the ICU nurses with access years of specialist qualifications 7-9 years was higher than those of within 3 years(P=0.011). Conclusions The career condition score of ICU clinical nurse specialists was at a medium level, it still needs to be further improved, managers should pay attention to the different levels of nurses to provide career training, in order to promote the professional development of critical care nurses.

The antiEGFR monoclonal antibodies cetuximab and panitumumab have been proven to be efficient in MCRC. The degree of EGFR expression (as confirmed by immunohistochemical analysis) did not correhte with the clinical response. In this review, we describe the current status of markers that might identify patients who are likely to benefit from treatment with cetuximab or panitumumab. These molecular markers include KRAS mutations, EGFR copy number, EGFR ligands (EGF, epiregulin), cyclin DI, IgG FcγR (FCGR2A-HI31R and FCGR3A-V158F), and nuclear factor-κB, that are crucial to avoid anti-EGFR treatment toxicity and reduce treatment cost.

Objective To explore the clinical characteristics of metabolic disorder and the incidence rate of metabolic syndrome (MS) in the patients with posthepatitic cirrhosis.Methods Four hundred and fifty-five patients with posthepatitic cirrhosis were included in the study and divided into hepatitis B related cirrhosis group (LCB group,351 cases) and hepatitis C related cirrhosis group (LCC group,104cases).The prevalence of metabolic disorder was recorded and the characteristics of posthepatitic cirrhosis with MS and without MS were compared and analysed.Results The prevalence of hyperglycemia,hypertension,hyperlipemia,obesity and MS in the posthepatitic cirrhosis patients was 46.59% (212/455),15.16% (69/455),15.38% (70/455),22.64% ( 103/455),12.53% (57/455) respectively.The prevalence of MS in LCB and LCC was 8.26% (29/351) and 26.92% (28/104).The levels of body mass index (BMI),fasting blood glucose,hypertension,cholesterol,aminotransferase (ALT) in LCB with MS patients were significantly higher than those in LCB without MS patients.There were no differences in the levels of HBeAg and HBV DNA between LCB with MS patients and LCB without MS patients.The levels of BMI,hypertension,triglyceride in LCC with MS patients were significantly higher than those in LCC without MS patients.There were no differences in fasting blood glucose,cholesterol and ALT between LCC with MS patients and LCC without MS patients.Logistic regression revealed that BMI was the independent factor in LCB and LCC with MS.Conclusions The prevalence of hyperglycemia and obesity are higher in LCB and LCC.The incidence rate of MS in LCB is less than that in the general population,while the incidence rate of MS in LCC is significantly higher than that in the general population,and it's nothing to do with the viral replication.BMI is an important factor affected in posthepatitic cirrhosis with MS.

Objective To investigate the expression level of adenosine 2A receptors in peripheral blood lymphocytes and the correlation with disease progression of Parkinson's disease (PD).Methods In this retrospcctive study,out patients with PD(42 cases)and healthy controls(32 cases) were recruited at Beijing Hospital.The expression level of A2A receptors in peripheral blood lymphocytes was detected by flow cytometry.The concentration of free A2A receptors in plasma was detected by enzyme linked immunosorbent assay (ELISA).The expression of A2A receptors and plasma free A2A receptors in peripheral blood lymphocytes of the PD group and the control group was compared.Multivariate regression analysis and single factor correlation analysis were performed on sex,age,course of disease,duration of medication,drug type and dose,motor complications,and PD unified Parkinson's disease rating scale (UPDRS)score.Results A2A receptor expression in lymphocytes was significantly higher in the PD group than in the control group (8.96 ± 4.73)％ vs.(5.39±2.42)％ (t=4.210,P＜0.05).There was no significant difference in A2A receptor concentrations in plasma between the two groups (1.82 ± 1.91) μg/L vs.(1.15 ± 0.71) μg/L(t=1.078,P＞0.05).In the PD group,A2A receptor expression in lymphocytes in patients with motor complications was statistically lower than in patients without them (P＜ 0.05).Lymphocyte A2A receptor levels in the 5-9 years duration subgroup were significantly lower than those in the ＜5 years duration subgroup (Z=2.780,P＜0.01) and the≥10 years duration subgroup (Z=-2.149,P＜0.05).Conclusions The expression of A2A receptors in peripheral blood lymphocytes is correlated with PD.The expression of A2 A receptors in peripheral blood lymphocytes of patients with PD fluctuates with the occurrence of motor complications and the progression of disease.Further research is needed to establish A2A receptors as a biomarker for monitoring disease progression.

Objective Through the practice of new practice teaching methods, to observe whether it can help students to strengthen their self-identity as ‘trainee doctors’. Methods By sim-ulating interrogation, building simulation medical environment and increasing operation project, the practice operation abilities and sense of identity were improved,The questionnaire were required to fill in at the beginning and at the end of the term, and the differences between two teaching methods in advantages, characteristics and the identity of ‘trainee doctors’by their own pairing were compared. Data were analyzed by software SPSS 18.0. Results The new teaching model, to a certain extent, alleviated the present situation of having relatively more students and insufficient source, which was superior to traditional teaching mode in improving students' initiative, enthusiasm, learning ability, practical ability, analysis of the problems, comprehensive ability and so on. It also enabled students to master some of doctor-patient communication skills(P<0.001), to realize the identity of‘trainee doctors’ (Z=-7.671, P<0.001). Conclusion The new practice teaching mode has solved the problems such as insufficient source in clinical teaching. It has also increased the initiative and enthusiasm of students' clinical learning, so that students can think, analyze and deal with the problems from the point of view of doctors, and implement the identity of a‘trainee doctor’.