Objective To evaluate the cause and treatment of complication of percutaneous intra-arterial femoral port-catherter system(PCS) implatation. Methods Two hundreds and two patients with malignant tumors in the thorax, abdomen, pelvis and limbs were treated by using chemotherapy and lipiodol embolization via PCS. The related complications rate was 17.3%(35/202). Results The complication included incision infection delayed healing, and wound dehiscence 17.1%(6/35); local hemorrhage 5.7%(2/35); falling down and detachment of catheter of PCS 5.71%(2/35) and 2.86%(1/35) respectively loosening 2.86%(1/35) and changing direction 2.86%(1/35). The indwelling catheter blockage was 31.4%(11/35) and migrating of catheter tip was 28.6%(10/35). Most of these cases were recovered after appropriate management without any fatal and serious outcomes. Conclusions The Technique of percutaneous intra-arterial femoral port-catheter system implantation is safe and reliable. The related complication is slight and easy for management.

Objective To evaluate the level situation of clinical doctors graduating from mil-itary medical university within a certain period, understand their career development, and explore and analyze the problems and deficiencies in doctoral education and training to provide reference for deep-ening the reform of clinical disciplines doctoral education. Methods Stratified random samples of 9 Hospitals were selected and the established evaluation index system of clinical discipline quality tracking and investigation questionnaire was used to evaluate doctoral quality. Evaluation was surveyed by self rating and other rating combination. Quality evaluation system contains 4 first level indicators such as the military and political quality, clinical, teaching and research level, the development po-tential as well as 15 second-level indexes. The scores of self-assessment and other evaluation were compared by Pearson rank correlation analysis. The corresponding indicator scores of different doctorate types were compared using the test of variance and the subject research and published papers were analyzed by χ2 inspection. Results The comprehensive score of graduated doctors is excellent, with self-evaluation score (92.72±7.06) and other evaluation score (93.61±8.05). Correlation coefficient is 0.33(P=0.04); The academic doctors have done better in publishing papers(χ2=5.97, P=0.01) and undertaking subject research(χ2=6.08, P=0.00), but poorer in clinical work compared with the doctors of professional degree. The assessed groups are inadequate in publishing high level papers and in un-dertaking research projects and doctors of different degree types have different cognition of the ele-ments of improving the quality. Conclusions Cultivating the doctors' clinical ability and innovation ability are the cores of deepening the reform of clinical doctoral education. We should focus on inno-vation ability , value the cultivation of the clinical professional doctoral degree and explore various joint evaluation systems to attain the goal of enhancing the education quality of doctors.

0.05); 88.6%, 60.0%, and 51.4% for those in group A2, and 59.3%, 48.1%, and 25.9% for those in group B2, respectively (P 8 cm.

Objective To evaluate the effect of transcatheter arterial chemoembolization using ethanol and iodized-oil emulsion(TACE-EIOE) on prognosis of patients with hepatocellular carcinoma(HCC). Methods Eighteen patients with histologically-proven HCC were underwent TACE-EIOE. The extent of apoptosis was analyzed by terminal deoxynucleotidy transferase-mediated dUTP-digoxigenin nick end labeling (TUNEL) staining. The expressions of Bcl-2, Bax, p53, Ki-67 and PCNA proteins were detected by immunohistochemical method. Changes of these markers, tumor necrosis, encapsulation, volume, cumulative survival were analyzed. Results Complete tumor necrosis was 33.33%(6/18), severe tumor necrosis was 44.44%(8/18), moderate tumor necrosis was 5.56%(1/18), lesser tumor necrosis was 16.67%(3/18). Apoptosis rate was (22.79?3.34)%. Complete encapsulation was 88.89%(16/18). Evident volume-lessening was 66.67% (12/18), partial volume-lessening was 22.22%(4/18),and stable volume was 11.11%(2/18). Ki-67,PCNA, p53, Bcl-2, and Bax were (30.93?18.10)%, (41.16?11.83)%, (53.41?18.13)%, (6.32?2.10)%, and(58.73?17.32)%, respectively. The cumulative 1-, 2-,and 3-year survival rates were 83.33%,72.22%,and 66.67% for patients, respectively. Conclusions The preoperative TACE-EIOE is safe, it might benefit patients with HCC.

This paper analyzes the characteristics of the follow-up quality survey and evaluation of medical graduate students in China.It raises that the follow-up quality survey of graduate students in medical schools should be institutionalized,standardized and normalized; the survey and evaluation should be conducted through close cooperation with the relevant departments and training units; comparative studies on graduates of different years should be conducted; and the indicator system and survey content should value the characteristics of times,training units and subjects; Finally,specific technical issues such as when and to whom the evaluation and survey should be conducted,survey arrangements,evaluation methods,the diversity of participants and determination of results are discussed and suggestions are put forward.

Objective To provide evidences and suggestions for educational innovation in military medical universities. Methods To carry out follow-up survey and evaluation in 85 graduates by using questionnaire survey and apply evaluation index system for quality follow-up among military clinical medicine masters. Results The average score evaluated by graduates is 78.39, the average score evaluated by hospitals is 86.00, The two average scores are normally distributed and have a positive correlativity (r=0.495). Conclusion The integrative quality of graduate students is good, but they should strengthen further in clinical capability, general quality and independent innovation.

BACKGROUND: Physical training induces adaptation changes on physiological function and anatomic structure of body, which significantly exist in individuals. Individual variation responses to physical training is determined by gene polymorphism. OBJECTIVE: To summarize the research progress on the association between gene polymorphism and exercise training sensitivity in recent years. RETRIEVAL STRATEGY: A computer-based search of Pubmed database was undertaken to identify the articles published from January 2002 to December 2006 with the key words of "gene polymorphism, endurance training, strength training, aerobic training" in English. Simultaneously, China Journal Full-text Database was searched for the relevant articles published from January 2002 to December 2006 with the same key words in Chinese. Totally 58 relevant articles were collected after the first trial. Inclusive criteria: ①articles on association between gene polymorphism and endurance training, ②articles on association between gene polymorphism and strength training, ③articles on association between gene polymorphism and hypoxia training. LITERATURE EVALUATION: The articles collected were prospective cohort studies on association of gene polymorphism with some physiological and biochemical parameters response to physical training. DATA SYNTHESIS: ①The individual variation responded to physical training in physiological and biochemical parameters are mostly determined by genetic factors, such as gene polymorphism.②Recently, there are lots of studies on association of gene polymorphism with physiological and biochemical parameters response to endurance training, strength training and hypoxia training.③Mostly studies indicate that there are associations among physiological and biochemical parameters response to endurance training, strength training and hypoxia training and I/D polymorphism in ACE gene, C1772T in HIF-1? gene and so on. CONCLUSION: Although gene polymorphism is a genetic marker of determining the physiological phenotype of human, the various genetype of the same gene polymorphism can cause different sensitivity change of physiological phenotype in the different races response to training. With the research progress on association between gene polymorphism and physical training sensitivity, it will indicate its related mechanism.

Objective To explore the effect of hypoxia-inducible factor 1α(HIF-1α)in pathological scar and its specific mechanism,and the therapy target of pathological scar.Methods Real time PCR and Western blot was used to test the expression of HIF-1αin normal tissue and pathological scar,meanwhile to detect the effect of hypoxic environment on the expression of HIF-1α.Fibroblasts activity in pathological scar and normal tissue under different oxygen concentration(20%,10%,5%,2% and 1%)was determined by MTT method.Determine the different expression of HIF-1αmRNA and protein in normal environment(20% oxygen) and hypoxic environment(5%oxygen).The changes of the number of fibroblasts after the silence of HIF-1αby HIF-1αshRNA virus using flow cytometer.Results The Real time PCR and Western blot results showed that the expressions of HIF-1αmRNA and protein in fibroblasts of pathological scar was significantly higher than that in normal tissue(P<0.05),and the activity of the keloid fibroblasts in hypoxia environment(5%,2% and 1%)was also higher than that in normal tissue(P<0.05).The expressions of HIF-1αmRNA and protein in keloid fiber cells were higher in hypoxia environment(5% oxygen)than those in normal environment(20% oxygen),but when silence the expression of HIF-1αin keloid fibroblasts,the apoptosis of fibroblast in hypoxia environment(5%oxygen)were significantly higher than control group[(0.021 ±0.001)%vs.(3.739 ± 0.039)%,P<0.05].Conclusion HIF-1αincreases significantly in the pathological keloid fibroblasts and could promote the proliferation of fibroblasts and its vitality,which could accelerate the formation of pathological scar.

Objective To introduce 13 clinical cases of reconstructing traumatic defect on skin of thumb and first web using nail skin flap of big toe connectedwith tibial flap of second toe.Methods From May 2003 to April 2007,a series of 13 case8 of traumatic thumb and first web defect were treated by transplantation of nail skin flap of big toe connecting with tibial skin flap of second toe.Among which two total hand degloving injury cages were included too.Two kind of way according the Gilbert type of the Ist metatarsus dorsal artery were used.Results All the cases were successful and healed by first intention.The contour of reconstructed thumbs showed to be normal or approximately normal.Follow-up examination were obtained in nine cases for 3-17 postoperative months(average 7 months).Sensations of pain,touch and temperature recovered.The two-point-discrimination sensation were found to be 7-17 mm respectively.Opposition measured were 60°-85°(average 75°).All the patients can be back to work and restored activities of daily living.Conclusion In treating soft tissue defect of thumb and first web,transplantation of the nail skin flap of big toe connecting with tibial lateral skin flap Can yield ideal skin covering and exceHent motor function.

ObjectiveTo investigate the effects of aliskiren on blood nitric oxide(NO) and bradykinin (BK) through analyzing the changes of NO, BK and non-dominant arm blood pressure before and after treatment of aliskiren and ramipril. MethodsThe chnical trial was conducted in 67 patients with essential hypertension. After a single-blind period of taking placebo orally once a day for 2 weeks, the patients were divided into different group in accordance with random table, and all patients were consecutively treated with drugs for 8 weeks. The trial uncovered showed that 17 patients were treated with ramipril (5 mg) in control group. Patients in trial group were given aliskiren and were assigned to three subgroups, 300 mg group (300 mg aliskiren, 16 cases), 150 mg group(150 mg aliskiren, 17 cases) and 75 mg group(75 mg aliskiren, 17 cases). The blood NO and BK before and after treatment in two groups were measured by enzyme linked immunosorbent assay and radioimmunoassay method. Non-dominant arm blood pressure was measured by calibration qualified mercury blood pressure instrument before and after treatment. Results The blood NO after treatment of aliskiren 8 weeks in trial group increased significantly than those before treatment [before treatment, the blood NO in 300 mg group, 150 mg group,75 mg group were (44.414 ±5.841 ), (43.496 ± 5.576), (41.037 ± 5.312) μ mol/L, after treatment they were(60.381 ± 6.756), (56.480 ±6.959), (53.766 ±7.276) μmol/L] (P <0.05). After treatment, non-dominant arm blood pressure decreased significantly in trial group (P < 0.05 ), but the blood BK had no significant defference before and after treatment (P >0.05). The blood NO and BK after treatment of ramipril 8 weeks in control group increased significantly than those before treatment [(57.286 ±6.431) μmol/L vs.(39.935 ±6.388)μ mol/L, (7.120 ± 1.015) μg/L vs.(5.232 ± 1.288) μg/L], and meanwhile non-dominant arm blood pressure decreased significantly(P <0.05). ConclusionsAliskiren and ramipril could increase the concentration of NO remarkably. Ramipril has strong effect in increasing the concentration of BK, but aliskiren hasn't effect on BK.