Facing the diverse social environment and development, several aspects of higher clinic medical education,such as educational philosophy,personnel cultivating goal and mode,are undertaking all kinds of shift,which can be embodied in the medical curriculum reform.

Objective To research the expression and clinical significance of miR‐145 in the marrow of acute myeloid leuke‐mia (AML) .Methods A total of 70 cases of bone marrow samples were collected from AML patients ,of which included 46 cases of new diagnosed patients(initial treatment group) ,24 cases of AML patients in complete remission(remission group) .Fourteen ca‐ses of non‐neoplastic patients were used as controls(control group) .The miR‐145 relative expression level was detected by real‐time quantitative PCR .Results The relative expression level of miR‐145 in initial treatment group was less than those of control group and remission group(P<0 .01) .Compared to before‐chemotherapy patients ,the expression level of miR‐145 in the 9 case of AML patients with complete remission after chemotherapy increased significantly(P<0 .05) .The relative expression of miR‐145 showed no significantly correlation with the percentage of blasts cells in bone marrow and the percentage of peripheral blood leukocyte count (P=0 .456 ,0 .394) .Conclusion The expression of miR‐145 in bone marrow cells of AML patients is down‐regulated ,which sug‐gested the development of acute leukemia .

Objective To understand the status of Ascaris eggs pollution in soil at national monitoring spots of soil-transmit-ted nematodiasis,so as to provide the evidence for making countermeasures and evaluating the control effect. Methods Ten households were selected from each of the 22 national monitoring spots annually according to the National Surveillance Program of Soil-Transmitted Nematodiasis(Trial),and the soil samples from vegetable gardens,toilet periphery,courtyards and kitchens were collected and examined by using the modified floatation test with saturated sodium nitrate. Fertilized or unfertilized eggs as well as live or dead fertilized eggs were discriminated and identified. In addition,a SWOT analysis of monitoring of Ascaris eggs pollution in the soil of rural China was carried out. Results A total of 1 090 households were monitored in 22 monitoring spots from 2006 to 2010. The total detection rate of Ascaris eggs in the soil was 30.73%,and the detection rates of fertilized,unfertilized and live fertilized eggs were 13.21%,26.42%and 20.28%,respectively. The total detection rates of Ascaris eggs in the vegetable garden,toilet periphery,courtyard and kitchen were 16.51%,13.49%,14.22% and 10.73% respectively. The SWOT analysis demonstrated that the monitoring work had both advantages and disadvantages,and was faced with opportunities as well as threats. Conclusion The pollution status of Ascaris eggs in the soil is still quite severe at some national monitoring spots,and the counter-measures such as implementing hazard-free treatment of stool,improving water supply and sanitation and reforming environment should be taken to protect people from being infected.

Objective To understand the infection status and variation tendercy of Enterobius vermicularis infection among children at national monitoring spots of soil-transmitted nematodosis from 2006 to 2010,and master the epidemic regularity,so as to provide the evidence for making control strategy and evaluating the control effect. Methods A total of 22 national monitor-ing spots of soil-transmitted nematodosis were established according to the National Surveillance Program of Soil-Transmitted Ne-matodiasis(Trial),and the children aged 3-12 years were examined through adhesive cellophane anal swabs,then the infec-tion rates of children with different ages,genders,nationalities and education levels were analyzed. In addition,the advantage, disadvantage,opportunity and threat of the monitoring work were analyzed by SWOT analysis. Results A total of 17 068 chil-dren were examined in 22 monitoring spots from 2006 to 2010,and 1 363 of them were found being infected with E. vermicu-laris,the average infection rate was 7.99%,and the infection rates of male and female children were 7.39%and 8.70%,respec-tivel;the average infection rates in each year were 10.01%,9.68%,7.41%,6.96%and 6.57%,respectively. From 2006 to 2009,the infection rates of E. vermicularis in children in Fujian Province was the highest,which were 56.15%,53.42%, 37.82%and 49.53%,respectively,but in 2010,the infection rate in Guangdong Province(46.06%)was the highest. The fur-ther analysis demonstrated that the female children,3-6 age group,Li nationality and children at kindergarten stage had relative-ly high infection rates. The SWOT analysis showed that the advantage of E. vermicularis monitoring in China was its wide cover-age and continuity,and the disadvantage was the relatively small investment from the government,the opportunity was that the national monitoring spot could drive the monitoring work at the provincial,county and other levels,and the threat was that the work was paid less and less attention to in recent years. Conclusion Though the infection rate of E. vermicularis in children at national monitoring spots of soil-transmitted nematodosis has been decreased year by year,high-endemic areas still exist,and thus the work on enterobiasis control and prevention still needs to be strengthened.

Objective To evaluate the effect of recombinant human erythropoietin (rHuEPO) on lung injury induced by hepatic ischemia-reperfusion (I/R) in rats.Methods Sixty healthy male SpragueDawley rats, aged 6-8 weeks, weighing 220-280 g, were randomly divided into 3 groups (n=20 each) using a random number table: sham operation group (group S) , hepatic I/R group (group I/R), and rHuEPO group (group E).I/R and E groups underwent I/R of 70 percent of the liver.The rHuEPO 4 000 U/kg was injected intraperitoneally at 24 h before I/R in group E, while the equal volume of normal saline was given in S and I/R groups.The rats were sacrificed at 3 h of reperfusion, and lungs were removed and cut into sections which were stained with haematoxylin and eosin and examined under light microscope.Wet to dry lung weight ratio (W/D ratio) was calculated.The expression of heme oxygenase-1 (HO-1) and inducible nitric oxide synthase (iNOS) in lung tissues was determined by immunohistochemistry.The content of malondialdehyde (MDA), and activities of superoxide dismutase (SOD) and myeloperoxidase (MPO) in lung tissues were detected.Results Compared with group S, the W/D ratio, MDA content, and MPO activity were significantly increased, the SOD activity was decreased, the expression of HO-1 and iNOS was up-regulated (P＜0.05) , and the pathological changes of lung tissues were obvious in E and I/R groups.Compared with group I/R, the W/D ratio, MDA content, and MPO activity were significantly decreased, the SOD activity was increased, the expression of HO-1 was up-regulated, the expression of iNOS was down-regulated (P＜0.05) , and the pathological changes of lung tissues were reduced in group E.Conclusion The rHuEPO can alleviate hepatic I/R-induced lung injury in rats, and the mechanism may be related to up-regulated expression of HO-1 and down-regulated expression of iNOS.

Objective To explore the clinical effect of transvaginal repair of cesarean scar diverticulum (CSD). Methods Totally 64 patients of CSD in the First Maternity and Infant Hospital, Tongji University between Mar. 2013 and Sept. 2014 underwent transvaginal repair of CSD were reviewed retrospectively and followed. Result All the patients had a prolonged period, and the duration was (14.8± 3.5) days; all the patients were received the transvaginal repair of CSD, there was no intra-operative complications, the procedures were successfully performed in all patients. The mean operation time was (67± 12) minutes, the mean blood loss was (53±32) ml, and the mean length of hospital stay was (4.0±1.1) days. All patients were followed after the operation, the duration of menstruation was (8.1 ± 3.5) days shorter in average, which was statistically significant (P<0.01);the operation effective rate was 94%(60/64) to assess the clinic syptoms, the operation effective rate was 95%(61/64) for anatomic assessment. The distance of the CSD from the serosa became thicker after surgery significantly, the distance was thicker (3.4 ± 0.4) mm compared with preoperation (P<0.01). Conclusions Transvaginal repair of CSD offers minimal invasiveness, good exposure and accurate resection. It is worth to be popularized in the treatment of patients with CSD.

Objective To investigate the status of microbial contamination in domestic washing machines,and pro-vide basis for strengthening hygiene and health management.Methods On-the-spot sampling,laboratory microbial detection,and questionnaire survey were performed to investigate and analyze the hygiene treatment and microbial contamination of domestic washing machines of Beijing residents.Results Source water of 115 washing machines were collected,no bacteria were detected.The total number of bacteria and fungi in washing water from 115 washing machines was 0-135 000 CFU/mL (13 206 CFU/mL on average)and 0-690 CFU/mL (229 CFU/mL on average) respectively.There was significant difference in bacterial colony forming unit in washing water from washing ma-chines of different length of service (P <0.05).15 specimens of washing water from 15 washing machines were per-formed bacteriological detection,17 kinds of bacteria were detected,most of which were opportunistic pathogenic bacteria.The major detected bacteria was Pseudomonas aeruginosa (66.67%),followed by Staphylococcus aureus (60.00%)and Escherichia coli (53.33%).Survey showed that 32.17% of residents reflected the washing ma-chines had peculiar smell and mildew spots,48.69% of users chose to open the covers for ventilation,38.26%adopted local wiping and cleaning of filter bags,only 10.43% chose to soak with disinfectant,while 24.35% didn’t know how to deal with.Conclusion Microbial contamination of domestic washing machines is serious,improper use and maintenance of washing machine is not conducive to health.

Background: Epidermolysis bullosa (EB) is a rare genetic disease with widely different clinical manifestations, but the relationship between genotype and phenotype is not fully understood. In the present study, we recruited a Chinese family in which two members had been diagnosed with localized EB simplex (EBS), with clinical manifestation, including blisters and erosions on the soles of the feet since infancy. Objective: To identify and confirm the genetic variation in a Chinese family diagnosed as localized EBS. Methods: Our study included two patients, other healthy members of the family, and 100 normal controls. Genomic DNA samples were isolated from each participant, and then polymerase chain reaction (PCR) direct sequencing was performed. Results: The results of PCR direct sequencing revealed a novel heterozygous missense mutation in codon 461 of exon 7 of KRT5 (c.1382T＞C), which led to an amino acid change (p.L461P) in the patients with EBS but was absent in unaffected family members and 100 unrelated control samples. Conclusion The present study broadens the mutational spectrum of EBS, and this knowledge could be harnessed for prenatal screening, gene diagnosis, and gene therapy for lo-calized EBS.

In order to ensure the normal teaching order during the prevention and control of the COVID-19 epidemic, the second semester of the 2019-2020 academic year in Central South University was devoted to the online teaching. In response to the school's call, the diagnostics teaching team has applied the Tencent classroom software, WeChat mini programs, analog teaching software and digital curriculum platform to carry out online teaching activities. On the basis of summarizing the previous online teaching experience, we have made a preliminary discussion and reflection on the online teaching, which will provide ideas and directions for the reform of medical education.

Objective To explore the thyroid nodule in Shanghai among the health physical examination population.Methods A retrospective method was used to analyze the examination data of 61 725 cases of people,who had a health examination in Huadong Sanatorium in 2015,including 38 648 men and 23 077 women,aged from 12 to 91 years old,and the average age was (49.3 ± 11.3) years old.They came from every district of Shanghai,and covered every level of living standards.Thyroid color Doppler Ultrasonography was used in the examination,and thyroid nodules were diagnosed in accordance with "the Guidelines for Thyroid Nodules and Differentiated Thyroid Cancer (2015)".All patients with thyroid nodules were divided by age (＜ 21,21-,31-,41-,51-,61-,＞ 70 years old) and gender,and the detection rate of multiple nodules and micro-nodules (the maximum diameter was less than or equal to 1.0 cm) of each group was calculated to reveal the current situation of multiple nodules and micronodules among the patients with thyroid nodules.Results The detection rate of thyroid diseases was 54.5％ (33 654/61 725),and was conspicuously higher in female (62.6％,14 448/23 077) than in male (49.7％,19 206/38 648,x2 =971.706,P＜ 0.05).The detection rate of thyroid nodule was 50.4％ (31 126/61 725),and the detection rate of female (53.8％,12 420/23 077) was higher than that of male (48.4％,18 706/38 648,x2 =28.572,P ＜ 0.05).Start from the age of 21,thyroid nodule detection rates of male and female (22.5％,30.3％,42.9％,60.8％,71.1％,79.2％;29.5％,39.3％,54.5％,70.0％,78.5％,86.4％) were increased along with increasing age,and the detection rates of female among all age groups were higher than those of male (x2 =34.253,116.647,235.972,139.312,28.053,11.427,P ＜ 0.05).In patients with thyroid nodules,multiple nodules and micro-nodules were the main,and the detection rate of multiple nodules (57.5％,17 911/31 126) was higher than that of the single nodules (42.5％,13 215/31 126,x2 =152.933,P ＜ 0.05).The detection rate of micro-nodules was 84.4％ (26 282/31 126),and the detection rate of female (82.0％,10 181/12 420) was lower than that of male (86.1％,16 101/18 706,x2 =95.548,P ＜ 0.05).Conclusions The detection rate of thyroid nodule is relatively high in the group of people receiving physical examination in Shanghai,and this disease is closely correlated with age and gender.Among patients with thyroid nodules,multiple nodules and micro-nodules constitute the majority.