Objective To research the position transition training effect of general practitioner of northeast district of Chongqing,and find out the problems and their reasons.Methods 326 students and 150 unit leaders were chosen to make a questionnaire survey(recycled 307,150).The Kirkpatrick model was also used for data analysis from 4 levels.The result was described in percentage.Results Reaction Level:42.02％(129/307) of the trainees were not satisfied with the time arrangement of clinical medicine training; Study Level:3 courses were at high failure rate 19.54％(60/307),22.8％(70/307),17.92％(55/307); Behavior Level:81.43％(250/307)of the trainees considered the training effective; Result Level:94.00％(141/150)unit leaders considered the training had a positive impact.Conclusion The time arrangement of clinical medicine training is mostly unsatisfied and the ability of instrument using and result interpretation is weak.Most people consider the position transition training is effective.

The deficiency in islet ?-cell secretion and (or) the decrease in insulin sensitivity of target tissue are the important pathophysiological mechanisms of diabetes. The methods for the assessment and evaluation of ?-cell function can be divided into: pulsatile insulin secretion, glucose secretagogues, non-glucose secretagogues (phase, peak value and duration) and other secretions. While the suitable method was chosen for the evaluation of ?-cell function, the sensitivity and specificity of different methods in the natural history of diabetes and the objective of evaluation should be all taken into account.

Objective Drug resistance is the main reason for chemotherapy failure ,it is to be solved how to overcome this . Recent studies indicate that epithelial-mesenchymaltransition (EM T ) may involved in chemotherapy resistance for some types of cancers .But it is still unknown whether EM T is involved in chemotherapy resistance for colorectal carcinoma .This study was con-ducted to investigate the relation between EM T and colorectal cancer chemotherapy resistance .Methods Abilities of migration and invasion of Oxaliplatin resistant colorectal carcinoma cell lines LOVO /L-OHP and wild type colorectal carcinoma cell lines LOVO were investigated by transwell migration and transwell invasion assays .The level of E-cadherin and Vimentin was detected by West-ern blot .EM T of LOVO was induced by GSK-3β inhibitor SB415286 treatment and validated by transwell migration and transwell invasion assays and Western blot for E-cadherin and Vimentin .The sensitivity of LOVO to Oxaliplatin after SB 415286 inducing EM T was evaluated by M TT and Annexin-V /PI assays .Results EM T phenotype was confirmed by morphology feature ,results of transwell migration and invasion assays and level changes of E-cadherin and Vimentin .In addition ,the results of proliferation and apoptosis tests showed that the sensitivity of LOVO to Oxaliplatin after SB 415286 inducing EM T decreased significantly ,which means chemotherapy resistance .Conclusion The direct association between EM T and chemotherapy resistance for colorectal carci -noma is proved in this study ,which provides basis for intervening chemotherapy resistance and new researching strategies .

Objective:To analyze influence of vaginal hysteroscopy and laparoscopic surgery on tubal pregnancy patients’ surgical outcome and inflammatory stress response.Methods: Chosen 86 cases of tubal pregnancy patients between July 2012 to July 2013 in our hospital undergoing surgery as study object, according to a random number table divided into hysteroscopy group (43 cases) and laparoscopic group (43 cases), compared surgical outcomes, perioperative differences in the level of inflammation and stress level.Results: No significant difference between hysteroscopy group and laparoscopic group on surgical success rate and ipsilateral tubal patency statistically(x2=0.241,x2=0.193;P>0.05), postoperative intrauterine pregnancy rate was higher than laparoscopic group, again ectopic pregnancy rate was less than laparoscopic patients(x2=7.294,x2=8.283;P<0.05); hysteroscopic surgery group E, Cor, IL-2, IL-6, IL-8, CRP levels were lower than laparoscopic group(t=6.842,t=6.283,t=8.536,t=6.106,t=6.283,t=6.376;P<0.05),TSH levels was higher than laparoscopic group(t=6.823,P<0.05).Conclusion:Vaginal hysteroscopy and laparoscopy can be used for the treatment of tubal pregnancy, hysteroscopy has an advantage in improving patient again intrauterine pregnancy, reduce postoperative systemic stress and inflammation levels, and promote the recovery of patients after surgery respect.

Objective: To analyze the effect of single-hole thoracoscopic surgical treatment on elderly spontaneous pneumothorax patients’ postoperative assessment and serological markers and explore single-hole thoracoscopic surgery application. Methods:78 cases of elderly patients with spontaneous pneumothorax were retrospectively analyzed, and divided into single-hole thoracoscopy group with 35 patients and conventional thoracoscopic group with 43 patients. Then the surgery indicators, postoperative pain scores and perioperative serum target level differences were compared between the two groups. Results: The operative time, postoperative drainage time and total hospital stays of single-hole thoracoscopic surgery patients were shorter than that of conventional thoracoscopic group. The differences were statistically significant (t=7.183, t=5.294, t=6.938;P<0.05). The blood loss and postoperative drainage were less. The differences were statistically significant (t=6.883, t=8.735; P<0.05). The postoperative pain scores within one week was less than conventional thoracoscopic group. The differences were also statistically significant (t=6.882, t=5.724, t=5.284;P<0.05). The serological indicators, CRP, IL-1, TNF-α,α1-AT levels of patients in the single-hole thoracoscopy group were lower than the conventional group (t=8.293, t=7.274, t=9.284, t=7.183;P<0.05). Conclusion:VATS and conventional hole thoracoscopic surgery can be used for treatment of spontaneous pneumothorax in elderly, but single-hole thoracoscopy has more advantages in reducing surgical trauma and postoperative pain and optimize systemic inflammation associated factors.

Genetic Predisposition to Disease ; Humans ; Olfaction Disorders ; congenital ; genetics

Humans ; Olfaction Disorders ; genetics ; Smell ; genetics

Five genes that are closely related with leukemia were detected and identified using COREMINE Medi-cal, and the abstracts of related papers covered in PubMed were analyzed with the biomedical text mining tool, Chilibot, which showed that leukemia interacts with the 5 genes detected using COREMINE Medical.

Objective To evaluate the safety and efficacy of laparoscopitotal mesorectal excision (TME) with sphincter-preservation in the treatmenof low rectal cancerby using metanalysi.MethodThe electronidatabase(PubMed ,Medline ,Ov-id ,Cochrane Library ,Controlled TrialRegistry ,SinoMedCBM ,Wanfang Dat,CNKI ,VIP ,eal) were retrieved .The related litera-tureon the randomized controlled trail(RCTs) and the non-randomized controlled trails(non-RCTs) comparing laparoscopiver-sulaparotomy TME with sphincter-preservation fotreating low rectal cancepublished from January 2001 to Octobe2012 were collected .The RevMan5 .2 software waused to conducthe metanalysi.ResultTwelve studieincluding 1 508 patientwere included ,in which the laparoscopigroup had 781 caseand the laparotomy group had 727 case.The metanalysiresultshowed thacompared with the laparotomy group ,the laparoscopiTME(LTME) group with sphincter-preservation had significantly lesestimated blood loss[mean difference(MD)= -67 .13 ,95% confidence interval(CI) (-78 .74 ,-55 .51) ,P＜0 .01] ,longedistal resection margins[MD=0 .15 ,95% CI(0 .01 ,0 .29) ,P= 0 .04] ,earlieintestinal functional recovery [MD= -1 .16 ,95% CI (-1 .32 ,-1 .01) ,P＜0 .01] ,shortehospital stay [MD= -3 .99 ,95% CI (-5 .36 ,-2 .63) ,P＜0 .01) ,lestotal morbidity [oddratio(OR)=0 .40 ,95% CI (0 .25 ,0 .63) ,P＜0 .01] ,anastomotileakage[OR=0 .60 ,95% CI (0 .37 ,0 .96) ,P=0 .03] ,urinary re-tention[OR=0 .40 ,95% CI(0 .18 ,0 .87) ,P=0 .02] and incision infection[OR=0 .26 ,95% CI(0 .11 ,0 .61) ,P=0 .002] .The statis-tically significandifferencewere nofound between the two groupin the numbeof lymph node dissection,length of resected specimen ,postoperative obstruction and the 2-yeaoverall survival rate(P＞0 .05) .Conclusion LTME with sphincter-preservation fotreating low rectal cancehathe advantageof lessurgical traum,rapid postoperative recovery and few complication.Never-theles,iineeded to conducfurtheresearch fovalidating whetheLTME with sphincter-preservation having the superiority in the aspectof postoperative anal function recovery and long-term outcome .

Objective To evaluate the diagnosis value of C-12 multiple tumor marker protein chip detective system for lung cancer. Methods The serum levels of 12 tumor makers were measured in 172 lung cancer patiens,52 pulmonary benign diseases patients. All lung cancer patients were definitly diagnosised by cytology or histology, including 89 squamous cell carcinoma patients, 72 bronchogenic adenocarcinoma patients, 11 small cell lung cancer patients; 12 patients in stage I, 28 patients in stageII, 65 patients in stage III, 67 patients in stage IV. The 12 common tumor markers in serum included CA199, NSE, CEA, CA242, CA125, CA153, AFP, Ferrtin, free-PSA, PSA, HGH, ?-HCG. Results At least one kind of tumor maker was found higher in 128 of the 172 lung cancer patients, the positive rate was 74.42%, and in 5 of the 52 pulmonary benign diseases patients, the positive rate was 9.62%,it is statistical significance between two the groups (P0.05) in different pathological types lung cancer patients .The positive rate was statistical significance in different stage lung cancer patients , the highest positive rate which in stage IV patients was 79.2% (P