Objective To survey on the graduate students about their own requirements, the guid-ance of tutors and the compliance, and put the gists for the educators and administrators. Methods Using the comprehensive questionnaires including Eugenie Creativity Test and Motivation Scale, the investigation surveyed on 900 graduate students in a medical university about their requirements and tutors' concerned aspects in their opinions, which was whether influenced by Intelligence (creativity), the Non-Intelligence factors (motivation) or not. Epidata 3.1 was used to input data of the investigation, and SPSS 16.0 statistical software was used to analyze it. The items were set as multiple-choices, and the percent of responses was used. Results The students thought the tutors' concerned aspects were mainly creative thinking [61.1%(1129/1847)], research methods [58.2%(1075/1847), specialty knowledge [41.8%(772/1847)], scientific spirit
[35.4%(654/1847)], academic morality [24.3%(516/2124)] and book knowledge [5.4%(100/1847) ], while the graduate students paid more attention to its research methods [72.4%(1538/2124)], innovative thinking [64.0%(1359/2124), professional knowledge [60.0%(1274/2124)], the spirit of science [33.9%(720/2124)], academic morality [24.3%(516/2124)] and book knowledge [10.0%(212/2124)]. The percentages of research methods and specialty knowledge concerned by most of the students were higher than those tutors' con-cerned in the students' opinion. The percentages of specialty knowledge concerned by the students with high innovation and motivation were 56.2%(443/789) and 58%(345/595), which were higher than those concerned by the tutors 38.5%(255/662) and 29.4%(148/503). Conclusion In the students' opinion, tutors concerned more creative thinking, the students concerned more research methods, while they concerned similarly in the other aspects. For the students, the guidance of the tutors cannot still meet their study demands, espe-cially in research methods and specialty knowledge. Those with different motivations and innovations have different study requirements.

To investigate the gene typing, molecular characteristics of virulence and resistance associated gene of Clostridium difficile from clinical isolates in China, the genes tcdA,tcdB of toxin A and B, cdtA,cdt B of binary-toxin, and erm B of clindamycin resistance were detected by conventional PCR. Genotyping of toxic C. difficile were conducted by means of analysis of 16s-23s internal spacer region polymorphism with PCR assay. Then the antibiotic resistance of toxic C. difficile to ampiciline, clindamycin, metronidazole and vancomycin was conducted with E-test. It was found that 8 toxic C. difficile strains were demonstrated out of 12 clinical isolates, in which 5 strains were tcdA+ and tcdB+, and 3 strains tcdA- and tcdB+, accounting for 62.5% and 37.5% respectively. Binary-toxin genes detection were negative in all the strains. Clindamycin resistance associated gene ermB was positive in 4 out of 8 toxic C. difficile strains, accounting for 50%. 8 toxic isolates were typed into 4 gene types, the dominant type was ZR I,accounting for 62.5%. Resistance rate of 8 toxic C. difficile strains against ampiciline(AC), clindamycin(CM), metronidazole(MZ) and vancomycin(VA) was 37.5%,87.5%,12.5%, and 0 respectively. No isolates belonged to ribotype 027 or 078. Isolation rate of toxic C. difficile is high to 66.7%. There is obvious gene polymorphism in clinical isolates of Chinese toxic C.difficite, and ZR I is preponderant genotype in 4 genotypes. C. difficile shows some resistance to ampiciline, clindamycin, metronidazole, but susceptive to vancomycin.

Objective To evaluate the value of diffusion-weighted imaging (DWI) in the differential diagnosis of cystic pancreatic lesions.Methods Thirty-four cystic pancreatic lesions confirmed clinically or pathologically were collected,including 11 case of non-neoplastic pseudocyst,5 cases of simple cyst,6 cases of serous cystadenoma,10 cases of mucinous cystadenoma and 2 cases of mucinous cystadenocarcinoma.All the patients underwent routine serial MR and echo-planar DW imaging examination of the pancreas with b values of 0 and 600 s/mm2.The appearances of signal intensity of DWI with all cysts were recorded.ADC maps were reconstructed,and the ratio of the cysts and cyst-to-pancreas ADC (ADCR) were calculated.The receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic value of ADC and ADCR.Results Among all the 16 non-neoplastic cysts,2 cysts were slightly hyperintense in DWI,and 14 cysts were isointense.Among all the 18 neoplastic cysts,17 cysts appeared slightly hyperintense or hyperintense in DWI,and 1 cyst was isointense.The difference between the two groups was statistically significant (P ＜ 0.001).The ADC values of non-neoplastic and neoplastic cysts were (3.30 ± 0.30) × 10-3,(2.74 ± 0.34) × 10-3 mm2/s ; and the ADCR values of non-neoplastic and neoplastic cysts were 1.85 ± 0.20,1.31 ± 0.21,the difference between the two groups was statistically significant (P ＜ 0.001).The areas under the ROC curves of ADC and ADCR diagnosing neoplastic cysts were 0.94 ± 0.04,0.98 ± 0.02,respectively.An ADC of 3.105 × 10-3 mm2/s showed 81.3％ sensitivity and 94.4％ specificity for predicting neoplastic cysts.An ADCR of 1.525 showed 100％ sensitivity and 88.9％ specificity for predicting neoplastic cysts.Conclusions Diffusion-weighted imaging is of importance in the diagnosis and differential diagnosis of pancreatic cysts,and can be applied as a complementary tool for routine MRI.

Objective To design a multiplex PCR for simultaneous identification and toxigenic type characterization of Clostridium difficile isolates. MethodsThree pairs of primers were designed for the amplification of a species-specific internal fragment of the tpi( triose phosphate isomerase) gene, an internal fragment of the tcdB ( toxin B) gene, and an internal fragment of the tcdA ( toxin A) gene. Twenty-one standard strains including Clostridium difficile ATCC 9689 and 47 isolates of Clostridium difficile were applied for the assessment of detection limit, specificity and detections of the multiplex PCR, respectively. Toxin A and Toxin B of 47 isolates were analyzed by ELISA. ResultsThe detection limit for DNA concentration of the multiplex PCR was 0.5 pg/μl. The specificity was determined to be 100％. Among the results of 47 isolates detected by multiplex PC R, 37 strains were tpi ( + )/tcdA (+)/tcdB ( + ), 10 strains were tpi ( + )/tcdA (-)/tcdB ( - ). Tpi ( + )/tcdA ( - )/tcdB ( + ) was not found. The toxin detection of 47 isolates by ELISA showed that 20 isolates were positive and 27 isolates were negative. Twenty isolates of toxin (+) by ELISA were all tpi( +)/tcdA( +)/tcdB(+) by multiplex PCR. ConclusionThe multiplex PCR method combined diagnosis and toxigenic type characterization contributes to the diagnosis for Clostridium difficile infection.

Objective To investigate the status of life quality in the elderly in Shanxi Province Changzhi City, and to analyze its influencing factors. Methods The quality of life, activities of daily living and status of community services were measured simultaneously by 36-Item Short Form Health Survey (SF-36). Activities of Daily Living Scale, Community Healthy Needs Scale and survey results were used and analyzed using t-test, correlation and stepwise regression analysis. Results According to the criterion of life quality in the elderly which were proposed by Zhang Lei, the quality of life in the elderly scored 72. 1-117.0, reached 98.5%. The quality of life in the elderly was impacted by the ability of caring oneself, marital status, degree of culture, economic situation and so on. The demand rate for health guidance and periodic physical examination was higher. Conclusions The quality of life in the elderly is at a medium level. There is a wide gap between the demand of community healthy services and the utilization of community healthy services.

Objective To investigate the magnetic resonance imaging (MRI) and computerized tomography (CT) imaging findings of hepatic angiomyolipoma (AML).Methods Twelve cases of hepatic AML,which were confirmed by pathologists between 2009 and 2011 in our hospital,were retrospectively analyzed.Results There were 3 males and 9 females with an average age of 44.17 years (range,34 to 60 years).There were 14 lesions,8 in left lobe,6 in right lobe.All of 12 cases were confirmed as angiomyolipoma by pathologists.Nine cases were performed with MRI,2 with CT,and 1 with both CT and MRI.The border of lesions were clear in 8 cases.Fat contents were shown on CT and/or MRI in 8 cases.After administrated with contrast medium,the lesion enhancement was still apparent or slightly decreased in 9 lesions from portal phase to delayed phase.The suppression of portal vein and inferior vena cava by tumor were seen in 5 lesions.Abnormal vascular distortion was seen in 6 lesions.None of 12 lesions were found with portal vein thrombosis.Conclusion The diagnosis of hepatic angiomyolipoma should be considered when CT and MRI show good boundaries,intratumoral fat content,delayed lesion enhancement,and vascular distortion.

Objective To investigate the effect of gender differences in distal femoral geometry on the clinical outcomes of total knee arthroplasty (TKA). Methods From March 2003 to October 2006, 213 cases with 294 osteoarthritic knees who had underwent primary TKA were involved in the study. The study included 87 men (118 knees) and 126 women (176 knees) who had a mean age of 64.4 years. All the cases were assessed with the knee-rating system of Knee Society, the knee range of flexion (ROF), corrected posterior offset (PCO) and anterior condylar offset (ACO) based on sex. Results Each patient had a Minimum of 2 years follow-up. The preoperative Knee Society scores and ROF, the two-year postoperative changes of stability scores and walking ability had no differences between the two groups. While greater improvements of postoperative pain scores and stair-climbing ability were seen in male. Men had better intraoperative ROF than women had ones, but there were no gender differences with regard to the two-year postoperative improvement of ROF. Corrected PCO decreased more markedly in female than in male. Corrected ACO decreased equally in female and male. The difference in the posterior condylar offset after TKA was statistically correlated with the change in pain scores, stair climbing ability and intraoperative ROF, respectively. Conclusion Male had a better outcome than female did after TKA. Femoral components which designed in the light of Caucasian anatomic characteristics couldn't match the native anatomy of distal femurs of Chinese female. Sexual dimorphism in humans and anatomic variations in various ethnic groups should be seriously considered in total knee prosthesis design.

Objective To investigate the quality of life of elderly caregivers and its factors. Methods Elderly caregivers living in Changzhi City were enrolled in this study. 36-item short-form (SF-36) health survey and Activity of Daily Living Scale ( ADL) were used as study tools. The data was analyzed by statistical description,t test or multiple regression. Results Those with score of quality of life reaching 72. 1 to 117. 0 accounted for 98. 8%. The total score and score of eight dimensions of SF-36 showed statistically significant difference between different daily living activity groups ( P < 0.05) . The state of health and self-care ability of the elderly imposed a major impact on eight dimensions of SF-36. Age, sex, level of education, marital status and wage had different impact on each dimension of SF-36. Conclusion The quality of life of elderly caregivers is at a medium level. The main factors of quality of live of elderly caregiver are their state of health and self-care ability of the elderly.

To investigate the relationship between serum glutamic acid decarboxylase antibody (GAD-Ab)titer and the first-phase insulin release (1PH)in newly-diagnosed type 2 diabetic patients. 1053 newly-diagnosed type 2 diabetic patients were divided into 3 groups, including 71 individuals with GAD-Ab≥1 U/ml (positive group), 171 individuals with GAD-Ab ranging from 0 to 1 U/ml (negative-1 group), and 811 individuals with GAD-Ab=0 (negative-2 group). IPH was evaluated by arginine stimulation test. In the patients of negative-2, negative-1, and positive groups, the respective values of 1 PH were subsequently decreased significantly (P< 0. 01) , and the detection rates of the decreased insulin secretion were 74. 85%, 87. 13%, and 100%, respectively. Stepwise regression analysis indicated that disease duration, GAD-Ab titer, HbA_1C, and body mass index were the major independent contributing factors. The titer of GAD-Ab has an important impact on 1PH defect in type 2 diabetic patient. Detection of GAD-Ab not only provides an evidence for clinical type, but would also be helpful in determining the islet β-cell function.

Objective To investigate the evaluation of medical doctoral students on medical statistics teaching. Methods An investigation was carried out among doctoral students of 2012 using questionnaires in a medical university. A total of 272 doctoral students were investigated and 266 (97.79%)of them had learned medical statistics before enrollment. Statistical description was used to analyze enumeration data by calculating cases and percentages. Results More than 88.00% of them thought that medical statistics was helpful for their future work. More than 60.00% of them thought that the present teaching contents were appropriate and about 93.00% of them thought that examina-tion mode was appropriate. However,65.00% of them thought that the class hours were not enough and some con-tents should be explained more clearly. Conclusions Both basic statistics methods and advanced statistics methods should be given consideration to. Some frontier or hot knowledge of medi-cal statistics should be arranged and the class hours should be increased to expand the content of teaching.