Aiming at the cultivation goal and requirements as well as the current status of learning and applying medical statistics for medical doctoral students, a new idea of medical statistics teaching for medical doctoral students that combined theory with practice, science research and paper writing was proposed, with respect to improving the teaching content, teaching with clinical cases, enhancing the teaching material development, paying attention to the computer practice, and providing the writing standard for research papers.

Objective To compare treatment and efficacy of thoracolumbar fractures by using three different screw fixations:traditional approach,the vertebral side clearance into the road and percutaneous pedicle. Methods A total of 82 single segmental thoracic lumbar fractures cases hospitalized from March 2011 to March 2014 ,with male 67 cases ,female 15 cases ,and average age(33.7+/-12.5)years old. Patients were randomly divided into three groups:traditional approach group (n = 23),operation through paraspinal muscle gap group (n = 30),percutaneous group(n = 29). These following indicators will be compared in three groups:duration of operation ,intraoperative blood loss ,intraoperative fluoroscopy time ,postoperative flow ,VAS scores before and after operation and Oswestry disability index , difference of spinal sagittal position Cobb′s Angle. Results Compared with the traditional approach group ,operation through paraspinal muscle gap group and percu-taneous group have obvious advantages in duration of operation,intraoperative blood loss,postoperative flow,VAS scores before and after operation ,the Oswestry disability index. Additionally ,above mentioned three surgical methods could recover kyphosis deformity ,and there was no statistically significant difference among three groups (P > 0.05). Conclusion In the treatment of monosegmental thoracolumbar fractures ,compared with traditional approach ,operation through paraspinal muscle gap and percutaneous pedicle screw internal fixation have more advantages which includes fewer trauma,less bleeding,faster recovery and lower incidence of postoperative low back pain.

Objective To investigate the change of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the skin of diabetic rats, and to explore the potential role of MMP-9/TIMP-1. Methods Diabetic rats were induced with streptozotocin (STZ). Then all rats were maintained for 6 weeks. Routine pathological examination and immnnohistochemistry were made to reveal the histological and cytological appearances. RT-PCR and Western blotting were used to detect the expression of mRNA and protein of MMP-9 and TIMP-1 in the skin. Results Six weeks after STZ treatment, examination of HE-stained skin sections from normal and diabetic animals revealed that the epidermis and dermis layers were thinner in diabetic rats than those in control rats. The skin of diabetic rats showed features of atrophy such as disorganization of connective tissue fiber bundles and enlarged space between collagen fiber bundles. In contrast, thick bundles of connective tissue were observed in the dermis of normal rat skin. In normal skin, cells had a bipolar, spindle-shaped appearance in the thick collagen bundles, while in the skin of diabetic animals the interstitial cells had a rounded, shrunken and crenated appearance. The relative values of expression of MMP-9 in diabetic group were higher than those in normal group with significant difference, however, the relative values of expression of TIMP-I in diabetic group were lower than those in control group. Conclusion The changes in cutaneous histology and cytology appear earlier than skin wound. These "underlying disorders" may be associated with the imbalance of MMP-9/TIMP-1.

Objective To study the clinical values and relativity of serum levels of NSE and ProGRP (P31-98) in patients with small-cell lung cancer. Methods Serum levels of NSE and ProGRP (31-98) was measured by ELISA in 159 patients with small cell lung cancer(SCLC), 99 patients with benign lung diseases, and 100 healthy subjects, 141 SCLC patients before and after treatment were also measured. Results The medians of NSE and ProGRP (31-98) was 21.33 μg/L and 323.70 pg/ml in patients with SCLC, 4.24 μg/L and 11.94 pg/ml in patients with benign lung diseases, 5.82 μg/L and 8.54 pg/ml in healthy subjects respectively,significantly increased in patients with SCLC as compared to that of the other two groups (P ＜0.01).Given the cut-off levels of 10.35 pg/L for NSE and 47.98 pg/ml for ProGRP(31-98), the sensitivity of diagnosis in SCLC was 71.1% and 88.7 %, respectively.The combination sensitivity and specificity of NSE and ProGRP(31-98)was 95.6 % and 96.8 %. The medians of NSE in SCLC patients with extensive and limited disease was 14.75 μg/L and 34.10 μg/L, the sensitivity was 51.14 % and 93.44 %, respectively; ProGRP (31-98) in the two groups was 143.14 pg/ml and 1061.14 pg/ml, 80.61% and 98.61%, respectively.In SCLC patients with remission after treatment the levels of NSE and ProGRP31-98 was significantly lower than that before treatment, but the levels without remission had no significantly change. There was significant relationship between NSE and ProGRP(31-98) in serum levels of patients with SCLC (r =0.379, P ＜0.01).Conclusion The serum levels of NSE and ProGRP (31-98) in patients are both increased, there are a significant relationship.But ProGRP(31-98) is a more specific and sensitive marker than NSE for the diagnosis of SCLC.The combination of the two markers can improve positive rate and validity.

OBJECTIVETo evaluate the clinical effectiveness of Yiqi Huoxue Tongyang Xiezhuo Recipe (YHTXR, capable of supplementing qi, activating blood, warming yang, and discharge turbidity) in treating coronary atherosclerotic heart disease (CAHD). and chronic heart failure (CHF) with carotid plaque patients, and to explore new ways of Chinese medicine (CM).

METHODSTotally 69 CAHD-CHF patients of qi deficiency phlegm stasis syndrome (QDPSS) with carotid plaque were recruited in this study using parallel cohort method. They were assigned to the treatment group (35 cases) and the control group (34 cases). Patients in the control group received routine treatment of Western medicine, while those in the treatment group were additionally treated with YHTXR (twice daily). The therapeutic course for all was three months. Cardiac function levels, echocardiography, carotid plaque, blood lipids and safety indicators were observed before and after treatment.

RESULTSAfter treatment the improvement of cardiac function levels was better in the treatment group than in the control group (P < 0.05). Decreased LDL-C levels were higher in the treatment group than in the control group (P < 0.01). There was statistical difference in left ventricular ejection fraction (LVEF), carotid intima-media thickness (IMT), LDL-C, TC, TG in the treatment group between before and after treatment (P < 0.05). LDL-C and TG also decreased in the control group after treatment (P <0.05). There was no significant difference in the left ventricular ejection fraction, carotid IMT, or TC in the control group between before and after treatment (P > 0.05). There was no significant difference in stroke volume, left ventricular end-diastolic diameter, the area of carotid artery plaque, or HDL-C in the two groups between before and after treatment (P > 0.05).

CONCLUSIONSYHTXR could effectively improve cardiac functions of CAHD-CHF patients of QDPSS with carotid plaque, reduce blood lipids and IMT. It had no significant adverse reactions for elderly patients in short term.

Carotid Intima-Media Thickness ; Coronary Disease ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Heart ; Heart Failure ; drug therapy ; Humans ; Lipids ; Plaque, Atherosclerotic ; drug therapy ; Qi ; Ventricular Function, Left

Objective To research the effects of short-term intensive insulin treatment on regaining the sensitivity of sulfonylureas in diabetes patients. Methods Thirty patients from outpatient and emergency department,including 12 male and 18 female,who took regular-dose sulfonylureas but was high blood glucose level,were selected to suspend the sulfonylureas treatment and were given the BIAsp30 to control the blood glucose level for three months,then they were stopped the BIAsp30 and took the same sulfonylureas used before.Results The average fasting blood glucose(FBG) was(9.4?7.5)mmol/L and the average postprandial 2 h blood glucose(PG2h)(or random blood glucose) was(14.2?7.2)mmol/L in 3 months before stopping the sulfonylureas.The average FBG was(5.7?0.7)mmol/L and PG2h was(7.2?1.4)mmol/L at the beginning of the insulin getting the blood glucose under control.The average FBG was(6.0?0.8)mmol/L and PG2h was (7.8?1.2)mmol/L during the insulin treatment.The average FBG was(6.1?0.6)mmol/L and PG2 h was(7.7?1.3)mmol/L at the end of the insulin treatment.The average FBG was(6.5?0.5)mmol/L and PG2h was(8.1?(0.8))mmol/L when continuing the sulfonylureas treatment in one months.It increased significantly to compare the blood glucose before the treatment of insulin to that after the treatment of insulin(P

Objective To explore the diagnosis and TNM stage effect of serum CYFRA21-1,VEGF and PDGF in patients with non-small cell lung cancer.Methods The electrochemiluminescence immunoas- say was used to detect serum CYFRA21-1,and the sandwich enzyme-linked immunoabsorbentassay(ELISA) was used to detect serum VEGF and PDGF in patients with non-small cell lung cancer and 30 normal healthy controls.Results Compared with healthy control group,the level of serum CYFRA21-1,VEGF and PDGF in non-small cell lung cancer group were much higher(P0.05).The serum CYFRA21-1 level was positively correlated with VEGF and PDGF(P

Objective To explore the therapeutic effect and safety of high-frequency diathermic therapy combined with oral S-1 and intraperitoneal perfusion chemotherapy on malignant seroperitoneum of advanced gastric carcinoma.Methods Fifty-two advanced gastric carcinoma patients with malignant seroperitoneum were divided into observation group and control group.Twenty-five patients in observation group were received DDP 60 mg/m2 combined with 5-Fu 600 mg/m2 and IL-2 3 000 000 U intraperitoneal perfusion chemotherapy,as well as oral S-1 of 40mg bid on day 1-14 of every 21 days for a total of two or three cycles.High-frequency diathermic therapy was administered thirty minutes after intraperitoneal perfusion chemotherapy,twice a week for 3 weeks.Twenty-seven patients in control group were treated with S-1 and intraperitoneal perfusion chemotherapy only.Results In observation group,4 patients were CR,15 patients were PR,5 patients were SD,1 patient was PD,and the response rate (CR+PR) was 76 ％.In control group,3 patients were CR,14 patients were PR,7 patients were SD,3 patients were PD,and the response rate (CR+ PR) was 63 ％ (P ＞ 0.05).Median survial time for observation group was 10.0 months,8.0 months for control group (P ＞ 0.05).Karnofsky scores after treatment in observation group was higher than that in control group,patients' clinical benefit rate were 80.0 ％ (20/25) and 51.9 ％ (14/27).The difference in life quality between the two groups was statistically significant (P ＜ 0.05).There was no significant difference in adverse reactions between the two groups (x2 =4.544,P =0.033).Conclusion High-frequency diathermic therapy combined with oral S-1 and intraperitoneal perfusion chemotherapy for advanced gastric carcinoma with malignant seroperitoneum has good short-term curative effects and security,and this method should be further studied.

Time perspective therapy (TPT) which belongs to positive psychology is a new psychological intervention to post-traumatic stress disorder (PTSD).A large number of studies abroad have testified that TPT is very long-term effective,what′s more, TPT has been popularized and improved by foreign scholars but not been applied in China.TPT has been a study issue in mental and psychological fields,but that how to apply TPT rightly in China needs to explore.Therefore, this paper systematically introduced and analyzed TPT theory, the problems of applying TPT and the enlightenment of nursing PTSD,so as to help Chinese scholars apply TPT to solve problems and status of nursing PTSD in China.

Objective To assess the effectiveness of the combined treatment model for Wilms'tumor and to improve treatment results.Methods Fifty-five patients diagnosed with Wilms' tumor between July 1981 to June 2010 were analyzed retrospectively.Eighteen patients were diagnosed by preoperative ultrasound-guided fine needle biopsy,and 53 patients were confirmed by postoperative pathology results.Seven cases were in clinical stage Ⅰ,19 cases in clinical stage Ⅱ,21 cases in stage Ⅲ,six cases in stage Ⅳ and two cases in stage Ⅴ.Thirty-five cases had histopathological subtype,30 cases had the favorable type,and five cases had the unfavorable type.Among the 55 patients,kidney tumor resection was performed on 48 cases,wide edge partial nephrectomy was performed on two cases,tumor enucleation was performed on one bilateral renal tumor case,kidney tumor resection with pulmonary metastasectomy was performed on two cases,and two cases had no surgical procedures.Eighteen cases received preoperative chemotherapy,40 cases received postoperative chemotherapy,and 12 cases received postoperative radiotherapy.Patients were grouped according to age,stage,histological type,treatment model,treatment course and whether or not they had radiotherapy.The Kaplan-Meier method was used in the evaluation and comparison of over survival (OS),disease free survival (DFS) and relapse free survival (RFS) of the different groups to reveal the relationship between different grouping factors with the prognosis of Wilms' tumor. ResultsThe median of follow-up was 34 mon ( ranging from 3 to 355 mon).The 3-year OS,5-year OS and 2-year DFS were 77.6％,69.0％ and 52.4％,respectively.The differences of OS in different stages ( P =0.006 ),DFS between pure operation group and combined therapy group ( P =0.004 ) and RFS between radiotherapy group and no radiotherapy group ( P =0.03 ) were significant,P ＜ 0.05.ConclusionsThe normative multi-disciplinary treatment model for patients with Wilms' tumor can achieve good results and is well tolerated.