Based on the principle of training students for rural areas and serving for grass roots,Mudanjiang medical college cultivates talents mainly from countryside and rural areas,thus it is of great importance to build up decent and accurate values for those will-be doctors who heal the wounded and prevent and cure diseases.As well as enhancing their professional qualifications,medical college teachers should also cultivate students' world view,philosophy,values,responsibility,occupational ethics,and a scientific development outlook.

Background and purpose:Lung cancer is the leading cause of morbidity and cancer-related mortality worldwide. A variety of driver genes were detected in lung cancer. Studies have shown that different gene mutations of lung cancer were found between different races. Most of Uyghurs live in Xinjiang, accompanied by a high morbidity of lung cancer. This study aimed to investigate the expression of driver genes in Uyghur patients with lung cancer in Xinjiang, China.Methods:This study collected the tissue specimens of 43 Uyghur patients with lung cancer, with a very different method to detectEGFR gene expression. real-time fluorescent quantitative polymerase chain reaction(RTFQ-PCR) was used to detectK-ras,ALK,ROS1, mutatedBRAF andPIK3CA gene expression. Analysis of the correlation between lung cancer gene mutations in Uyghur and clinical features of patients with lung cancer were performed.Results:Among 43 cases of specimens,EGFR mutation rate was 11.63%, while theEGFR gene mutation rates in adenocarcinoma and squamous cell carcinoma were 26.67% and 4.76%, respectively.EGFR gene mutation was not detected in large cell carcinoma, adenosquamous carcinoma and small cell lung cancer.EGFR gene mutation rate in patients with adenocarcinoma (26.67%) was signiifcantly higher than that in other types of lung cancer (3.57%). The difference was statistically signiifcant (P=0.024). There were 6 patients withK-ras12/13 heterozygous mutation, and the mutation detection rate was 16.28% (6/43). There were 2 patients withPIK3CA heterozygous mutation, and the mu-tation detection rate was 4.65% (2/43).EGFR andK-ras mutations occurred simultaneously in 1 case. No relationship was found betweenEGFR mutations and age, gender, smoking status, TNM staging, ECOG score among Uyghur lung cancer patients. This study did not ifnd mutation inALK,ROS1 fusion gene andBRAF gene among the 43 specimens. Conclusion:Compared with Asian populations, Xinjiang Uyghur patients with lung cancer have a lower rate ofEGFR mutations and a higher rate ofK-ras mutations, which is similar to the characteristics of European Caucasians.

Interferon-tau (IFN-tau) is a newly discovered IFN of type I. It was originally found for its role as a pregnancy recognition hormone in ruminant animals such as sheep and cows. Like the other type I IFNs, IFN-tau have the same biological activities including antiviral, antiproliferative and immunomodulatory effects. In order to clearly identify the function of IFN-tau, the coding sequence of IFN-tau was amplified by PCR from IFN-tau cDNA, this fragment digested by EcoR I and BamH I and was inserted into pBV220 to form the recombinant plasmid pBV220/IFN-tau which was then transformed into E.coli BL21. It was found that pBV220/IFN-tau was highly expressed as inclusion body in BL21. Next, the expressed protein was purified on S-100 High Resolution and the purified product was confirmed by amino acid sequence analysis. Moreover, the standard antiviral activity test indicated that the activity of IFN-tau was about 2.09?106IU/ml.

Objective To investigate whether functional Wnt-?-catenin signaling is present in activated hepatic stellate cells (HSC),and the effect of blocking this signaling on activation of HSC. Methods?-catenin expression in HSC was examined by immunocytochemistry.Wnt signalings in HSC-T6 were assessed using a T cell factor (TCF)-dependent luciferase reporter gene (pTOP- FLASH) assay.Wnt signalings in HSC-T6 were blocked by transfecting with a dominant negative TCF (dnTCF) expression plasmid,then the expression of alpha smooth muscle actin (?-SMA) and collagen typeⅠwere examined by Western blot.Results?-catenin staining was positive in the nuclei of HSC-T6.Luciferase activity in the cells transfected with pTOPFLASH was significantly higher than that in the cells transfected with pFOPFLASH (P

Objective To explore the relationship between acceptance of disability and hope level in patients with total laryngectomy.Methods Totally 84 patients with total laryngectomy were recruited and investigated with the general information questionnaire,Acceptance of Disability Scale (ADS)and Herth Hope Index (HHI).Results The total score of ADS was (85.82±12.64),which showed medium level acceptance of disability.The total score of Herth Hope Index (HHI) was (35.50±8.12),which showed high level HHI.Significantly positive correlation was found between acceptance of disability and HHI.Conclusions Nurses should pay more attention to the acceptance of disability in patients with total laryngectomy,and provide effective psychological intervention to improve the patients' menial health and quality of life.

Objective To evaluate the diagnostic accuracy of contrast-enhanced MR angiography (CE MRA) in infrapopliteal occlusive diseases of diabetic patients.Methods A total of 105 patients with known diabetes and peripheral vascular occlusive disease who underwent both CE MRA and DSA examnations were included in this study.They had no obvious stenosis or with stenosis of less than 75％ in iliac,femoral,and popliteal arteries.Every infra-popliteal artery was anatomically divided into 9 vascular segments as tibiofibular trunk artery,proximal and distal anterior tibial artery,proximal and distal posterior tibial artery,proximal and distal peroneal artery,plantar and dorsalis pedis artery.There were 945 segments.The arterial stenosis was accessed with CE MRA and DSA respectively.The segments were scored in 5 categories as＜30％,≥30％ and＜50％,≥50％ and＜75％,≥75％ and＜100％,and 100％ according to stenostic degrees.The Kappa test was used to compare the diagnostic consistency of CE MRA and DSA.Taken DSA as a gold standard for reference,ROC curve was drawn to calculate the diagnostic accuracy of CE MRA in diagnosis of lower limb arterial disease.Results The ratio of statistically valid segments for both CE MRA and DSA were 97.7％ (923/945) in 945 vessel segments of 105 patients,and 390 of 923 arterial segments were both indicated as occlusion by CE MRA and DSA.The diagnostic consistency for the segments was listed in the decreasing order as follows:proximal peroneal artery,proximal posterior tibial artery,distal posterior tibial artery,proximal anterior tibial artery,distal anterior tibial artery,tibiofibular trunk artery,dorsalis pedis artery,plantar artery,distal peroneal artery,and corresponding Kappa values were 0.88,0.86,0.84,0.84,0.81,0.77,0.75,0.75 and 0.73,P＜ 0.05.The AUC(area under ROC curve) of CE MRA was 0.893 with 95％ confidence interval of 0.882 to 0.904.Conclusion CE MRA is an accurate imaging modality in the diagnosis of infrapopliteal occlusive disease s for diabetes.

Objective To compare the differences in mucin-histochemistry and etiology of Barrett's esophagus (BE) intestinal metaplasia (IM) , cardiac intestinal metaplasia (CIM) and gastric antrum intestinal metaplasia (GA-IM). Methods Alcian blue /periodic acid-schiff (AB/PAS) and high iron diamine / alcian blue (HID/AB) histochemical methods were used to classify IM in BE, cardia and gastric antrum, and IM were classified into three subtypes: complete small intestinal type (type Ⅰ ) , incomplete small intestinal type (type Ⅱ) and incomplete colonic type (type Ⅲ). Compared the prevalence of different subtypes of IM in above-mentioned sites, and investigated their relationships among the symptoms of gastroesophageal reflux disease (GERD) and Helicobacter pylori (Hp) infection. Results The prevalence of type Ⅲ IM in long-segment BE (LSBE) and short-segment BE (SSBE) is 75. 0% and 63. 3% respectively, it is significantly higher than that in CIM (23. 1% ) and GA-IM ( 17. 7% ) (P

Objective To evaluate the feasibility and initial experience of laparoscopic pyelolithoto- my within renal sinus.Methods A total of 19 patients(14 men and 5 women)of nephrolithiasis on 21 sides underwent laparoscopic pyelolithotomy within renal sinus.Of them,9 cases with other upper urinary tract diseases were treated by laparoseopic pyelolithotomy at the same time.The patient age ranged from 16 to 67 years(mean,41 years).The calculi were 1.2 to 3.5 cm in diameter,and were found on the right side in 11 cases,left side in 6,and both sides in 2.Five cases concomitantly had ureteral calculi;of them,1 had bi- lateral ureter calculi with ipsilateral steinstrasse,2 had pyelic polyp(1 with giant hydronephrosis after open ureterolithotomy),and 1 had giant bydronephrosis with pyelolithiasis during pregnancy with double-J tube drainage.Twelve cases(13 sides)had experienced unsuccessful extracorporeal shock wave lithotripsy,and 1 failed with minimally invasive percutaneous nephrolithotomy.Results The procedure was successful in all the 19 cases.The operative time ranged from 75 to 240 rain(mean,115 rain).The intraoperative blood loss ranged from 30 to 100ml(mean,50 ml).One case experienced 5-d urine leakage,and was spontaneously cured.The hospital stay was 5-9 d(mean,6 d).Double-J tube drainage was 4-6 weeks.During the follow- up(3-36 months),KUB and IVU showed no upper urinary tract stricture and no residual stones except for 1 stone of 0.7 cm in the renal lower calyx in 1 case.The kidney function was improved in all cases.Con- clusions Laparoscopic pyelolithotomy is new and minimally invasive alternative approach for renal calculi. With this procedure the urinary tract complications can be treated concomitantly,thus it can partially replace open surgery.

Objective:To expose the vulnerability of HIV/AIDS infection among youth out of schools in a holistic view through understanding lifestyle,peer relations,awareness of HIV/AIDS,and HIV/AIDS prevention service of the youth.Methods:A cross-sectional survey based on the collective random sampling was conducted among 584 youth out of schools with or without a job in Anshan City,Liaoning Province in October 2005.Results:The awareness rate of HIV/AIDS among youth out of schools was 58.9%,and 65.6% of the subjects never accepted any health service related to HIV/AIDS prevention.42.6% of the respondents had sexual experience,and the rate of having sexual experience among males(62.3%)was higher than that of females(37.7%).And 30.5% of the youth seldom or never used a condom,51.2% of the youth having sex didn't use a condom in his/her last sex.28.2% of the youth having sex were ever involved in commercial sex relations.22 of the respondents(3.8%)had the experience of drug substance,the rate of having sex experience among youth who used the substance was higher than that of the youth who never used the substance.Smoking,alcohol abusing,visiting recreation places,high month consumption were the risk factors of pre-marital sex,and high awareness of HIV/AIDS was the protective factor of pre-marital sex.Conclusion:The youth out of schools were vulnerable in sexual behavior,substance use,peer influencing,social environment,and HIV/AIDS prevention service in terms of HIV/AIDS infection.

Objective To study the risk factors of mortality in severe sepsis and septic shock patients. Methods 142 patients with severe sepsis and septic shock in ICU were observed and divided into alive group (98 patients)and dead group (44 patients)by using hospital mortality.The risk factors of mortality in severe sepsis and septic shock patients were assessed by binary logistic regression.Results Independent mortality risk factors were inotropic agents (OR =4.329,95%CI:1.045 -17.937,P =0.043),blood glucose >10 mmol/L (OR =3.771,95%CI:1.214 -11.710,P =0.022)and APACHE Ⅱ score (OR =3.098,95%CI:2.012 -4.760,P =0.000),while PaO2 /FiO2 after early goal -directed therapy (EGDT)was protective factor (OR =0.682,95%CI:0.500 -0.930, P =0.016).Conclusion Severe sepsis and septic shock patients with inotropic agents,blood glucose >10mmol/L, high APACHE Ⅱ score and decreased PaO2 /FiO2 after EGDT indicate poorly prognosis.