Antineoplastic Agents/therapeutic use* ; Gastrointestinal Stromal Tumors/drug therapy* ; Humans ; Liver ; Liver Neoplasms/drug therapy* ; Lung ; Naphthyridines/therapeutic use* ; Urea/analogs & derivatives*

Objective To evaluate obstetrics and gynecology training quality by analysis of clinical knowledge and clinical skills scores for long-term graduates.Methods A retrospective analysis of clinical knowledge and clinical skills scores was performed in obstetrics and gynecology training for 134 long-term graduates.Results The clinical knowledge and clinical skills scores of obstetrics and gynecology training were 82.27?7.68,87.69?7.24.There was no,P﹥0.05.Only the scores of clinical skills judged by one teacher in interview was correlated with clinical knowledge scores,while there were no correlation between clinical knowledge judged by other five teachers and scores of clinical skills.Conclusion There was no correlation between clinical knowledge and the scores of clinical skills scores.Culturing students’practical ability and communication ability is worth strengthening,while the consistency of teachers’evaluation standard should be improved.

Hospital Restructuring ; Hospitals ; Occupational Health Services

Objective To obtain highly purified botulinum neurotoxin A light chain(BoNT-ALC) protein in E.coli by genetic engineering and multi-step purifications, and identify its metalloproteases activity.Methods The full-length of BoNT-ALC was cloned from BoNT A by PCR and inserted into plasmid pET-22b.Then pET-22b-ALC was transformed into E.coli BL21( DE3) strains and induced by IPTG.The protein was purified by Ni-NTA sepharose,anion exchange column and gel filtration.The enzymatic activity of the protein was identified by SNAP-25.Results and Conclusion A highly purified and homogeneous protein is obtained, which shows good enzymatic activity.

The research data at home and abroad show that the overall burnout rate of clinical professional graduate students was high. They are vulnerable to burnout because of long duty hours, learn-ing pressure, intense and overloading work and especially the significantly reduced personal accomplish-ment in the situation of the contradiction between doctors and patients in our country. Burnout not only re-sults in psychological distress and physical symptoms, but also has negative effect on the quality of graduate medical education during residency training. Therefore, educators need to develop an active awareness of burnout and ought to perform interventions such as formulating the appropriate learning goals, improving the work efficiency, reducing work hours, positive psychological counseling and stress management training to prevent such occurrences.

Objective To investigate current status of healthcare-associated infection(HAI)and community-associated infection(CAI)of different levels of hospitals in Xinjiang.Methods Infection,antimicrobial use and pathogen detection in patients in second-class and above hospitals in Xinjiang on March 20,2014 were performed cross-sectional survey by bedside visiting and medical record reviewing methods.Results A total of 66 208 patients in 132 hospitals were investigated,HAI prevalence rate and case prevalence rate was 1.83% and 2.02% respectively;CAI prevalence rate and case prevalence rate was 24.53% and 24.83% respectively.HAI prevalence rate in third-class hospitals was higher than second-class hospitals (2.58% vs 1.44%,P <0.001),while CAI prevalence rate was lower than second-class hospitals (17.84% vs 28.01%,P<0.001).HAI prevalence rate was highest in intensive care unit (14.91%),CAI was highest in pediatric department. The common infection sites were respiratory tract,surgical site and urinary tract.Antimicrobial usage rate was 31.27%, antimicrobial usage rate in second-class hospitals was higher than that of the third-class hospitals([35.95%,n=15 642]vs [22.32%,n=5 064],χ2 =1 288.974,P <0.001),pathogen detection rate in third-class hospitals was higher than that of the second-class hospitals([59.40%,n=2 224]vs [53.59%,n=6 436],χ2 =38.964,P <0.001 )Gram-negative bacilli were main isolated pathogens,the top 3 pathogens were Escherichia coli ,Klebsiella pneumoniae ,and Acinetobacter bau-mannii .Conclusion The cross-sectional survey can reflect infection status of different levels of hospitals,surveillance of targeted microbial detection and rational antimicrobial use should be strengthened,management of infection in high risk population and key sites should be paid close attention.

Objective To evaluated the correlations between MSCT features and expression of VEGF-C,lymphatic vessel density (LVD)in gastric carcinoma.Methods Both plain MSCT and triphasic dynamic contrast-enhanced scan were performed in 58 patients with gastric carcinoma.All patients underwent total/subtotal gastrectomy after MSCT scanning.All specimens were collected into liquid nitrogen or deep freeze refrigerator.Detection procedure for VEGF-C mRNA was performed using RT-PCR,and the LVD was detected with 5’-nucleotidase (5’-Nase)histochemistry.Results The VEGF-C positive rate and the LVD in tumor tissue were high-er than those in normal tissue (P < 0.05 ).In the tumors between diffused and intestinal groups and between non-metastasis and lymph node metastasis groups,the VEGF-C positive rate was 87.1% and 59.3%,87.8% and 41.2%,and the LVD was 8.04±4.58 and 4.08±2.44,8.50±4.70 and 3.64 ± 1.41,respectively,indicating statistically significant differences (P <0.05 ).Conclusion Over-expression of VEGF-C and higher LVD are closely correlated with the lymph node metastasis and Lauren types of MSCT fea-tures of gastric carcinoma.VEGF-C can promote the lymphangiogenesis in carcinoma and further lymph metastasis.

Objective To study the appropriate neck irradiation volume for neck lymph nodenegative nasopharyngeal carcinoma patients by Meta-analysis.Methods The related references published from Jan 1990 to Jun 2013 were searched in Pubmed,Embase,Cochrane and Wangfang Databases.The qualified references for enrollment criteria were screened and the relative data were collected.The OR (Odds ratio) value by fixed effect model was used to evaluate the data for patients who received radiotherapy between the upper neck and whole neck irradiation.The endpoints including 5-year neck local control rate (LCR),neck-in-irradiation LCR,and neck-outsides-irradiation LCR.Results Five qualified references were screened and belonged to respective research.There enrolled 1 333 patients,including 970 patients who received the upper neck irradiation and 363 patients who received the whole neck irradiation,respectively.The forest plots revealed that there were no significant differences for 5-year neck LCR,neckin-irradiation LCR,and neck-outsides-irradiation LCR for patients received radiotherapy between the upper neck and whole neck irradiation.These OR values were 0.89 (95％ CI:0.41-1.94),1.29 (95％ CI:0.58-2.88) and 0.42 (95％ CI:0.07-2.36),respectively.Conclusions The Meta-analysis results suggest that irradiation to the upper neck for neck lymph node-negative nasopharyngeal carcinoma can be appropriate.

Objective To compare the agreement among Chinese 1992, 2008 and UICC 2010 staging systems of nasopharyngeal carcinoma (NPC) and evaluate their predictive value of radiotherapeutic prognosis.Methods 347 NPC patients without distant metastasis treated in our hospital from 2000 to 2005 were retrospectively analyzed.Every patient was categorized into T, N, and clinical stage by Chinese 1992, 2008 and UICC 2010 staging systems, respectively.Kappa value was used to evaluate the agreement among three systems.Kaplan-Meier method was used to analyze the 5-year overall survival (OS), local-free survival (LFS) and distant metastasis-free survival (DMFS), the difference between subgroup was tested by Logrank.Results The agreement of clinical stage, T and N stage between Chinese 2008 and UICC 2010 staging system was better than that of them compared to 1992 staging system, Kappa value were 0.700、0.881 and 0.722.The agreement of T stage was better than N and clinical stage among these three staging system.The difference of OS between stageⅢ and stage Ⅳ was significant in Chinese 2008 and UICC 2010 staging system (χ2=4.48,P=0.034;χ2=8.88,P=0.003), and with no different in 1992 staging system (χ2=0.40,P=0.526).There was no significant difference of LFS between T1 and T2,T2 and T3,T3 and T4 in all staging systems (χ2=1.85,0.53,0.50,P=0.174,0.467,0.479;χ2=1.25,2.10,1.99,P=0.264,0.148,0.159;χ2=0.77,0.60,0.87, P=0.381,0.441,0.350).There were no significant differencesin 1992 staging system, while there was significant differences of DMFS between N1 and N2, N2 and N3 in 2008 stage system, N1 and N2 in UICC 2010 stage system.Conclusions The predictive value of Chinese 2008 and UICC 2010 staging system for prognosis were similar, and were better than that of 1992 staging system in NPC.

Drug resistance of Acinetobacter baumannii ( Ab) in surgical ICU from January 2008 to December 2009 was investigated retrospectively. Total 114 clinical strains of Ab were isolated from surgical ICU and 92 strains were from respiratory tract (80.7% ). The prevalence rate of multiresistant Ab in 2009 was higher than that in 2008 (75. 7% vs 50. 0% , x2 = 7. 703, P = 0. 006). The results indicate that to monitor and control drug resistant of Ab constantly is important for the prevention of nosocomial infection.