The cultivation of general practitioner is a key to improve China's community-based medical and health care system.Zunyi Medical University,in the process of cultivating tuition-free students with the mode of serving and staying in the countryside after their graduation,always upholds the principles of being oriented by post competence,being led by medical humanities,optimizing featured courses about general practitioner,carrying out students-centered teaching methodology,focusing on training students' autonomous learning ability,and fully building the practical teaching system,so as to strive to cultivate high-quality talents in the field of general medicine to make them better serve the rural community-based medical institutions.

Objective To further investigate the pathohistology of chronic gastritis in children and the relationship between helicobacter pylori(Hp) infection and mucosal chronic inflammatory.Methods Gastric antrum biopsies were carried out from children who had chronic gastritis confirmed by gastroendoscopy during the past 3 years in our hospital.The results of pathohistological observation were analyzed by retrospectire method.Results One thousand six hundred cases of chronic gastritis were included,in which 1007 cases without Hp infection,593 with Hp infection.Among the patients without Hp infection,mild inflammatory were much more than mode-(rate) or severe inflammatory(86% vs 14%).Although,in patients with Hp infection,mild inflammatory were the most common presentation(63%),moderate and severe inflammatory were more predominant in patients with Hp infection.The degree of inflammatory was increased with the quantity of Hp infection.The ratio of lymphocytes,neutrophils and lymphoid follicles in gastric mucosa was much higher in Hp positive group than negative one(94%,40%,22% vs 60%,11%,5%,respectively),and the difference was significant in statistic analysis.Gastric mucosal atrophy was found more in Hp positive group(16.5%) than negative one(7%).The proportion of intestinal metaplasia in cases with Hp infection was 1.5% compared with 0.1% in these children.Conclusion The study shows that there is a close relationship between Hp and antrun chronic inflammation and mucosal atrophy.

Objective To evaluate the effects of different doses of lidocaine on suppressing fentanyl-induced cough and determine a safe suppressing dose.Methods Two hundred patients undergoing general anesthesia were randomized to four groups evenly.The following medications were given within ten seconds:normal saline 10ml (groupⅠ,control group),lidocaine 1 mg/kg (groupⅡ),lidoeaine 1.5 mg/kg(groupⅢ),lidocaine 2mg/kg (groupⅣ).Toxic symptoms of lidocaine were recorded within lmin after the administration of lidocaine,then fentanyl 3?g/ kg was given intravenously within 5 seconds.Cough incidence and cough grade were recorded within 2rain after the administration of fentanyl.Systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rates (HR),and satu- ration of pulse oximeter(SpO2) were recorded during different time points of induction,all recorded data were anal- ysed by the statistical software,P value

Objective To elucidate clinical significance of the varied concentration of cytokines in patients , the concentration of endothelin-1(ET-1) in cerebrospinal fluid(CSF) and serum were investigated in 36 patients with acute craniocerebral injury .Methods In this study ,36 patients with acute craniocerebral injury were divided into two groups by their GCS scores ( GCS≤12 as moderate-severe injury group ,GCS>12 as mild injury group ) .Concentration of ET-1 in CSF and serum in 36 patients with acute craniocerebral injury were detected by ELISA .Results The con-centration of ET-1 was(38.89 ±9.50)μg/L in cerebrospinal fluid ( CSF) in moderate to severe patients ,which were significantly higher than that in mild injury groups [(22.25 ±8.55)μg/L](t=5.453,P=0.000) and control groups [(15.67 ±7.72)μg/L](t=8.347,P=0.000).And the levels of ET-1 in CSF in the mild injury groups were also obviously higher than that of the control groups (t=2.390,P=0.023).On the other hand,the concentration of ET-1 was(107.02 ±17.25)μg/L in sera in moderate to severe patients ,which were also significantly higher than that in mild injury groups[(46.21 ±11.19)μg/L](t=12.176,P=0.000)and control groups[(32.34 ±10.64)μg/L] (t=16.163,P=0.000).And the levels of ET-1 in sera in the mild injury groups were obviously higher than that of the control groups(t=3.751,P=0.001).The concentration of ET-1 in sera was significantly higher than that of CSF (t=9.974,P=0.000).Conclusion The concentration of ET-1 in CSF and sera in patients with acute craniocere-bral injury were associated with severe of brain injury .

Objective To observe the effect of different intra-abdominal pressure and different time points on hemodynamics,ent-tidal CO_2(P_(ET)CO_2) and airway pressure(Paw) during the procedure of gynecological laparoscopic operations.Methods 60 cases undergoing gynecological laparoscopic operations were randomly divided into two groups:the intra-abdominal pressure was 1.3kPa in groupⅠ(30 cases) and 1.9kPa in groupⅡ(30 cases).ASAⅠgrade.In both groups,systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP), heart rates(HR).S-T.Paw and P_(ET)CO_2 were monitored and recorded before anesthesia(T_0),shortly after intubation (T_1),pre-pneumoperitoneum (T_2),5min after pneumoperitoneum (supine position) (T_3) and 5min (T_4),10min (T_5),20min(T_6),30min (T_7) after trendelenbury position (head down 200) and 5rain after deflation (T_8).Results In both groups SBP,DBP,MAP at time point T_3,T_4,T_5 were increased significantly compared with those of T_0 (P0.05),but there was significant difference in Paw and P_(ET)CO_2 in different time points within the same group and between the same time point in different groups after pneumoperitoneum(P

Objective To address the neural basis of Chinese idioms processing with different kinds of stimuli using an event-related fMRI design.Methods Sixteen native Chinese speakers were asked to perform a semantic decision task during fMRI scanning.Three kinds of stimuli were used: Real idioms (Real-idiom condition);Literally plausible phrases (Pseudo-idiom condition,the last character of a real idiom was replaced by a character with similar meaning);Literally implausible strings (Non-idiom condition,the last character of a real idiom was replaced by a character with unrelated meaning).Reaction time and correct rate were recorded at the same time.Results The error rate was 2.6%,5.2% and 0.9% (F = 3.51,P0.05 )for real idioms,pseudo-idioms and wrong idioms, respectively.Similar neural network was activated in all of the three conditions.However,the right hippocampus was only activated in the real idiom condition,and significant activations were found in anterior portion of left inferior frontal gyrus (BA47)in real-and pseudo-idiom conditions,but not in non-idiom condition.Conclusion The right hippocampus plays a specific role in the particular wording of the Chinese idioms.And the left anterior inferior frontal gyms (BA47)may be engaged in the semantic processing of Chinese idioms.The results support the notion that there were specific neural bases for Chinese idioms processing.

Objective To investigate the outcome of the free double-skin paddle string-type composite fibular flap in the reconstruction of the combined defects of ulna and radium. Methods From June 2005 to July 2009, 5 cases with combined defects of ulna and radium were reconstructed using the free double-skin paddle string-type composite fibular flap. The length of fibular segment for the reconstruction of ulnar defect ranges from 4.5 to 7.5 cm. The length of fibular segment for the reconstruction of radial defect ranges from 5.5 to 7.0 cm. The size of the flap varies from 5.0 cm × 3.0 cm to 8.0 cm × 5.5 cm. At the 12 month follow-up, the function of reconstructed forearm was evaluated based upon Enneking scoring system.Results Ten flaps in the 5 cases all survived. The time for the transplanted fibula healed on the radium and ulna was 4-6 months. The 5 patients were followed up from 14 months to 2 years. The forearm rotation functions were excellent in 2 cases, good in 2 cases and poor in 1 case. The eligible rate was 80%. The average Enneking score was 24.8, which indicated an average of 81.3% recovery of limb function. Conclusion Bone graft with blood supply can ensure the activity of osteocytes, which facilitates the fracture union.Whilst, the procedure can reconstruct multi-location and multi-tissue defects in the forearm. Therefore, the double-skin paddle string-type composite fibular flap is an ideal alternative for the reconstruction of the combined defects of ulna and radium and the skin.

Background The establishment of diabetic animal model is a crucial step for the study about diabetic eye diseases. At present,the main modeling method include the injection of streptozotocin and alloxan. But the shortcoming of the former is an expensive price, and that of the later is high death rate of animals. Objective This experiment was to discuss the way which decrease the death of alloxan-injected animal and explore the effects of high blood glucose on the posterior capsular opacification (PCO). Methods Forty clean healthy male New Zealand white rabbits were randomly divided into 2 groups. 90mg/kg of alloxan were injected via ear vein once in 20 rabbits to create the diabetic animal models,and the equivalent amount of normal saline solution was injected at the same way as normal blood glucose group. The successful models were selected in the animals with the blood glucose level over 12. 0 mmol/L two weeks later, and PCO of lens were graded based on the method of Odrieh under the slit lamp. Extracapsular lens extraction was then performed on the right eye of rabbits in both groups, and the posterior capsules were obtained from these eyes at the 6th, 10th and 14th days after operation. The expression of proliferating cell nuclear antigen ( PCNA ) in posterior capsular lens epithelial cell was detected by immunohistochemistry. Results The modeling successful rate was 70% after injection of alloxan. The body weight of rabbits in high blood glucose group was significantly lowed and the blood glucose was significantly elevated in comparison with normal blood glucose group ( all P<0. 05). Two weeks after surgery ,2 eyes occurred 2 grade of PCO and only one eye showed the 1 grade of PCO in the high blood glucose group. However, 1 grade of PCO was found in 3 eyes in the normal blood glucose group. Biopsy revealed that PCNA was positively expressed in the cell nuclei of LECs in high blood glucose group rather than the normal blood glucose group from the 10th day after surgery. The proliferation index of PCNA was 0. 86±0. 04 and 0. 25±0. 03 respectively in high blood glucose group and normal blood glucose group, showing a significant difference between them (t = -16. 171 ,P = 0. 000). Conclusion Stable diabetic models of rabbits can be created by intravenous injection of 90 mg/kg alloxan. High blood glucose level is one of the important factors for the development of PCO.

This study examined the current changes of human ether-a-go-go-related gene (hERG) mutation derived from a LQT2 Chinese family with a highly penetrating phenotype. Mutation was identified and site-directed mutagenesis was performed to induce the mutation in wild-type (WT) hERG. WT hERG and mutated V535M were cloned and transiently expressed in HEK293 cells. At the 48th and 72nd h after transfection, membrane currents were recorded using whole cell patch-clamp procedures. An A>G transition at 1605 resulting in replacement of V535M was identified. Compared to WT, V535M mutation significantly decreased tail currents of hERG. At test potential of -40 mV after depolarizing at +50 mV, tail current densities were 83.35±7.06 pA/pF in WT and 50.38±7.74 pA/pF in V535M respectively (n=20, P<0.01). Gating kinetics of hERG revealed that V (1/2) of steady-state inactivation shifted to negative potential in the mutant (V (1/2,V535M): -61.81±1.7 mV vs. V (1/2, WT): -43.1±0.71 mV). The time constant of recovery from inactivation was markedly prolonged in the mutant compared to WT among test potentials. V535M hERG mutation demonstrated markedly decreased tail current densities, which suggests that V535M is a new loss-of-function mutation of hERG channel responsible for LQT2.

Objective To assess the contrast-enhanced ultrasound (CEUS) characteristics of pleomorphic adenoma (PA) and carcinoma ex pleomorphic adenoma (CXPA).Methods A retrospective analyse was made from the contrast-enhanced ultrasonic features of 42 PA and 8 CXPA.The features included tumor size,echotexture,boundary,shape and blood flow richness on conventional US imaging and rise time (RT),time to peak (TP),peak intensity(PI),time from peak to one half(HT),mean transit time (MTT),and area under the curve(AUC) on contrast-enhanced ultrasound.Results All of PA and CXPA were hypoechoic,but there was no difference between them in shape and blood flow richness (P ＞0.05).37.5％ CXPA has hetergeneous echotexture with the presence of anechoic area,but it appeared in only 4.8％ PA(P ＜0.05).The following findings were observed from a perfusion kinetics of CEUS in all of PA and CXPA:slow in,centripetal,heterogeneous enhancement,with no enhancement area.Well-defined margins were presented in 42 PA and in 7 CXPA(P ＜0.05).Their time-intensity curves showed RT,TP,HT and MTT in CXPA group were obviously higher than those in the PA group(P ＜0.05).However there was no statistical difference in PI and AUC between both groups (P ＞ 0.05).Conclusions Conventional US and CEUS perfusion patten provide limited diagnostic information for distinguishing PA from CXPA.CXPA could be diagnosed by ill defined margins,more internal anechoic area and poorly defined margins.But CEUS quantitative analysis can significantly promote the differentiation.