In view of the lack of health resources and medical treatment in Cangzhou City,especially at grass-roots level,Cangzhou medical college innovated the training mode for clinical medical students and actively explored the cooperation between school and hospital in the educational practice in an aim to improve the quality of talent training and to cultivate high-leveled specialized talents willing to stay in hospitals at grass-roots level and be useful.

Secreted protein acidic and rich in cysteine (SPARC) is expressed in esophageal cancer abnormally.On the one hand,recent studies show that high SPARC expression is correlated with progression and metastasis of esophageal cancer.On the other hand,high SPARC expression increases chemosensitivity and improves short-term efficacy in patients.

The habenula complex,an ancient and conservative nucleus during biological evolution, is involved in many i mportant biological functions,such as maternal behavior,pain,sleep,learning and reward.As an important node in the dopamine reward network,its functions(including the maintenance of individual survival while avoiding disadvantages)and mechanis m in the reward process have attracted wide attention.The dysfunction of habenula is closely related to many psychotic disorders,such as de-pression,schizophrenia and drug habituation.Habenula may also become a potential target for clinical treatment of these mental illnesses.So clarifying the role and neurobiological mechanisms of habenula in the central nervous system is of great theoretical and clinical value.

Objective To investigate the diagnosis judgment values of trimester ultrasound screening for simple single umbilical artery fetal malformation.Methods From January 2011 to January 2015,selected the 15-28 weeks pregnant singleton pregnancies in Shunyi Hospital of Beijing Chinese Medicine Hospital for system fetal ultrasound,in which the single umbilical artery group of 50 patients,50 cases of healthy pregnant women (control group),the two groups were carried ultrasound screening with single umbilical artery flow spectrum analysis,and observed the prognosis.Results The single umbilical artery fetal bladder after abdominal oblique horizontal cross-section of the umbilical artery bypass saw one side of the bladder,and there were 24 patients the malformations with the incidence rate was 48.0％.In the two groups can be clearly demonstrated umbilical artery condition,but the umbilical artery pulsation index(PI),arterial resistance index (RI) and peak valley ratio of umbilical artery blood flow velocity (S/D) value in the single umbilical artery group were 1.02±0.17,0.66±0.06 and 3.08 ±0.57,significantly higher than those of the control group (0.75 ± 0.21,0.53 ± 0.08,2.11±0.27;t=7.298,11.874,15.983,P＜ 0.05).In the single umbilical artery group,there were 32 patients of abortion,10 patients of birth were,8 patients ogpregnancy.Perinatal death in 8 cases,the mortality rate was 16.0％,the single umbilical artery fetal malformations of perinatal mortality was significantly higher than that of children with simple single fetal umbilical artery (x2 =9.333,P ＜ 0.05).Conclusion Trimester ultrasound screening for single umbilical artery combined with simple two-dimensional ultrasound and umbilical arteryblood flow velocity conditions can improve fetal malformations value judgment,provide a reliable detection method to reduce oerinatal mortality.

Purpose:To study the efficacies and adverse effects of three different regimens in treatment of patients with gastrointestinal adenocarcinoma, which consisted of two doses of CF(20 mg/m 2, 200 mg/m 2) and two methods of administration of 5-Fu (continuous intravenous infusion and two hours per day intravenously) and DDP 20 mg/m 2. Methods:We selected 36 cases with GI adenocarcinoma and randomizedly divided them into A and B groups, who were hospitalized from January 1999 to November 2000. At the same time, 29 cases hospitalized from April 1997 to December 1998 with the same disease were designated as C group (control) . A group: CF 200 mg/(m 2.d) for 5 days, 2 hours intravenously ; 5-Fu 3 g/m 2 , continuous intravenous infusion during 5 days; DDP 20 mg/(m 2.d) for 5 days, 2 hours IV. B group: CF 20mg/(m 2.d) for 5 days, 2 hours, IV.; the dosage and usage of 5-Fu and DDP as A group. C group: CF 200 mg/m 2, usage as A, B groups; 5-Fu 600 mg/(m 2.d) for 5 days, 2 hours; dosage and usage of DDP as A, B groups. One cycle of these regimens consisted of three weeks and they were evaluated after three cycles. Results:There were 8 cases of gastral cancer and 12 of rectal cancer in A group whose response rates were 50% and 41.7% respectively. B group had 7 cases of gastric cancer and 9 cases of rectal cancer, their response rates were 42.9% and 44.4%. C group consisted of 14 cases of gastric cancer and 15 cases of rectal cancer, whose response rates were 35.7%and 40%, respectively. Adverse effects included hematological, renal and bladder and gastrointestinal toxicity. A group was similar to B group. C group had more renal and bladder toxicities(27.5%) and incidence of phlebitis was 34.5%. Conclusions:Combination regimen of low dose of CF, continuous intravenous infusion of 5-Fu and DDP is of better efficacy, tolerance and relative economy, especially suitable for to the elderly patients.

Objective To discuss the correlation of the p53 overexpression and human papilloma virus (HPV) infection with the occurrence, development of the vulvar squamous cell carcinoma in elderly women. Methods Samples from 68 patients with vulvar squamous cell carcinoma and samples of formalin-fixed paraffin-embedded blocks from 38 patients with vulvar dystrophy were determined by immunohistochemistry. HPV infection was examined with monoclonal or polyclonal antibodies. Fifteen normal vulvar skin samples were used as controls. Results Positive expression rate of p53 and HPV in vulvar squamous cell carcinoma samples were 54.4% and 45.6% respectively, in the dystrophy samples were 18.4% and 55.3% respectively. All showed significant difference between the two groups. None was positive in the controls. Conclusions There are high expression of p53 and HPV in the elderly women with vulvar squamous cell carcinoma. p53 mutation and high risk HPV infection play an important role in the development of vulvar squamous cell carcinoma.

Objective To evaluate the expression of adhesion molecules CD62,CD63 and abnormal functional status of platelets in women with preeclmpsia and their relation to progression.Methods The expression of surface antigens CD62,CD63 in peripheral blood and functional status of platelets were measured by flow cytometry in 68 women with preeclmpsia,30 non-pregnant normal women and 52 normal pregnancy women as the controls.Results There was no significant difference among defferent stages in normal pregnant women,but the CD62,CD63 positive platelets were (7 41?1 98)%,(12 99?2 37)% and (36 52?8 92)% respectively for mild,moderate and severe preeclmpsia,it double high (P

Objective To evaluate whether the forced expiratory volume in sixth scend(FEV6) was the optimal surrogate for forced vital capacity (FVC) in the diagnosis for chronic obstructive pulmonary disease (COPD).Methods Retrospectively analyzed the spirometric data of 142 COPD patients (7 cases with mild COPD,60 cases with moderate COPD,48 cases with severe COPD,27 cases with extremely severe COPD) admitted to Hebei Chest Hospital from October 2011 to October 2012 who had FEV6 data.FEV6,FEV5,FEV4 and FEV3 were measured on volume-time curves and the diagnostic value was analyzed.Results FEV6,FEV5,FEV4 and FEV3 were highly correlated to FVC (r =0.994,0.939,0.935 and 0.923 respectively,P ＜0.001).Assuming =70％ as the diagnostic standard for obstruction,FEV1/FEV6 had a diagnostic rate of 92.96％ with a false negative rate of 7.04％.FEV1/FEV5,FEV1/FEV4 and FEV1/FEV3 had higher false negative rates (9.86％,13.38％ and 27.46％ respectively) than FEV6.The value of FEV1/FEV6-FEV1/FVC had no statistical significance between the mild-moderate and the severe-extremely severe COPD groups(t =1.376,P =0.171).Conclusion There is a strong correlation between FEV6 and FVC.FEV6 may be the best surrogate for FVC in the diagnosis of chronic obstructive pulmonary disease.Elevating diagnostic critical value can reduce the false negative rate.

Objective To investigate the diagnosis and treatment of cervical intraepithelial neoplasia and their clinical effect Methods The cases who were diagnosed as CIN through cytology, colposcopy biopsy and histopathological diagnosis were collected from January 2004 to June 2009 in Songjiang Hospital Affiliated to Shanghai Jiaotong University School. Drug therapy, physical therapy, cervical conization and hysterectomy were performed according to the lesion degree of CIN and patients' willingness. Some cases were further treated with surgery, radiotherapy or chemotherapy according to the pathological findings of the initial excision specimens. With long-term follow-up at 6,24 months after the treatment,we performed a comparative analysis on pathological diagnosis and therapeutic effects. Results Seven hundred and fifty cases of CIN were diagnosed after cervical cancer screening,among which,460 cases of CIN Ⅰ ,180 cases of CINⅢⅡ and 110 cases of CIN Ⅲ. Five hundred and Senventy-eight cases received treatment, among which, 46 cases received drug treatment After 6 months, focus disappeared in 32 cases, sustained in 10 cases, upgraded in 2 cases and canceration occurred in 2 cases. 13 cases received physical therapy,no recurrence occured. Four hundred and thirty-five cases received conization treatment, 34 cases with focus upgraded and 4 case recurred after the operation. 84 cases received hysterectomy, of which, 11 cases focus upgraded after the operation and no recurrence. The cases with focus upgraded or recurred all received additional treatment. The effective rate of physical therapy,conization treatment and hysterectomy on all grades of CIN was more than 98% at 2 years, and 69. 7% of drug treatment. The omission diagnostic rate of colposcopy guided biopsy on invasive carcinoma was 2. 2% , and the residual rate of focus of hysterectomy specimens after conization was 16. 2% . Conclusion Colposcopy including multi-point biopsy has high accuracy and specificity in early diagnosis of CIN . Cervical conization is the main method of the treatment of CIN. Patients with CIN Ⅲ and without desire of fertility should consider the removal of the uterus after cervical conization. Drug conservative therapy of CIN should be chosen carefully.

Objective To assess the efficacy of high intensity focused ultrasound (HIFU) for the ablation of feeding-artery in uterine fibroids.Methods A total of 45 women with uterine fibroids who had children accepted HIFU treatment.Color Doppler and contrast-enhanced ultrasound were used to target the supply vessels entered the fibroid.HIFU treatment was focused primarily on locations where supplying vessels entered the fibroid.Conventional ultrasound,color Doppler ultrasound,contrast-enhanced ultrasound and MRI were performed before and after HIFU treatment to observe the changes of imaging.Results After HIFU treatment,the volume of uterine fibroids decreased to certain extent.The blood signals decreased or disappeared in the treated regions.Bewteen two groups of the uterine fibroids diamete ≥5 cm and ＜5 cm,there were significant differences in the percentage of the nonperfusion regions in the volume of uterine fibroids (≥70％,P ＜0.05).Conclusions Ablation of feeding artery by HIFU is an effective treatment for the uterine fibroids.HIFU treatment is effective for the ablation of feeding-artery in uterine fibroids whose diameter less than 5 cm.