Improvement of the review of dissertation for doctoral degree is important for the training of qualified doctors.Current practice includes double-blind review and open review.This paper compares and analyses the outcome of the two kinds of reviews and found that double-blind review is more objective that the other(the mean of open review score is 96.39±2.069,the mean of double-blind review score is 85.18±6.635.P=0.001,P＜0.01).In the end some suggestions are proposed to improve the double-blind review system.

The paper analysed the double-blind review result of Ph.D candidates' dissertation at Peking University People's Hospital.Rigor deficiency and inadequate knowledge about the research subjects were identified as the main problems.In the end some suggestions were proposed from two aspects,namely,full-process management of Ph.D training and supervisor-team construction.

Postgraduate administration is faced with new challenge in the affiliated clinical hospital because of the increasing quantity of postgraduates.The paper analyzed the characteristics of postgraduate administration and the status quo of information system construction in the affiliated clinical hospital and proposed the ideas of constructing information system for postgraduate administration from three aspects including system-frame,system-function and system-management.The purpose of the study was to provide reference for improving quality of postgraduate administration.

Objective To construct and implement theSTARnurse training model, and discuss its application effect and the problems that should be paid attention to, and to provide operational cases and practical basis for nursing clinical education. Methods Through literature review and expert consultation, the framework and content of STAR nurse training model were set up and implemented. The questionnaire survey and semi structured in-depth interviews were conducted among the nurses in the hospital to evaluate the effect of improving the nurses′self-directed learning ability. Results After the implementation of the project, the scores of the three dimensions of self-management, desire for study and self-control were (3.67±0.57), (4.05±0.54), (3.99±0.50) points, which were higher than (3.55±0.49), (3.71± 0.52), (3.53±0.42) points before implementation. The difference was statistically significant (P<0.05 or 0.01). The semi structured in-depth interviews showed that all the nurses believed that STAR nurse training model could promote independent learning and stimulate interest in learning. 14 nurses thought it was beneficial for the nurses to find the problems. Conclusions STAR nurse training model can create a favorable learning environment for nurses, and stimulate the learning motivation. It plays a positive role in improving nurses′ability of self-directed learning.

Traditional Chinese Medicine as a rare heritage from our progenitor is becoming more and more important in the world. A lot of foreign students have come to China for learning TCM , and the number of foreign students has increased with time. A lot of issues occur during the teaching process for the foreign students. The problems including the source of students' quality, language, teaching material and clinic practice during the teaching process for the foreign students were ana-lyzed in the article, and the resolutions according to the problems were put forward to attract more and more foreign students to learn TCM and promote TCM in the world.

Objective: To investigate the in vitro antibacterial activity of triclosan combined with different antibacterial agents against triclosan-resistant multidrug-resistant Acinetobacter baumannii (A.baumannii). Methods: A total of 626 A. baumannii strains were collected from the First Affiliated Hospital of Wenzhou Medical University from 2016 to 2017. The sensitivity of these A. baumannii strains to common antibiotics was detected by VITEK 2-compact automatical microbiological analyzer and the minimum inhibitory concentrations (MIC) of triclosan were detected by agar dilution method. Checkerboard method was used to detect the changes in MIC values of triclosan against 16 triclosan-resistant multidrug-resistant A. baumannii strains after it was used in combination with four external ointments, including gentamicin, erythromycin, chloramphenicol and kanamycin, and three common antibiotics of imipenem, meropenem and ciprofloxacin, respectively. Fractional inhibitory concentration index (FICI) was used to evaluate the joint bacteriostatic effects. Results: Among the 626 A. baumannii strains, 17 were resistant to triclosan with a drug resistance rate of 2.7% (17/626). These triclosan-resistant strains had high MIC values for ciprofloxacin, imipenem, ceftazidime and other commonly used clinical antibiotic and most of them were multidrug-resistant. After triclosan was used in combination with seven different antibacterial drugs, the MIC values of all drugs decreased to various degrees compared with those when they were used alone. Triclosan in combination with gentamicin, chloramphenicol and ciprofloxacin showed synergistic effects on 62.5%, 56.25% and 62.5% of the 16 strains and additive effects on 37.5%, 43.75% and 37.5%, respectively. When it was used in combination with erythromycin, kanamycin, imipenem and meropenem, synergistic effects on 37.5%, 25%, 12.5% and 12.5%, additive effects on 37.5%, 56.25%, 62.5% and 62.5%, and indifferent effects on 25%, 18.75%, 25% and 25% of the strains were detected, respectively. No antagonistic effect was found between triclosan and any of the above antibiotics. Conclusions Triclosan combined with gentamicin, chloramphenicol and ciprofloxacin had better in vitro antibacterial effects against the triclosan-resistant multidrug-resistant A. baumannii strains in this study with synergistic and additive effects. Some indifferent effects were found between triclosan and kanamycin, erythromycin, imipenem and meropenem, but no antagonistic effects were detected.

Objective To investigate the chlorhexidine acetate-resistance in Klebsiella pneumoniae ( K. pneumoniae) clinical isolates and to analyze the possible mechanisms and molecular epidemiology of re-sistant isolates. Methods A total of 332 K. pneumoniae clinical isolates were collected in the First Affilia-ted Hospital of Wenzhou Medical University in 2015. Standard agar dilution was used to screen chlorhexidine acetate-resistant isolates. The minimum inhibition concentrations ( MIC) of chlorhexidine acetate to resistant isolates with and without the presence of carbonyl cyanide m-chlorophenyl hydrazone ( CCCP) , which was an efflux pump inhibitor, were analyzed. Efflux pump genes of cepA, qacE and qacΔE1 that carried by and ex-pressed in those isolates were detected by polymerase chain reaction ( PCR) and quantitative real-time PCR ( RT-qPCR) , respectively. The biofilm formation ability was measured by crystal violet staining. The homol-ogy among the chlorhexidine acetate-resistant isolates was investigated with multilocus sequence typing ( MLST) and pulsed-field gel electrophoresis ( PFGE) . Results Twenty-five K. pneumoniae strains were re-sistant to chlorhexidine acetate. The MIC values of chlorhexidine acetate for them were reduced by at least four-fold in the presence of CCCP. Strains carrying the genes of cepA, qacE and qacΔE1 accounted for 100％, 40％ and 40％, respectively. The expression of the efflux pump genes in the chlorhexidine acetate-resistant isolates was higher than that in the susceptible isolates. The biofilm formation ability of the chlo-rhexidine acetate-resistant isolates was better than that of the susceptible isolates. Furthermore, negative, weak-positive and positive biofilm formation ability was observed in four ( 16％) , 20 ( 80％) and one (4％) strains, respectively. The results of MLST and PFGE showed that the 25 chlorhexidine acetate-resist-ant isolates belonged to 19 different sequence types ( ST) with diverse PFGE patterns. Conclusions This study suggested that active efflux was the main mechanism of chlorhexidine acetate resistance in K. pneumoni-ae. The 25 chlorhexidine acetate-resistant K. pneumoniae strains possessed different biofilm formation ability and shared low homology.

OBJECTIVETo observe the effect of activation of Notch1 signaling pathway by Notch intracellular domain (NICD) plasmid transfection on pancreatic cancer cell proliferation and explore the underlying mechanism.

METHODSThe transfection rates were observed under microscope with fluorescence stimulation, and mRNA expression levels of Hes1 were detected by real-time PCR. Cell proliferation changes were evaluated by CCK-8 after NICD and control plasmid transfection in pancreatic cancer cells. Caspase 3 activity was examined using a caspase 3 detection kit.

RESULTSThe transfection rates of NICD plasmid were up to 80% by fluorescence stimulation observation. Hes1 expression was significantly increased after NICD plasmid transfection, suggesting the activation of Notch1 signaling pathway. NICD plasmid transfection significantly promoted cancer cell proliferation compared to control plasmid transfeciton. The activities of caspase 3 were obviously decreased after NICD plasmid transfection in 3 pancreatic cancer cell lines.

CONCLUSIONActivation of Notch1 signaling pathway by NICD plasmid transfection can promote the proliferation of pancreatic cancer cells by inhibiting the apoptosis pathway.

Apoptosis ; Basic Helix-Loop-Helix Transcription Factors ; metabolism ; Caspase 3 ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; Homeodomain Proteins ; metabolism ; Humans ; Pancreatic Neoplasms ; metabolism ; pathology ; Plasmids ; Receptor, Notch1 ; genetics ; metabolism ; Signal Transduction ; Transcription Factor HES-1 ; Transfection

Objective To investigate the outcomes and relative risk factors in subjects with impaired fasting glucose in Inner Mongolia,China.Method A total number of 32 villages in Kezuohou Banner and Naiman areas in Inner Mongolia were selected as the baseline surveys study fields from 2002 to 2003.Patients with IFG(5.6 mmol/L≤FPG＜7.0 mmol/L) but without history of diabetes were selected as the study subjects.A follow-up study was conducted in 2013.Multinomial logistic regression analysis was used to evaluate the correlated factors.Results There were 384 patients with IFG recruited in the study.Out of them,150 (39.1％) progressed to normoglycaemia,174 (45.3％) remained as IFG,and 60 (15.6％) developed into type 2 diabetes mellitus.Through adjustment multivariately,patients that returning to the status of normoglycaemia were significantly associated under the function of TG (OR=0.692,95％CI:0.502-0.952,P＜0.05) and those developed to diabetes were significantly associated with factors as age (OR=1.052,95％CI:1.014-1.090,P＜ 0.05) or obesity (OR=2.924,95％ CI:1.353-6.320,P＜0.05).Conclusion 15.6％ of the IFG patients developed diabetes mellitus among the Inner Mongolian population.Elevated TG was an inhibition factor for patients returning to normoglycaemia while both age and abdominal obesity were risk factors for the development of diabetes in the Inner Mongolian population.

Purpose: Higher neutrophil-lymphocyte ratio (NLRs) indicate a pro-inflammatory state and are associated with poor survival. Conversely, higher albumin-globulin ratio (AGRs) may be associated with improved prognosis. We aimed to investigate the association between NLR and AGR and prognosis and survival in patients with breast cancer. Methods: This retrospective study included all patients with stage I–III breast cancer between 2011 and 2017 in Singapore General Hospital and National Cancer Center Singapore.Multivariate logistic regression analysis of NLR, AGR, age, stage, grade, and subtype was performed. Survival data between groups were compared using Cox regression analysis and log-rank tests. Results: A total of 1,188 patients were included, of whom 323 received neoadjuvant chemotherapy (NACT) and 865 underwent upfront surgery. In patients who underwent NACT, a higher AGR was significantly associated with a higher pCR rate (cut-off > 1.28; odds ratio [OR], 2.03; 95% confidence interval [CI], 1.13–3.74; p = 0.020), better DFS (cut off > 1.55; hazard ratio [HR], 0.37; 95% CI, 0.16–0.85; p = 0.019), and better CSS (cut off > 1.46; HR, 0.39; 95% CI, 0.17–0.92; p = 0.031). Higher NLR was significantly associated with worse DFS (cut off > 4.09; HR, 1.77; 95% CI, 1.07–2.91; p = 0.026) and worse CSS (cut off > 4.09; HR, 1.98; 95% CI, 1.11–3.53; p = 0.021). In patients who underwent upfront surgery, higher AGR correlated with significantly better OS (cut off > 1.17; HR, 0.54; 95% CI, 0.36–0.82; p = 0.004) and higher NLR correlated with worse OS (cut off > 2.38; HR, 1.63; 95% CI, 1.09–2.44; p = 0.018). Conclusion NLR and AGR are useful in predicting the response to NACT as well as prognosis of patients with breast cancer. Further studies are needed to explore their value in clinical decision making.