In recent years, many countries in the world has established the projects of medical education objectives. The goals for the projects are to develop a consensus within the medical education community on the attributes that medical students should possess at the time of graduation, and to set several learning objectives that can guide each medical school as it establishes its own program.Chinese medical schools should feel a sense of urgency in responding to the intent of these actives.

Objective To explore the application value of calcium hydroxide agent in root canal disinfection of patients with chronic periapical periodontitis in stomatology department.Methods 108 cases patients with chronic periapical periodontitis from June 2013 to June 2014 in Cixi Guanhaiwei Zhen Health Centers were randomly divided into study group (n =54) and control group (n=54).The control group received camphor phenol cotton for root canal disinfection, and study group received calcium hydroxide agent.The clinical curative effect between two groups was compared.Results After 7 days’ treatment, the total effective rate was 98.15%in study group, which was significantly higher than 79.63%in control group (χ2 =9.375,P<0.05).After follow up 6 months, the total effective rate was 94.44%in study group, which was significantly higher than 77.78%in control group (χ2 =6.271,P<0.05).The incidence of endodontic interappointment pain (EIP) in study group was 11.11%, which was significantly lower than 25.93%of control group (χ2 =3.93,P<0.05).Conclusion Calcium hydroxide agent has a significant efficacy on in root canal disinfection of patients with chronic periapical periodontitis in stomatology department, could reduce the incidence of EIP and promote healing of chronic periapical periodontitis, which is the first disinfectant in the stomatology department of primary hospital.

Aim To observe the effects of amlodipine on cell cycle,cell cycle-related genes and cyclin expression of human breast carcinoma MCF-7 cells.And to probe effects of amlodipine on cell cycle and its mechanism of human breast carcinoma MCF-7 cells.Methods In vitro growth inhibitory effects of amlodip-ine on human breast carcinoma MCF-7 cells were determined by MTT assay,cell cycle distribution was detected by flow cytometry,the Mrna expression levels of cell cycle-related genes cyclinD1 and p21 were treated by RT-PCR,and the protein expression of cell cycle protein cyclinD1 and p21 were assessed by Western blot.Results With dose and time dependently,amlodipine could inhibit the proliferation of human breast carcinoma MCF-7 cells in vitro.The IC_(50) was 14.439 μmol·L~(-1).When breast cancer cells MCF-7 were treated with 7.22 μmol·L~(-1)(1/2 IC_(50)),14.439 μmol·L~(-1)(IC_(50))and 28.88 μmol·L~(-1)(2IC_(50))amlodipine for 48 h,the ratios in the G_0/G_1 phase were significantly increased as compared with control group(P<0.05).Amlodipine inhibited the expression of Mrna and protein of cyclinD1,while increased the expression of Mrna and protein of p21.Conclusions Amlodipine exhibits obvious anti-tumor activities on human breast carcinoma MCF-7 cells and arrest cell cycle in G_1 phase.The mechanism of G_1 phase arresting may be related to modulating the Mrna and protein expression of cell cycle-related gene cyclinD1 and p21.

[Objective]To summarize the experiences of total hip replacement with cementless joint components in the treatment of osteoarthritis secondary to acetabular dysplasia in adults and to evaluate its early effect. [Method]From March 2000 to March 2007, thirty hips in 25 adult patients with osteoarthritis secondary to acetabular dysplasia undergoing total hip replacement with cementless joint components were included in this study. Of the patients, 5 were male and 20 were female.Their ages ranged from 35 to 55 years with an average age of 55 years. The patients mainly complained of pain and claudication. According to the Hartofilakidis classification , Semi-dislocation occurred in 21 hips and high-dislocation in 9 hips.Five patients underwent bilateral total hip replacements and twenty patients had unilateral total hip replacement.[Result]The duration of follow-up ranged from 8 months to 7 years ( average 3 years and 9 months ) . The average Harris score was increased from 36.09 to 88.21 points, They could take care of themselves and returned to their previous job. All the patients were pain-free and there was no sign of aseptic looseing or subsidence.[Conclusion]Total hip replacement with cementless joint components is an effective method for the treatment of osteoarthritis secondray to acetabular dysplasia in adults.The key point to the success for operation are appropriate cementless joint components, deepened medial wall of the acetabulum and improved the techniques of bone graft in the true acetabulum.

Objective To compare the cerebral protection effect of unilateral and bilateral antegrade selective cerebral perfusion during total aortic arch replacement. Methods From June 2003 to March 2004, 16 patients undergoing total aortic arch replacement were divided into two groups, randomized: unilateral antegrade selective cerebral perfusion (unilateral group, n=8) and bilateral antegrade cerebral perfusion (bilateral group, n=8). Preoperative and postoperative brain CT scan were performed. During the operation, the pressure in innominate artery and left common carotid artery were monitored. Blood gas samples were drawn from jugular venous bulb. Results There was no postoperative death and all patients were discharged from hospital. No new brain infarction occurred. Transient neurological dysfunction occurred in 1 patient of each group. In unilateral group, the pressure in innominate artery was higher than that in left common carotid artery during antegrade selective cerebral perfusion (P0.05). Conclusion Both methods of brain protection for patients undergoing total aortic arch replacement resulted in favorable levels of mortality and morbidity. The circle of Willis was patent and collateral flow was adequate. Unilateral antegrade selective cerebral perfusion has the advantage of simplicity. The bilateral perfusion pressure was more even in bilateral antegrade selective cerebral perfusion, and whether bilateral antegrade selective cerebral perfusion carry a higher risk of embolism need further investigation.

Objective To evaluate various immediate managements of traumatic posterior urethral disruption in children. Methods 22 boys,2 to 14 years of age,with pelvic fracture and posterior urethral disruption were treated.There were 5 cases of partial urethral disruption,4 being managed by immediate suprapubic cystostomy and 1 by urethral catheterization.Of 17 cases of complete urethral disruption,6 underwent immediate suprapubic cystostomy with anastomosis of the disrupted ends later.The other 11 cases underwent primary urethral anastomosis via the perineum route. Results All the 5 partial disruption were cured without any complication.In 6 cases of complete urethral disruption with immediate suprapubic cystostomy,delayed repair was undertaken in 5. Of the 11 cases with primary urethral anastomosis,success and satisfactory result have been achieved in 10.Only 1 needed urethrostomy for further management. Conclusions For incomplete urethral disruption suprapubic cystostomy alone is indicated.For complete urethral disruption,primary urethral anastomosis via the perineal route would yield good result with much less chance of complications.

Objective:To study the ultrastructural changes of the junctional epithelial after dental preparation. Methods: Junctional epithelium (JE) of left premaxillary teeth was detached by diamond bur in 8 rabbits (group 1) and by surgical knife in another 8 rabbits (group 2). JE of the right teeth without treatment was used as the controls. 4 animals in each group were sacrificed 1 and 2 weeks after operation respectively.Samples were prepared for transmission electron microscope observation.Results: In the two tested groups reattachment was observed 2 weeks after operation,degeneration of mitochondria in JE cells and destruction of basement membrane were observed. No significant difference was observed between group 1 and group 2.Conclusion: Dental preparation may result in ultrastructural changes of JE cells.

Objective To explore the impact of nursing intervention on quality of life of blood dialysis patients.Methods 60 cases of hemodialysis patients were selected and divided into the experimental group and the control group with 30 patients in each group.The control group was given conventional nursing,while the experimental group was given systematic health education and psychological nursing.The differences in life quality before and after the intervention in the experimental group was evaluated with self-designed questionnaire.The changes in motor function,psychological function,social function,and material life were compared before and after the intervention between two groups.Results After the intervention,the score of motor function,psychological function and total evaluation of the experimental group were higher than those of the control group.Conclusions Nursing intervention can effectively alleviate the discomfort feeling of patients,reduce their mental pressure,increase their quality of life.Nursing intervention is closely related with quality of life.

Objective To investigate the expression of retinol binding protein 4(RBP-4) in maternal scrota and subcutaneous adipose tissue and its relationship with insulin resistance(IR)in gestational diabetes mellitus(GDM).Methods From May 2008 to April 2009,62 pregnant women who underwent elective cesarean section in the Department of Obstetrics.Affiliated Hospital of Qingdao University Medical College,were recruited,including 32 with GDM(GDM group)and 30 with normal glucose tolerance test(control group).Enzyme-linked immunosorbent assay(ELISA)was used to determine the serum concentrations of RBP-4 and radio immunoassay to measure the serum levels of fasting insulin (FINS).Fasting plasma glucose (FPG) was tested by glucose oxidase,and the Home model insulin resistance index(HOMA-IR)Was caleulated.Reverse transcription PCR(RT-PCR)and Western blot were applied to investigate the expression of RBP-4 mRNA and protein in subcutaneous adipose tissue.The correlations between the expression of RBP4 mRNA and protein in subcutaneous adipose tissue and the serum RBP-4 concentrations and HOMA-IR were analyzed. Results (1) The serum concentrations of RBP-4、FINS、FPG、HOMA-IR in GDM group were significantly higher compared with the control group [(27. 0 ±1.2) mg/L vs. (19.4±1.8)mg/L, (12.1±1.4)mU/L vs. (8.3±0.8)mU/L, (5.3±0.9)mmoL/L vs.(4. 1±0. 6) mmol/L, 2. 5 ± 0. 2 vs. 1.5 ± 0. 1, P < 0. 05, respectively]. ( 2 ) The expression of RBP-4 mRNA and protein in subcutaneous adipose tissue in the GDM group were significantly higher than that of the control group (0. 76 ± 0. 12 vs. 0. 53 ± 0. 06, 0. 74± 0. 09 vs 0. 54 ± 0. 06, P < 0. 05). (3) In the GDM group, the expression of both RBP-4 mRNA and protein in the subcutaneous adipose tissue were positively correlated with HOMA-IR(r=0. 575 and 0. 851, P < 0. 05). The serum concentration of RBP-4 were also positively correlated with HOMA-IR (r = 0. 635, P < 0. 05 ). No correlations was found between the expressions of RBP-4 mRNA and protein in subcutaneous adipose tissue with the serume RBP-4 concentrations. Conclusion High expression of RBP-4 mRNA in subcutaneous adipose tissue and the elevation of serum RBP-4 levels in GDM women may contribute to IR.

This study retrospectively analyzed 7 patients with severe pectus excavatum who underwent thoracoscope-assistant Nuss procedure from July 2006 to June 2008.All the participants were followed up for 1 to 24 months(mean,15.7 months).No intraoperative or postoperative complications were found in any of the patients.The operating time was 40 to 55 minutes.Mean hospital stay was 5 days (range,4 to 7days).Our experience with the minimally invasive repair of pectus excavatum might be encouraging.thoracoscope-assistant Nuss could effectively treat pectus excavatum in children,associated with minimal invasion,lower morbidity,less hospital stay,and considerable improvement in physiologic and psychological function.