With a view to some common problems and characteristics of medicine graduate students education,how to intensify the moral education work of medicine graduate students under the new situation is researched and discussed,and some countermeasures and suggestion are put forward in this article.to systemically organize the ideological and political education work for freshmen;to exert the theory guidance of medical ethnics in moral education of graduate students;to intensify education and management in graduate students,and fully play the education role in management and serving;to adopt detailed measures to promote the performance of tutors and specialty departments in teaching,scientific research and academic education;to include medical social practice of poor-salvation into moral education program for medicine graduate students.

OBJECTIVE Learned through the seeing about the infection management of the Japanese Oita Medical University affiliated hospital and analyzed our hospital infection management′s status,to understand the dynamic management of hospital infection.Moreover these suggested that we attach importance to the management of hospital infection and constantly explore new ways of hospital infection management.METHODS According to the comparative presentation of these two hospitals′ awareness and practices of infection management from China and Japan,this paper probed into the direction of our hospital infection management development.RESULTS Hospitals in every country of the world have attached great importance to their infection management,but their specific practices were different.CONCLUSIONS By comparing inspection,every hospital should maintain the individualized characteristics and learn from each others′ strong points to offset their own weakness in order to gain continuous improvement of hospital infection management.

Background Glaucoma is characterized by loss of retinal ganglion cells (RGCs) followed by visual field defects.Spectral domain OCT(SD-OCT) enabled more precise and quantitative assessments of macular ganglion cell complex (GCC) thickness.Objective This study was to evaluate the diagnostic ability of GCC thickness in identifying primary open angle glaucoma (POAG).Methods A prospective study was performed.Seventy POAG patients and 30 healthy volunteers were enrolled in Beijing Tongren Hospital from November 2015 to April 2016.Macular GCC thickness and peripapillary retinal nerve fiber layer (RNFL) thickness were measured with RTVue SD-OCT,and Humphrey perimetry was performed on the eyes.The patients were assigned to the early stage POAG group,advanced POAG group and later stage POAG group based on the mean defect (MD) of visual field.The average,superior,inferior GCC and RNFL,focal loss volume (FLV),and global loss volume (GLV) were measured and compared among the groups.The correlations between GCC thickness or RNFL thickness with MD were evaluated in the POAG eyes.The discrimination capabilities of GCC thickness or RNFL thickness were assessed and compared by using areas under the receiver operating characteristic (ROC) curves (AUC).Results Compared with the normal control group,the average,superior,inferior GCC thickness and RNFL values were evidently reduced,the FLV and GLV were significantly increased in the early stage POAG group,advanced POAG group and later stage POAG group (all at P＜0.001).Compared with the early stage POAG group,the average GCC and RNFL thickness values were significantly reduced,and GLV was increased in the advanced POAG group and later stage POAG group (all at P＜0.05).In the later stage POAG group,superior RNFL was thinner than that in the early stage POAG group (P =0.003).The superior GCC value were lower in the later stage POAG group than that in the early stage POAG group and advanced POAG group (all at P＜0.001).Compared with the early stage POAG group,the inferior GCC and RNFL thicknesses were decreased and the FLV was increased in the advanced POAG group and the later stage POAG group (all at P≤0.01).Linear positive correlations were found between average GCC,superior GCC,inferior GCC,average RNFL,superior RNFL or inferior RNFL and MD (r =0.624,0.583,0.601,0.571,0.447,0.537,all at P＜0.001),and the positive correlations were also seen between average GCC and average RNFL,between superior GCC and superior RNFL or between inferior GCC and inferior RNFL (r =0.648,0.630,0.602,all at P＜0.001).The AUCs were 0.965,0.979,0.924,0.985,0.980,0.990,0.979 and 0.992 in the average GCC,superior GCC,inferior GCC,FLV,GLV,average RNFL,superior RNFL and inferior RNFL,with the largest AUCs in the FLV and inferior RNFL thickness.No significant difference was found in the AUC between FLV and inferior RNFL thickness (P＞0.05).Conclusions Inferior GCC is more susceptible to glaucomatous damage.FLV and GLV from GCC pattern parameters are sensitive indicators for diagnosis of POAG.GCC thickness could be a valid structural parameter for detecting glaucoma and can be used as a marker in glaucoma assessment.

OBJECTIVE: To investigate the preventive and therapeutic effects and the possible mechanisms of Dilingdan Decoction (DLDD), a compound Chinese herbal medicine, on rats with renal tubulointerstitial fibrosis induced by unilateral ureteral obstruction (UUO). METHODS: Sixty SD rats were randomly divided into sham-operated group, untreated group, enalapril-treated group and DLDD-treated group. Blood urea nitrogen (BUN), serum creatinine (SCr), urine protein quantization in 24 hours and pathological changes of the obstructed kidney were observed. The expressions of transforming growth factor-beta1 (TGF-beta1), alpha-smooth muscle actin (alpha-SMA), fibronectin (FN) and laminin (LN) were detected by immunohistochemical method and colored-multimedia pathological image analysis system. RESULTS: Massive inflammatory infiltrates and collagen expression in renal interstitial in the untreated group were observed on the 7th day. Compared with the sham-operated group, percentages of area of TGF-beta1, alpha-SMA, FN and LN expressions in the untreated group were markedly increased (P<0.05), while the percentage of area of interstitial fibrosis was decreased in the DLDD-treated group as compared with the untreated group (P<0.05). On the 14th day, the percentages of area of TGF-beta1, alpha-SMA, FN and LN expressions were declined in two treated groups as compared with the untreated group (P<0.05), but had no statistical difference in biochemical indicators, including BUN, SCr and 24-hour urinary protein. On the 21st day, the level of SCr and the percentage of area of TGF-beta1 expression in the DLDD-treated group were lower than those of the enalapril-treated group (P<0.05). CONCLUSION: DLDD can reduce the excretion of urinary protein and the degree of interstitial fibrosis, and significantly inhibit the expressions of TGF-beta1, alpha-SMA, FN and LN. DLDD is superior to enalapril in protecting renal function after long-time application in rats.

Objective: To observe the clinical efficacy of electroacupuncture and waist-building exercise in treating lumbar disk herniation. Methods: A multi-center, randomized controlled trial was adopted. Three hundred cases of lumbar disk herniations were divided into two groups, an observation group in which 149 cases were treated by electroacupuncture and waist-building exercise, and a control group in which 151 cases were treated by electroacupuncture alone. The clinical efficacy and long-term relapse rate were observed and compared between the two groups. Results: Among 149 cases in the observation group, 80 cases were cured, 57 cases improved, 12 cases failed and 4 cases relapsed; the cure rate was 53.7%, the total effective rate was 91.9% and the relapse rate was 5.0%. Among 151 cases in the control group, 74 cases were cured, 51 cases improved, 26 cases failed and 12 cases relapsed; the cure rate was 49.0%, the total effective rate was 82.8% and the relapse rate was 16.2%. There were significant differences in the cure rate and the total effective rate between the two groups (P<0.05). Conclusion: Combined electroacupuncture and waist-building exercise had better effects than electroacupuncture in treating lumbar disk herniation.

Objective To measure right ventricular longitudinal strain (RVLS) of pulmonary hypertension(PH) patients by two-dimensional speckle tracking echocardiography,and explore its clinical application value on evaluating right ventricular function and hemodynamics in PH.Methods A total of 66 patients diagnosed as PH by right-heart catheterization were divided into Group Ⅰ (WHO FC Ⅰ / Ⅱ) and Group Ⅱ(WHO FC Ⅲ/Ⅳ) according to WHO pulmonary hypertension function classification.The right ventricular function parameters included:global right ventricular longitudinal strain (RVLSglobal),free-wall right ventricular longitudinal strain (RVLSFw),tricuspid annular plane systolic excursion (TAPSE),right ventricular fractional area change (FAC),tissue Doppler-derived tricuspid lateral annular systolic velocity (s') and right ventricular index of myocardial performance (RIMP).Systolic pulmonary artery pressure (sPAP) was calculated through tricuspid regurgitation pressure gradient.Hemodynamic parameters include:mean pulmonary arterial pressure (mPAP),pulmonary vascular resistance (PVR),pulmonary capillary wedge pressure (PCWP) and cardiac index (CI).Results ①Compared with Group Ⅰ,Group Ⅱ presented with higher sPAP (P ＜0.05).There also were significant differences between two groups in RVLSglobal,RVLSFw (P ＜0.01) and conventional right ventricular function parameters:TAPSE,RIMP and s' (P ＜0.05).②mPAP,PVR and CI had significant difference between two groups (P ＜0.01),while PCWP had no significant difference.mPAP and PVR increased more remarkable and CI decreased more significant in Group Ⅱ.③RVLSglobal had positive correlation with mPAP (r =0.646,P =0.000) and PVR (r =0.628,P =0.000) measured by right-heart catheterization;RVLSFW also had positive correlation with mPAP (r =0.652,P =0.000) and PVR (r =0.634,P =0.000).Conclusions Right ventricular longitudinal strain could evaluate the degree of decrease in right ventricular function of PH patients and reflex the change of hemodynamics at the same time,which may offer more reliable information to clinical treatment.

Objective To measure tricuspid annular displacement by two-dimensional speckle tracking echocardiography in pulmonary hypertension (PH) patients,and compare with the right ventricular function parameters,finally discuss the clinical application value of this technology in evaluating the right ventricular function in PH.Methods A total of 58 patients diagnosed or suspected diagnosed as PH were divided into PH group and control group according to pulmonary arterial systolic pressure measured by echocardiography.The right ventricular function parameters included:tricuspid annular plane systolic excursion (TAPSE),right ventricular fractional area change (FAC),tissue Doppler-derived tricuspid lateral annular systolic velocity (s') and right ventricular index of myocardial performance (RIMP).The parameters of tricuspid annular displacement included:the peak systolic tricuspid annular displacement at right ventricular free wall (TMAD1),the peak systolic tricuspid annular displacement at interventricular septum (TMAD2),the peak systolic tricuspid annular displacement at midpoint of tricuspid annulus (TMADm) and the right ventricular longitudinal shortening (TMADm％).Results ① There were significant statistical differences between two groups in TAPSE,RIMP,FAC and s' (P ＜0.01),TMAD1 (P＜0.05),and TMAD2,TMADm and TMADm％ (P ＜0.01).② Area under ROC curve indicated that parameters of tricuspid annular displacement had moderate predictive value in predicting the decline of right ventricular function in PH patients (P ＜0.01).③ Setting 15.5％ as cut-off value for TMADm％ to assessment FAC＜35 ％,TAPSE＜17 mm,RIMP＞0.54 and s'＜9.5 cm/s,their sensitivities were 81.8％,84.4％,85.7％ and 72.3％ respectively,and their specificities were 72.0％,73.1％,70.3％ and 100％ respectively.Conclusions The tricuspid annular tissue displacement parameters can predict the decrease of right ventricular function in patients with PH,and provide a new diagnostic index for clinical treatment and prognosis.

Objective To observe the growth and biological features of bone mesenchymal stem cells (BMSC) from psoriatic patients. Methods Peripheral blood mononuclear cells were isolated from 5 patients with active psoriasis vulgaris and 5 normal human controls, and BMSC were obtained and purified using plastic adherence method followed by primary culture and passage in vitro. The cell morphology, density and growth were observed with microscopy. Cell growth pattern was evaluated by MTT assay. Flow cytometry was applied to identify surface antigens, including CD29, CD34, CD45 and CD106, on these cells. Results No significant difference was observed in the morphology of primary or descendant BMSC between the patients and controls.The primary BMSC from psoriatic patients tended to adhere to the plastic wall later, confluence and grow more slowly compared with those from the controls. The BMSCs from both psoriatic patients anti healthy donors were positive for CD29, but negative for CD34 or CD45. On the 4th day of culture, the BMSC from psoriatic patients exhibited a decrease in proliferation, with the absorbence at 470 nm (A470) being 0.081±0.0066 and 0.095±0.0130, respectively for BMSC from the patients and controls (t=2.358, P<0.05). Conclusion There is a decrease in the proliferation of BMSC from psoriatic patients which show a morphological similarity to those from healthy controls.

Objective To study the formations of several ridges in peripheral artery velocity tracing. Methods The experimental models of constrainting limb and adrenaline were performed in 6 juvenile susscrota domesticas,tbe variations of the external lilac artery velocity tracing observed,and the parameters of peak systolic velocity (PSV), minimum post-systolic velocity (MPV), peak diastolic velocity(PDV) and end diastolic velocity(EDV) were obtained. Results With the increase of downstream circulation resistance, systolic waveshape inclined to acumination, MPV gradually degraded to zero and negatively increased subsequently, diastolic wave amplitude lowered, and EDV gradually decreased to zero. The stronger vasoconstriction was, the more striking the variations were. Conclusions Cardiac ejection forms systolic dominant wave, post-systolic backward ware is the result of backstreaming because of elastic recoil of downstream artery,and diastolic forward ware is the result of blood transient acceleration caused by elastic recoil of upstream artery. Systemic vascular resistance has significant effect on diastolic waveshape,and the occurrence of post-systolic backward ware implies downstream circulation resistance obviously increases.

Objective To study the haemodynamics changes in the proximal upstream artery caused by different degrees of abdominal aorta extremity stenosis.Methods The lateral walls of the abdominal aorta extremity were pinched with the vascular clamp to achieve 1/4,1/2 and 3/4 stenosis or occlusion in 6 juvenile susscrota domesticas,the velocity tracing of the proximal artery recorded,and the parameters of the peak systolic velocity(PSV)and minimum diastolic velocity(MDV)were obtained and statistically analyzed for their correlation with different degrees of abdominal aorta extremity stenosis.Results The diastolic velocity tracing vanished when stenosis reached a certain degree,the needle ridge and low amplitude diastolic velocity tracing emerged when stenosis to a certain extent,and only the needle ridge was present when the abdominal aorta extremity was completely obstructed.PSV reduced with the aggravation of stenosis.Conclusions The proximal upstream artery systolic ridge caused by abdominal aorta extremity stenosis tends to be acUminate,which indicates serious stenosis of the downstream artery.The systolic needle ridge and the absence of diastolic velocity tracing would suggest a complete obstruction of the blood stream in the downstream lumina.