A questionaire before class,an analysis and an interview after exam were applied to evaluate the effect of bilingual teaching in biochemistry to provide important experiences and directions for carrying out bibingual teaching in the future.

For the reform and development of clinical laboratory education, based on the previous course reform, Laboratory Medicine College of Chongqing Medical University has put the leading teachers'responsibility system of laboratory medicine course into practice. In the recent 3 years, the course is better organized.The students are more interested in the course and they communicate more with teachers than ever before. The effect of the course is obvious. The leading teachers' responsibility system in laboratory medicine course should be promoted.

Objective To explore the technology of excision,and finishing on donative pancreas during combined pancreas-kidney transplantation.Methods We successfully harvested multiple abdominal organs together on 40 cases.Wide surgical exposure was obtained.Cannulas were placed for in situ cooling in portal vein and abdominal aorta,and flushed with HC-A (2000 ml) and UW (1000 ml) with the pressure being 10 cm H2O.The intestine was flushed with 0～4 ( normal saline (1000 ml) and metronidazole (200 ml),the liver,kidney,pancreas,spleen and duodenum were en bloc excised and isolated,and the pancreas and kidney were pruned.Results Excision of donative abdominal organ was successfully performed on all 40 cases.The en bloc warm ischemic time was 3.2 min (2～5 min).The cold ischemic time of pancreas was 10.6 h (8～15 h).The cold ischemic time of kidney was 8.5 h (4～16 h).Post-operation mean withdrawal-insulin time was 9.5 days (4～17 d),FFG 6.7 μmol/L (4.4～10.7 μmol/L),GHbA1c 4.4 ％ (4.1 ％～4.7 ％).Creatine was 87.2 (56～121) μmol/L one month after operation.There were 2 cases of DGF after operation,and the creatine level was returned to the normal within one month after operation.Conclusion Technology of excision,preservation and finishing on donative pancreas for combined pancreas-kidney transplantation was one of the key points for successful transplantation.

Objective To analyze the complications, treatments and prognosis of simultaneous pancreas-kidney transplantation. Methods Forty cases of simultaneous pancreas-kidney transplantation performed between Dec. 1999 and Jan. 2010 in our center were retrospectively analyzed. Results Regarding surgical complications, 4 cases had severe hematuria after operation,which needed clinical intervention, including 1 patient receiving catheterization in duodenum to stop bleeding. Two patients were treated with continuous bladder irrigation, and the remaining one received surgical haemostasis because of donor's duodenum and bladder anastomotic artery hemorrhage.Abdominal hemorrhage occurred in 4 patients, including pancreatic hemorrhage in 3 cases and duodenal muscularis hemorrhage in one case. All of them received surgical treatment for hemostasis.Abdominal infection occurred in 8 cases: one died of multiple organ failure, 2 cases were cured after drainage of abscess, 2 cases underwent surgical removal of abscess, and 3 cases were cured after antibiotic therapy. In one case of postoperative anastomotic leakage, pancreas was resected. Four cases of postoperative ileus were cured by continuous clysis with traditional Chinese medicine. Seven cases had pulmonary bacterial infections, including one cases associated with fungal infection. They were cured by the anti-infective treatment. Other complication included poor healing in 5 cases and urinary infection in 2 cases. After combined simultaneous pancreas-kidney transplantation, 10 patients received reoperation because of surgical complications (14 operations). The re-operation rate was 25 %, including 2 patients (4 operations) for hematuria, 4 patients for abdominal hemorrhage, 2 patients (3 operations) for abdominal infection, 1 patient for pancreatic venous thrombosis, 1 patient for anastomotic leakage, and 1 patient for pancreatic fistula. Conclusion Although simultaneous pancreas-kidney transplantation provides a successful and effective treatment for diabetics with endstage renal disease, surgical complication is still affecting the pancreas and kidney grafts after transplantation.

Objective To investigate the clinical effects of tube flushing in donor duodenum to prevent the hematuria post combined pancreas-kidney transplantation(SPK)with pancreatic fluid drainage through bladder.Methods 18 cases of diabetic patients associated with end-stage renal disease were subjected to combined pancreas-kidney transplantation with pancreatic fluid drainage through bladder,within which 12 cases were pre-placed douche tube in donor duodenum,while the other six were not.As for the cases in group with the tube,T tube of No.10 was put in the donor duodenum through the abdominal wall and then bladder.After that the tube was fixed using 5-0 absorbable suture,then the bladder sutured if the tube was smooth confirmed by flushing with saline.After the operation,flushing was maintained using saline consecutively with the speed of 500 ml/h through the douche tubes of these 12 patients.Then the speed was changed to 250 ml/h 3 days later if the flushing fluid was limpid.One week later,changed to rinse intermittently and prolonged the flushing interval gradually.Till 14 days post the operation,flushing was ceased.After 2 days' survey,the urethral catheter was removed.As for the other 6 cases without douche tube,the urethral catheter was removed during 7-10 days after the operation if hematuria didn't occur.Results In the 12 cases with douche tube,there was only one patient(8.3 %,1/12)having slight hematuria on the 7th day after the cessation of the bladder washout.Through strengthening the flushing,the hematuria disappeared.The urethral catheter was removed on the 14th day after the operation and the hematuria never happened again.In the group without the douche tube,4 cases(66.7 %,4/6)had serious hematuria complicated with bladder obturation.The incidence of that was obviously higher than in the group with the douche tube(P＜0.05).Only one patient(1/12,8.3%)in the group of regular insertion of douche tube had urinary system infection,but in the group without the tube,the incidence of urinary system infection was 66.7 %(4/6)(P＜0.05).Conclusion The tube flushing in donor duodenum can significantly reduce the occurrence of hematuria after combined pancreas-kidney transplantation with pancreatic fluid drainage through bladder.

Objective To explore the expression of matrix metalloproteinase-3 (MMP-3) and matrix metalloproteinase-10 (MMP-10) in normal endometrium, atypical hyperplasia and endometrial adenocarcinoma. We aimed to study the relationship of MMP-3 and MMP-10 expressions with infiltration depth, histologic grade and clinical phase in order to explore the role of MMP-3 and MMP-10 in the occurrence, infiltration and metastasis of endometrial adenocarcinoma. Methods The expressions of MMP-3 and MMP-10 were measured by immunohistochemistry in 12 cases of normal endometrium, 12 cases of atypical hyperplasia and 42 cases of endometrial adenocarcinoma. Results The expression of MMP-3 was 73.8% (31/42), 25.0% (3/12) and 8.3% (1/12) in endometrial adenocarcinoma, atypical hyperplasia and normal endometrium, respectively, whereas the expression of MMP-10 was 76.2% (32/42), 33.3% (4/12) and 0(0/12), respectively. Both MMP-3 and MMP-10 expressions exhibited a pattern of decreased intensity in endometrial carcinoma, atypical hyperplasia and normal endometrium. Furthermore, the statistical analysis showed that the expression of both proteins was significantly greater in endometrial carcinoma than in atypical hyperplasia and normal tissue (P<0.01). Expressions of MMP-3 and MMP-10 had a significant correlation with such clinical parameters as histologic grade, depth of myometrial infiltration and clinical stage (P<0.01). Conclusion MMP-3 and MMP-10 can be used as tumor markers of endometrial carcinoma, and the combined detection of them can increase the detection rate of endometrial carcinoma.

Objective To study the effect of perioperative psychological nursing on living-related liver transplantation. Methods The following measures were adopted according to the donors' concrete condition: using nursing procedure in holistic nursing, to assess and determine the main problems in perioperative period, nurses mastered psychological nursing knowledge and skills in individualized psychological nursing, giving pertinent and individualized health education to patients in accordance with their psychological problems during the perioperative period. Results The donors could face the operation with good psychological state after being given fully-integrated and whole-system psychological nursing. Conclusions Psychological nursing is important for living-related liver transplantation during the perioperative period.

Objective:To clarify the relationship between epidermal growth factor receptor (EGFR) mutations and the clinicopathologic features of primary lung adenocarcinomas in Xinjiang.Methods:The mutations of EGFR gene at exons 18 -21 in 59 cases (including 15 cases of Uighur and 44 cases of Han) of lung adenocarcinoma tissues,which were obtained from surgical resection,were detected by amplifica-tion refractory mutation system (ARMS)method.And the relationships among mutations,race and clini-copathologic features were analyzed.Results:The frequencies of EGFR mutations in lung adenocarcinoma were 20% for Uighur,which was lower than that in Han (54.5%),P <0.05.The deletion mutations at exon 19 were seen in 2 of 15 Uighur cases and 9 of 44 Han cases.EGFR mutations were present,inclu-ding exon 21 L858R in one Uighur case and 12 Han cases,exon 18 G719X in two of 44 cases of Han, exon 21 L861Q in one of them.On histological type,the frequencies of EGFR mutation in alveolar pre-dominant adenocarcinoma was 71% (22 /31),which was higher than both that in solid predominant and mucinous carcinoma (6.7%,20% respectively).According to statistic analysis,EGFR mutations were without correlation with the patient’s gender,age,location,gross type,smoking status and lymph node metastasis(P >0.05).EGFR mutation was more frequent in well-differentiated cancer,mainly in acinar carcinoma,while poorly differentiated adenocarcinoma and mucous adenocarcinoma were lower.Conclu-sion:There was a difference of EGFR mutation in primary lung adenocarcinoma between Uighur and Han in Xinjiang,perhaps reflecting ethnic genetic variation,which is worth further analyzing.EGFR mutation was commonly detected in well or middle differentiated adenocarcinoma,mainly in acinar carcinoma.

Objective To investigate laparoscopic management in patients of posttraumatic acute acaleulous cholecystitis (AAC).Methods In this study,laparoscopic exploration was performed in 14 AAC cases during the past 5 years.Results Nine patients were treated with laparoscopic cholecystectomy,three by laparoscopic subtotal cholecystectomy,two were converted to open surgery.All patients were cured without major complications.Conclusions Laparoscopic cholecystectomy in the treatment of AAC is safe,less traumatic and quickly recovery in carefully selected AAC patients.

Objective To analyze the clinical characteristics and coagulation parameters of the infants with placental abruption . Methods Analysis was made on clinical and laboratory indexes of the hospitalized children of the NICU of Bayi Clinical Medical College of South Medical University ,enrolled from August 2012 to January 2013 ,including 60 infants with placental abruption as observation group and 60 infants without placental abruption as the control group .Results From clinical manifestations and lab date ,significant differences were found in gestational age ,polyembryony ,premature rupture of membrane ,birth weight ,intrauterine growth retardation ,motherhood gestational hypertension ,mother gestational diabetes mellitus ,asphyxia ,APTT ,D-dimer on admis-sion between the observation group and control group (P<0 .05) .Conclusion Placental abruption is the result of placental insuffi-ciency ,which may cause coagulation disorder and thus show the pathological state of high condensation in infants .