The essential purpose of medical education is to cultivate qualified medical talents for health career.In the course of medical edUCation reform.it is the most important task to focus on the specjalties of mealical education,to follow the rules from medical education,to make jnnovations on the basis of practical conditions and to develop medical edUCation by means of innovation.

With the gradual transformation of the American medical model from biomedical medel to bio-psycho-social model,the advancement both in the medical security and service system,preventire medicine as well as the protection of environment have been emphasized,while the revolution of the medical education has been carried out according to the divemified requirements of the bio-psyeho-social model,and the focus of health care has been moved forward.

Objective To investigate the levels and clinical significance of serum adiponectin(ADPN),high sensitive C-reactive protein(hs-CRP)and cystatin C(CysC)in type 2 diabetic nephropathy.Methods 75 outpatients and the inpatients with type 2 dia-betes mellitus(T2DM)in our hospital from February 2013 to May 2013 were selected and divided into three groups according to the urinary albumin excretion rate (UAER),normal-albuminuria group(UAER<30 mg/d,30 cases),micro-albuminuria group (UAER 30-300 mg/d,22 cases)and macro-albuminuria(UAER>300 mg/d,23 cases).30 subjects of healthy physical examination were selected as the control group.Urine microalbumin was measured by the immune turbidimetric method,UAER was calculated ac-cording to the 24 h urine volume,CysC and hs-CRP were measured by the immune turbidimetric method,and ADPN was measured by the enzyme linked immunosorbent assay(ELISA).The ADPN,hs-CRP and CysC levels were compared among groups.Results The ADPN level in 3 type 2 diabetic nephropathy groups was lower than that in the control group,the difference was statistically significant (P <0.05 ).With increase of UAER,serum ADPN,hs-CRP and CysC levels in 3 type 2 diabetic nephropathy groups were increased,the difference among the groups was statistically significant (P <0.05 ).The levels of serum ADPN,hs-CRP and CysC in type 2 diabetic nephropathy were positively correlated with UAER(r=0.715 6,0.476 3,0.741 3,P <0.05).Conclusion The combined detection of serum ADPN,hs-CRP and CysC has important reference value for the diagnosis and disease course of early renal damage in T2DM.

Objective: To study the relationship between the activation of hepatic stellate cell(HSC) and the early stage of liver fibrosis in experimental diabetic tree shrews.Methods: Tree shrews were divided randomly into normal control group and streptozocin(STZ)-treated group.STZ-treated animals were then divided into diabetic group and STZ control group.ALT,AST,Type Ⅳ collagen(Ⅳ-C),Laminin(LN) and Hyaluronic acid(HA) were detected respectively before and after modelling.Liver biopsy was performed at the end of the experiment(8th week).All of the liver specimens were observed in light microscope and transmission electron microscope.?-smooth muscle actin(?-SMA) was detected by immunohistochemistry and computer image analysis system.Results: Early fibrosis of the liver in diabetic tree shrews can be found by both light and electron microscope.There were some ?-SMA positive HSCs,namely,activated HSCs could be observed in the liver of diabetic group but not in other two groups.The expression of ?-SMA increased significantly in the liver of diabetic group as compared with that of other two groups.In addition,the level of expression of ?-SMA was positively correlated with the collagen area density in diabetic group.Conclusion HSC may play an important role in the development and aggravation of liver fibrosis in diabetic tree shrews.

Objective To investigate and compare the impacts of health education and psychological intervention on the clinical effects of patients with hypertension. Methods 102 hypertension cases were collected and were randomly divided into three groups, health education group (36 cases), psychological intervention group (30 cases) and comparison group (36 cases). Compliance with prescription,anxiety level and blood pressure were observed both before and after the health education and psychological intervention. Result After health education,compliance with prescription in health education group was significantly improved ( P ＜ 0. 01 ), and blood pressure control of health education group was more preferable than the comparison group ( P ＜ 0. 01 ). After psychological intervention,anxiety level in psychological intervention group was significantly decreased ( P ＜ 0. 05 ), and blood pressures control of psychological intervention group was more preferable than the comparison group ( P ＜ 0. 01 ). Blood pressures had no statistical significance between health education group and psychological intervention group. Conclurion Health education could improve compliance with prescription, and paychological intervention could improve patients' mentl health, and both of them were conducive to the control of blood pressure of patients.

Objective To discuss the effect of autoantibodies positive on maternal and infant combined with literature by investigating the positive rate of different gestational thyroid autoantibodies,so as to improve the diagnosis and treatment of diseases.Methods A total of 549 cases of pregnant women were divided into early pregnancy group (178 cases),middle pregnancy group(192 cases),late pregnancy group (179 cases).The level of thyroid peroxidase antibody (TPOAb),thyroglobuhn antibody (TGAb),thyroid stimulating hormone receptor antibody (TRAb),thyroid stimulating hormone (TSH) were determined by electrochemiluminescence.And compared with 200 healthy people (control group).Results The positive rate of TPOAb was 18.54％ (33/178),the positive rate of TGAb was 19.66％ (35/178),the positive rate of TRAb was 0.56％ (1/178) in early pregnancy group.The positive rate of TPOAb was 15.62％ (30/192),the positive rate of TGAb was 16.15％ (31/192),the positive rate of TRAb was 0.52％ (1/192) in middle pregnancy group.The positive rate of TPOAb was 16.20％ (29/179),the positive rate of TGAb was 16.76％ (30/179),the positive rate of TRAb was 0.56％ (1/179) in late pregnancy group.The median TPOAb TGAb and the positive rate in early pregnancy group was higher than that in middle pregnancy group,late pregnancy group and control group,the difference was statistically significant (P ＜ 0.01).The median TPOAb,TGAb and the positive rate in middle pregnancy group was higher than that in late pregnancy group and control group,the difference was statistically significant (P ＜ 0.01).Conclusion More attention should be paid to gestational thyroid autoantibodies incidence,take the necessary intervention should be of high risk pregnant women.

Objective To investigate the prevalence of glucose‐6‐phosphate dehydrogenase (G6PD) deficiency and distribu‐tion of mutations in G6PD gene in Guiyang region .Methods A total of 515 DNA samples taken from newborn umbilical cord blood were collected ,15 mutations and one single nucleotide polymorphism in G6PD gene were detected by using of the Sequenom Mas‐sArray MALDI‐TOF‐MS system .Results Among the 515 samples ,10 were determined to have one of the G6PD gene mutations with a detection rate of 1 .94% ,5 mutation types were detected as follow :1388G>A accounted for 40 .0% (4/10 cases) ,1024C> T and 519C> T accounted for 20 .0% (2/10 cases) respectively ,1376G> T and 95A>G accounted for 10 .0% (1/10 cases) respec‐tively .The single nucleotide polymorphism allele frequency of 1311C>T was 12 .79% .Conclusion Guiyang is a region with higher prevalence of G6PD deficiency ,1388 G>A is the most common mutation of G6PD gene in this region .

Objective To evaluate the risk factors for surgical site infection(SSI)following limb fracture surgery, and provide basis for making prevention and control measures.Methods Clinical data of 1 453 patients undergoing limb fracture surgery in 16 hospitals between January 1,2014 and June 30,2014 were collected,risk factors for SSI were analyzed by univariate and multivariate logistic regression analysis.Results Among 1 453 patients undergoing limb fracture surgery,12 developed SSI(0.83%).Univariate analysis showed that risk factors for SSI following limb fracture surgery were infection at the other sites 7 days before operation,time from injury to operation,opera-tion opportunity, duration of operation,open fracture, wound type, and anesthesia type ( all P < 0.05 ). Multivariate logistic regression analysis showed that independent risk factors were wound type,anesthesia type, open fracture,time from injury to operation,and duration of operation,OR(95% CI)were 12.47(2.78-15.88), 11.55(2.84 - 17.02),10.79 (2.72 - 11.13 ),2.35 (2.12 - 6.81 ),and 3.07 (1.88 - 4.13 )respectively. Conclusion Risk factors for SSI following limb fracture surgery are multiple,the key to the prevention and control of SSI are identifying risk factors and strengthening the management of key points.

Objective To explore the changes and clinical significance of iron metabolism indexes such as serum ferritin (sFn),serum transferritin (sTf),serum transferritin receptor (sTfR) in patients with hematologic malignant disease before and after treatment.Methods Fifty-nine patients with hematologic malignant disease were enrolled.We measured the blood routine,bone marrow routine and iron bound of bone marrow cells and sFn、sTf、sTfR before and after treatment.The control group was 43 healthy Volunteers.Result Before treatment the level of patients sFn increased obviously,which was higher than that of control significantly (P ＜ 0.05).After chemotherapy,the level of sFn in remission group decreased obviously,which was still higher than that of normal control.sFn expression in non-remission group was not different from that before therapy or normal control (P ＞ 0.05).The level of sTf was lower than that of control significantly pretreatment and aftertreatment (P ＜ 0.05).While there was no different between remission group and nonremission group after chemotherapy (P ＞ 0.05).The level of sTfR in non-remission group after chemotherapy was higher than that of control.Correlation analysis showed that there was positive correlation between the serum level of sFn and the original and naive bone marrow cells (r =0.347).And there was negative correlation between sFn and hemoglobin (r =-0.207).But there was no significant correlation between sFn and bone marrow iron.Conclusions It is possible to predict treatment response and prognosis in hematologic malignant disease by the decrease of sFn after chemotherapy.But sTf and sTfR are not good indexes to predict treatment response in a short time.Prevalence of anemia among patients with tumor was not only because of iron deficiency.So iron supplementation should be cautious.

Objective To explore the feasibility of clinical applications of the transvaginal cavity mirrors operation on treating ectopic intra-uterine device (IUD) in uterus.Methods The clinical information was collected about 2 patients who suffered from ectopic IUD in pelvic and underwent transvaginal laparoscopic surgery.Results Ectopic devices were taken out by transvaginal laparoscopy operation in all two cases.The operation time was short and quick recovery was quickly.Conclusion Transvaginal laparoscopy operation was proved as a minimally invasive method for ectopic IUD in uterus.