The Doctor Practical Technique Test is one of the two important parts in the Doctor Qualification Tests.The article expounds its importance and complication as well as how to grasp each point of the test.It also makes a statistic analysis of its test results in Chongqing,the feedback information of which will be an enlightenment and help to the reforms in medical education and the standarlized training of clinical residents.

Objective To study the rationality in the use of proton pump inhibitors (PPI) to stress ulcer(SU) prophylaxis in pa-tients receiving aseptic-contaminative and contaminative incision operation .Methods A retrospective analysis was performed on the use of PPI to SU ,which taken from surgical patients received aseptic-contaminative and contaminative incision operation and hospi-talized from January 2013 to April 2013 .Results Among 1 745 patients in the study ,540(30 .95% ) received a stress ulcer prophy-laxis with PPI .The rate of prophylaxis to ICU ,general surgery ,urology ,thoracic surgery and neurosurgery was higher than other departments(except for between ICU ,thoracic surgery ,neurosurgery and orthopedic) .A total of 232 patients had risk factors , 72 .41% of the patients who received prophylaxis .A total of 1 513 patients did not have risk factors ,24 .59% of the patients who received prophylaxis ,the rate of prophylaxis to general surgery ,thoracic surgery and urology was higher than other departments (except for ICU ,and between thoracic surgery with orthopedics ) .In prevention of SU ,the usage rate of Lansoprazole was higher than that of Omeprazole and Pantoprazole .Preoperative prophylactic usage rate was 14 .44% .Excessive dosage was 0 .93% .Preven-tive medicine treatment longer accounted for 12 .78% .Conclusion The phenomenon such as non-risk factors ,inappropriate of medi-cation time and long course of treatment are existed ,when physicians use the PPI for SU prophylaxis in surgical patients receiving aseptic-contaminative and contaminative incision operation .Therefore ,treatment recommendations for SU prophylaxis are needed to restrict PPI use for justified indications .

Objective To evaluate clinical and endoscopic characteristics of ischemic colitis (IC), and to explore the methods for the early diagnosis of IC. Methods Thirty six patients diagnosed as IC in Hua dong Hospital from June 1975 to December 2000 were reviewed. All patients underwent colonoscopy with biopsy within 5 days of symptoms, and repeated the exam in 2 weeks to 2 months. Results Of the 36 cases (12 men and 24 women, average age 60.5 years old, range 35 84), 31 were over 50 years of age. IC usually presented with sudden onset of left lower quadrant abdominal pain, diarrhea and hematochezia. Patients' ischemic lesions were most often on the left colon. It consisted transient or reversible colitis in 30 cases, stricture colitis in 5 cases and gangrene colitis in only 1 case. Morphologic changes varied with the duration and severity of the injury. Conclusion Colonoscopy with biopsy is the main method for the diagnosis of IC. It should be performed in the early stage of the onset of symptoms.

Objective To study the role of cell apoptosis during the chemotherapy of human gliocytoma in order to get effective suvilliance on the effect of chemotherapy. Methods Gliocytoma cells were isolated and cultured from 40 human gliocytoma samples. Mitochondrial membrance potential (MMP), cell cycle, the level of Bcl-2 and Bax were detected by flow cytometry (FCM) at 24, 48, 72 hours respectively of incubation with Lomustine (CCNU) and Teniposide (VM-26), and the trends were also analysed. Results MMP decreased greatly, the apoptosis part in the cell cycle ananlysis increase, the expression level of Bcl-2 decreased, and that of Bax increase rapidly, while the Bcl-2/Bax ratio decreased. Conclusions CCNU and VM-26 have singnificant effect in gliocytoma chemotherapy on inducing gliocytoma cell apoptosis. VM-26 has more stronger effect on the cell cycle. MMP is the most sensitive and the fastest index in apoptosis detection.

Hepatectomy ; methods ; Hepatic Veins ; surgery ; Humans ; Liver ; surgery

ObjectiveTo investigate effects ofEuphorbiae ebracteolatae Radixon the proliferation and apoptosis in human papillomavirus (HPV)-18-infected HeLa cells.MethodsThe alcohol extract ofEuphorbiae ebracteolatae Radixwas prepared. Cell proliferation was determined using the MTT assay, and apoptotic cells was determined using the Hoechst 33258 staining.ResultsHPV-18-infected HeLa cells were treated with 10, 20 μg/mlof the alcohol extract ofEuphorbiae ebracteolatae Radixfor 12 h, the cell proliferation inhibition rate were significantly increased compared to the control group (16.36% ± 5.06%, 18.59% ± 5.99%; allP<0.01);HPV-18-infected HeLa cells were treated with 0.625, 1.25, 2.5, 5, 10, 20 μg/ml of the alcohol extract ofEuphorbiae ebracteolatae Radixfor 72 h, the cell proliferation inhibition rate were significantly increased compared to the control group (13.82% ± 3.66%, 30.24% ± 6.58%, 43.29% ± 4.29%, 53.32% ± 1.41%, 54.24% ± 1.97%, 50.68% ±1.74%;allP<0.01). The Hoechst 33258 staining showed that HPV-18-infected HeLa cells were treated with 10 μg/ml of the alcohol extract ofEuphorbiae ebracteolatae Radixfor 24 h, the apoptotic cells were found.ConclusionEuphorbiae ebracteolatae Radixcould inhibit the proliferation and induce apoptosis in HPV-18-infected HeLa cells.

Objective To explore the mechanism of blood-stage treatment in patients with psoriasis vulgaris through studying the level change of IFN-?, IL-4, IL-10 and IL-17 in patients with blood-stage treatment during activity and quiescence period separately. Methods 20 patients with psoriasis vulgaris in active stage(blood heat syndrome)and 20 patients with psoriasis vulgaris in resting stage(blood stasis syndrome) were recruitedto observe the treatment effects by the PASI score,and to observe thechange of IFN-?, IL-4, IL-10, IL-17 before and after treatment in the serum by ELISA. Results The PASI scores of two groups were both significantly decreased after treatment (blood heat syndrome group t=6.685, P<0.01;blood stasis syndrome group t=4.959, P<0.01). The levels of cytokines were significantly different between patients in the periods of activity and quiescence. Onvarying degrees, the levels of cytokines of two groups were improved after treatment. The levels of cytokines IFN-?, IL-17 in blood heat group significantly decreased(t=3.024, P<0.01;t=2.543, P<0.05). The levels of cytokines IL-17 drop but the levels of cytokines IL-4 raised in blood stasis group,that were significantly differentwith the levels before treatment(t=2.417, P<0.05; t=2.547, P<0.05). Conclusion The levels of INF-?, IL-4, IL-10 and IL-17 could be effectively modulated with blood-stage treatment in treating psoriasis vulgaris.

Objective To evaluate the clinical and endoscopic features of ulcerative colitis(UC). Methods The cases of UC were collected from 1975 to 2001. According to the diagnostic criteria of Chengdu conference, 486 and 490 patients were diagnosed as UC in our hospital from 1975 to 1994 and from 1995 to 2001 respectively. Their records were retrieved and the data were analyzed for sex, age, presentation, the course of the illness and lesion range. Results In the two groups from 1975 to 1994 and from 1995 to 2001, the proportion of patients diagnosed as UC under colonoscopy was increased from 3.51% to 4.44%. The ratio of male to female was 1.67 and 1.25 respectively. The mean age at the diagnosis increased from 42.4 years old to 51.5 years old, and the peak age was between 30 and 49 years old, between 40 and 49 years old and greater than 60 years old respectively. The typical clinical manifestations of UC were bloody mucopurulent stool, diarrhea and abdominal pain. Proctosigmoiditis or proctitis was found in 269 patients (55.4%) and 316(64.5%), left side colitis in 84(17.3%) and 68(13.9%), pancoltitis in 58( 11.9% ) and 70(14.3%) respectively. In the two groups, there were 437( 89.9% ) and 443(90.4%) patients who had the course of less than 10 years respectively. The definitive diagnosis of UC was dependent on biopsy. Conclusions The lesions of UC are commonly located in the left side colon, the course of UC is short, the age of onset is relatively high in the middle and old aged group, and the prevalence of both malignancy and complications is low. Colonoscopy with biopsy is considered to be the major means for the diagnosis of UC.

0.05). After dividing the patients into early-onset and late-onset subgroups, there were significant differences of DRD4 genotype and allele frequency between early-onset patients and controls (P0.05). Conclusion The results suggested that the polymorphism of DRD4 receptor gene may be associated with early-onset OCD. The 3/4 genetype may be the risk factor of early-onset OCD. Early-onset and late-onset OCD may have different etiology.

OBJECTIVETo sum up the causes of recurrence of chronic subdural hematoma (CSDH) from failure of trepanation and drainage and explore its prevention and treatment.

METHODSFrom October 1988 to June 2002 a total of 358 patients with CSDH were treated with trepanation and drainage in our hospital. Among them 15 patients had recurrence of CSDH after operation. The data of the 15 patients were reviewed retrospectively.

RESULTSOf the 15 patients, 13 were cured by retrepanation and redrainage, one cured by removal of hematoma by craniotomy with bone flap, and one, a 1-year old child, gave up reoperation due to severe encephalatrophy.

CONCLUSIONSMost CSDHs which recur after trepanation and drainage can be cured by retrepanation and redrainage. For the patients with repeated recurrence of CSDH removal of hematoma capsule can be considered. The causes of recurrence of CSDH are related to disease course, the thickness of hematoma capsule, the severity of encephalatraphy and whether the hematoma cavity is drained or irrigated completely, and operation methods.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Drainage ; Female ; Hematoma, Subdural, Chronic ; prevention & control ; surgery ; Humans ; Infant ; Male ; Middle Aged ; Postoperative Complications ; Recurrence ; Reoperation ; Treatment Outcome ; Trephining