The hardcore of clinical medicine program education is to insist on improving the students'practical capability.The efficient methodology is the key to it.In this paper,the authors investigate the practice of Suzhou University and try to find out the ways to assess the graduates in this program.Also,the authors point out the deficiency in the assessment and put forward mending measures in order to improve the quality of clinical medicine graduate program education.

Objective:To investigate 7-11-years-old children's emotional responses, emotional attributions, coping styles to success and failure situation in learning. Methods: With clinical interview method ,90 pupils from seven-years-old to elevelen-years-old were asked to inference to the dramatis personae's affect reaction, emotional attribution in the given situation.Results:Children's emotional response and emotional attribution in learning context is self-regarded, coping style also decline to self effort .There were no age and sex differences in emotional responses to successful situation,there were age differences to failure situation,and there were no sex difference in emotional attribution.Conclusion:Children's emotional responses and emotional attribution to success and failure in learning have different features.

Osteosarcoma is the most common primary malignant tumor that develops in bone. Since chemotherapy was introduced into the multi-modality treatment regimen for high-grade osteosarcoma, its prognosis has been impressively improved; about two-thirds of all patients could achieve long-term survival. This review summarized the history of chemotherapy for osteosarcoma and current chemotherapeutic treatment strategies for classical osteosarcoma. The review also emphasized the necessity that the patients should be treated in specialized centers and prospective, multi-institutional trials are needed.

Objective To study the clinical significance of the expression of matrix metalloproteinase-9(MMP-9) and E-cadherin(E-cad) in patients with non-small cell lung cancer (NSCLC).Methods Immunohistochemical method (SP) was used to detect the expression of the MMP-9 and E-cad in 62 NSCLC tissues and 18 normal lung tissues.Results The positive expression rate of MMP-9 and the abnormal expression rate of E-cad in NSCLC were closely related to the TNM stages,pathological grades and lymph node involvement (P

Objective:To evaluate the relationship and prognostic significance of matrix metalloproteinase-9(MMP-9)、epidermal growth factor receptor(EGFR) in patients with non- small cell lung cancer(NSCLC). Methods:Immunohistochemical method (S-P) was used to detect the expression of the MMP-9、EGFR in 62 NSCLC tissues and 18 normal lung tissues. Results:The positive expression rates of MMP-9 and EGFR were 67.7%,58.1% respectively in the 62 NSCLC.Their expression levels were significantly higher than those in 18 para-cancerous normal lung tissues(P

[Objective]To understand the changes of children's blood lead levels and intelligence quotient (IQ) andthe effects of automobile exhaust on the prevelance rates of respiratory symptoms of children. [Methods] 151 pupilsof Y primary school in urban area were selected as exposure group, 160 pupils of Z primary school in Pudong districtwere selected as control group. The health questionaire survey and health examination were carried out amongpupils. The peripheral blood lead levels of the forth finger were determined. The IQ was determined by combinedRaven's Test. The data were statistically analzed by EPI Info and SAS statistic softwares. [Results] Significant differ-ences of blood lead levels were observed between exposure group and control group. The blood lead levels (x) negatively correlated with children's IQ (y) (y= 120. 11--0. 129x) . The prevelance rates of sore and uncomfortable feelings and foreign body sensation in throat and cough of exposure group were significantly higher than those in controlgroup. The ORs of corresponding symptoms were 1.71, 2, 64 and 2. 92 respectively. The multiple linear regressionanalysis showed that exposure to automobile exhaust and the distances from the residential region to street with heavytraffic were the main factors affecting the children's peripheral blood lead levels and the prevelance of respiratorysymptoms. [Conclusion] Further control of the emission of automobile exhaust and reasonable planning of location ofresidential areas were the main measures to control the prevelance of lead poisoning and its related diseases of children.

Objective:To understand the roles of PTHrP in the pathogenesis of temporomandibular joint after over mechanical loading. Methods:Fifteen adult New Zealand rabbits were subjected to traction between the mandibular ramus and zygomatic arch in the postero-superior direction unilaterally using elastic force. The rabbits were killed respectively at 2, 4 and 6 weeks and the histologic changes were observed by Hematoxylin & Eosin staining. The expression of PTHrP in the condyle of TMJ was observed by immunohistochemistry. Results:Stronger expression of PTHrP could be found in proliferation cell layers and upper hypertrophy cell layers in the early stage after operation, and weaker expression in mid stage, but stronger near the chondrocyte clusters. Conclusion:It is suggested that PTHrP might relate to the regeneration of condyle cartilage.

Objective To establish a method for quantitative detection of hepatitis B virus covalently closed circular DNA(HBV cccDNA ) in infected cells. Methods The transfected cell line HepG2.2.15 which can consistently produce Dane particles was maintained in DMEM containing 380 ?g/ml G418 and 10% fetal bovine serum. Cells in the exponential period were harvested from flasks, then intracellular HBV cccDNA was extracted from pellet containing 1?10~6 cells with mini plasmid extraction kit (QIAGEN).The extraction product was further purified by mung bean nuclease to remove HBV relaxed circular DNA possibly remained. HBV cccDNA was quantitatively detected by fluorescent PCR with selective primer set and Taqman MGB probe. Culture medium before exponential period, HBV DNA positive and negative serum samples from patients with chronic hepatitis B (mild) were amplified simultaneously to test the specificity of the fluorescent PCR method. Plasmids containing whole HBV genome were amplified with the same primer set and fluorescent probe to determine the sensitivity of the method. Results HBV cccDNA was detectable in HepG2.2.15, and the average quantity was 18 copies per cell approximately. No detectable fluorescent signal was observed when culture and serum samples were amplified. The detectable HBV cccDNA was as low as 10~3 copies per ml at least by this method. Conclusions This method is convenient, highly specific and highly sensitive. It can be utilized in the quantitative detection of intracellular HBV cccDNA as well as in the screening and evaluation of antiviral agents.

Objective To explore the surgical indication, the operative procedure and effect of breast-conserving surgery plus combined treatment for the patients with early breast cancer. Methods 51 patients with early breast cancer were treated with breast-conserving surgery (BCS) plus radiotherapy, chemotherapy and hormonotherapy postoperatively. The result of breast-conserving group was compared with 56 patients treated by modified radical mastectomy (control group). Results 25 patients underwent quadrant resection plus axillary lymph node dissection (ALND), 15 patients were subjected to local resection plus ALND, and 11 patients received quadrant resection only. All patients were followed-up for an average of 16.9 months. In BCS group, one patient was found to have local recurrence, and the distant metastasis rate was 0%. In the control group, no patient had local recurrence and the distant metastasis rate was 3.6%. The operative complication rate in BCS group and control group was 13.7% and 33.9% respectively (p﹤0.05). Conclusion Breast-conserving surgery plus combined treatment is safe and satisfactory for early breast cancer. It can be considered as the first choice for the treatment of patients with breast cancer in early stage.

Objective To evaluate the efficacy and safety of dipeptidyl peptidase-4 inhibitor,linagliptin,in subjects aged 60 years or older with type 2 diabetes mellitus (T2DM).Methods Data from eight 24-week,multinational,multicenter,randomized,double-blind,placebo-controlled,parallel-group studies were analyzed.Patients aged 60 years or older with T2DM were received oral linagliptin (5 mg/d) or placebo in combination with mefformin,or metformin plus sulfonylurea.Efficacy was assessed by the changes in glycosylated hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) from baseline to 24 weeks of treatment.Safety endpoint included the frequency and intensity of adverse events.Results A total of 1 421 patients (placebo 429,linagliptin 992) were included in the full analysis set (FAS).Mean ages of the subjects were (67.4 ± 5.6) years in the linagliptin group and (66.7-± 5.6) years in the placebo group.Baseline HbA1c was (8.0 ±0.8) ％ in the linagliptin group and (8.1 ±0.9) ％ in the placebo group.At the end of 24-week,placebo-adjusted reduction in HbAlc in subjects with linagliptin was (0.7 ±0.1)％ (95％ CI 0.6-0.8,P ＜0.000 1),and placebo-adjusted reduction in FPG in subjects with linagliptin was (0.88 ±0.12) mmol/L(95％ CI 0.65-1.11,P ＜0.000 1).Overall safety and tolerability in the two groups were similar.Adverse events occurred in 57.1％ of patients in the placebo group and 61.1％ of patients in the linagliptin group,and the incidence of adverse events leading to discontinuation was 3.2％ in the placebo group and 3.8％ in the linagliptin group.Serious adverse events occurred in 1.6％ of patients in the placebo group and 2.8％ of patients in the linagliptin group.Investigator-defined hypoglycaemia occurred in 7.3％ of patients in the placebo group and 11.9％ of patients in the linagliptin group.Among them,most were mild or moderate hypoglycaemia,and severe hypoglycaemia only occurred in 0.2％ of patients in the placebo and 0.5％ in the linagliptin groups.Overall incidence of hypoglycaemia in linagliptin group was slightly higher than that in placebo group,which might be due to the fact that more patients were taking sulfonylureas in linagliptin group than in placebo group (26.8％ linagliptin;18.4％ placebo).No difference could be viewed in hypoglycaemia between the two groups in patients without sulfonylureas (1.2％ linagliptin,1.1％ placebo)Moreover,no severe hypoglycaemia was reported in subjects without sulfonylureas.The incidences of other adverse events were similar in both groups.Conclusion Linagliptin was efficacious in lowering glucose with a safety profile similar to placebo in type 2 diabetic patients aged 60 years or older.