To accomplish the teaching target on clinical practice in Gynecology and Obstetrics for seven-year program,we should consider the features of clinical practice in Gynecology and Obstetrics,choose appropriate teaching methods and make best use of entrance guidance and teaching ward-round and so on to improve students'comprehensive ability.

Objective To explore the sub-health and TCM physical constitution of stroke patients’families.Method Four hundred and twelve family members of stroke patients hospitalized during September 2001 to May 2013 were involved in the survey by filling out TCM physical constitution scale(TCMPC)and the sub-health self-rating scale(SSS)for the purpose of investigating the sub-health and conditions of TCM physical constitution.Results Of all the patients,189 were in sub-health,accounting for 45.87%. There were 7 main clinical symptoms related to sub-health,including poor sleep,less activeness,proneness to upsets and irritation, memory loss,depression,tension in interpersonal relations and appetite loss,with the incidences ranging from 64.55%to 48.15%. In TCM,51.85%of the family members were balanced in physical constitution,10.58%of them had Yang-deficiency constitution, 14.29%of them had Yin-deficiency,23.28%of them other kind of constitution.Conclusions The family members of stroke patients have a high rate of sub-health.The members in sub-health hold a balanced constitution,Yang-deficiency or Yin deficiency.In order to eliminate their sub-health,improving the quality of care for patients with stroke,we should guide the families of stroke patients to develop good living habits,strengthen the TCM mental nursing,help them to establish a good social support system.

Objective To investigate the.expression and significance of peritoneal fluid (PF) erythropoietin (EPO) and neutrophils activation peptide-78 (ENA-78)in patients with endometriosis.Methods The levels of EPO and ENA-78 in peritoneal fluid (PF) were measured by means of enzymelinked immunosobent assay (ELISA) in 30 women with endometriosis (9 in Ⅰ ～ Ⅱ stage,21 in Ⅲ～ Ⅳ stage)and 30 without endometriosis.And the relationship between the PF levels of EPO and ENA-78 in patients with endometriosis was analyzed.Results The PF levels of EPO and ENA-78 in women with endometriosis [ (9.272 ± 2.284 ) IU/L,( 2.068 ± 0.794 ) ng/ml ] were significantly higher than those in control group [ (5.759 ±0.502) IU/L,(0.886 ±0.145 ) ng/ml,P ＜0.05].There were no significant differences in the PF levels of EPO between stage Ⅰ ～ Ⅱ [ (9.549 ± 1.996) IU/L] and Ⅲ ～ Ⅳ [ (9.181 ± 1.897) IU/L,P ＞0.05].The ENA-78 concentrations of PF in stage Ⅲ～ Ⅳ [ (2.517 ± 0.518 )ng/ml] were significantly higher than those in stage Ⅰ ～ Ⅱ[ ( 1.137 ±0.169)ng/ml,P ＜0.05].There were no obvious correlations in PF EPO and ENA-78 in patients with endometriosis.Conclusions The excessive expression of EPO and ENA-78 in the PF of women with endometriosis suggests that EPO and ENA-78 may be an important role in the pathogenesis of endometriosis.

OBJECTIVE: To explore the therapeutic effect of prostaglandin E1 lipid drug-loaded microcapsules(Lipo PGE1) on the earlier diabetic nephropathy (DN). METHODS: 72 cases with early DN were randomly divided into treatment group and control group. The control group were assigned to receive routine hypoglycemic agent,blood pressure controlling, and symptomatic treatment, while the treatment group were given another drip infusion of Lipo PGE1 20ug plus NS100ml q.d besides the routine therapy as in the control group. Both groups received 3 weeks’ course of treatment. The changes of urinary albumin excretion rate(UAER), urinary transferrin(TRF), urinary microglobulin(?1MG)and so on in the 24h urine of the 2 groups before and after treatment were observed.RESULTS: There was great decrease in UAER, TRF and ?1MG in the 24h urine in the treatment group after treatment(P

OBJECTIVE To explore the clinical characteristics of hospital infection in diabetic nephropathy(DN). METHODS To retrospectively analyze the incidence rate of hospital infection,the infection sites,pathogenic bacteria,and predisposing factors in 348 cases with diabetic nephropathy,and to compare the index above with the homeochronous 466 diabetic patients without DN. RESULTS Sixty two cases occurred hospital infection from 348 cases with DN,the infection rate was 17.82%,the infection sites were most frequently in respiratory tract(37.10%),then urinary tract(24.19%) and digestive tract(19.35%),the major predisposing factors were out of control of blood glucose,renal sufficiency,advanced age,and longer stay in hospital. CONCLUSIONS The incidence rate of hospital infection is higher,the valid measures to control the hospital infection are to control the blood glucose effectively,to improve the renal function and timely to use the method of anti-infection with forcefulness.

Objective To study the therapeutic effects of mycophenolate mofetil(MMF) in the treatment of refractory idiopathic thrombocytopenic purpura(ITP).Methods 16 refractory ITP patients were treated with MMF (1.0～1.5g/d),which were given in divided doses for three months as one course;the patients with significant therapeutic effect were given the dose for another three months and reduced by degree.Results Very effective results were obtained in 4 cases,striking improvement in 7,partial response in 1 and no response in 4.The total efficacy was 68.75%.The main side effect was observed as light digestive malaise.Conclusion MMF has striking therapeutic effect in treating refractory ITP with little side effect and can be used as an effective way of treatment.

Objective To study the effects of calaium channel blocker(CCB) on c-fos expression and nervous function following peripheral nerve injury.Methods Sciatic nerve was crushed with pincers to make the models of sciatic nerve crush injury in rats.The model rats were administered with Flunarizine 1 mg/kg(low dose group),2 mg/kg(high dose group) and normal saline 10 ml/kg(model group) via intraperitoneal injection.The c-fos positive cells at 1st and 4th week and nerve conduction velocity of sciatic nerve,distance between right behind toes were examined at 4th week respectively by immunohistochemical,behavior and electrophysiologic techniques.The results were compared with normal rats.Results(1) The c-fos positive cells were higher significantly in model and Flunarizine low dose groups compared with normal control group(all P0.05).Conclusion The c-fos expression following peripheral nerve injury can be reduced by CCB,which has the protective effect on the damaged peripheral nerve function.

Objective To investigate the relationship between Serum BNP and heart failure in patients un-dergoing maintenance peritoneal dialysis ( MPD) .Methods 80 uremia patients who underwent MPD and 40 healthy volunteers were enrolled in the study.In the morning of treatment, we assessed their cardiac function according to in-terrogation, physical examination, chest X-ray and echocardiography while detecting BNP, Scr, BUN levels in the fasting venous serum of upper extremity.Results 80 MPD patients were divided into 2 groups:a heart failure group (Group A, n=42) and a normal cardiac function group (Group B, n=38).40 healthy volunteers served as a con-trol group ( Group C ) .There were no significant differences in age, weight and sex ratio among 3 groups ( P>0.05).The time period of maintenance peritoneal dialysis in Group A and B was similar (P>0.05).Compared with Group C, the levels of Serum BNP, Scr and BUN were significantly higher in Group A and B( P<0.05) .There were no significant differences of Scr and BUN between Groups A and B ( P>0.05) .The level of Serum BNP was signifi-cantly higher in Group A than that in Group B (P<0.05).Conclusion The level of Serum BNP may be closely re-lated to the cardiac function and it may be used as a predictor for heart failure in MPD patients.

Objective:To investigate the effects of pulmonary rehabilitation on anxiety/depression and subjective/objective sleep quality of elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods:From February 2018 to February 2019, 120 elderly patients with stable COPD were selected and randomly divided into the experimental group (pulmonary rehabilitation exercise combined with conventional COPD treatment) and the control group (simple COPD conventional treatment). Sixty cases in each group were intervened for 8 weeks. Before and after treatment, Hamilton anxiety scale (HAMA) was used to evaluate anxiety, Hamilton depression scale(HAMD)was used to evaluate depression, Pittsburgh sleep quality index(PSQI)and sleep log were used to evaluate subjective sleep quality, and objective sleep quality was monitored by multi-channel sleep monitor.SPSS 21.0 software was used to analyze and process the data. Chi square test, independent sample t test and paired t test were used for statistical analysis. Results:After 8 weeks of intervention, the HAMA and HAMD scores of the experimental group were lower than those of the control group (HAMA: (7.57±3.19) vs (10.15±4.89), t=-3.428, P=0.001; HAMD: (8.22±4.73) vs (10.60±6.49), t=-2.300, P=0.023). COPD patients with anxiety decreased (χ 2=7.566, P=0.006). After treatment, the subjective sleep latency of the experimental group was shorter than that of the control group ((42.00±9.88)min vs (47.25±10.27)min, t=-2.854, P=0.005). The subjective sleep efficiency was higher than that of the control group ((76.00±4.50)% vs (74.00±5.20)%, t=2.272, P=0.025), and the objective sleep latency was shorter than that of the control group ((28.02±5.59)min vs (32.95±6.21)min, t=-4.575, P<0.05). Conclusion:Pulmonary rehabilitation exercise can improve the anxiety and depression of elderly patients with stable COPD, and improve the subjective and objective sleep quality.

Objective To evaluate the change of left atrial(LA) volume and function in patients with paroxysmal atrial fibrillation (PAF) after catheter ablation using real-time tri-plane echocardiography (RT-3PE) as well as quantitative tissue velocity imaging (QTVI).Methods Eighty-two PAF patients underwent first-time RFCA were included.Routine and tri-plane ultrasound images of 1 week before and 1 month,3 months,6 months after RFCA were stored for offline analysis.A range of LA structural and functional parameters were measured off-line using the EchoPAC workstation,including LA anteroposterior diameter (LADap),LA mediolateral diameter (LADml) and LA superior-infra diameter (LADsi),early and late diastolic transmitral flow velocity and ratio (E,A and E/A),the peak velocity of pulmonary vein and ratio (S,D,Ar,S/D),the maximum volume of the left atrium (LAVmax),the volume before LA active contraction obtained at time of the P wave on the surface electrocardiogram(LAVp),the minimum volume of the left atrium (LAVmin),LA passive emptying fraction (LAPEF),LA active emptying fraction (LAAEF),LA total emptying fraction (LATEF),LA expansion index (LAexpI),average peak velocity of six wall of the left atrium (Vs,Ve,Va).Results After 3,6 months,LADap decreased significantly(P ＜ 0.05) ;3 months of follow up,peak A increased,E/A ratio decreased (P ＜0.05);6 months of follow up,peak A increased,E/A ratio reduced,peak S increased,peak D reduced,S/D increased(P ＜0.05) ;3 months of follow up,LAVmin reduced,LAAEF and LATEF increased (P ＜0.05);6 months of follow up,LA volume decreased,LAAEF and LATEF increased (P ＜0.05);3,6 months of follow up,the average Va increased(P ＜0.05).Conclusions LA reconstitution and function were recovering slowly 1 month after RFCA,and noticeable improvement can be observed 3 and 6 months after RFCA.