Based on B.S. Bloom's taxonomy of educational objectives, development of medical students' core competence requirements is paid great attention to meet the needs of society within worldwide medical education community. The Institute for International Medical Education has developed the “Global Minimum Essential Requirements in Medical Education” of medical students' core competence oriented in the educational objectives of physicians.

In recent years,PET-CT plays an important role in Hodgkin' s lymphoma (HL).It has emerged as the most accurate tool for staging,treatment monitoring,and response evaluation in HL.PET-CT has high sensitivity and specificity.It provides an opportunity to monitor the quality of response during treatment,permits separation of node from involved regions,and adds prognostic information.PET-CT has become integral to modern lymphoma management,but as a relatively new imaging technique it is still being studied and neither its full potential nor major limitations have been fully understood.The recent observations from clinical trials and clinical experiences with PET-CT in the 54th ASH annual meeting are discussed to explore its advantages and limitations.

Retinal neovascularization is a complicated pathophysiological process as a result of imbalance between angiogenic and anti-angiogenic factors. Correct understanding of the signaling pathways,exploring the critical factors involved in retinal angiogenesis, looking for new strategies by reconstructing the new vessels are helpful for knowing the mechanism of the occurrence and development of reitnal neovascularization, which would be good for preventing and treating retinal neovascularization diseases.

ABSTRACT:Objective To study the effects of arotinolol,propranolol and carvedilol on rat portal hypertension and make a comprehensive evaluation of the three drugs.Methods Portal hypertension was induced with CCl4 in rats.Arotinolol,propranolol,and carvedilol were administered for 2 weeks after the model was stable.Mean arterial pressure (MAP),heart rate (HR)and portal venous pressure (PVP)were measured at intubation;α-SMA expression was measured by immunohistochemistry;Masson staining was used to test collagen fibers area.Results Compared with model group,both arotinolol and carvedilol could significantly reduce PVP level (P <0.001),which was lower than that in propranolol group (P <0.001,P =0.032).Compared with those in model group,both MAP and HR in arotinolol group and carvedilol group were significantly reduced (P <0.05),MAP in carvedilol group was lower than in arotinolol group (P = 0.01 1 ).MAP was obviously decreased in propranolol group compared with model group (P =0.003),but HR had no sighificant difference between the two groups (P =0.143).Only TBIL in arotinolol and propranolol groups reduced significantly compared with model group (P <0.001 ).However,ALT, ALB and TBIL were obviously ameliorated in carvedilol group compared with model group (P <0.001,P <0.001, P =0.045).The expression ofα-SMA and the area of collagen fibers in arotinolol,carvedilol and propranolol groups
significantly declined compared with those in model group (P <0.05 ).Conclusion Arotinolol can significantly reduce cirrhotic rats’ portal pressure,with effects similar to those of carvedilol.The effect of arotinolol in improving liver function is weaker than that of carvedilol,but the side effects on MAP are milder than those of carvedilol.

Objective:To investigate prognostic factors of the T-cell non-Hodgkin’s lymphoma (T-NHL),and to study the clinical efficacy of CHOPE plus L-asparaginase (L-ASP)regimen for T-NHL.Methods:Retrospective analyses were made of 61 T-NHL patients who were treated from July 2007 to August 2013.Randomly divided into two groups CHOPE and CHOPE +L group (Based on CHOPE,added with L-ASP on the 1st,3rd,5th,7th,9th and 11th day).Results:Of the 61 patients evaluatd with the median survival was 22 (3 -65)months,the complete remission rate was 52.50%,the partial remission rate 29.51%,and the response rate 80.01%.The complete remission rate was 57.89%,and the patial remission rate 84.21% in CHOPE +L and the complete remission rate 43.48%,the response rate 78.26% in CHOPE,respectively (both P >0.05).The 1-,2-,and 5-year overall survival rates were 91.0%,87.6% and 65.7% respectively (P >0.05 ).But the overall survival rate in CHOPE +L was significantly higher than that in CHOPE group in extranodal NK/T-cell lymphoma,nasal type (ENKTCL)(P <0.05 ).The analysis of the prognostic factors indicated that ENKTCL,the outside junction lesions,and the CR rate were poor factors with statistic significance in T-NHL.Conclusion:CHOPE +L regimen has better efficacy for ENKTCL,but whether CHOPE +L regimen is used in the treatment of T-NHL,large prospective clinical trials are worth for further investigation.

ObjectiveTo study chronic inflammatory demyelinating polyneuropathy(CIDP)after allogeneic hematopoietic stem cell transplantation(allo-HSCT)and the clinical manifestation,diagnosis and treatment.MethodsThe clinical manifestation,laboratory examination,treatment and outcome of a patient with chronic myeloid leukemia after allo-HSCT were studied.ResultsAcute and chronic graft-versus-host disease(GVHD) were occurred in the patient followed by chronic multiple nervous system symptoms from +105 day including facioplegia,decreased muscle strength and dysuria.According to clinical manifestation,results of cerebrospinal fluid exam and electroneurophysiology exam,CIDP was diagnosed.The clinical condition was improved after treatment with intravenous immunoglobulin,glucocorticoid, immunosuppressive agents and functional exercises,but the patient died of secondary infection finally.ConclusionCIDP after allo-HSCT is a rare complication of nervous system and difficult to diagnose and treat.Numerous transplant-related causes are probably associated with the development of CIDP.The main causes are GVHD and immune dysfunction.Early accurate diagnosis and rational treatment is of great importance.

Objective To discuss the risk factors of the chronic obstructive nephropathy progression.Methods A retrospective analysis of the patients with chronic obstroctive nephropathy was performed.Multivariate logistic regression was used to identify correlate risk factors of the chronic obstructive nephrupathy progression.All calculation were compu- ted with the aid of SPSS 10.0 software package.Results In the analysis of risk factors of the chronic obstructive ne- phropathy progression,gender(OR=1.963,P=0.018),hypertention(OR=2.228,P=0.039),hyperuricemia (OR=4.204,P=0.000),hypocalcemia(OR=2.612,P=0.031),proteinuric(OR=1.639,P=0.049),hy- poabumia(OR=5.505,P=0.000),SIRS(OR=6.113,P=0.000),anemia(OR=5.257,P=0.000),renal atophy(OR=5.964,P=0.009),contrast medium(OR=6.113,P

Objective To evaluate the survival status and efficacy,prognosis and safety of several combined chemotherapies in previously untreated patients with follicular lymphoma (FL).Methods Clinical data of 62 previously untreated FL patients were analyzed retrospectively,in order to analyse survival status and to compare the efficacy and safety of different combined chemotherapies.Results The percent of FL patients achieved complete response (CR) after initial therapy was 80.0 ％ (44/55),while achieved for more than 5 years accounted for 23.6 ％ (13/55).Ten-year overall survival (OS) rate was 77.8 ％.The relapse rate was 34.5 ％,and the OS rate in patients with recurrence was significantly lower than in non-recurrence patients (93.8 ％ vs 61.6 ％,P =0.012).The disease-free survival (DFS) and progression-free survival (PFS)rates in FC/FMD (fludarabine,cyclophosphamide/fludarabine,mitoxantrone,dexamethasone) group comparing with CHOP (cyclophosphamide,epirubicin,vincristine,prednisone)-like group were significantly higher (80.0 ％ vs 21.1％ and 80.0 ％ vs 29.2 ％,P ＜ 0.05),but the differences had no statistical significance when adding rituximab (88.9 ％ vs 72.7 ％ and 90.0 ％ vs 73.5 ％,P ＞ 0.05).The OS,DFS and PFS rates in rituximab group were higher than those in the group without it (96.4 ％,79.2 ％ and 79.2 ％ vs 82.9 ％,39.3 ％ and 44.5 ％,P ＜ 0.05).The DFS and PFS rates in fludarabine group comparing with the group without it were significantly higher (86.2 ％ vs 49.4 ％,87.1％ vs 52.7 ％,P ＜ 0.05),but the differences between OS rates had no statistical significance (92.9 ％ vs 89.1％,P ＞ 0.05).The major adverse effects were hematologic toxicity,infection,nausea/vomiting and abnormal liver function.The hematologic toxicity of chemotherapies including fludarabine was stronger,but well-tolerated.Conclusion With initial combined chemotherapies,the CR rate of FL could receive a higher level.It is considered that chemotherapy might cure a part of FL patients thoroughly.Rituximab could increase the OS time significantly.FC/FMD regimen could increase the PFS time,comparing with CHOP-like regimen,while the difference has no statistical significance when adding rituximab.Systemic chemotherapies are well tolerated.

Background The clinical effectiveness of soft corneal contact lens for correction of myopia has been confirmed.Theoretically,aspherical soft hydrophilic corneal contact lens has better visual qualify for myopic eyes,and the lenses have been applied widely.But abnormal tear film,even many cornea and conjuctiva diseases caused by soft contact lens have been reported,so the effectiveness and safety of aspherical soft hydrophilic corneal contact lens are worth concerning.Objective This clinical trail was to compare the effectiveness and safety between aspherical and NUV soft hydrophilic contact lens for myopic eyes.Methods A randomized,double-blind and controlled clinical study was performed under the approval of Ethic Committee of Qingdao Municipal Hospital and informed consent of each patient.One hundred and forty eyes of 70 myopic patients were enrolled in QingdaoMunicipal Hospital from July to October,2012.The subjects were randomized into the trial group and control group using random number table.Aspherical soft hydrophilic contact lenses were worn in the trial group and NUV soft hydrophilic contact lenses were worn in the control group.The characteristics of the lens surface,outcomes and the eye number in different scores of ocular signs and symptoms were assessed before and 15 minutes,1 week,2 weeks and 1 month after wearing lenses.Results The sores of humidity of anterior surface,the sediment in anterior and posterior surface are 0 in both lenses in various time points after wearing.The corrected visual acuity of all the subjects were ≥ 1.0.The eye number of 2-3 scores in various ocular signs was 0 in both groups,but the eye number of 1 score in palpebral conjunctival congestion and limbus congestion were more in the trail group than those in the control group in different time points (all at P＜0.05).There were significant differences in corneal fluorescine staining between the groups in different time points (all at P＞0.05).There was no eye for 2-3 scores of eye symptoms in both groups.The eye number for 1 score in foreign body sensation increased in the target-trail group compared to the control group at various time points (P =0.002,0.006,0.005,0.005).However,there was no statistically significant differences in the eye number for 1 score in visual clearness and stability between the two groups at the follow-up duration (all at P＞ 0.05).Conclusions Aspherical soft hydrophilic corneal contact lens has good outcomes in corrected visual acuity for myopia like NUV soft hydrophilic contact lens,but the wearing of aspherical soft hydrophilic corneal contact lens induces more ocular discomfortableness.

Objective To explore the clinical effect of Jiangru Formula(Herbal formula for soothing the liver,clearing heat,activating blood and removing stasis)combined with TCM surgical treatment for plasmocyte mastitis.Methods Fifty five patients with plasmocyte mastitis were treated with Jiangru Formula orally and TCM surgical treatment to see the effect of this method.Results The total effective rate was 100%.The average treatment period was(28?13.61)days.The recurrence rate was 1.82%.Conclusion The combination of Jiangru Formula with TCM surgical treatment for plasmocyte mastitis is effective in shortening the treatment period,reducing the recurrence rate and keeping the shape of the breast.