Objective To compare sequence analysis of the yeast-like fungal isolates with traditional methods and analyze the feasibility of identification of common yeast-like fungal by sequence analysis of gene. Methods 115 yeast-like fungal isolates were collected in the clinical laboratory of Beijing Tongren Hospital. DNA of yeast-like fungal was extracted and then amplified with universal primers of part of 18S rRNA genes followed by sequencing directly. The sequences obtained were submitted to the GenBank (NCBI) to identify the fungi. At the same time, the CHROMagar Candida and Vitek 32 YBC were used to identify the fungi. The identification accuracy with three methods was compared to explore the feasibility of the identification of sequence analysis. Results 18S rRNA gene sequence analysis was compared with traditional method. There were some differences in the identification results of 13 strains. The coincidence rate between CHROMagar Candida and sequence analysis was 89. 2% (91/102) and the coincidence rate between Vitek 32 YBC and sequence analysis was 91.3% (105/115). The positivity rate of species-level identification by CHROMagar Candida , Vitek 32 YBC and the 18S rRNA gene sequence analysis were 88. 7 % ( 102/115 ), 100% ( 115/115 ), 100% ( 115/115 ). Conclusion Identification of medically important yeast-like fungal by sequence analysis of the 18S rRNA gene is reliability.

According to teaching outline and clinical training characteristic of psychophy-laxis speciality(including Psychiatry and Medicopsychology),we explored how to strengthen the clinical thinking ability and clinical skill training for clinical medicine students based on cultiva-tion of elementary knowledge and theory,and we also established a set of more appropriate item system of clinical skills assessment so as to improve the practice quality in psychiatry and medical psychology departments.

Objective:To study the molecular composition of bismuth potassium citrate. Methods:The content of bismuth was de-termined using a volumetric method, the content of potassium was determined by atomic absorption spectrometry, and the content of cit-rate root was determined by ion chromatography. The structure was predicted using 1 HNMR and the crystal structure was studied using X-diffraction test and scanning electron microscopy. The changes in the percentage ratio of the three components were investigated by accelerated stability tests. Results:On the dried basis, the percentage of the three molecular components was bismuth of 35%-38%, potassium of 7%-11% and root citrate of 49%-52%. The NMR spectra and the data indicated that the product had three isomers with the molecular structure of bismuth∶potassium∶root citrate=2∶2∶2. The X-diffraction test and SEM showed that the three forms of amor-phous, monocrystalline and polycrystalline might exist. The percentage ratio of the three elements before and after the stability test was basically stable. Conclusion:Bismuth potassium citrate may have three crystal forms with the percentage of the three structure parts within a certain range, and the structure is relatively stable.

Objective To establish a method for the determination of gallic acid in Gongyanping Dispersible Tablet by HPLC.Method A HPLC method was performed on Hypersil ODS column(4.0?250 mm,5 ?m).The mobile phase was acetonitrile(0.2 %CH3OH)-water solution of 0.1 %triethylamine and 0.1 %phosphoric acid(1 ∶99).The detection wavelength was 220 nm and flow rate was 1.0 mL/min.Results Gallic acid showed a good linearity in the range of 0.022～0.352 ?g,r=0.999 9.The average recovery was 99.70 %,and RSD was 1.61 %.Conclusion This method is effective and can be used for the quality control of Gallic acid in Gongyanping Dispersible Tablet.

Objective To explore the teaching efficacy of applying scene simulation in enteral nutrition nursing skills training.Methods Totally 126 nursing students were randomly divided into 2 groups:experiment group with scene simulation teaching method and control group with traditional teaching method.Comparison of teaching efficacy between the two methods was made.Results The students in experiment group can skillfully complete nutritional care and get the praise of teachers.The satisfied patients made by students in experiment group were higher than those in control group 14.28％ - 19.05 ％ ( P＜0.05 ).The assessment scores of theoretic knowledge test and enteral nutrition nursing manipulation examination and comprehensive nursing skill test were higher in experimental group than in control group 6.69 - 11.94 ( P＜0.005 ).Conclusion Scene simulation teaching method is suitable for enteral nutrition nursing skill training and is favored by nursing students.

Objective To differentiate between peri-prosthetic infection and aseptic loosening using quantitative analysis of triphasic bone scintigraphy.Methods Twenty-eight patients (9 males,19 females; mean age 67.5 years,range 49-80 years) with recurrent joint pain after arthroplasty were retrospectively assessed.All patients underwent triphasic bone scintigraphy.ROI of each joint was drawn and the ratios of affected to unaffected side were calculated.The ratios of blood flow phase,blood pool phase,static phase,Creactive protein (CRP) and erythrocyte sedimentation (ESR) were quantitatively analyzed by ROC curve.The final diagnosis was based on microbiological and histological examinations.The optimal cut-off value was chosen based on the ideal sensitivity and specificity.Results Nine patients were diagnosed as septic loosening,17 patients aseptic loosening,1 patient bursitis of hip joint and 1 patient suture reaction.Taking the positive results of blood flow phase or blood pool phase as standard for diagnosing septic loosening,the sensitivity,specificity and accuracy of bone scintigraphy were 7/9,78.9％ (15/19) and 78.6％ (22/28),respectively.The AUC of blood pool phase was 0.942,and the sensitivity and specificity were 8/9 and 78.9％(15/19),respectively,with the optimal cut-off value of 1.40.The AUCs of blood flow ratio and CRP were 0.816 and 0.795,with cut-off values of 1.53 and 1.20,respectively.The AUCs of static phase ratio and ESR were 0.474 and 0.722,respectively,both P＞0.05.Conclusions For the diagnosis of septic loosening,quantitative analysis of triphasic 99Tcm-MDP bone scintigraphy,particularly with the ratio of blood pool phase,is more accurate than qualitative analysis.

To understand the personality characteristics and temperament type of medical students in Xi'an Jiao tong University,and to provide scientific evidence for their targeted mental intervention by analyzing graphs about Eysenck personality questionnaire revised in China.,310 medical students were investigated by using EPQ(adult version).We found that there were more male students with typical psychoticism personality than female students with the same personality,and there was statistical significant difference in the distribution of the type of temperament between male and female students.Medical students with stable personality probably accounted for two-thirds of the total.Female students were mainly manifested unstable personality with extraversion,while male students were unstable introvents.In future we should take targeted psychological intervention measures.We are supposed to focus on each student's personality characteristic,temperament type and other specific conditions for a variety of education.

Objective To compare the clinical effect of the primary total hip replacement (THR)and the secondary THR after failed internal fixation in elderly patients with displaced femoral neck fracture,so as to investigate the optimal treatment for displaced femoral neck fractures in elderly patients.Methods From January 2006 to December 2012,22 patients treated with a secondary THR after failed internal fixation were chosen as the observation group and 30 patients treated with a primary THR were chosen as the control group,the operation time,blood loss,postoperative Harris scores for hip joint and health-related quality of life (~ index score) were observed and analyzed in two groups.Results Both of the groups were followed up successfully and each of the groups had 1 patient died.There were no joint infection,re-operations and any other complications in both groups.The operation time in observation group was longer than that in control group [(114.82 ±32.13) min vs.(90.63 ± 16.24) min],blood loss was more than that in control group [(551.73 ± 241.62) ml vs.(314.46:± 156.72) ml],there was significant difference (P ＜ 0.05).But the Harris score and KPS index score between two groups had no significant differences (P ＞ 0.05).Conclusion The primary THR in elderly patients with displaced femoral neck fracture has lower risk in operation tocompare with the secondary THR after failed internal fixation,but the two ways are similar in the hip joint function recovery and improve patients quality of life.

Objective To study the universal newborn hearing screening (UNHS) results obtained in Beijing from 2007 to 2010 and to evaluate the index of hearing screening in Beijing. Methods The newborn born in Beijing just from October 1, 2007 to September 30, 2010 were selected and their hearing screening and diagnosis data were retrospectively collected. Results From 2007 to 2010, 470537 infants (90.2%) were screened in Beijing as 1st stage UNHS. 43019(9.1%) failed otoacoustic emission (OAE) tests. 31009 infants (72.8%) were screened in 2nd stage UNHS and 4568 failed tests. 1262 infants were referred for more testing and 1087 of them were diagnosed regularly.501infants were normal. 266 infants were finally diagnosed with single hearing loss and 303 infants were diagnosed with binaural hearing loss. 61infants were diagnosed with severe binaural hearing loss. Conclusion Establishment of the perfect newborn hearing screening system and advanced information system, and follow-up for the suspected children actively by doctors of community health care unit facilitate to improve UNHS.

Objective To evaluate the effects of four types of variance reduction techniques ( ring counter grid, high electron cutoff energy, termination of electron tracking in some structures, and emission direction?biased sampling of source) on the efficiency and accuracy of Monte Carlo simulation for the single source channel of the Leksell Gamma Knife. Methods The single source channel of the Leksell Gamma Knife was modeled using Monte Carlo software MCNP . Four types of variance reduction techniques were used to simulate the dose distribution in the water?like phantom. The computation efficiency and simulation result were compared between the four techniques. Results All techniques substantially improved the computation efficiency and had little effect on the accuracy of the simulation ( relative error less than 2. 5%) . However, if the electron cutoff energy was above 50 keV, the simulation became quite inaccurate due to neglect of the scattering of high?energy electrons and their dosimetric contribution to the penumbra. When the scattering of high?energy electrons and their dosimetric contribution to the penumbra were ignored, the dose to the Profile platform was overestimated and the dose to the penumbra was underestimated. Conclusions Rational use of variance reduction techniques can substantially improve the efficiency of Monte Carlo simulation for the single source channel of the Leksell Gamma Knife. However, the impact of variance reduction techniques on the accuracy of the simulation should be carefully evaluated.