Establishing a teaching quality control system and strengthening the supervision to the teaching quality is an important means and guarantee of the constant improvement and perfection of the quality of teaching at affiliated hospitals

ObjectiveTo investigate the clinical efficiency of oral warfarin after cardiac valve replacement and the influence of vitamin K epoxide reductase complex subunit 1(VKORC1) gene polymorphisms on warfarin maintenance dose.MethodsOne hundred and fifty-nine patients who got cardiac valve replacement surgery were chosen and received anticoagulation therapy by oral warfarin.The prothrombin time (PT),international normalized ratio (INR) of patients were recorded and the safety ranges of PT and INR were calculated statistically.VKORC1 gene polymorphism of patients weredetected by PCR-PFLP technology by adjusting the dose of warfarin,and the results were compared.ResultsThe safety monitoring range of PT of oral warfarin after cardiac valve replacement surgery was 15.36 -24.82 s,safety monitoring range of INR was 1.33 - 2.62.The occurrence rate of bleeding during anticoagulation was 13.21％(21/159).The weekly dose of warfarin of VKORC1 gene type AA [(24.28 ± 10.79) mg] was significantly higher than that of VKORC1 gene type GA[ ( 16.64 ± 7.43 ) mg] and type GG[ ( 12.12 ± 7.17 ) mg](P＜ 0.05or ＜0.01 ).ConclusionsThe polymorphism of VKORC1 gene is the dominant factor of the differences of warfarin maintenance dose.The warfarin dose in patients with different gene type is different.The clinical safety monitoring ranges of PT and INR in patients with oral warfarin after cardiac valve replacement are lower than the recommended ranges of European and American countries.Therefore,the index of patients after surgery should be detected regularly.

0.05). Conclusion The movement of train has not obviously affect to the routine blood test.

Objective To evaluate the effect of 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) on S.epidermidis biofilms.Methods S.epidermidis was cultured on cover glasses,with or without thepresence of ALA at 50 mmol/L for 16 hours followed by the exposure to different doses (100,200,300 J/cm2) of red light.S.epidermidis receiving neither pretreatment nor irradiation served as the negative control.Subsequently,confocal laser scanning microscopy (CLSM) was used to observe the structure and evaluate the biological activity of S.epidermidis biofilms; colony forming units (CFUs) of S.epidermidis were counted for the evaluation of killing effect of ALA-PDT; scanning electron microscopy (SEM) was used to observe the morphological structure of the biofilms.Results The number of colony forming units per milliliter (CFU/ml) was (210 ± 7.55) × 105,(91 ± 1.53) × 105,(16 ± 1.52) × 105 for S.epidermidis pretreated with ALA followed by irradiation with red light at 100,200 and 300 J/cm2 respectively,significantly different from untreated S.epidermidis ((388 ±8.89) × 105,all P ＜ 0.01) and S.epidermidis irradiated with red light only.Increased ratio of dead to live cells was observed in ALA-pretreated S.epidermidis irradiated with red light at 100,200 and 300 J/cm2compared with untreated S.epidermidis (1.254 ± 0.096,1.301 ± 0.160 and 3.410 ± 1.140 vs.0.358 ± 0.057,all P ＜ 0.01) and S.epidermidis irradiated with red light only.SEM showed that the biofilm structure was loose and obscure in S.epidermidis treated with ALA-PDT,and even disappeared with S.epidermidis distributed in single colonies when the dose of red light was 300 mJ/cm2.Conclusion ALA-PDT shows a potential bactericidal activity against S.epidermidis in biofilms,which can not only reduce biofilm vitality,but also damage biofilm structure.

For the past few years,with the extensive application of nanoparticle technology in photodynamic therapy (PDT) of cancers,there have been some improvements of the stability of photosensitizers,the tumor targeting,the working depth and the yield of singlet oxygen by a variety of ways.Furthermore,with nanoparticle,PDT also can be combined with some other treatments together.Finally,the use of nanoparticle vectors for PDT is a novel and promising approach which might improve the efficiency of photodynamic therapy for tumors,overcome many adverse effects and increase the indications of PDT.

The DNA microarray study showed that in STZ-induced diabetic rats the elevatedexpression of 42 genes in artery were depressed markedly after atorvastatin treat ment .This suggeststhat atorvastatin may have the protective effects on the diabetic vascular lesion.

ObjectiveTo investigate and analyze the prevalence and risk factors of acute stress disorder (ASD) among survivors of road traffic accidents.MethodsA total of 206 participants ( 168 men,38 women) were administrated with the acute stress disorder scale (ASDS) 2 to 23 days after the traffic accidents.ResultsThere was a total of 61 (29.6％) possible ASD patients among all participants.Women had more serious ASD symptoms than men (male:36.70 ± 11.42; female:41.18 ± 12.58; P＜ 0.05 ),the married's ASD symptom severity was higher than the single's ( married:38.37 ± 11.94 ; single/widowed/divorced:30.86 ± 8.37 ; P ＜ 0.01 ),people with low degree of education had more severe ASD symptoms than the people who had high degree of education (P＜0.05) ; being elder( r=0.43,P＜0.01 ),having fear / helpless / horror experience of accident ( r=0.21,P＜ 0.01 ) were significantly correlated with the severity of ASD symptoms.According to linear regression analysis,age could positively predicted ASD symptoms ( β =0.29,P ＜ 0.01 ) too.ConclusionASD is a common mental problems among Chinese survivors of road traffic accident,and the main predictive factors of ASD include gender,age,marital status,the degree of education,whether there is fear / helpless / horror experience of accident.

Objective To investigate the drug resistance status quo of imipenem-resistant Pseudomonas aeruginosa and carbap-enemase gene carrying in Xi′an area for guiding the clinical rational use of antibacterial drugs.Methods 151 strains of imipenem-re-sistant Pseudomonas aeruginosa isolated from clinical samples in 4 hospitals from August 2012 to July 2013 were continuously col-lected.Then the drug resistance characteristics of imipenem-resistant Pseudomonas aeruginosa were investigated by the antimicrobi-al drug sensitivity test.The PCR technique was adopted to detect the carrying situation of carbapenemase drug-resistance genes in imipenem-resistant Pseudomonas aeruginosa.Results Totally isolated 151 strains of imipenem-resistant Pseudomonas aeruginosa were mainly distributed in the neurosurgery ICU (37.1%),neurology ICU (27.1%)and the burn department (19.9%);the detec-ted strains were sensitive to polymyxin B and resistant to other 9 kinds of antibacterial drugs in different degrees;94 strains carried VIM gene,32 strains carried IMP gene,5 strains carried SPM gene and 3 strains carried SIM gene.Conclusion The multidrug re-sistance and pan-drug resistance phenomenon of imipenem-resistant Pseudomonas aeruginosa is serious,its cause might be related with the carbapenemases-producing drug resistant gene expression,the drug resistance genes are dominated by VIM and IMP.Clinic should strengthen the bacterial drug resistance monitoring and use antibacterial drugs rationally and effectively for preventing the spreading of imipenem-resistant Pseudomonas aeruginosa.

Objective To evaluated the renal hemodynamic changes in early diabetic nephropathy rats by color Doppler ultrasound and its correlation with podocyte damage.Methods Twenty male SD rats were randomly divided into 2 groups:,control group and diabetic nephropathy group.After 8 weeks,the systolic peak velocity (Vmax),diastolic minimum velocity (Vmin) and resistance index (RI) were measured by color Doppler ultrasound,the pathological changes in kidney tissues were obseved by HE staining,nephrin deposits were observed by immunofluorescence,and the nephrin mRNA expression in the renal cortex were detected by RT-PCR method.The difference of those results between two groups were compared,and the relationship between nephrin mRNA expression and index of renal hemodynamic were analysed.Results Compared with rats in control group,the Vmax and Vmin was lower among rats in diabetic nephropathy group [(16.63 ± 2.85)cm/s vs (24.16 ± 3.35)cm/s,P ＜0.001 and (5.41 ± 1.11)cm/s vs (9.87 ± 2.26) cm/s,P ＜0.001].However,the RI was higher than that of control group (0.73 ± 0.14 vs 0.57 ± 0.12,P =0.034).Bigger glomerular volume,increased mesangial matrix,increased mesangial cells,and visible focal lymphocytic or mononuclear cell infiltrated were observed in diabetic nephropathy group.The expressions of nephrin were lower in the cortex of renal in diabetic nephropathy group compared to control group (0.276 ± 0.015 vs 0.507 ± 0.024,P ＜0.001).Correlation analysis suggested nephrin mRNA expression was positively correlated with the Vmax and Vmin (r =0.931 and r =0.944,all P ＜0.001),and negatively correlated with RI (r =0.786,P ＜0.001).Conclusions Renal hemodynamic changes assessed by color Doppler ultrasound associated with podocyte damage in diabetic nephropathy rat,which is a noninvasive method of evaluation of early kidney damage.

Objective To investigate the effect of lliac fascia compartment block on early analgesia of patients during performed the whole knee replacement.Methods Forty patients undergoing single whole knee replacement were randomly divided into group A and B,20 cases in each group.Before anesthesia,patients in group A underwentthree in one femoral nerve block guided by nerve stimulator with 20 ml of 0.5％ ropivacaine.Patients in group B underwent lliac fascia compartment block with 25 ml of 0.5％ ropivacaine.Visual analogue score (VAS) during rest and movement were recorded at 0 (T0),0.5 (T1),1 (T2),2 (T3),4 (T4),6 (T5),and 8 h (T6) after a patient fully awoke from surgery.Results In group B,Resting VAS scoresofpatientswere(4.5±0.7),(4.5 ±0.6),(4.2 ±0.8),(4.4 ±0.5),(4.3 ±0.7),(4.4 ±0.6),(5.2 ±0.6) at T0-T6 time point,and moving VAS were(4.7 ±0.6),(4.4 ±0.7),(4.4 ±0.5),(4.3 ±0.6),(4.4±0.6),(5.0 ±0.7),(5.1 ±0.6),all higher than that of group A((1.5 ±0.6),(1.7 ±0.6),(1.7 ± 0.6),(1.7 ±0.6),(1.9 ±0.6),(2.0 ±0.6),(2.2 ± 0.5) and(1.6 ±0.6),(2.0 ±0.6),(1.8 ±0.6),(1.7 ± 0.6),(2.0 ± 0.6),(2.3 ± 0.6),(2.5 ± 0.7),and there was significant difference (resting VAS∶ F (between group) =17.672,P ＜ 0.05,F(within group) =5.062,P ＜ 0.001,F(interaction) =1.443,P =0.143) ; Moving VAS:F (between group) =8.183,P ＜ 0.001,F (within group) =7.742,P ＜ 0.001,F (interaction) =0.85,P =0.424).Conclusion Iliac fascia compartment block had proved with early analgesic effect in patients with total knee replacement.Iliac fascia block is simple,safe,and can be performed without nerve stimulator.Therefore iliac fascia block has a certain clinical application.