Preeminent Doctors Education and Training Plan has put forward an urgent request to reform the five-year clinical undergraduate medical talent training mode and strengthen the professional spirit cultivation for medical students. As a pilot project, our college continuously explored the professional spirit cultivation mode for medical students in preeminent physician class and has almost established the three-dimensional mode of whole process, joint participation, multi approach and stressing practice.

?AIM: To study the changes of choroidal thickness and hemodynamic parameters in patients with diabetic retinopathy and their influencing factors.?METHODS: From January 2013 to January 2015, 100 patients (100 eyes) with type 2 diabetes were divided into 3 groups:34 patients without diabetic retinopathy ( NDR) , 36 patients with non proliferative diabetic retinopathy ( NPDR) group, and 30 patients with proliferative diabetic retinopathy (PDR). According to the results of OCT, the patients with diabetic retinopathy were divided into 2 groups: diabetic macular edema ( DME ) group ( 28 cases) , and 38 cases without diabetic macular edema. During the same period in our hospital 35 subjects for physical examination were selected as the control group. The hemodynamic parameters of the posterior ciliary artery in different groups of patients at different distance from the center of the macular were compared, analyzing influencing factors.?RESULTS:With the aggravation of diabetic retinopathy, the choroidal thickness in different distance from the center of the macular decreased. The choroidal thickness of NPDR and PDR group were thinner than that of the control group (P<0. 05). The choroidal thickness of NDR group was not different from the control group (P>0. 05). There was no significant difference in the choroidal thickness between the DME patients and non DME patients (P>0. 05). Pearson correlation analysis showed that there was no significant correlation between choroidal thickness of patients with diabetic retinopathy and diabetic duration, fasting blood glucose, HbA1c, eye axis length, systolic blood pressure and diastolic blood pressure (P>0. 05), but there was a correlation with BCVA (logMAR) (P<0. 01). EDV and PSV in NDR group and NPDR group were significantly lower than those in control group, RI was higher than that in control group. PSV and EDV in PDR group were significantly lower than those in other three groups, RI was higher than the other three groups, and the difference was statistically significant ( P<0. 05).?CONCLUSION:With the severity of retinopathy in type 2 diabetic patients, the choroidal thickness decreased, and the thickness of the choroid is beneficial in the comprehensive analysis of 2 diabetic retinopathy.

Objective To report the surgical approach for the treatment of giant or extensive skin lesions due to the infection of human papilloma virus (HPV). Method Surgical treatment was performed for 10 patients with verruca vulgris, 20 with condyloma acuminatum, and 8 with epidermodyplasia verruciformis, whose giant or extensive lesions were poorly responsive to routine non-surgical therapy. Results Recurrence of lesions was found in 2 of 10 patients with verruca vulgris and 5 of 20 condyloma acuminatum in 6 months after operation, with a total recurrent rate of 25%. The extensive skin lesions were removed and the functions of affected limbs were recovered in patients with epidermodyplasia verruciformis after operation, however, the long-term topical retinoids was needed to control the recurrence of the lesions. Conclusion Surgical approach is effective for the treatment of the giant or extensive skin lesions due to HPV infection.

OBJECTIVETo investigate the effect of photodynamic therapy combined with compound betamethasone in the treatment of hypertrophic scar.

METHODS37 cases of keloid were divided into two groups, 19 cases in the treatment group, 18 cases in the control group. The patients in treatment group were treated with photodynamic therapy combined with compound betamethasone injection therapy. The patients in the control group were treated by compound betamethasone injection. The effect and recurrence rate were compared before and after treatment.

RESULTSThe effective rate was 89.5% in the treatment group, 55. 6% in the control group, showing significant difference between the two groups (P = 0.029) The relapse rate in treatment group was significantly lower than that in the control group (P = 0.047) CONCLUSIONS: Photodynamic therapy combined with compound betamethasone has good effect and safety for the treatment of hypertrophic scar. The combined treatment can reduce the treatment period and side effects

Betamethasone ; therapeutic use ; Case-Control Studies ; Cicatrix, Hypertrophic ; drug therapy ; Combined Modality Therapy ; methods ; Glucocorticoids ; therapeutic use ; Humans ; Photochemotherapy ; methods ; Recurrence

Objective To evaluate the effects of acitretin combined with clarithromycin on tumor growth in human oral epidermoid carcinoma xenografts in nude mice,and to investigate their antitumor mechanisms.Methods A cell line of human oral epidermoid carcinoma was subcutaneously inoculated into 31 Balb/c nude mice to establish a xenograft model of human skin tumor.Then,the nude mice were randomly classified into 6 groups according to a double blind protocol:control group (n =6) remaining untreated,placebo group (n =5) treated with wheat flour,acitretin group (n =5) treated with acitretin 7.2 mg/kg per day,clarithromycin group (n =5) treated with clarithromycin 100 mg/kg per day,acitretin + placebo group (n =5) treated with both acitretin (7.2 mg/kg per day) and wheat flour,and acitretin + clarithromycin group (n =5) treated with acitretin (7.2 mg/kg per day) and clarithromycin 100 mg/kg per day.All the drugs were intragastrically administrated once daily.After three weeks of treatment,mice were sacrificed and xenografts were removed.Then,the size and weight of xenografts were measured,and pathological analysis was conducted.Real time-PCR was performed to quantify the mRNA expressions of vascular endothelial growth factor (VEGF) and nuclear factor (NF)-κB,and immunohistochemistry was carried out to observe the expression of VEGF as well as to determine microvessel density (MVD) and Ki-67 proliferation index.By using the software SPSS 19.0,analysis of variance was performed for comparison of measurement data,and least significant difference (LSD) test for paired comparisons.Results Both the size and weight of xenografts in the acitretin + clarithromycin group were significantly lower than those in the other groups (all P ＜ 0.05).Real-time fluorescence-based PCR revealed weaker mRNA expressions of VEGF and NF-κB in the acitretin + clarithromycin group compared with the control group,clarithromycin group and acitretin group (all P ＜ 0.05).As immunohistochemistry showed,the acitretin + clarithromycin group displayed a decrease in the expression rate (all P ＜ 0.01) and staining intensity of VEGF,MVD (all P ＜ 0.01) with a sparse distribution of microvessels,Ki-67 proliferation index (all P ＜ 0.05) and proliferative activity of tumor cells compared with the control group,clarithromycin group and acitretin group.Conclusion Acitretin combined with clarithromycin can synergistically inhibit the growth of human oral epidermoid carcinoma xenografts in nude mice,downregulate VEGF expression,and suppress angiogenesis and tumor proliferation.

Electrophoresis, Capillary ; methods ; Humans ; Micelles ; Paraquat ; blood

The effects of pretreatment methods of Jerusalem artichoke tubers on microbial lipids fermentation with an oleaginous yeast strain Rhodosporidium toruloides Y4 were investigated in shaking flask culture.The yeast strain accumulated substantial amount of lipids using either purple-or white-skinned Jerusalem artichoke tubers as sole carbon and energy source.When cells were cultured on the extracted juice or the acidhydrolysate,cellular lipid content reached 40%(w/w),while cultured on the pulp,the white-skinned tubershadhigher lipid productivity,yielding 12.1 g lipids per100 g dried tubers.Major fatty acid constituents of microbial lipids were those contained 16-and 18-carbon atoms based on GC analysis,which is quite similar to traditional vegetable oil.Microbial lipids prepared from Jerusalem artichoke can be applied to biodiesel production.

ObjectiveTo compare the clinical results of small surgical incision of bilateral spinous process and traditional open surgical incision in posterior single level lumbar interbody fusion,and assess the application value of the small surgical incision of bilateral spinous process in posterior single level lumbar interbody fusion.MethodsFrom December 2006 to June 2008,70 patients with lower lumbar vertebral diseases underwent single segment posterior lumbar interbody fusion.Patients were randomly divided into small surgical incision of bilateral spinous process group(Hereinafter referred to as small incision group) of 36 cases and 34 cases of conventional open group.Small incision group included 20 males and 16 females with an average age of 52.0 years.Traditional open group included 16 males and 18 females with an average age of 53.2 years.Two groups of operative time,blood loss,postoperative drainage,X-ray projection operation frequency,hospital stay,complication rate,creatine phosphokinase (CPK) level,multifidus cross-sectional area,postoperative low back pain visual analogue scale(VAS),Oswestry disability index(ODI),interbody fusion rate were compared,respectively.ResultsAll of 70 cases were followed up for 12-24 months (average,16).There were no statistically differences in the operation time,the number of X-ray projection,complication rate,and fusion rate between the two groups (P＞0.05),but there were significant differences in blood loss,postoperative drainage,the first day and the third day of postoperative the level of CPK,postoperative multifidus muscle cross-sectional area,postoperative low back pain VAS,hospital stay,and postoperative ODI between the two groups(P＜0.05).ConclusionSmall surgical incision of bilateral spinous process and traditional open surgical posterior lumbar interbody fusion were satisfied with the efficacy,but small surgical incision of bilateral spinous process with less trauma,shorter hospital stay,and rapid postoperative recovery.

For systematic scientific management,based on information and,it is the trend to develop a information system that is based on internet technology and dynamic management concept.The system is project-centered,integrating the procedures of application,review,approval,mid-term review,summarization,and assessment.According to the preliminary operation of the system,it is proved effective with anthropic factors much lowered,and the coherence and continuity of the projects and ther reproducibility of data are much guaranteed.

Objective To evaluate the relationship of myocardial MR contrast delay-enhancement and nuclear perfusion-metabolism pattern in patients with idiopathic dilated cardiomyopathy (IDCM).Methods Forty-two consecutive patients (29 men and 13 women,age:(53 ±12) years) diagnosed clinically with IDCM were enrolled.All patients underwent 99Tcm-MIBI SPECT,18F-FDG PET imaging and MR contrast delay-enhancement imaging within 3-7 d.The myocardial perfusion-metabolism segment analysis was performed using a 17-segment model.Segmental 99Tcm-MIBI and 18F-FDG uptakes were scored visually using a 4-grade scoring system (0 =normal uptake,1 =mildly reduced uptake,2 =moderately reduced uptake,3 =severely reduced uptake).Patterns of perfusiorn/metabolism were classified as normal,mismatch,mild-to-moderate match and severe match.Myocardial MR contrast delay-enhancement was classified into 3 categories (non,mid-wall and transmural delay-enhancement).x2 test was used to analyze the differences of perfusion/metabolism patterns among non,mid-wall and transmural delay-enhancement groups and the myocardial MR contrast delay-enhancement incidence among four perfusion/metabolism groups.Resuits Among the 42 patients,myocardial delay-enhancement was present in 18 patients,of which 94.4％ (17/18) showed abnormal myocardial perfusion/metabolism patterns and only 33.3 ％ (8/24) patients without abnormal myocardial delay-enhancement had abnormal myocardial perfusion/metabolism patterns (x2 =15.944,P ＜ 0.001).Perfusion/metabolism patterns varied in three different categories of non,mid-wall and transmural delay-enhancement (x2 =14.276,P ＜ 0.001).The normal peffusion/metabolism pattern proportions in the non,mid-wall and transmural delay-enhancement groups were 86.2％ (526/610),71.0％ (44/62) and 28.6％ (12/42),respectively.The incidence of transmural delay-enhancement (44.4％ (12/27)) was significantly higher in segments with severe match than that in the other 3 groups (normal:2.1％ (12/582) ; mismatch:18.1％ (15/83) ; mild-to-moderate match:13.6％ (3/22) ; x2 =112.530,P ＜ 0.001).Conclusions MR contrast delay-enhancement is much more sensitive in detecting moderate fibrosis,while nuclear perfusion-metabolism imaging can detect more impaired but viable myocardium.Combining the two imaging modalities is useful for providing comprehensive evaluations of myocardial injury in patients with IDCM.