Medical postgraduates are the future core force of clinical diagnosis and treatment,scientific research,education and sanitary administration.Therefore,to cultivate qualified professionals,the key of contemporary medical postgraduate education is to pay more attention to comprehensive quality training in order to make students adapt to the continuous development of society and medical model.The First Clinical College in Wuhan University has implemented the hospital administration internship in combination with social needs and explored the education model of contemporary medical students with comprehensive quality.

Objective To compare the effecacy and safety of lower dose peginterferon alfa-2b plus ribavirin versus standard interferon alfa-2b plus ribavirin for treatment of chronic hepatitis C in China.Methods 192 patients with chronic hepatitis C were assigned peginterferon alfa-2b 0.5?g/kg each week plus ribavirin 750～1050 mg/d or standard interferon alfa-2b 3 MIU TIW plus ribavirin 750～1050 mg/d for 48-week treatment and 24-week fellow-up.Results The sustained virological response (SVR)rate in lowe-dose peginterferon alfa-2b plus ribavirin group was 53.8%,and the SVR rate in standard interferon alfa-2b plus ribavirin was 58.1%.The SVR was similar between the two treat- ment group(P=0.966 for both comparisons).The adverse event rate was higher in peginterferon al- fa-2b plus ribavirin group than in standard interferon alfa-2b plus ribavirin group(P=0.033 for both comparisons),but there was no new or unique adverse event in related to pegylation of interferon alfa-2b. Conclusion The effecacy and safety was similar between lower-dose peginterferon alfa-2b plus ribavirin and standard interferon alfa-2b plus ribavirin for treatment of chronic hepatitis C.

Background Dyslipidemia is one of the major causes of age-related macular degeneration (AMD).At present,the study of the preventive and treating methods of A MD is still a hot spot.Objective The purpose of this study was to observe the effect of tonifying the spleen and promoting blood circulation on the retina and Bruch membrane in apolipoprotein E-deficient (ApoE-/-) mice with dyslipidemia.Methods Thirty-six ApoE-/-mice aged 2 months were randomly divided into the normal diet group,high fat diet group and medicine group.A diet with a higher content of fat was given for 5 consecutive months to the mice of the high fat diet group and medicine group,and in the last month,a concoction that tonifies the spleen and promotes blood circulation was gavagely administered in the medicine group,and an equivalent volumes of normal saline solution was administered in the same way in the normal diet group and high fat diet group.Total plasma cholesterol (TC),low density lipoprotein (LDL)and triglyceride (TG) were detected by (ELISA? Name of assay?) using the 7170 Hitachi automatic biochemical analyzer,and morphological changes of the retina and Bruch membrane were examined by light microscopy and transmission electron microscopy.The number of outer nuclear layer (ONL) cells,retinal pigment epithelial (RPE) cells and the thickness of the Bruch membrane were examined by semi-quantitative histopathology with the Mias 2000 Imaging Analyzer System.Results The concentrations of TC,LDL and TG were (6.47 ±0.49) mmol/L,(1.46 ±0.10)mmol/L and (0.62 ±0.21) mmol/L,respectively,in 7-month-old mice of the medicine group,showing a significant reduction in comparison with (10.53 ±0.30) mmol/L,(1.90±0.13) mmol/L,(1.15±0.29) mmol/L of the high fat diet group,and (9.63 ± 0.18) mmol/L,(1.12 ± 0.15) mmol/L,(0.88 ± 0.21) mmol/L in the normal diet group (P＜0.05-0.01).The disorder and atrophy of ONL and RPE cells,divergence of fiber of the Bruch membranes were found in both the high fat diet group and normal diet control group under the light microscope,and drusen formed in some of the mice in the high fat diet group.However,ONL and RPE were well organized in the medicine group.The cell numbers in the ONL and RPE layer in the 7-month-old mice were (23 124.00±755.18) and (10.75±0.59),respectively,in the medicine group,(19 107.00 ± 1436.82) and (8.55 ± 1.11),respectively,in the high fat diet group,(21 663.00± 1073.27) and (9.75 ±0.58),respectively,in the normal diet group,with significant differences among them (P＜0.05-0.001).Thickness of the Bruch membrane in the medicine group extensively reduced in high fat diet group and normal diet control group (P＜0.01).The ultrastructures of the RPE and Bruch membrane were much more improved in the mdedicine group.Conclusions Tonifying the spleen and promoting blood circulation can attenuate hyperlipemia in ApoE-/-mouse;furthermore,it lessens the pathological abnormalities in the ONL,RPE and Bruch membrane.

Background Retinal angiomatous proliferation (RAP) is a subtype of neovascular age-related macular degeneration (AMD).There are currently very few studies on RAP.Objective This study was to explore the pathogenic mechanism of RAP in apolipoprotein E-deficient (ApoE-/-) mice with dyslipidemia.Methods Twenty-four 2-month-old SPF ApoE-/-mice were randomly divided into the high fat diet group and the normal diet group,and twelve 2-month-old C57BL/6 mice received the normal diet as controls.A diet with a higher content of fat was given for 4 consecutive months in the high fat diet group,and normal diet was given in the same way in the mice of the normal diet group.The mice were sacrificed at 6 months of age.The expression of vascular endothelial growth factor (VEGF) in the retinal pigment epithelial (RPE) cells,the expression of vascular endothelial growth factor receptor-2 (VEGFR-2) in the outer plexiform layer (OPL),microvascular density (MVD) and microvascular area (MVA) in the OPL were examined by immunohistochemistry and semi-quantitatively by histopathology with the Mias 2000 Imaging Analyzer System.The expression of VEGF protein in the retina was examined by Western blot.Results The MVD in the retinal OPL were (20.67±3.20) and (19.50± 1.87),respectively,in the ApoE-/-mice of the high fat diet group and the normal diet group,which were significantly higher than that (12.50±1.87) of the C57BL/6 normal diet group (all at P＜0.01).MVA in the retinal OPL were (626.49± 120.99) μm2 and (514.06±88.83) μm2 in the ApoE-/-mice of the high fat diet group and the normal diet group,respectively,showing a significant increase in comparison with the (336.52±84.96) μm2 of the C57BL/6 normal diet group (P＜0.01).The staining area of VEGF in RPE cells was (21 048±1849) μm2 in the ApoE-/-mice of the high fat diet group,showing a significant increase in comparison with the (17 116±2023) μm2 of the C57BL/6 normal diet group.However,no significant difference was found in the staining area of VEGF between the ApoE-/-mice with normal diet group and the C57BL/6 normal diet group ([17 854±2967] μm2 vs.[17 116±2023] μm2) (P＞0.05).Significant elevation was also seen in the staining area of VEGFR-2 in the retinal OPL of the ApoE-/-mice of the high fat diet group (12 193±3806)μm2 and the ApoE-/-mice of the normal diet group (11 969± 3616)xm2 compared with C57BL/6 mice of the normal diet group (5387±2225)μm2(all at P＜0.01).The relative expression values (VEGF/β-actin) of VEGF in the retinas were (1.51 ±0.32) and (1.17±0.39) in the ApoE-/-mice of the high fat diet group and the normal diet group,respectively,showing a significant increase in comparison with (0.28±0.14) of the C57BL/6 normal diet group (P＜0.01).Conclusions The expression of VEGF and VEGFR-2 in the retinas increases in the ApoE-/-mouse,which leads to the enlargement of MVD and MVA in the retinal OPL and subsequent RAP occurrence.

Objective To prepare controlled release microspheres of vascular endothelial growth factor(VEGF)& calcium alginate and observe their effect on proliferation of human umbilical vein endo- thelial cells(HUVEC)in order to provide theoretical basis for controlled release of VEGF facilitating an- giogenesis of tissue engineering bone.Methods VEGF-calcium alginate microspheres were prepared by using the needle extrusion/external gelation method to investigate physicochemical character and in vitro release of VEGF.According to the different ingredients added into the culture medium,the seconda- ry cultured HUVEC were divided into four groups,ie,control group,microsphere group,VEGF group and VEGF-calcium alginate microsphere group,in which the proliferation of the cultured HUVEC was ob- served with cell counting method,MTT method and flow cytometry.Results The calcium alginate mi- crospheres were revealed as spherical shape and evenly distributed,with mean grain diameter of(560?50)?m,carrying capacity of 0.72 ng/mg and the encapsulation efficiency of 54%.Smooth controlled re- lease in VEGF-alginate microspheres lasted for more than 10 days.Proliferation of the cultured HUVEC was accelerated the most in VEGF group at the beginning but in EGF-calcium alginate microsphere group at midanaphase compared with other groups,with statistical difference(P＜0.05).There was no statis- tical difference upon cell counting,cell activity and time point of cell cycle between control group and mi- crosphere group.Conclusion VEGF-sodium alginate microapheres can continue activity of VEGF,re- lease VEGF for over 10 days and promote proliferation cultured HUVEC for a long time.

Objective To study the safety and efficacy of transhepatic arterial infusion embolization using microspheres combined with lipiodol for treatment of hepatocellular carcinoma(HCC).Methods Transhepatic arterial chemoembolization(TACE)was performed with 1-2 ml 300-500?m mierospheres and 10-20 ml lipiodol for treatment of HCC.Changes of liver function,AFP,responses of tumor and complications related to embolization were analyzed before and after TACE.Results Thirty six patients with HCC were enrolled into this study.After TACE,patients' liver function got worsen and tumor size decreased significantly(P＜0.05).Conclusion TACE with use of microspheres combined with lipiodol is an effective treatment for HCC,but should be taken carefully to avoid hepatic failure.

Objective To explore the mechanism and safety of miltidrug-resistance gene 1(MDR1)transfection into the bone marrow mononuclear cells of rabbit in vitro with the adenovirus vector promoted by ultrasonic microbubble.MethodsBone marrow mononuclear cells of rabbits were collected and divided into 5 groups after cultured in the 6-well plate according to the different experimental conditions(MDR1 gene was transferred into the cells with or without ultrasound irradiation and microbubbles)：conventional culture group (A)，Ad5-MDR1 group(B)，Ad5-MDR1+ultrasound irradiation group(C)，Ad5-MDR1+microbubbles group(D)，Ad5-MDR1+ultrasound irradiation+microbubbles group(E).The positive transfection rate of MDR1 gene in mononuclear cells of different groups were tested by flow cytometry,and the survival rate of cells in different periods were tested by trypan blue exclusion method.Moreover,the appearance and ultramicrostructure of cells were observed by electronmicroscope.Results①The transfection rate of MDR1 gene in different groups were 0.39%±0.11%，5.03%±0.35%，4.93%±0.38%，5.25%±0.80%and 19.93%±1.51%respectively.The transfection rate of MDR1 gene in group E was higher than those in other groups(P＜0.05).②Compared with those in control groups(group A，B，C and D)，the transfection rate in group E was significant raised by ultrasound irradiation and microbubbles.However,there were no significant difference in survival rate of cells between the five groups(P＞0.05).③After ultrasonic irradiation，there were transient holes on the cell membrane，which could disappear after irradiation by ultrasound for 24 hours.And the temporary swelling of organelles was reversible.Conclusions Microbubbles irradiated by ultrasound can cause small transient holes on eell membrane and increase permeability of it，and enhance the transfection of MDR1 gene in bone marrow mononuclear cells with the adenovirus vector，which is safe and available.

Objective To explore characteristics of the elements of syndrome, the disease position and the relationship between chemical indicators and TCM syndromes of type 2 diabetic encephalopathy. Methods 2 501 cases of type 2 diabetes clinical data were collected from Guang'anmen Hospital of China Academy of Chinese Medical Sciences, Beijing University of Chinese Medicine, Dongzhimen Hospital, Dongfang Hospital, etc. in nearly 3 years, among which, 342 cases were type 2 diabetic encephalopathy. The original clinical data were double entried in epidata by two people, establishment forms in excel, factor analysis and Bayesian networks were used as data mining research methods. Results 20 elements which characteristic root more than 1 were derived by factor analysis, 68.4% were covered. Of all 20 elements, five factors belong to Yin, five factors belong to blood stasis; lassitude, shortness of breath, stool frequency were appeared when fasting glucose abnormalities; lassitude, hemiplegia were appeared when 2-hour postprandial blood glucose abnormalities;lassitude, feverish palms and soles, stool frequency, more nocturnal enuresis when glycated hemoglobin abnormalities by Bayesian networks. Conclusion The Elements of the syndrome of type 2 diabetes encephalopathy were deficiency of Yin and blood stasis; and the main positions for diabetic patients were liver, spleen and kidney. Patients with impaired fasting glucose were Qi deficiency; Patients with impaired 2-hour postprandial glucose were Qi deficiency or pathogenic wind attacking collaterals; Patients with abnormal hemoglobin were Qi deficiency and Yin deficiency.

Objective To study the relationship between the inflammatory cytokine levels and the expression of hepatic alpha-7 nicotinic acetylcholine receptor (α7 nAChR) in hyperlipidemia rats and to investigate the intervention effect of Yirui Capsules ( mainly composed of Radix Salviae Miltiorrhizae, Fructus Crataegi, Rhizoma Alismatis, etc). Methods Fifty male SD rats were randomly divided into blank control group ( fed with conventional diet, N=10) and high-fat diet group (fed with high-fat diet, N=40). After feeding for 14 d, the forty rats in high-fat diet group were further randomly divided into model control group, and low-, middle-, and high-dose Yirui Capsules groups (140, 280, 560 mg/kg, respectively), 10 rats in each group and the treatment lasting 30 days. And then, the serum levels of lipids were detected, C-reactive protein (CRP) and tumor necrosis factor (TNF) -α in the serum were detected by enzyme-linked immunosorbent assay ( ELISA) , and the expression of hepatic α7 nAChR was analyzed by immunohistochemical staining and reverse transcription-polymerase chain reaction (RT-PCR) . Results Yirui Capsules in different dosages could improve serum lipid levels in hyperlipidemia rats to various degrees. The contents of serum inflammatory cytokines CRP and TNF-α and the mRNA expression of hepatic α7nAChR were increased in the model control group as compared with those in the blank control group ( P<0.01). The contents of inflammatory cytokines CRP, TNF-αand the mRNA expression of hepatic α7nAChR were decreased in the three Yirui Capsules groups as compared with those in the model control group ( P<0.01). The results of immunohistochemical staining for α7nAChR expression were consistent with RT-PCR results. Conclusion The expression of hepatic α7nAChR is increased in hyperlipidemia rats. Yirui capsules are effective on decreasing inflammatory cytokine levels, improving lipid metabolism, and down-regulating α7nAChR expression.

Objective To analyze the relationship between clinical competence of baccalaureate nursing students and its potential related factors,and investigate the results of curriculum reform of 4-year nursing undergraduate education.Methods The records of 263 baccalaureate nursing graduates were retrieved.Variables including age,years of college education,sex,college entrance examination scores,average scores of basic courses,average scores of public courses and average scores of professional courses were collected.Clinical competence was measured by the clinical practice tests at various clinical units.The linear regression analysis was performed to find out the influencing factors of clinical competence.Results The clinical competence was significantly related to sex,average scores of public courses and average scores of professional courses(P