Objective To understand the clinical medicine graduates competency status of Kunming Medical University in the past 5 years and provide important reference for cultivating students in medical university. Methods The questionnaire results in the relevant departments responsible person of Yunnan provincial municipal and district 26 hospitals were system analyzed by fuzzy comprehensive evaluation method. Results In the past 5 years, the graduates occupation competence of clinical medicine in Kunming Medical University is good. Among them, the graduates’core competency gets the lowest score, but the graduates’post competency gets the highest score. Conclusion The graduates’core competency should be strengthened in training of doctor-patient communication skills and quality evaluation of clinical practice for medical students.

Objective To investigate the superiority of augmentation rhinoplasty by using ear cartilage.Methods We excised ear cartilage from patient's unilateral ear.106 cases were performed through suitable ear cartilage that was carved to some shape and then transplanted to nasal tip and columella,and two alar cartilages were sutured and implant was used for rhinoplasty.Results All cases were followed up for one year after operation without implant slipping and malposition of implant,with better figure after enhancing and lengthening nasal tip.Conclusions This method of augmentation rhinoplasty using ear cartilage can avoid complications such as slipping,malposition and exposure of implant.Therefore,it is deserved to recommend clinical application.

Recently,staging,chemoradiotherapy schedule,new chemotherapy agents and application of targeted therapy drugs are widely investigated in small cell lung cancer(SCLC).Some progresses are achieved in prophylactic cranial irradiation of extensive stage and some new chemotherapy agents such as irinotecan,oral topotecan and pemetrexed etc are widely investigated.There are still some disputes about staging,the timing of chemoradiotherapy in localized SCLC and so on.

Objective To observe the curative effects of traditional Chinese plus western medicine and west ern medicine on patients with nephropathy(IgAN).Methods 45 cases of IgAN were randondy allocated to two groups.22 cases(control group)were treated with routine western medicine and 23 cages(treatment group)were trea ted based on syndrome differentiation.on a course of treatment.The changes of urine routine;24h urine protein;serum creatinine and BUN were observed in patients with IgAN.Results The total effective rate(91.3%)was significantly higher(65.2%)(x2=6.02,P＜0.05);Treatment after 24h urine protein(0.48±0.32)g,urine BBC count(25.7±13.6)104/ml was significantly lower than before treatment(1.62±1.05)g,(64.4±30.1)104/ml(t=2.889,t=2.945,P＜0.01);two groups after treatment Scr,BUN has dropped,and before treatment had no significant difference (t=1.752,P＞0.05).Conclusion The curative effect of traditional Chinese plus western medicine exerts a better effect than the sole western medicine in patients with IgAN.

Objective To establish monitoring indicators to predict the pregnancy outcome of threatened abortion. Methods In one hundred and five pregnancy patients, normal pregnancy was 35 cases ( normal pregnancy group), continued pregnancy was 35 cases(continued pregnancy group ), failure abortion was 35 cases (failure abortion group).The levels of cancer antigen 125(CA125),progesterone,estradiol, β -hunan chorionie gonadotrophin( β -hCG) were monitored and compared among three groups. Results The levels of progesterone,estradiol, β-hCG were lower in failure abortion group than those in normal pregnancy group and continued pregnancy group (P＜ 0.05); CA125 in failure abortion group was higher than that in normal pregnancy group and continued pregnancy group (P ＜0.05). The accuracy of combination progesterone,CA125,estradiol and β-hCG was 100.00% (28/28). Conclusion The integrated method which combination monitoring CA125, progesterone, estradiol, β -hCG can improve the prediction accuracy of the early outcome of abortion.

Objective To explore the changes and clinical significance of gestational diabetes mellitus in late pregnancy with fetal ductus venosus blood flow waveform parameters.Methods 23 cases of 24-40 gestational weeks gestational diabetes and 60 cases of normal fetus were selected,color Doppler ultrasonography in the venous catheter into the subarachnoid catheter blood flow waveform was applied to record,including the determination of blood flow parameters:ventricular peak systolic velocity ( DVS) ,left ventricular diastolic peak flow velocity ( DVD) ,atrial systol-ic peak velocity (DVA),and DVRI=(DVS-DVA)/DVS.Results DVS(42.72 ±3.63)cm/s,DVA (12.34 ± 3.11)cm/s and DVRI(0.49 ±0.08) of fetal ductus venosus gestational diabetes group and normal pregnancy group had significant difference (t=3.232,9.664,2.470,all P<0.05),especially the difference between the two groups of DVRI had statistically significant.Conclusion Color Doppler flow spectrum curve of ultrasonic detection of fetal duc-tus venosus have clinical significance in gestational diabetes mellitus.

Objective To investigate the clinical effect and complications of candesartan in the treatment of stress-induced hypertension.Methods 60 patients with stress-induced hypertension were randomly divided into experimental group and control group.Experimental group was treated with candesartan,the control group was treated with benazepril.The efficacy of the two groups was compared.Results After the treatment for 4 weeks,8 weeks,SBP/DBP in the two groups had significant differences compared with before treatment (t =5.32/3.76,5.94/3.99,8.61/5.83,2.34/5.67,all P ＜ 0.05).The incidence rate of complications in the experimental group was 6.7％,which was significantly lower than 25.0％ in the control group (x2 =4.32,P ＜ 0.05).Conclusion Candesartan in the treatment of stress-induced hypertension has significant effect,the incidence of complications is lower.

Objective:To analyze the current situation and the problems and influencing factors of TB control from health service providers in rural area of Chongqing city to provide references.Methods:The leaderships of relevant departments,TB patients or suspects,normal residents and doctors were interviewed by qualitative methods such as key information interviews,in-depth interview,focus group discussion.Results:Diagnostic delay,failure in referring or tracing and patients'adherence are the main problems of TB prevention and control in rural area of chongqing city.Health service providers'capacity and attitude impacted its effect.These factors are further related to the implementation of policies,hospital infrastructure,the mechanisms of health financing and management.Conclusion:Greater importance should be attached to the rural doctors.In order to improve the effects on the control of TB,the government should strengthen training,funding and management.

Objective:To investigate the relationship between aging,gender and coronary heart disease(CHD) in the elderly and very elderly.Methods:A total of 733 consecutive patients underwent Judkins of coronary angiography for enrolled in this study from April 2002 to Dec.2007.Age and clinical characteristics of non-coronary heart disease group(n=306),single-vessel group(n=211),double-(n=126) and multi-Vessel group(n=90) were compared referred for angiography.Quantitative comparison of age and risk factors were made among patients with 4 ranges of Gensini's score corresponding to quartile cut points.The impact of age,gender on CHD was analyzed in four age groups:

Objective To investigate the distribution and resistance of non-fermenting bacteria isolated from our hospital and offer a basis for the treatment of bacterial infection.Methods 236 strains of non-fermenting bacteria were isolated from clinical samples between May.2004 and Dec.2006were identified with API identified test (API Inc.France) and Kirby-Bauer (K-B) test used for the antibiotics susceptivity test. Results Totally 236 strains of non-fermenting bacteria were isolated from the 1303 pathogenic strains. The most common bacteria were Pseudomonas auruginosa(57.6%),followed by Acinetobacter baumannii(7.6%)and Pseudomonas putida(6.4%).64%of non-fermenting bacteria were isolated from the sputum. these bacteria had various resistance to all detected antibiotics. Conclusions non-fermenting bacteria had high isolated rate and multi-antibiotic resistance,so antibiotics should be correctly under the guidance of antibiotic susceptibility testing.