Objective To explore the content of the goals set by medical freshmen. Meth-ods 189 freshmen who major in clinic medicine were asked to answer the goals they set in the period of five years colleges’life,another 100 freshmen were selected to categorize the goals with high frequencies and then factor analysis were employed.Results 46 goals with high fre-quency can be classified into 11 factors. Conclusion Although the content of the goals set by the medical freshmen included some unreasonable points,it is basically in line with that of our present goals of cultivating medical students.

Objective This article introduced the concrete methods and benefits of promoting and holding competition of acupuncture and moxibustion in TCM universities or colleges. A regular skill competition will not only stimulate students' passion for TCM study and expand teaching methods, but also serve as a effective way to enhance practical skills of students.

ObjectiveTo analyze the effect of lowering the upper limit of normal fasting glucose on the distribution of impaired gheose regulation(IGR)in the population in Wuhan urban area.MethodsThe health profiles of 1896 people after physical examinations were analyzed by X2 test.ResultsThe low limit for impaired fasting glucose(IFG)was decreased from 6.1 to 5.6 mmol/L,IFG increased 271 patients.the prevalence of IFG increased from 13.1%to 27.4%(X2=62.68,P<0.05),and the value of normal glucose test decreased from 60.3%to 47.5%(X2=120.03,P<0.05).Overweisht or obesity,hypetention,fatty liver,hyperlipidemia,ECG abnormality were significantly different(P<0.05)in groups of fasting glucose 5.6-6.0 mmol/L to<5.6 mmol/L and to 6.1-6.9 mmol/L ConclusionThe new cut point of IFG has significantly influenced the distribution of IGR in the population of Wuhan urban areas.In the newly IFG.increased subjects,metabolic abnormalities of glucose and lipid occur,and an intervention of life-style is needed for them.

Objective To examine the relationship between renal vascular lesions and clinical prognosis in lupus nephritis patients. Methods Renal biopsy specimens and clinical data of 451 patients with lupus nephritis in our hospital from January 1998 to February 2006 were enrolled in this study. According to renal vascular lesions, those patients were classified into six groups: no renal vascular lesion (NVL), immune complex deposits (ICD), lupus vasculopathy (LV),thrombotic microangiopathy (TMA), vasculitis (VAS) and arteriosclerosis (AS). The relationship of renal vascular lesions and the clinical features was retrospectively analyzed. Results (1) In 451 lupus nephritis patients, 247 eases (54.8%) had renal vascular lesion. The incidence of the ICD, LV, TMA, AS and VAS were 8.4%, 9.8%, 6.7%, 29.3% and 0.7%, respectively. (2) The incidence of vascular lesions in IV type lupus nephritis was 69.7%, which was higher than others.(3) Except ICD group, the incidences of renal insufficiency and hypertension were significantlyhigher in vascular lesion groups than those in NVL group (P<0.05). TMA group showed the most severe clinical manifestation, including anemia and depression of platelet. (4) The prognosis of TMAgroup was the worst. The prognosis among other groups was not significantly different.Conclusions Vascular lesions are common in lupus nephritis. TMA patients present not only the most severe clinical manifestation with the poorest prognosis. Other vascular lesions also indicate an elevation of blood pressure and Scr level, but without significant difference in prognosis.

Objective To investigate the clinical and pathological features of Fabry disease in Chinese patients. Methods This retrospective study included all in-patients Fabry disease patients at PUMC Hospital from 2004 to 2014.Results The 12 patients included 10 males and 2 females.The middle age at onset was 10.The most fre-quent symptoms in our group were pain(10/12), angiokeratoma(9/12), renal abnormalities (7/12), hearing loss ( 6/12 ) , hypohidrosis ( 5/12 ) , cardiac abnormalities ( 5/12 ) , cerebrovascular abnormalities ( 3/12 ) and ophthalmological abnormalities ( 3/12 ) .The severe clinical manifestations were more frequently found in males . Electron microscopy plays a very important role in pathological diagnosis of Fabry disease .7 patients were suspec-ted to have family history .5 patients were examined regularly in which 4 cases were stable , and 1 patient re-ceived hemodialysis after 3 years'follow-up.Conclusions Onset of Fabry disease is early, many organs could be involved and patients may have different clinical manifestations.There are great differences in clinical features be-tween male and female patients .

Objective To discuss the relationship between serum anti-Phosphalipase A2 receptor (PLA2R) antibodies and glomerular IgG4 subclass in patients with membranous nephropathy and evaluate the diagnostic value of the two markers.Methods Patients diagnosed as membranous nephropathy from October 2011 to April 2014 in Peking Union Medical College Hospital were included and divided into IMN and SMN groups accoding to their clinical diagnosis.Serum anti-PLA2R antibodies and glomerular IgG subclasses were both detected by indirect immunofluorescence assay.Receiver operator characteristic curves were used to evaluate the diagnostic efficiency of anti-PLA2R antibodies and glomerular IgG4.Results Prevalence of serum anti-PLA2R antibodies of IMN patients was 69.5％ (41/59); prevalence of MLN patients was 4.8％ (1/21).Within the IMN group,thirty-five patients showed positive results of both serum anti-PLA2R antibodies and glomerular IgG4; Six patients were positive for serum anti-PLA2R antibodies but negative for glomerular IgG4; Seventeen patients were positive for glomerular IgG4 but negative for serum anti-PLA2R antibodies; one patient was negative for both tests.The sensitivity of serum anti-PLA2R antibody was 69.5％ and the specificity was 95.2％; the sensitivity of glomerular IgG4 was 89.8％ and the specificity was 52.3％.The sensitivity of the combined marker consisting of serum anti-PLA2R antibody and glomerular IgG4 was 59.3％ and the specificity was 100％.Four out of the six patients secondary to HBV infection,one out of the three patients secondary to Sj(o)gren syndrome,one out of the three patients secondary to malignant tumor showed positive results of serum anti-PLA2R antibodies.Conclusions Serum antiPLA2R antibodies were of high prevalence among IMN patients; the prevalence among SMN patients varied with etiologies.Results of serum anti-PLA2R antibodies and glomerular IgG4 were helpful to rule out secondary etiologies in the diagnosis of membrnous nephropathy.

Objective To evaluate the role of low salt (LS) medium and the involvement of p38 mitogen-activated protein kinase (p38 MAPK) in the expression of cyclooxygenase-2 (COX-2) and production of PGE2 in a mouse macula densa derived cell line (MMDD1 cells). Methods Confluent MMDD1 cells were exposed to serum free DMEM/F12 in a 1:1 mixture with normal saline (NS), 300 mmol/L mannitol (to reduce NaCl to half, LS solution). Semi-quantitive reverse transcription and polymerase chain reaction amplication (RT-PCR) and Western blotting were used to detect the expression of COX-2 mRNA and protein with LS solution. The content of PGE2 in the supernatant was examined by enzyme linked immunosorbent assay (ELISA). Expression of total and phosphorylated p38 MAPK kinsae was examined by Western blotting in LS solution. Results The COX-2 mRNA abundance and protein expression of MMDD1 cells were up-regulated in LS group as compared to NS group (16 h mRNA 0.94?0.12 vs 0.26?0.09, 28 h protein 0.59?0.02 vs 0.25?0.07, rspectively, all P

Objective To analyze the relationship between renal pathological characteristics and clinical prognosis in type 2 diabetic kidney disease patients,and discuss predictive value of pathological type and indexes for renal function declining rate and related outcome events.Methods Ninety-two type 2 diabetes patients from PUMC Hospital (with macroalbuminuria and followed up no less than 6 months,excluding patients with non-diabetic renal disease) were divided into typical diabetic glomerulopathy group (DG,n=51) and atypical diabetes-related renal disease group(ADRD,n=41) according to renal pathological findings.A retrospective cohort study was performed to investigate renal pathological features and prognosis.Results Total of 29 renal outcome events and 12 death events occurred in DG group and none in ADRD group; the survival rate and kidney survival rate are different between two groups (P ＜ 0.05); DG group,thick GBM,severe vascular and tubular lesion are predicative indicators for renal outcome event; mesangial volume fraction is predicative indicator for renal outcome events independent of age and serum creatinine.Conclusions DG and ADRD patients have different prognosis and might undergo different pathophysiological mechanisms; renal pathological type and mesangial volume fraction could help predicting outcomes of type 2 diabetic nephropathy patients.

Objective · To compare the efficacy and prognostic factors of HCAG regimen with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia (AML) patients. Methods · Forty-one patients with AML (aged 55-71 years) were randomly divided into two groups (Group HCAG and Group IA) between 2014 and 2016 for induction and consolidation therapy. Multivariate analysis was applied to identify prognostic factors for relapse-free survival (RFS). Results · A total of 29 patients (70.7%) achieved complete remission (CR). The estimated 2-year overall survival (OS) was 66.8% in Group HCAG and 75.4% in Group IA (P=0.913). The estimated 2-year RFS was 61.8% in Group HCAG and 49.1% in Group IA (P=0.411). Age remained as the unfavorable prognostic factor, leading to significant differences in OS and RFS. In addition, RFS was influenced by cytogenetic/molecular risk stratification. Conclusion · Although HCAG seemed not to particularly benefit the group, the dose reduction of anthracyclines may be applied in elderly patients with comparable short-time outcome. Furthermore, the introduction of homoharringtonine resulted in an improvement of treatment response for more than 20% compared with CAG regimen.

Objective: To investigate the imaging features of cerebral small vessel disease(SVD) in systemic lupus erythematosus(SLE) patients with impaired renal function and their related risk factors. Methods: Seventy-six SLE patients and forty age- and sex-matched healthy controls were recruited, and SLE patients were divided into the impaired renal function group [estimated glomerular filtration rate (eGFR) <90 ml/(min·1.73 m²)] (n=38) and the normal renal function group [eGFR≥90 ml/(min·1.73 m²)] (n=38) according to their eGFR. All subjects underwent brain MRI, cognitive and psychiatric testing. The SVD scores were measured, total white matter hyperintensity (WMH) and SVD scores were calculated, and the risk factors of SVD scores were analyzed by using ordinal logistic regression. Results: SLE patients in the impaired renal function group showed higher basal ganglia PVS, centrum semiovale perivascular space (PVS), periventricular WMH, deep WMH and total SVD scores compared with normal controls or patients with normal renal function (H=44.568, 31.380, 31.172, 43.419, 24.317, P<0.001) . The ordinal logistic regression analysis showed that C-reactive protein was a risk factor for SVD in patients with SLE(OR=1.323, P<0.01). Conclusion SLE patients with impaired renal function had a higher SVD burden on MR imaging, particularly PVS in the basal ganglia and deep WMH, which was affected by the C-reactive protein level.