25 years group. Among 129 cases who had taken antihypertensive drugs before operation, only 43 cases continued to use drugs after operation, therefore, rate of antihypertensive drugs administration decreased significantly after operation (P

The clinical comprehensive ability is the core of the cultivation of professional degree graduate tralning. It includes the ability of clinical analysis, the ability of clinical operation and the ability of clinical communication, which is compatible with the core of the evaluation of post compe-tency in knowledge, technology and attitude. Teaching Section of Internal Medicine of the First Clinical College of Harbin Medical University combined the professional Degree Graduate tralning with the resident tralning with the post competency as the direction. We adopted a series of effective methods such as strict management of clinical rotation and multiple dimensioned evaluation system. We organized clinical discussion and set up clinical skill tralning course and standardize teaching ward inspection et al. to improve the comprehensive clinical ability of the postgraduates. The formative evaluation and summative assessment were combined in department rotation examination and the feedback system was set up. By the above tralning, the comprehensive clinical ability of the postgraduates has improved effectively, which can match the level of the first phrase resident physician. Combined with the tralning of other department, the postgraduates can be qualified for the general physician.

OBJECTIVE:To observe the effects of Sodium chloride injection and Glycerine enema on the relief of postoperative defecation pain,edema around wound and incision in patients with complex anal fistula. METHODS:100 patients with complex anal fistula were selected and divided into group A(33 cases),B(33 cases)and C(34 cases)according to random number table. Group A was given Sodium chloride injection 300-500 ml,water bath heated to 35-37℃,into the rectum via enema bag before defecation,and defecated after controlling defecation for 5-10 min. Group B was given Glycerine enema 110 ml into the rectum,and defecated after controlling defecation for 5-10 min. Group C could defecated directly when they felt obvious defecation desire. VAS score of initial defe-cation,defecation frequence and time within 24 h after initial defecation,edema around wound and incision within a week after initial defecation were observed in 3 groups as well as the occurrence of ADR. RESULTS:VAS score of initial defecation,defecation fre-quence and time,edema around wound and incision in group A and B were significantly lower/shorter than in group C,with statistical significance(P<0.05). Above indexes of group B were slightly lower than those of group A,without statistical significance(P>0.05). No obvious ADR was found in group A and B during treatment. CONCLUSIONS:Both Sodium chloride injection and Glycerine enema can relieve postoperative defecation pain in patients with complex anal fistula,and reduce edema around wound and incision with good safety. The two drugs should be selected according to patient’s condition.

Objective To evaluate the effect of controlling cost by introducing hand hygiene products with lower price on promoting hand hygiene compliance.Methods The application status and cost of hand hygiene products in 2012 was as pre-intervention group,2013 was as post-intervention group.Effective and lower price hand hygiene products were introduced in 2013,consumption and cost of hand hygiene products before and after the intervention was compared.Results Consumption of hand hygiene products per patient-day before and after the intervention was significantly different ([10.56±16.46]mL vs [13.79 ± 16.93 ]mL,Z=4.14,P <0.01 );cost of hand hygiene products per patient-day before and after the intervention was not significantly different ([1 .23 ±2.07]yuan vs [0.92±0.59]yuan,P >0.05).Conclusion Introduction of hand hygiene products with lower price in this hospital can improve hand hygiene compliance to certain degree without increasing the cost of hand hygiene.

Doctors in the past dynasties always used ephedra to treat disease of exogenous wind-cold,cough,asthma and edema,but ignored its application in treating arthromyodynia.It could be deduced from the record of the books of Chinese medicine and prescriptions that ephedra had the nature of pungent and warm,could dispel wind and remove wetness,warm channel and expel cold,remove obstruction in collaterals.All of those were correspondent with the pathogenesis of arthromyodynia.Thus,ephedra can be widely used in types of arthromyodynia.Proven case was also included in this article.

Objective To survey and analyze medical postgraduates' ideological and political awareness to provide evidence for improvement of ideological and political education.Methods By using the self-made questionnaire a survey was conducted among 1 199 medical postgraduates from April 1,2013 to April 10.The questionnaire included general condition,politics status,religion,collective consciousness,learning goals,the view about the construction of ideological and political education counselor team,etc.Advice and suggestions were given according to the analysis of the results.Results A total of 1 169 valid questionnaires were collected.Among all the members,the communist party members and league members account for 33.7％ and 47.6％,respectively; 92.5％ of the students had no religious beliefs; 15.1％ served as departments cadres,6.4％ served as universitylevel cadres; 41.3％ of the students thought their tutors care for them very much,and 66.9％ of the students could communicate with tutors weekly; 38.9％ of the students complained the main pressure came from family,while 24.2％ thought the main pressure came from the employment pressure; 47.5％ thought it was very necessary to establish a professional counselor team.Conclusions The survey is scientific and reasonable,providing a reliable basis to improve our postgraduate education.Most medical postgraduates have a firm and correct political position,and their world oudook and outlook on life are basically stable.However,there are many problems needed to be solved immediately.Considering the particularity of graduate education,it is necessary to reinforce the professional counselor and tutor team and further explore the medical postgraduates' ideological and political awareness education to promote the development of postgraduate education.

Iron uptake mechanism of Vibrio alginolyticus was primarily investigated. V.alginolyticus could survive in the medium with high-concentration iron chelator. The strain of V. alginolyticus isolated from diseased fish produced more siderophore than that from marine environment. The extract of siderophore from V. alginolyticus could stimulate the growth of Escherichia coli mutant AN93. Under iron limitation,the growth rate was decreased and several outer membrane proteins were induced. Adding iron into the iron-limited medium the normal growth could be recovered.

Objective To investigate the genotype in Chinese patients with nonclassical 21 hydroxylase deficiency (NC 21OHD). Methods Eight patients with NC 21 OHD, 35 patients with classical one and 20 normal controls were studied as followed: CYP21 gene was amplified into fragment 1 (exon1→exon3) and fragment 2 (exon3→exon10) through PCR with specific primers. Second round PCRs were performed using fragment 1 and 2 as template, and PCR products were digested by restrictive endonucleases to analyze mutations by 3% 4% agarose gel electrophoresis. Results (1) The most frequent mutation in 8 cases of Chinese NC 21 OHD was P30L(6/16,37.5%), followed by V281L(4/16,25.0%). NC 21 OHD also carried mutations causing moderate or severe degree of enzymatic compromise, such as i2g (3/16, 18.8%), Q318X and R356W (1/16, 6.3% respectively), and I172N (3/16, 18.8%). (2) In ACTH 1 24 stimulation tests of 8 NC 21 OHD patients, basal 17 OH progesterone level was (23.9?28.4)?g/L and stimulated 17 OH progesterone level was (92.0?83.7)?g/L. (3) Genotype had strong correlation with phenotype in 21 OHD patients. Conclusion (1) As compared with caucasians, the most frequent mutation in Chinese NC 21 OHD is P30L, not V281L. (2) Much more attention should be paid to patients with hyperandrogenism to screen NC 21 OHD.

Objective To observe the clinical effect of HuaYu TongFu KaiQiaoFang on serum homocysteine (Hcy)in patients with acute cerebral infarction. Methods Sixty cases of acute cerebral infarction admitted into the comprehensive ward and intensive care unit(ICU)of the First Affiliated Hospital of Guiyang College of Traditional Chinese Medicine from December 2010 to January 2012 were randomly divided into two groups,each group including 30 cases. The control group was given conventional treatment,and based on the conventional therapy,the treatment group was additionally given HuaYu TongFu KaiQiaoFang(a traditional Chinese medicine decoction including the following ingredients:Safflower 10 g,Chishao 10 g,Chuanxiong 10 g,Notoginseng 10 g,Angelica Sinensis 10 g, Shichangpu 10 g,Polygalae 10 g,Glauber's salt 5 g,Rhubarb 6 g),one dose a day by oral or nasal administration for consecutive 14 days. Before and after treatment in the two groups,the serum Hcy level was detected by enzyme-linked immunosorbent assay(ELISA),and the clinical efficacy was assessed by Pearson or Spearman correlation analysis to observe the correlation between neurological deficit score(NDS)and Hcy levels. Results Before treatment, the difference of serum Hcy(μmol/L)and NDS levels between the two groups was not statistically significant(both P>0.05),while after treatment,the levels in the two groups were significantly decreased in comparison with those before treatment(P<0.05 or P<0.01),and the degree of descent in treatment group was more obvious compared with that in control group(Hcy:7.78±2.51 vs. 10.18±2.41,NDS:10.60±2.25 vs. 14.60±3.70,both P<0.05). After treatment,the total effective rate in the treatment group was significantly higher than that in the control group (90.0%vs. 76.7%,P<0.05). Before treatment,the NDS was positively correlated with Hcy(r=0.675,P<0.05). Conclusion HuaYu TongFu KaiQiaoFang can significantly reduce the level of serum Hcy and improve the nerve function,thus its clinical effect for treatment of acute cerebral infarction is remarkable.

Objective To investigate the effects of penehyclidine hydrochloride combined with ulinastatin on postoperative cognitive function in the patients undergoing thoracic surgery.Methods One hundred and twenty patients undergoing lung cancer thoracotomic radical resection were randomly divided into hydrochloride penehyclidine composite ulinastatin group(HU group),hydrochloride penehyclidine group(H group),ulinastatin group(U group)and control group(C group).The arterial blood was collected for detecting OI,TNF-α,IL-6 and IL-8.The serum levels of S-100β and NSE were detected.The MMSE scores were evaluated.Results Compared with the H group and U group,the levels of TNF-α at T3-4 in the HU group were decreased,and the levels of IL-6 and IL-8 at T2-4 were decreased,while OI was increased(P＜0.05).Compared with the H group and U group,the serum levels of S-100β and NSE at T5-8 in the HU group were decreased(P＜0.05);compared with the H group and U group,the MMSE scores at T6-7 in the HU group were increased(P＜0.05).Conclusion Penehyclidine hydrochloride combined with ulinastatin could reduce the inflammation reaction during one lung ventilation in thoractomy and improves the postoperative cognitive function.