The author reviewed the development of general practice education in our country,deliberated and summarized the problems about the construction of curriculum system,the ranks of teachers and practice base in general practice education in higher medicine colleges.

Objective To probe into the usage of statins in the patients with coronary artery disease in elderly patients. Methods From Jun 1,2009 to Mar 31,2009 in our hospital, 323 elderly outpatients with coronary artery disease were included in the investigation. The data were statistically analyzed. Results 62.2% of the patients used statins. The statins usage rates (44. 8% ,61.3% ,71.3% ) among three age groups(60 -69 years old,70- 79 years old, and ＞ 80 years old)were significantly different. The rates of statins usage were significantly different between male and female groups. Conclusion The usage of statins as secondary prevention of coronary artery disease varies and there is urgent need to standardize the usage of statins according to the treatment guideline.

Objective To study the effects of using the dropping retention-enema in the clinical practices.Methods Divided 60 cases who need retention-enema into the experimental group and the control group,there were 30 cases in the each group.The traditional retention-enema method was used in the control group,while the dropping retention-enema method was used in the experimental group.Compared the related factors between the two groups.Results All the factors which can indicated the clinical effects in the experimental group were better than those of in the control group,P

Objective To investigate the influence of neutrophil-lymphocyte ratio (NLR) on radiosensitivity and prognosis,the relationship between NLR and clinical features,and the clinical value of NLR in patients with nasopharyngeal carcinoma (NPC).Methods 2006 to 2011 in the cancer center of Zhongshan University admitted to the newly diagnosed nasopharyngeal cancer patients in 266 cases.The association of pretreatment NLR with radiotherapy doses 20,40,and 60 Gy and therapeutic effect at 3 months after radiotherapy was analyzed,as well as the influence of NLR on overall survival (OS),local recurrence-free (LRF),and distant metastasis-free (DMF) rates.The Kaplan-Meier method was used to calculate survival rates and the log-rank test was used for survival difference analysis.Results NLR showed differences across patients with different T stages and sexes (P=0.039,0.032).The patients with NLR≤3 had significantly higher OS,LRF,and DMF rates compared with those with NLR＞ 3 (P=0.004,0.025,0.045).As NLR increased,the radiosensitivity in patients with NPC was reduced gradually,and radiosensitivity showed a significant difference between sensitive group and moderately sensitive group (P=0.043).When the radiotherapy dose was 40 Gy,the tumor regression group had a lower NLR than the residual tumor group (P=0.025).Conclusions In patients with NPC,an increased pretreatment NLR is an adverse prognostic factor,and NLR can be used as a simple and convenient method to evaluate the prognosis of patients with NPC.

Securin is a multifunctional protein which is encoded by PTTG gene.In the metaphase to anaphase transition during mitosis,Securin is involved in sister chromatid separation.The aberrant expression of Securin is found in many endocrine and related cancers,such as pituitary tomour,thyroid cancer,ovarian cancer,colon cancer et al.The function of Securin in cancer is related to its gene transactivation and association with other poteins like p21,p53.

OBJECTIVE To strengthen and explore the effect of target monitoring in ICU.METHODS To put out prospectively the target monitoring of the nosocomial infection in ICU from Jan 2006 to Dec 2007.RESULTS A total of 3917 patients were monitored and 217 of them suffered from infection.The day infection rate was 11.7‰,and the infection rater per thousand day were 13.4‰,10.0‰ in 2006 and 2007,respectively.The infection rate related to urinary catheter,central venous catheter and ventilator were 1.2‰,0.9‰,4.1‰,2.8‰,14.2‰,6.0‰ in the past two years,respectively.It decrease 0.3‰,1.3‰,8.2‰,respectively.Ventilator-associated infection was the main infection part of hospital infection,and the patients after liver transplantation ICU had the highest infectionrate.CONCLUSIONS Prospective target monitoring is a scientific monitoring method that plays an important role in controlling and preventing hospital-acquired infection.It deserves recommendation.

Objective To investigate pulmonary embolism (PE) clinical characteristics, the first clinical symptoms, and risk factors.Methods Incidence trends, clinical manifestations, etiology and inducing factors of 459 PE cases were analyzed retrospectively.Results For women the two peak period of PE incidence are 20-25 years of age and 60-70 years of age, for men are 20-30 years and 60-70 years;For both men and women PE incidence is peaked at 40-65 years of age.Circular distribution statistics showed the peak incidence of PE falls from November 30 through April 4, roughly in seasons of winter and spring.Dyspnea, chest distress, were among the most common symptoms (64.04％).Pulmonary infarction trilogy accounted for only 8.50％.Surgery, trauma, fracture were the primary causes for PE (44.88％), with tumor accounting for 13.0％.The veins affected by DVT are plexus venosus leg muscle, femora popliteal vein, iliac veins, tibial and peroneal veins.Conclusions The incidence of PE has obvious central tendency of age, season.Clinical symptoms are varied and non-specific.Surgery, trauma and fractures are the primary cause of PE, tumor is an independent risk factor for PE.

The protein product of metastasis-associated in colon cancer 1 (MACC1) gene induces the activation of hepatocyte growth factor/mesenchymal-epithelial transition factor (HGF/c-Met) signaling pathway through transcriptionally activating c-Met gene and upregulating its expression to further promote tumor invasion and metastasis.High level expression of MACC1 is associated with the occurrence and metastasis of a wide variety of human tumors, such as colon cancer, gastric cancer, liver cancer, lung cancer, ovarian cancer etc.In addition, the overexpression of MACC1 is also closely associated with clinical TNM stages and distant metastasis.Thus, MACC1 can serve as an independent indicator of tumor metastasis and prognosis, and become a new target for gene therapy.

Objective To study the effect on renal function about repeated use of contrast media , and whether alprostadil has protective effect towards contrast-induced nephropathy ( CIN) .Methods 80 adult patients who had ever received contrast examination and scheduled to have PCI within 1 month were randomly divided into two groups: the simple hydration group and the hydration plus alprostadil therapy group.The serum level of creati-nine,urea, Cystatin C, Urineβ-microglobulin and creatinine clearance were recorded and compared between the two groups , and were observed before and after repeated exposure of contrast medium.The incidence of CIN was analyzed .Results Compared with pre-contrast levels , serum levels of urea, creatinin, Cystatin C and Urine β-microglobulin all elevated after single and repeated contrast media use in patients in the simple hydration group ( P<0.05 ) .The incidence of CIN did not differ after single or repeated contrast used (2.5%vs.15.0%, P>0.05).After repeated contrast exposure compared with patients with simple hydration , patients in the alprostadil group had repeated serum levels of urea [(7.4 ±2.3) mmol/L vs.(9.1 ±2.6) mmol/L], creatinia [(87.2 ±25.6) μmol/L vs.(96.9 ± 25.8) μmol/L], Cystatin C [(0.8 ±0.3) mg/L vs.(1.4 ±0.3) mg/L] and Urine β-microglobulin [(207.0 ±31.9 ) μg/L vs.(279.3 ±37.3 ) μg/L] were all lower with higher creatinin clearance [(92.2 ±24.2) ml/min vs.(78.2 ±27.5) ml/min](all P<0.05).The incidence of CIN in patients with alprostadil did not differ after single or repeated contrast used (2.5%vs.7.5%, P>0.05).The incidence of CIN in patients treated with alprostadil had no difference compared with patients with simple hydration after repeated contract (7.5% vs.15.0%, χ2 =0.501,P=0.479).Conclusions Contrast media can cause damage to renal function .Short-term repeated use of contrast media can further worsen renal function without significant increase in CIN rates .Alprostadil may have renoprotective effect towards CIN .

Objective To investigate the effect of small interfering RNA (siRNA) mediated silencing of △Np73 on 5-FU chemotherapy sensitivity in SW620 colocancer cells and provide new treatment approach for the colon cancer.Methods siRNAs were transfected into SW620 colon cancer cells.The expression of △Np73 was observed.Cell viability of colon cancer cells were measured by MTr assay and cell apoptosis was assessed with flow cytometry after treatment of control siRNA or △Np73 siRNA or combined with 5-FU,respectively.The tumorigenesis was assessed by injecting △Np73 siRNA or control siRNA transfeeted SW620 colon cancer cells into nude mice,followed by treatment with 5-FU in the tumors.Results △Np73 siRNA was able to strongly inhibit △Np73 expression,however,it did not inhibit the growth of cells.Combination treatment with △Np73 siRNA and 5-FU produced significant higher apoptotic cell(42.9%) as compared with those with 5-FU treatment(18.9%) alone or those with △Np73 siRNA(8.8%) alone.The treatment with 5-FU in the xenngrafts derived from △Np73 siRNA transfected SW620 cells in nude mice can inhibitor tumor growth significantly (t=15.32,P<0.05).Conclusion △Np73siRNAs can specifically repress the expression of △Np73.Thus it sensitizess the cells to 5-FU chemotherapy in colon cancer.