With the change of medical model and the transfer of health to communities and rural towns,the expanding enrollment of colleges and universities makes collegiate internship progrms more and more difficult Clinical College of Guilin Medical University explores the new methodology of teaching practice,constructs and practises the new molde of internal madichine teaching,Combines the coummunity internship programs with hospital internship programs.and was improved the quality of practice teaching

Accidents, Occupational ; statistics & numerical data ; Adolescent ; Adult ; Factor Analysis, Statistical ; Humans ; Male ; Middle Aged ; Occupational Injuries ; epidemiology ; Risk Factors ; Young Adult

Objectve To investigate the application value of ultraifltration with millipore ifltration method test of old biological samples DNA. Methods 23 old blood samples separately were cut blood piece equally suitable size of three groups, labeled A, B and C group. DNA was extracted by magnetic bead methed and get DNA template with 80μL, 80μL, 20μL elution solution, respectively, then the DNA template in group A and C take right amount directly ampliifed, group B with milipore ultraifltration ifltration condensed amplication. PCR products were detected by ABI3130xl genetic analyzer and analyzed by GeneMapperID V3.2 software. The date were analyzed by using SPSS software. Results No samples were ampliifed for all STR loci in group A. There were 18 cases in group B samples amplified all STR loci and 11 samples in group C. Conclusion Application of millipore ultrafiltration method can signiifcantly improve the old biological samples DNA classiifcation success rate.

ObjecfiveTo explore clinical value of 64-slice spiral CT coronary angiography in diagnosing coronary atherosclerotic heart disease. as compared to that with selective coronary angiography.MethodsOne hundred and thirteen patients who underwent both 64-slice spiral CT coronary angiography as well as selective coronary angiography at an interval of no more than one month at Zhongshan Hospital.Shanghm in 2006 were selected for the study and their imaging reports were analyzed and compared.ResultsImages of 910 segments of coronary arteries were collected and assessed.Sensitivity,specificity and likelihood ratio for negative test result of 64-slice spiral CT coronary angiography in diagnosis of coronary atherosclerotic heart disease were 73.8 percent.97.0 percent and 24.4,respectively,with an overall agreement of 93.2 percent,positive predictive value of 82.7 percent and negative predictive value of 95.0 percenL ConclusionsSixty-four-slice spiral CT coronary angiography has hish specificity,negative predictive value and positive likelihood ratio,with high accuracy,in diagnosing coronary atherosclemtic heart disease.

Objective To investigate the genotypes and encoding resistance genes differences of Acinetobacter baumannii and analyze their interrelations with multi-drug resistance.Methods A total of 77strains Acinetobacter baumannii were collected random from the second Xiangya Hospital during September 2008 to September 2009.The K-B method which was WHO recommended was adopted to Acinetobacter baumannii drug sensitivity test to 15 kinds of antibiotics to establish susceptibility spectrum.At the same time,random amplified polymorphic DNA(RAPD)technique was used to establish DNA fingerprinting.The genes of β-lactamase(TEM-1,IMP,OXA-23,OXA-24,AmpC),aminoglycoside-modifying enzymes[aac(3')-Ⅰ ,aac(6')-Ⅰ ,ant(3")-Ⅰ]and 16S rRNA methylase(armA,rmtA,rmtB)were detected by PCR and sequenced,and find the relationship between the gene encoding and multi-drug resistance.In addition,we compared the rates of resistance genes of Acinetobacter baumannii and the relations with the genotype and the multi-resistance.Results Thirty-one sensitive strains and 46 multi-drug resistance strains(10 Pan-drug resistances)were isolated.Seventeen types from A to Q were separated using RAPD technique.E genotype widely popular in the ICU was the advantage type in multi-drug resistance strains,and the rate was 47.1%.While the various types scattered in sensitive strains.The positive rates of TEM-1,IMP,OXA-23,OXA-24,AmpC,aac(3')-Ⅰ ,aac(6')-Ⅰ ,ant(3")-Ⅰ ,armA in the multi-drug resistance strains and the sensitive strains were 95.7%,39.1%,84.8% ,54.3%,87.0%,89.1%,84.8%,45.7%,63.0% and 58.1%,9.7%,32.3%,48.4%,48.4%,29.0%,45.2%,12.9%,9.7%,respectively,and there was significant difference except for OXA-24 using the X2 test(P ＜ 0.05).All isolates were negative for rmtA gene and rmtB gene.Drug susceptibility analysis showed that the resistant rate was significantly higher of the strains carrying resistant genes than that of the resistance negative strains.When the strains were resistant to gentamicin and amikacin,the rate of three aminoglycoside genes positive was 34.8%.The trains containing all the measured β-lactamase genes were all resistant strains.Conclusion Compared with the sensitive Acinetobacter baumannii strains,a broad resistance spectrum and a high drug resistance rate were showed in multidrug resistance strains isolated from clinic,which harboring many kinds of β-lactamase genes and aminoglycosides genes with a high separation rate,and the same clone of multiple drug-resistant strains may be transmitted in and among wards.

Field operations,work and war on plateau is an important part of future war. It is necessary to study the early treatment and evacuation of scull injury. Research and survey were made in 7 field hospitals and hundreds of records were summaried before treatment criterion in early phase was put forward for patients on plateau as well as the evacuation in different level and stage,which aims to actively save patients' lives within limited time and reduce the death rate and prevent deformity. References are provided for war,training,and construction in battlefield.

Objective To study the percutaneous permeability through mouse skin of lidocaine hydrochloride-loaded destran-based niosomes(LID-HLD-BNs)in vitro and in vivo. Methods HPLC was employed to exam lidocaine hydrochlo?ride. Lidocaine hydro-chloride-loaded conventional liposomes (LID-CLs) and lidocaine hydrochloride injection (LID-IJ) were used as control. Isolated mouse skin was added into Franz diffusion cell to evaluate the permeability of LID-HLD-BNs in vitro. Confocal Laser Scanning Microscopy(CLSM)was used to observe the permeation depth of mouse skin in vivo. Re?sults The permeation rate and cumulative permeation amount were significantly higher in LID-HLD-BNs group than those of LID-CLs and LID-IJ groups (P<0.05). CLSM studies also confirmed that HLD-BNs reached deeper layers of the skin. Conclusion LID-HLD-BNs has good transdermal ability.

Objective To evaluate the expression of epidermal growth factor-like domain 7 (Egfl7) in atherosclerotic plaques and effects of its small interference RNA (siRNA) on angiogenesis gene expression in human endothelial cell line (HUVEC). MethodsEgfl7 expression in atheroscleroticplaquesweredetectedinhumaniliacarteryandmousearteriaeusing immunohistochemistry and immunofluorescence stainings.The siRNA targeting Egfl7 was transfected into HUVEC by lipofectamine with non-transfected cells and unconcerned siRNA as controls.At 0 h,12 h,24 h and 48 h after intervention,the levels of mRNA and protein of Egf17,vascular endothelial growth factor(VEGF),platelet derived growth factor-A (PDGF-A),platelet derived growth factor-B (PDGF-B),vascular cell adhesion molecule(VCAM) and intercellular adhesion molecule (ICAM)were measured by RT-PCR and Western blotting,respectively. ResultsThe expressions of Egfl7 in human iliac artery and mouse arteriae were increased.The expressions of Egfl7 in HUVEC at the levels of mRNA were[(0.14±0.02),(0.09±0.01),(0.02±0.01)]and the levels of protein[(0.71±0.11),(0.39±0.09),(0.07±0.01)]at 12 h,24 h and 48 h after siRNA intervention,respectively,which were decreased as compared with 0 h intervention [(0.31 ±0.05) and (0.93±0.08) ].Other genes such as VEGF,PDGF-A and PDGF-B were reduced or silenced at the levels of protein and mRNA in HUVEC with siRNA longer interventions(all P＜0.05).ConclusionsThe expression of Egfl7 in atherosclerotic plaques is increased.The siRNA inhibiting Egfl7 gene expression results in silence of other factors involved in angiogenesis.

ObjectiveTo investigate the clinical value of serum cystatin C(CysC) and urinary microalbumin(MA) in the diagnosis of early renal function injury in patients with essential hypertension.MethodsOne hundred and twenty patients with essential hypertension(hypertension group) were divided into three groups by the results of blood pressure:grade 1 with 48 cases,grade 2 with 47 cases,grade 3 with 25 cases.Thirty healthy subjects were selected as control group.Serum CysC,urinary MA and serum creatinine (Cr) were detected in all subjects.ResultsThe serum CysC and urinary MA in grade 1,2 and 3 hypertension group [(1.57 ±0.48),(2.12 ±0.72),(2.91 ± 1.09) mg/L and(18.12 ±5.43),(29.01 ±8.07),(46.06 ± 13.21 ) mg/L] were obviously higher than those in control group [ (0.71 ± 0.23 ),(9.35 ±5.17)mg/L](P＜ 0.05).The serum Cr had no significant difference between grade 1,2,3 hypertension group and control group (P ＞ 0.05 ).Serum CysC was positively correlated with urinary MA in hypertension group (r =0.613,P ＜ 0.05),serum CysC and urinary MA were both negatively correlated with estimated glomenlar filtration rate (eGFR)(r=-0.635,-0.563,P＜0.05).ConclusionsSerum CysC and urinary MA are sensitive indexes of early renal function injury in patients with hypertension.The combined determination of serum CysC and urinary MA can improve the detection rate of early renal function injury.

ObjectiveTo construct ompW- and ompW+ mutants of Salmonella paratyphi A with λRed system,and then study the function of the gene preliminarily.Methods Homologous regions were amplified from the genome Salmonella paratyphi A 50973,and then connect with kana fragment from plasmid pET22b-kan to construct a recombinant vector.The resultant fragments were amplified and transferred into 50973 with the help of λRed system after its concentration.Then the ompW- mutant was obtained PCR identification.Connect the recombinase expression plasmid pACU184 with full fragment of ompW regulatory region and coding region,then transfer the connection product into the mutant,the ompW+ mutant was obtained after double digest identification.Full cells of the wild,ompW- and ompW+ mutants were samples for SDS-PAGE and Western blot to detect the expression of protein OmpW.Biochemical identification of wild strain and mutant strains was conducted,so did the growth curves of the wild and the ompW- mutant.Choose BALB/c mice as a model to determine median lethal dose LD50 of the wild and mutant strains in order to observe the correlation between ompW gene and bacterial virulence.ResultsompW gene was knocked out in Salmonella paratyphi A 50973,also the ompW+ mutant was constructed; The wild and ompW+ mutant express the protein OmpW,while the ompW- mutant lost the protein.Each of the wild and mutant strains was Salmonella paratyphi A,and no obvious difference could be observed for their growth curves.LD50 for each strain was also similar.Conclusion The ompW gene has no correlation with the virulence in S.paratyphi A 50973,but the contribution of the mutants made an important foundation for the further study of functions of the gene ompW in Salmonella paratyphi.