[Objective]To discuss the clinical experiences and unique views of Professor XIA Guicheng, a master of Chinese medicine in treating adenomyosis dysmenorrhea. [Method] To analyze the understanding of professor XIA Guicheng about the pathogenesis of adenomyosis dysmenorrhea. To sum up the clinical experiences in treating adenomyosis dysmenorrhea according to the kidney to adjust the cycle. [Result]For adenomyosis dysmenorrhea, XIA believes that the pathogenesis of this disease is the key virtual reality. The virtual refers to the deficiency of kidney-yang which is the root of its occurrence.The subject refers to the blood stasis which is its pathological basis. The deficiency of kidney-yang losses of warm effect, leading to stagnation of Qi and blood stasis for dysmenorrhea. According to the principle ofJi ze zhi biao,huan ze zhi ben, when the dysmenorrhea attacks severely, we should control the pain from the standard treatment, mainly including relieving spasm and pain ,warming Yang wet and tranquilizing mind. We ought to value the root cause in normal time, that is the kidney to adjust the cycle. In particular, we pay attention to the inter ovulation period of warming kidney to help Yang, and the patient's daily life, emotional diet. [Conclusion] Professor XIA Guicheng 's experience in treating adenomyosis dysmenorrhea is worth to spread.

Objective To explore mechanics condition in artificial knee joint replacement tibial prosthesis with different shaft body shapes implanted into tibia in different inclination angle,and discuss which shaft shape in tibial prosthesis is suitable in different inserted angle.Methods Finite element model of tib-ial prosthesis with cylindrical handle,square taper shank,columns taper shank,ladder airfoil cross wing shape with column wing handle were built and assembled with bone cement and polymer polyethylene pad.The finite element software ANSYS15.0 was used to analyze the variation of stress and strain of all kinds of body shape handle prosthesis in tilting to 0° and 3°,6°under the working condition of the existing literature data.Results Different stress and strain changes were observed in the finite element models of tibial prosthesis with different shaft shapes in tilting to 0°,3°,and 6°.Conclusions For the different tibial prostheses of 6 kinds of shaft shapes,when placed in tilting to 3°,prosthesis with cylindrical taper shank and column wing were suitable to be chosen; and when placed at 0°,prosthesis with ladder airfoil handle should be avoided to use,because of stress concentration easily could lead to a fractured in bone cement; Placed in the lean 6° level,prosthesis with cylindrical,square taper shank,cylindrical handle taper shank and column wing handle were suitable to be chosen.

Toxoplasma gondii is a medically and agriculturally important protozoan parasite that can infect virtually all the mammalian and avian species. Previous studies showed that the family of rhoptry proteins (ROPs) plays a key role in the invasion process of T. gondii, and its several members can be potential marker for population genetic researches of Toxoplasma. In order to estimate whether other member is also suitable as the novel genetic marker, the variation of ROP41 gene among 11 T. gondii isolates from different hosts and geographical locations and two reference strains was examined in this study. Our results showed that all the examined sequence of TgROP41 gene was 1473 bp in length, and their A+T contents were between 48.47% and 48.88%. Sequence analysis presented 14 nucleotide mutation positions (0%-0.54%), leading to 5 amino acid substitutions (0%-0.61%) through alignment with T. gondii ME49 strain (ToxoDB: TGME49_266100). Furthermore, phylogenetic analyses by MP and BI methods based on deduced amino acid sequences of TgROP41 gene was only able to distinguish the type I strain, but not able to separate the two classical genotypes (Type II and III) into the respective clusters. These results indicated limited sequence diversity in the TgROP41 gene.

OBJECTIVE To investigate the cognition on hand hygiene and the reasons affecting the hand hygiene performance in hospital.METHODS Medical staff of 358 parsons were randomly selected by questionnaire.RESULTS It was higher cognition among medical staff on hand washing indication learned from Standards of Hand Hygiene among Medical Personnel in Medical Institutions(draft for soliciting opinions) issued by the Ministry of Health.The cognition coincidence of hand sterilization indication was 68.04%,but existed some less cognition or miscognition in this field among them.The main factors affecting the hand hygiene performance were busy at work,to which was the primary cause to affect use of stream water to wash hands.The concept that using stream water wash hand is reliable is the primary cause influence medical staffs to use alcohol scrape hand.CONCLUSIONS The nosocomial infection monitoring,guidance and control should be emphasized in the field of more use of the fast hand antiseptics instead washing hands and supervising the relevance of the amount of hand hygiene product consumpsion to nosocomial infections.

Based on summarizing the importance of education environment and the development and current status ofresearch on medical education environment, the authors measured the status of, and the problems existing in, educationenvironment of China Medical University by DREEM (Dundee Ready Education Environment Measure), and then sug-gested strategies to modify the education environment and hence to improve the quality of medical education on thebasis of the advanced concepts of education environment design and construction in the world and the authors' experi-ence in the reform of medical curriculum.[

To improve the quality of health care by improving the quality of residency training,the Accreditation Council for Graduate Medical Education of USA has renewed the standards and methods of residency training to improve health care,and issued the compe- tence-based training standards. The residents have to achieve six key competences when they finish the training. The University of Washington,School of Medicine,responds to the new re- quirements and standards by reforming its residency training pathway,enriching formal teach- ing/training activities,and improving its supervision and the evaluation. We should use for refer- ence reforming the residency training in China.

Objective To compare the renal effects of dopamine and dobutamine in patients with sepsis.Methods 90 patients with sepsis were admitted to this study.After resuscitation,each patient was randomly given different vasoactive agent.The changes in urine output,fractional excretion of sodium(FeNa),and creatinine clearance(CCr)were observed.Results The urine output and FeNa in dopamine group were increased significantly as compared with control group and dobutamine group[(3072±480),(2038±515)and(362±522)ml/24h,(3.80±1.09),(2.06±1.14)and(2.10±0.95)%](P＜0.05).Compared with control group and dopamine group,CCr increased significantly in dobutamine group[(79.2±39.1),(50.6±21.8)and(47.4±16.7)ml/min](P＜0.05).Conclusion Dopamine infusion markedly elevates urine output and FeNa,but has no effect on CCr.Dobutamine treatment misht significantly increase CCr,but has no effect on urine output.

Objective To study the effects of treating irritable bowel syndrome (IBS) with modified TongXieYaoFang. Methods 83 IBS patients were randomly recruited into a treatment group (45 patients) and a control group (38 patients). In the control group, Trimebutine, 200mg, and Bifid triple viable capsule, 420mg, 3 times/day was given orally to the patients, while on the basis of that, the treatment group was administrated with modified TongXieYaoFang in addition. Both groups were treated for one course of 4 weeks. Results The total effective rate of the treatment group and the control group was 93.3% and 71.1% respectively, showing significant difference between the two groups (X2=7.2938, P<0.01 ). Conclusion TongXieYaoFang combined with western medicine is effective in treating IBS.

Objective To explore the clinical characteristics of multiple primary carcinoma (MPC) in elderly patients and the effects of postoperative adjuvant chemotherapy on the prognosis and advanced cancer genesis. Methods The study population consisted of 220 elderly patients with malignant tumor. Thirty-seven elderly patients with MPC were selected in the study. The characteristics including onset age, carcinoma sites, effects of postoperative adjuvant chemotherapy, interval and survival time between first and advanced cancer were analyzed. Results of the 220 subjects,37(16.8%) patients were MPC, among whom 2 patients were synchronous multiple primary carcinomas (SMPC) and 35 patients were metachronous multiple primary carcinomas(MMPC). The median ages at onset were 70,77 and 77.5 years old for the first,second and third tumor respectively. Among a total of 82 tumor focus, the most predilection site of MPC was gastrointestinal tract, with a 34.2%(28 cases) in colorectum and a 13.4%(11 cases) in stomach. The postoperative patients were divided into two groups: 23 accepted adjuvant chemotherapy (chemotherapy group) and 14 accepted no adjuvant chemotherapy (no chemotherapy group). The survival time of chemotherapy group was significantly longer than no chemotherapy group (x2= 4.63, P = 0.0427 ). The median intervals between the first and the second cancer were 6 years and 4 years in chemotherapy group and no chemotherapy group, respectively(x2=1.63, P = 0.207), while the median intervals between the second and the third cancer were 7 years and 2 years, respectively(x2 = 4.255,P=0.043). The mediansurvival time of the third cancer postoperative patients were 3.5 years and 7 months in chemotherapy group and no chemotherapy group, respectively (x2 = 4.62, P = 0.0316 ) . ConclusionsPostoperative adjuvant chemotherapy may prolong the survival time and delay the advanced cancer genesis in elderly patients with MPC.

Objective To analyze the sequence of the novel conjugative plasmid pO157_Sal detected in outbreak isolates of Escherichia coli O157∶H7 .Methods The traE genes of the outbreak isolates in China were amplified by polymerase chain reaction (PCR) and the products were sequenced .The TraE sequences of Escherichia coli O157 ∶ H7 strains from other sources were retrieved from GenBank . Phylogenetic tree based on the TraE sequences was constructed by Neibhor-joining analysis .The whole plasmid sequences of pO157_Sal and pEC4115 were compared .Results The sequences of traE gene were identical among the Chinese isolates . There were homologous sequences of TraE in Escherichia coli O157∶H7 isolates from different sources .Twenty-one out of the 52 pO157_Sal genes were homologous to genes of pEC4115 with amino acid level identity ranging from 28% to 51% .Conclusions Although similar TraE sequences and similar plasmid are found in Escherichia coli O157∶H7 isolates from different sources ,pO157_Sal is only observed in Chinese outbreak isolates .The TraE sequences are conservative among the outbreak isolates ,indicating they are from the same specific source .