This paper analyzes the characteristics of the follow-up quality survey and evaluation of medical graduate students in China.It raises that the follow-up quality survey of graduate students in medical schools should be institutionalized,standardized and normalized; the survey and evaluation should be conducted through close cooperation with the relevant departments and training units; comparative studies on graduates of different years should be conducted; and the indicator system and survey content should value the characteristics of times,training units and subjects; Finally,specific technical issues such as when and to whom the evaluation and survey should be conducted,survey arrangements,evaluation methods,the diversity of participants and determination of results are discussed and suggestions are put forward.

Adult ; Endocarditis ; microbiology ; Humans ; Male ; Mycoses ; Recurrence

Objective To investigate the effects and toxic side effects of concurrent radiotherapy and chemotherapy combined with adjuvant chemotherapy in nasopharyngeal carcinoma.Methods 141 patients of nasopharyngeal carcinoma divided into two groups randomly.All patients treated two-dimension exact radiotherapy and concurrent chemotherapy which combined DDP and 5-Fu intravenously for two circles,then experiment group started adjuvant chemotherapy 3 weeks later after above treatment,which intravenous DDP and 5-Fu for other three circles.Results All patients completed concurrent radiotherapy and chemotherapy,63 patients of treatment group completed adjuvant chemotherapy.The mainly toxic side effect was mucositis,leukopenia and low-platelet,and gastrointestinal reaction during therapy,there is no statistical significance in two groups.The regression rate of lymph nodes is 94.4 ％(n=67)and 87.3 ％(n=62)in nasopharynx and neck after 3 month of radiotherapy and concurrent chemotherapy.All patients followed up 3 years.The total survival rate of two groups were 94.3 ％,84.8 ％,78.6 ％ and 90.1％,75.0 ％,62.5 ％ respectly in 1,2 and 3 year,the mean survival period was 36 months and 27 months,and this differece was statistical significance(x2=7.356,P=0.007).The total survival rate of Ⅲ stage patients of two groups were 98.2 ％,92.5 ％,83.7 ％ and 93.0 ％,83.2 ％,68.2 ％ respectly in 1,2 and 3 year,the both mean survival period was 36 months,and this differece was statistical significance(x2=8.081,P=0.005).The total survival rate of Ⅳ stage patients of two groups were 81.3 ％、53.8 ％、42.9 ％ and 78.6 ％、36.4 ％ 、22.3 ％ respectly in 1,2 and 3 year,the meat survival period were 22 month and 14 month respectly,and this differece was statistical significance(x2=3.903,P=0.048).The progression-free survival rate of two groups were 90.0 ％、76.2 ％、68.8 ％,and 81.7 ％、60.3 ％、34.3 ％ respectly in 1,2 and 3 year,the meat progression-free survival period was 30months and 22months,and this differece was statistical significance as well(x2=13.616,P=0.000).Conclusion The therapy of concurrent radiotherapy and chemotherapy combined with adjuvant chemotherapy was obviously increased total survival rate and progression-free survival rate in nasopharyngeal carcinoma,especially to Ⅲ and Ⅳ stage patient of nasopharyngeal carcinoma.But the long period effects still remains unclear.

Objective To study the expression of CD4+, CD25+ regulatory T cells and its significance in carcinoma of stomach. Methods Flow cytometry was used to quantify and analyze the results of CD4+, CD25 + regulatory T cells and CD8+ T cells in 76 patients with gastric cancer. Results CD4+, CD25+ regulatory T cells expression in gastric cancer tissue, adjacent tissues and control group are (1.2±0.9) %, (6.4±1.1) % and (4.1±0.8) %. The results have statistical significance (P<0.05). CD8+ T cells markedly de-creased in gastric cancer tissue, while CD4+ , CD25+ regulatory T cells increased. But this manifest did not happen in adjacent tissues.Conclusion CD4+, CD25+ regulatory T cells suppress gastric cancer though inhibiting CD8+ T cells.

Objective To observe the inhibitory effect of atorvastatin on bleomycin-induced pulmonary fibrosis in SD rats and study their possible mechanism.Methods 30 male SD mice under SPF condition with average body weight of 250g were randomly allocated to three groups (n =10,each) of saline control group (control group),bleomycin-induced pulmonary fibrosis group (pulmonary fibrosis group) and atorvastatin treatment group (treatment group).Bleomycin (5mg/kg) (versus 0.2 ml saline in control group) were endotracheally instilled in pulmonary fibrosis group and the treatment group in order to establish the model of pulmonary fibrosis.Subsequently,the rats in the treatment group received daily atorvastatin (10 mg/kg) orally.5 rats in each group were sacrificed on 7th and 28th day after intratracheal instillation.Their lung tissues were taken and tested.The histological changes in the lungs were evaluated by hematoxylin-eosin and masson stain.The tumor necrosis factor (TNF-α) level and hydroxyproline content in lung tissues were measured by enzymelinked immunosorbent assay (ELISA).The expressions of Kruppel-like factor 2 (KLF2) protein and mRNA in lung tissues were measured by Western blotting and Real-Time PCR.Results The lung tissue in model group had significant bleeding and oozing inflammatory response on the 7th day and pulmonary fibrosis on the 28th day.Bleeding and oozing inflammatory response and pulmonary fibrosis were subdued in treatment group on the same days as compared to the model group.Hydroxyproline and TNF-α contents in lung tissue were significantly higher in model group than in control group (both P＜0.05).KLF2 protein and KLF2-mRNA expressions in lung tissues were significantly lower in model group than in control group (both P＜0.05).The above changes were partially reversed in treatment group.Compared to model group,treatment group showed that hydroxyproline and TNF-α contents in lung tissues were significantly reduced (both P＜0.05) and KLF2 protein and KLF2 mRNA expressions in lung tissues were significantly increased (both P＜ 0.05).Conclusions Atorvastatin can reduce the secretion of TNF-α and alleviate bleomycin-induced pulmonary fibrosis.The mechanism inhibiting fibrosis might be associated with up-regulation of KLF2-mRNA expression.

Objective:To assess the preventive and therapeutic effects and primary mechanisms of Danshen injections in the treat-ment of hepatic encephalopathy ( HE) . Methods:The acute ammonia poisoning model induced by ammonium chloride was established in mice, and HE model with liver injury induced by carbon tetrachlorie and high blood ammonia induced by thioacetamide was made in rats. The time of death was detected in the first model, and the histamine levels in blood and brain, liver function and liver pathologi-cal histology changes were detected respectively in the other model. Results:In the acute ammonia poisoning experiment, the time of death in Danshen injections group was longer than that in the control group. Furthermore, Danshen injections could notably decrease the histamine levels in blood and brain, reduce the levels of ALT, AST, ALP and Tbil in serum and improve the function of liver to show the preventive and therapeutic effects on HE. Conclusion:Danshen injections exhibit promising preventive and therapeutic effects on HE, which may be related to decreasing histamine levels in blood and brain.

NS2 is a nonstructural protein of Periplaneta fuliginosa densovirus(PfDNV) with a molecular mass of 30 kD,whose function is not yet clearly understood. In order to study the expression,subcellular distribution and the function of NS2 protein,the coding region of NS2 was amplified from the hindgut tissue of cockroaches infected with PfDNV by RT-PCR and then the recombinant prokaryotic expression vector pET28a-NS2 was constructed. The recombinant plasmid was transformed into E. coli BL21(DE3) to express the 6?His fusion protein in the bacteria. After purification,the fusion protein was injected into New Zealand rabbits to prepare polyclonal antibody. The specificity of the anti-NS2 antibody was successfullyproved by western blotting on the eukaryotic expressed products of NS2 protein.Meanwhile,the full sequence of ns2 gene was also cloned into the eukaryotic expression vector pAC. The recombinant plasmid pAC-NS2 was then transfected into Schneider line 2(S2) cells to express NS2 protein in the insect cells. The subcellular localization of NS2 in the insect cells was then investigated by indirect immunofluorescence technique using the anti-NS2 polyclonal antiserum. The confocal laser scanning microscope observation showed that NS2 protein was located primarily in the cytoplasm with some punctate nuclear staining.

Objective To evaluate the clinical outcomes of external fixator with lumbopelvic distraction spondylodesis in treatment of vertically unstable pelvic fractures. Methods From January 2008 to March 2009, 9 patients (4 males and 5 females) with a vertically unstable pelvic fracture were treated with modular external fixator with lumbopelvic distraction spondylodesis. According to the classification of Tile, 9fractures were classified as type C. This fixation construct comprises a vertical lumbopelvic distraction component which fixed L4.5 and the posterior superior iliac spine and a transverse fixation which fixed anterior iliac spine with external fixator. Results All patients were followed up 12-18 months after surgery, with an average of 14.3 months. Postoperative X-ray showed satisfactory reduction of pelvic fracture. Pelvic fractures healed in all patients without loss of reduction 3-6 months after operation. According to Matta reduction evaluation criteria, 6 patients were excellent and 3 good. For the two patients with sacral neurological injuries,appropriate surgical decompression was performed to improve the symptom and minimize the deformity. No iatrogenic complications of neurovascular injury occurred. Patients now walk unassistedly without pain in the waist or legs, and with no shortening of lower limbs or claudication. By considering symptom and satisfactory scores, the Majeed functional assessment revealed that seven patients had excellent results and two good at one year. Conclusion External fixator with lumbopelvic distraction spondylodesis that allowed early mobilization and ambulation, with general applicability and definite safety, is an effective surgical technique for the treatment of vertically unstable pelvic fracture.

OBJECTIVETo evaluate effectiveness therapeutic regimens for obstructive sleep apnea hypopnea syndrome (OSAHS) children at an acceptable cost.

METHODThis study was performed at Yuying Children's Hospital of Wenzhou Medical University from Mar. 2008 to Dec. 2010. Prospective random number table method was used for the analysis; 60 children with mild OSAHS were divided into Mild OSAHS Montelukast Treatment (MM) group and Mild OSAHS Adenotonsillectomy Treatment (MAT) group. 32 children in MM group were treated with leukotriene receptor antagonists (LTRAs), while 28 children in MAT group were treated with adenotonsillectomy. Also, 58 children with moderate and severe OSAHS were divided into severe OSAHS Montelukast Treatment (SM) group and severe OSAHS Adenotonsillectomy Treatmen (SAT) group. Twenty-two children in SM group were treated with LTRAs, while 36 children in SAT group were treated with adenotonsillectomy. All selected children were evaluated by polysomnography (PSG) and Obstructive Sleep Apnea-18 (OSA-18) items before and after a six-month treatment. Both records were taken and analyzed, surgical complications and the reason for non-remission after operation were also analyzed. Two therapies were compared based on economic consideration and therapeutic effect. Result (1) PSG: A significant change of a significant change of Apnea Hypopnea Index (AHI) was observed in MM group after the treatment (before receiving the treatment 4.56 ± 1. 26, and after receiving the treatment 3. 48 ± 1. 52, t =3. 50, P <0. 05). But for oxygen desaturation Index (ODI) (MM group 2. 18 ± 2. 19, and MAT group 1. 80 ± 2. 34) and Lowest Oxygen satuation (LSaO2) (MM group 91. 66 ± 2. 34, and MAT group 92. 79 ± 2. 18), there was no significant difference in MM group and MAT group after the treatment (ODI, t =0. 65, and LSaO2 t = - 1. 93, P >0. 05). (2) OSA-18 scores: Significant differences were found in sleeping disorder (before 14. 81 ± 6. 28, and after 10. 56 ± 3. 57), the degree of familial stress (before 13. 56 ± 3. 54, and after 8. 97 ± 2. 96), and OSA-18 total scores (before 52. 66 ± 1. 11, and after 42. 56 6. 48) in MM group after the treatment (sleeping disorder Z - 3. 14, the degree of familial stress Z = -4. 50, and OSA-18 total scores Z= -4. 01, P <0. 05). (3) In addition to the cost of drugs, groups with surgical treatment had a larger economic burden than those with LTRAs treatment. (4) Treatment was totally effective for 28 children (88%) in MM group, and 28 children (100%) in MAT group. Meanwhile, treatment also achieved an obvious effect on 2 children (9%) in SM group, and in 35 children (97%) in SAT group. In MAT group, 3 children improved (11%). And in SAT group, 7 children improved (19%), but treatment was found to be ineffective in 1 case (3%). Among those effective and ineffective cases in groups with surgical treatment, there were 9 children with nasal diseases.

CONCLUSION(1) Surgical treatment is recommended as the first choice for children with moderate and severe OSAHS. And for those who also suffer from nasal diseases, treatment combining drugs with surgery is necessary. (2) LTRAs therapy has a good effect for mild OSAHS. Surgery is also recommended when drugs could not achieve any obvious improvement in clinical symptoms of children with mild OSAHS.

Adenoidectomy ; Blood Gas Analysis ; Child ; Cost of Illness ; Humans ; Oxygen ; Polysomnography ; Prospective Studies ; Sleep Apnea, Obstructive ; surgery ; Sleep Wake Disorders ; Tonsillectomy ; Treatment Outcome

Objective To investigate the impact of 1,25(OH)2D3 on histological changes and activation of STAT3 in BLM?induced pulmonary fibrosis mice. Methods 30 male C57BL/6 mice were randomly divided into control group ,BLM group and BLM+VD group. Mice in BLM group and BLM+VD group received intratracheal injection of BLM(3 U/kg). Control group were intratracheally injected equal volume of sterile saline. From the first day after the surgery,mice in BLM+VD group received intraperitoneal injection of VD (5μg/kg·d). After 21 days, H&E and Masson′s trichrome staining were carried out. Aschroft score were used to evaluate histological changes in lungs. IL?6,IL?4 and INF?γin BALF were assessed by Elisa. p?STAT3,α?SMA and Collagen I were detected by western blot (WB) and immunohistochemistry. Results Fibrosis score and level of α?SMA,Collagen I in BLM group were significantly higher than that in control group (P < 0.05). However ,treatment with VD effectively at?tenuated fibrosis (P<0.05). IL?6 and IL?4 increased while INF?γwas decreased in BALF of BLM group (P<0.05). VD could ameliorate these changes. Upregulation and neuclear translocation of p?STAT3 were observed in BLM group,while VD intervention could inhibit phosphorylation of STAT3. Conclusions VD attenuate BLM?induced pulmonary fibrosis and regulate inflammatory cytokines probably by blocking STAT3 activation.