Clinical final examination is an important link in the standardized training of residents in dermatology and quantification of evaluation indicators is one of the important parameters. In this study, the scores of clinical examinations of six candidates who participated in standardized training of residents in dermatology of Sun Yat-Sen University in June 2019 were taken as examples to explore the quantitative indicators of standardized and multi-station clinical final examinations. The indicators contained four stations and five links: skin pathological reading, skin biopsy, medical history collection and physical examination, medical record writing, and comprehensive questioning, which covered the main contents of the standardized training outline of residents in dermatology. Each evaluation indicator was refined and quantified. Finally, heuristic ideas were put forward, including a wider range of standardized and multi-station clinical examinations, introduction of new examination places, and utilization of information technology.

Objective:To investigate the acceptance and attitude toward a novel fecal immunochemical test (FIT) in colorectal cancer screening among populations in China.Methods:From May 2018 to May 2019, 2 474 people aged 50-74 years were recruited from five provinces of China (Zhejiang, Anhui, Jiangsu, Hunan and Yunnan). The general demographic characteristics, acceptance of the new FIT technology and operational difficulties through the whole screening process were obtained through questionnaire survey. Multivariate logistic regression model was used to analyze the factors related to difficulties encountered in sampling stool, reading and uploading results.Results:The subjects were (60.0±6.4) years old, and female, high school of above educated, unemployed/retired/other, married and with medical insurance status of “new rural cooperative medical care (NRCMC)” accounted for 61.7% (1 526), 29.0%(718), 34.3% (849), 92.7% (2 293) and 31.3%(775), respectively. The population's acceptance of the FIT technology was 94.8%. In the process of FIT screening, the percentage of occurred difficulties in sampling stool, reading and uploading results were 33.1% (819), 46.4% (1 147) and 62.9% (1 557), respectively. The main difficulties were the uncertainty about whether the sampling operation was standard (28.0%), the inability to accurately judge the result displayed (32.5%) and the need for help without using a smartphone (44.2%). The results of multivariate logistic regression model analysis showed that people aged 65-74 years old and with medical insurance status of “NRCMC” were more likely to encounter difficulties in sampling, and those who were unemployed/retired/other and living with 3 or more family members were less likely to encounter difficulties in sampling. Those aged 65-74 years old, farmers or migrant workers, and those with “NRCMC” were more likely to encounter difficulties in readingresults, and those with 3 or more family members were less likely to encounter difficulties in reading result. Those with “NRCMC” were more likely to encounter difficulties in uploading results, and those with education level of high school or above, living with more than 3 family members were less likely to encounter difficulties in uploading results.Conclusion:The acceptance of the new FIT technology is relatively high among the subjects. Age, education level, occupation, number of family members living together and medical insurance status might be related to difficulties encountered in sampling stool, reading and uploading results, and it can be further strengthened in terms of the technology and characteristics of sub-populations.

Objective:To investigate the acceptance and attitude toward a novel fecal immunochemical test (FIT) in colorectal cancer screening among populations in China.Methods:From May 2018 to May 2019, 2 474 people aged 50-74 years were recruited from five provinces of China (Zhejiang, Anhui, Jiangsu, Hunan and Yunnan). The general demographic characteristics, acceptance of the new FIT technology and operational difficulties through the whole screening process were obtained through questionnaire survey. Multivariate logistic regression model was used to analyze the factors related to difficulties encountered in sampling stool, reading and uploading results.Results:The subjects were (60.0±6.4) years old, and female, high school of above educated, unemployed/retired/other, married and with medical insurance status of “new rural cooperative medical care (NRCMC)” accounted for 61.7% (1 526), 29.0%(718), 34.3% (849), 92.7% (2 293) and 31.3%(775), respectively. The population's acceptance of the FIT technology was 94.8%. In the process of FIT screening, the percentage of occurred difficulties in sampling stool, reading and uploading results were 33.1% (819), 46.4% (1 147) and 62.9% (1 557), respectively. The main difficulties were the uncertainty about whether the sampling operation was standard (28.0%), the inability to accurately judge the result displayed (32.5%) and the need for help without using a smartphone (44.2%). The results of multivariate logistic regression model analysis showed that people aged 65-74 years old and with medical insurance status of “NRCMC” were more likely to encounter difficulties in sampling, and those who were unemployed/retired/other and living with 3 or more family members were less likely to encounter difficulties in sampling. Those aged 65-74 years old, farmers or migrant workers, and those with “NRCMC” were more likely to encounter difficulties in readingresults, and those with 3 or more family members were less likely to encounter difficulties in reading result. Those with “NRCMC” were more likely to encounter difficulties in uploading results, and those with education level of high school or above, living with more than 3 family members were less likely to encounter difficulties in uploading results.Conclusion:The acceptance of the new FIT technology is relatively high among the subjects. Age, education level, occupation, number of family members living together and medical insurance status might be related to difficulties encountered in sampling stool, reading and uploading results, and it can be further strengthened in terms of the technology and characteristics of sub-populations.

Taking the course's characteristics and advantages into account, this study explores the systematic implementation of standardized teaching rounds in the clinical probation sessions of the Dermatology and Venereology course , and evaluates its effect by analyzing the cases of 125 medical students from grade 2015 of Sun Yat-sen University . The results showed that the implementation of standardized teaching rounds has positive effect on the course.

Objective: To analyze changes in sensitivity of clinical strains of Ureaplasma urealyticum (Uu) to 9 kinds of common antibiotics from 2017 to 2018. Methods: The results of drug sensitivity testing of clinical Uu strains, which were isolated from 19 431 patients in Laboratory of Sexually Transmitted Disease (STD) , Department of Dermatology and Venereology, The Third Affiliated Hospital, Sun Yat-Sen University from 2007 to 2018, were analyzed retrospectively. Of the 19 431 patients, 6 076 were males, and 13 355 were females. Their age ranged from 15 to 68 years. The tested antibiotics included minocycline, doxycycline, erythromycin, azithromycin, clarithromycin, roxithromycin, ciprofloxacin, sparfloxacin and levofloxacin. Results: Resistance rates of clinical Uu strains to minocycline and doxycycline gradually decreased from 10.08% and 10.42% in 2007 to 1.15% and 2.61% in 2018, respectively, while sensitivity rates to minocycline and doxycycline gradually increased from 85.88% and 87.56% in 2007 to 97.02% and 96.42% in 2018, respectively. The resistance rate and sensitivity rate of clinical Uu strains to erythromycin fluctuated greatly during 2014—2017, with the resistance rate fluctuating around 20%, and the sensitivity rate fluctuating around 50%. The resistance rate of clinical Uu strains to azithromycin dropped rapidly from 42.02% in 2007 to 8.39% in 2011, and then fluctuated slightly around 10%. However, the sensitivity rate to azithromycin increased from 8.40% in 2007 to 86.05% in2011, and remained above 80% from then on to 2018. During 2007—2018, Uu strains showed low resistance rates (10%-20%) and high sensitivity rates to clarithromycin (80%-90%) , and the resistance and sensitivity rates to roxithromycin were similar to those to erythromycin. Uu strains showed constantly high resistance to ciprofloxacin (more than 80% after 2013) and low sensitivity (persistently less than 10%) . The sensitivity rate of clinical Uu strains to sparfloxacin fluctuated around 40%, while the resistance rate was maintained below 10% after 2011. The resistance and sensitivity rates of Uu strains to levofloxacin were similar to sparfloxacin, but the sensitivity rate to levofloxacin was relatively lower, which had been maintained at about 30%. Conclusion From 2007 to 2018, clinical Uu strains maintained a relatively stable low resistance rate and a high sensitivity rate to minocycline, doxycycline and clarithromycin, a high resistance rate and low sensitivity rate to ciprofloxacin, and a low resistance rate and sensitivity rate to sparfloxacin and levofloxacin; a relatively stable low resistance rate and a high sensitivity rate to azithromycin were achieved only after 2011; the resistance rate and sensitivity rate to erythromycin and roxithromycin fluctuated greatly.

Objective To evaluate the efficacy and safety of omalizumab on the treatment of chronic spontaneous urticaria (CSU) by systemic review and meta-analysis.Methods Electronic databases,such as PubMed,Clinicaltrials.gov,the Cochrane Database of Systematic Reviews,and the Cochrane Central Register of Controlled Trials,were searched to collect randomized controlled trials (RCTs) about the efficacy and safety of omalizumab in the treatment of CSU.Two reviewers independently screened RCTs according to the inclusion and exclusion criteria,extracted data,and assessed the quality of the included RCTs.And then,a meta-analysis was carried out by using RevMan 5.3 software for comparisons of the efficacy and safety of the 75-,150-,300-,600-mg omalizumab groups versus the placebo group after 1-month treatment,as well as the total omalizumab group versus the placebo group.Results A total of 7 RCTs involving 1 365 patients were included in this meta-analysis.The results showed that the total omalizumab group and different omalizumab subgroups were superior in improving the urticaria activity score of 7 days (UAS7) and wheal number score of 7 days to the placebo group (all P ＜ 0.05).For the improvement in the itch severity score (ISS) of 7 days and complete response rate for main symptoms (UAS7 =0),the total omalizumab group,75-,150-and 300-mg omalizumab groups were superior to the placebo group (all P ＜ 0.05),but there were no significant differences between the 600-mg omalizumab group and the placebo group (P =0.07).The dermatology life quality index (DLQI) was better in the total omalizumab group,150-and 300-mg omalizumab groups than in the placebo group (all P ＜ 0.05),but no significant difference was observed between the 75-mg omalizumab group and the placebo group (P =0.50).There were no significant differences in the incidence of common adverse events or serious adverse events between the total omalizumab group as well as the 75-,150-and 300-mg omalizumab subgroups and the placebo subgroup (all P ＞ 0.05).Conclusions Omalizumab can improve clinical symptoms and life quality of patients with CSU,and is effective in improving the UAS,ISS,wheal number score,DLQI and complete response rate for main symptoms (UAS =0) with high safety.Subcutaneous injection of omalizumab at a dose of 150 or 300 mg/month shows the best efficacy in improving the clinical symptoms and life quality of patients with CSU.

Objective To analyze the rate and distribution of positive provocative tests in patients with inducible urticaria,and to investigate the role of provocative tests in the etiological diagnosis of chronic urticaria.Methods Among patients who visited the special clinic for urticaria in the Department of Dermatology of the Third Affiliated Hospital,Sun Yat-sen University from January 2016 to December 2017,127 patients with suspected inducible urticaria were selected,and underwent 6 provocative tests for inducible urticaria,including delayed pressure urticaria provocative test (DPUPT),symptomatic dermographism provocative test (SDPT),vibratory angioedema provocative test (VAEPT),cold urticaria provocative test (CUPT),heat urticaria provocative test (HUPT),and aquagenic urticaria provocative test (AUPT).Statistical analysis was carried out by chi-square test for comparison of positive rates between male and female patients.Results Among the 127 patients with suspected inducible urticaria,106(83.46％) showed one or more positive provocative tests.The positive rate of SDPT was the highest (79.53％,101/127),followed by HUPT (22.05％,28/127) and CUPT (9.45％,12/127).The positive rate of HUPT was significantly higher in female patients (30.14％,22/73) than in male patients (11.11％,6/54;X2 =4.301,P ＜ 0.05).The patients with positive DPUPT,VAEPT and AUPT all showed positive SDPT responses.Among the 12 patients with positive CUPT reactions,11 showed positive SDPT responses.Among the 28 patients with positive HUPT reactions,26 showed positive SDPT responses.Of the 48 patients with one or more positive non-SDPT provocative tests,the patients with 2 positive non-SDPT provocative tests accounted for 18.75％ (9/48).Conclusion Provocation tests for inducible urticaria are of great clinical significance for the etiological diagnosis of chronic urticaria.

Objective: To analyze the genetic characteristics of the hemagglutinin(HA) and neuraminidase(NA) genes of the influenza A/H1N1(09pdm) viruses isolated in the city of Yancheng in 2014-2017. Methods: The throat swab specimens of patients with influenza-like illness (ILI) from sentinel surveillance hospitals and outbreak sites were detected using the method of real time RT-PCR. The influenza A/H1N1(09pdm) viruses were isolated using MDCK cell culture method in 2014-2017. The strains in 2014-2017 were selected randomly and their sequences of the HA1 and NA genes were amplified through one step RT -PCR method and the PCR products were sequenced. The mutations of genes and acid locus were analyzed and the evolutional trees were generated using bioinformatics software. Results: The clustering relationships of the respective branches of HA1 and NA genes of seventeen A/H1N1(09pdm) strains isolated in Yancheng area were basically the same and the phylogenetic trees of HA1 and NA genes were respectively clustered into four evolutionary branches. Compared with the vaccine strain A/California/07/2009(H1N1pdm)in the Northern Hemisphere, a total of three antigen epitopes (Ca, Sa, Sb) in HA1 genes of strains in Yancheng area were involved in six antigenic sites (K154R, S162N, K163Q, S185T, L191I, S203T); there were three mutations (D222G/N, G223R, E224K) in the 220 ring and one locus (L191I) in the 190 helix of the receptor binding sites; the two strains (A/Jiangsu-YC/SWL1540/2017, A/Jiangsu-YC/SWL1545/2017) isolated in 2017 increased the 162NQS glycosylation site. Because the strains of the antigen epitopes, receptor binding sites and glycosylation sites in the HA1 genes had a certain degree of variations in Yancheng area in 2014-2017, the protective effects of vaccine strain A/California/07/2009 (H1N1pdm) was limited at the gene level. The two strains (A/Jiangsu-YC/SWL1540/2017 and A/Jiangsu-YC/SWL1545/2017) isolated in 2017 were clustered with vaccine strain A/Michigan/45/2015(H1N1pdm) and had better protective effects. Seventeen A/H1N1(09pdm) strains had no mutations in catalytic residues and drug resistant sites of NA genes, but a part of strains had a certain degree of variations in glycosylation sites of NA genes. Conclusions These results indicated the HA1 and NA genes of influenza A/H1N1(09pdm) viruses circulated in Yancheng area in 2014-2017 changed gradually. The accumulation of these mutations would result in antigenic drift of influenza A/H1N1(09pdm) viruses.

Objective To study the curative effect of minimally invasive surgery in the treatment of rectal cancer.Methods 100 patients with rectal cancer were researched.They were randomly divided into observation group and control group,50 cases in each group.The control group received traditional abdominal radical operation,the observation group was treated with minimally invasive surgery.The operation effect was compared between the two groups.Results The operation time,length of stay and feeding time after operation in the observation group were shorter than those in the control group[(78.45±12.34)min vs.(98.24±25.31)min,(3.12±0.43)d vs.(7.53±1.12)d,(1.23±0.30)d vs.(3.56±0.57)d](t=4.967,25.992,25.578,all P<0.05).The amount of bleeding during operation of the observation group was less than that of the control group[(11.23±2.31)mL vs.(26.58±4.04)mL](t=23.323,P<0.05).The incidence rate of postoperative complications of the observation group was significantly lower than that of the control group[6.00%(3/40) vs.20.00%(10/50)](x2=4.332,P<0.05).After surgery,the quality of life in the observation group was higher than that in the control group[(57.82±6.84)points vs.(48.23±4.50)points](t=8.282,P<0.05).After 1 year of follow-up,there were no significant differences in metastasis rate,recurrence rate and survival rate between the two groups[2.00%(1/50) vs.6.00%(3/50),0.00%(0/50) vs.4.00%(2/50),98.00%(49/50) vs.92.00%(46/50)](x2=1.042,2.041,1.895,all P>0.05).Conclusion The effect of minimally invasive surgery for patients with rectal cancer is significant,it is worthy of promoting.

Objective To analyze the changes of serum fatty acid synthase (FAS),carcinoembryonic antigen (CEA) and carbohydrate antigen 72-4 (CA72-4) in patients with gastric cancer and its clinical diagnostic value.Methods Forty five patients with gastric cancer and 45 patients with benign gastric cancer treated in our hospital from January 2016 to December 2016 were enrolled in this study.Forty five healthy subjects were enrolled in this study.The levels of FAS,CEA,and CA72-4 in three groups were analyzed.Results The levels of FAS,CEA,and CA72-4 in patients with gasttric cancer [(12.73 ± 5.48) mg/L,(31.36 ± 14.51) ng/ml,and (39.32 ± 18.76) U/ml] were significantly higher than those in benign gastric cancer group [(2.26 ± 1.15) ng/L,(3.24 ± 1.47) ng/ml,and (3.75 ± 1.69) U/ml],and normal control group [(1.83 ± 0.92) mg/L,(2.71 ± 1.54) ng/ml,and (3.13 ± 1.82) U/ml] (P ＜ 0.05).FAS,CEA,and CA72-4 levels in patients with lymph node metastasis of gastric cancer [(13.58 ± 6.09) mg/L,(6.25 ± 11.54) ng/ml,and (41.31 ± 13.67) U/ml] were significantly higher than those without lymph node metastasis [(9.21 ± 5.42) mg/L,(28.38 ± 9.72) ng/ml,and (26.75 ± 11.86) U/ml] (P ＜ 0.05).The sensitivity of FAS,CEA,and CA72-4 in patients with gastric cancer was significantly lower than that in combined detection,the specificity of FAS,CEA,and CA72-4 in patients with gastric cancer was significantly higher than that in combination test (P ＜ 0.05).The sensitivity of FAS,CEA,and CA72-4 in patients with lymph node metastasis was significantly lower than that in combination test,and the specificity of FAS,CEA and CA72-4 was significantly higher than that of combined detection (P ＜ 0.05).Conclusions FAS,CEA,and CA72-4 can be used as indicators of gastric cancer and diagnosis of lymph node metastasis.Combined detection of three indexes can improve the diagnostic sensitivity and have good clinical significance.