The ability of prevention, treatment and management of infectious diseases is a basic requirement for general practitioners. This article introduces our experience in the infectious disease rotation for general practice residency training, focusing on the rotation management at different stages of training to explore how to improve teaching quality and the ability of trainers in a short period of the rotation.

Objective To evaluate the effect of doxofylline on pulmonary inflammatory response induced by mechanical ventilation in rats with chronic obstructive pulmonary disease (COPD).Methods Thirty adult male Sprague-Dawley rats,aged 8 weeks,weighing 200-250 g,were divided into 3 groups (n=10 each) using a random number table method:control group (C group),COPD group and doxofylline group (Dox group).Rats were fed in normoxia for 2 months,and normal saline 0.2 ml was injected into the trachea on 1st and 30th days in C group.Rats were exposed to cigarette smoke for 30 min every day,lasting for 2 months,and lipopolysaccharide 200 μg (0.2 ml) was injected into the trachea on 1st and 30th days in COPD and Dox groups.Two months later,rats in each group were anesthetized,tracheally intubated,and then mechanically ventilated.Doxofylline 50 mg/kg was intravenously injected immediately after intubation in Dox group,and the equal volume of normal saline was given instead in C and COPD groups.Pulmonary specimens were taken after 120 min of mechanical ventilation for examination of pathological changes and for determination of wet/dry weight ratio (W/D ratio) and tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) contents (by enzyme-linked immunosorbent assay).Results No significant pathological change of lung tissues was found in C group,and COPD pathological changes were observed in COPD and Dox groups.Compared with C group,the W/D ratio and TNF-α level were significantly increased,and the IL-10 level was decreased in COPD and Dox groups (P＜0.05).Compared with COPD group,the W/D ratio and TNF-α level were significantly decreased,and the IL-10 level was increased in Dox group (P＜0.05).Conclusion Doxofylline can reduce the pulmonary inflammatory response induced by mechanical ventilation in rats with COPD.

Urinary tract infection(UTI)is a common disease of the urinary system. Based on a case of male outpatient with primary acute uncomplicated pyelonephritis and the relevant guidelines, this article analyzes the identification, diagnosis and differential diagnosis as well as comprehensive management of uncomplicated upper urinary tract infection, in order to provide information and clinical thinking for general practitioners.

Objective To explore the influence of anti-syphilis treatment to pregnant women with lower titer seroresistance on infantile serum,so as to provide the guidance for clinical diagnosis and treatment.Methods Totally 134 cases of pregnant women with lower titer syphilis serofast reaction were divided into treatment group (75 cases) and untreated group(59 cases) according to whether received anti-syphilis treatment during their pregnancy.The change of syphilis serology toluidine red unheated serum test (TRUST) and Treponema pallidum particle assay (TPPA) for the two groups mothers and babies were compared.Results (1) The first detection of TRUST titers between the two groups of pregnant women did not show statistically significant difference (x2 =0.520,P ＞ 0.05).(2) Among the 134 neonates,20 cases(14.9％) were negetive for both TRUST and TPPA,23 cases (17.2％) were Treponema pallidum particle assay(TPPA) positive only,91 cases (67.9％) were positive for both TRUST and TPPA and showed lower or equivalent TRUST titers compared to their mothers,without significant differences between the two groups(x2 =0.892,P ＞ 0.05).(3)In the two groups of babies with the same TRUST titers,the seroreversion time of TRUST showed no significant differences(P =0.229,0.309,1.000).The negative time of TRUST in infants with neonatal higher titer was later than those with neonatal lower titer in the two groups (all P ＜ 0.05).The infant with TRUST + showed longer duration than those with neonatal TRUST-in TPPA seroreversion(all P ＜ 0.05).The seroreversion time of TPPA in infants with neonatal TRUST titer of 1:4 in untreated group was later than that in treatment group[(14.1 ±1.4)months vs.(12.5 ±1.1)months,t =2.900,P =0.010].Conclusion The treatment for mothers with lower titer seroresistance in pregnant period had no influence in the positive rate of TRUST and TPPA in the neonates and seroreversion time of TRUST in infant.It may have certain effect to shorten the seroreversion time of TPPA in infant with high TRUST titer by the treatment.

Objective To construct the evaluation index system of clinical nursing competence for higher vocational nursing skills contest. Methods A total of 31 nursing experts participated in the three-round consultation by Delphi technique, and empirically tested the final result. Results The response rates of questionnaire investigation for the three-round were 93.6%(29/31),100.0%(29/29) and 100.0%(29/29) respectively. The specialist authority coefficient was 0.861,and the coordination coefficients for each round were 0.207,0.291 and 0.371, respectively, P<0.01.The overall reliability coefficient was 0.921, evaluators reliability correlation coefficient was 0.942. There were significant correlation between each item and total score, P<0.05. The overall degree of differentiation was 0.523. Finally, the clinical nursing competence assessment system for higher vocational nursing skills contest was constructed,including 3 first-level indexes,10 second-level indexes and 39 third-level items. Conclusions The results of three-round expert consultation are reliable, the reliability, validity and differentiation are high. To evaluate clinical nursing ability higher vocational nursing students provide scientific basis.

Objective To explore the level of knowledge,attitude and practice in preventing sudden deafness and the influencing factors among nursing students in Taiyuan City.Methods By random cluster sampling,1 187 nursing students from 6 universities in Taiyuan City were surveyed about the level of knowledge,attitude and practice and the influencing factors by questionnaires in November 2013.The results underwent analysis.Results Total scoring rate of knowledge,attitude and practice of preventing sudden deafness in the nursing students was 48.36％ (574/1 187),among which knowledge,attitude and practice was 28.30％ (336/1 187),62.68％ (744/1 187) and 54.34％ (645/1 187),respectively.Logistic regression analysis showed that whether taking health education or not,different parents' education degree and household capita monthly income had significantly different influence on level of knowledge,attitude and practice of preventing sudden deafness,P＜0.01.Significant correlation existed between knowledge and attitude,attitude and practice,r=0.467,0.149,P＜0.05.Conclusions The level of knowledge,attitude and practice of preventing sudden deafness of the nursing students is low and has muhifaceted influencing factors.Colleges and universities should strengthen the health propaganda,and community should step up intervention to the families of low income and low education degree,at the same time to improve the compliance of health behavior in order to play a role in prevention and treatment of sudden deafness among nursing students.

Objective To analyze the DCE-MRI features and ADC value in triple-negative breast cancer and HER-2 overexpres-sion breast cancer,and to improve the j udgment of both characteristic in MRI.Methods To analyse the DCE-MRI imaging of TNBC and HER-2 overexpression breast cancer,measured the ADC value and compared the statistics.Results Compared with the shape, margin,the way of enhancement and ADC value of the TNBC and HER-2 overexpression breast cancer,the distinction has statisti-cally significant(P<0.05);there were no statistically significant difference among age,mass or nomass,categories of lesions and TIC,(P>0.05).Conclusion DCE-MRI features of the shape,margin,the way of enhancement and ADC values were useful for the diagnosis of TNBC and HER-2 overexpression breast cancer.

This study is to investigate the therapeutic effect and mechanism of indole-3-carbinol (I3C) on pig serum-induced liver fibrosis of rats. The liver fibrotic model of rats was induced by pig serum. After models were successfully established, rats in the treatment groups were administered with I3C through intraperitoneal injection or curcumin by intragastric administration, daily for 17 days. Hepatic hydroxyproline (Hyp) content was measured. The liver histology and immunohistochemistry with a-smooth muscle actin (alpha-SMA) were assayed. Hepatic stellate cells line, HSC-T6 was incubated with different concentrations of I3C (25, 50, and 100 micromol x L(-1)) for 24 h. The effect of I3C on cell apoptosis was identified by FITC-Annexin V/PI double labeled assay. And the mRNA expressions of Bax and Bcl-2 were measured by real time RT-PCR. The results showed that hepatic content of Hyp decreased by I3C treatment, as compared with the fibrotic model control. Histopathological changes, such as steatosis, necrosis, deposition of collagenous fiber reduced remarkably and the expression of alpha-SMA was significantly down-regulated in the I3C-treated groups (P < 0.01). Apoptosis analysis showed that I3C significantly increased HSC-T6 apoptosis rate and the expressional ratio of Bax to Bcl-2. The results indicated that I3C could effectively cure pig serum-induced liver fibrosis in vivo by inducing HSC apoptosis and promoting ECM degradation.

Objective To investigate the association of HLA-DRB1 alleles in Han population of Shanxi childrcn with nephrotic syndrome of non-IgA mesangial proliferative glomerulonephritis (MsPGN). Methods HLA-DRB1 was performed by polymerase chain reaction-sequence specific primers technique, and twenty patients with nephrotic syndrome of non-IgA MsPGN were detected. Results Analysis of the fre- quencies of specific at the HLA-DRB1 loci revealed significantly higher frequencies of HLA-DRB1 * 11 al- leles among the nephrotic syndrome patients of non-IgA MsPGN comparing with controls (22. 50% vs 8.33%, x2= 9. 544, P = 0.002, CI = 1. 674-9.995, RR = 4.09). Nine patients with HLA-DRB1 * 11 all accompanied hematuria, hypertension or short renal insufficiency. Conclusion The results suggested that HLA-DRB1 * 11 alleles contribute to genetic susceptibility to nephritic syndrome of non-IgA MsPGN. The pa- tients with HLA-DRB1 *11 easy accompanied hematuria, hypertension or short renal insufficiency.

Background Familial hyperaldosteronism type Ⅱ(FH-Ⅱ) is characterized by autosomal dominant inheritance and hyperaldosteronism.Linkage analysis demonstrated chromosome 7q22 most likely harbor the genetic defect.Objective To identify the disease locus in a Chinese pedigree with FH-Ⅱ using genetic linkage analysis.Methods Haplotypes of the FH-Ⅱ pedigree were analyzed using four microsatellite markers(D7S531,D7S2521,D7S511,D7S481) at 7p22 to determine the critical region,and multipoint logarithm of odds(LOD) scores were calculated to assess linkage with FH-Ⅱ.Results Several members(affected members) in the family had hypertension,hypokalemia,hyperaldosteronism,low renin activity.Hypertension and hypokalemia was improved by spironolactone test.Dexamethasone suppression test was performed but without clinical or hyperaldosteronism improvement in three affected members,confirmed FH-Ⅱ family pedigree.The same haplotypes D7S531(ac,n=24)-D7S2521(ac,n=11)-D7S511(ca,n=21)-D7S481(ac,n=16) were shared by all known affected members and one suspicious member,but also by one unaffected member of the family,making it unlikely that this region contains the causative gene mutation.In this FH-Ⅱ family,the LOD scores of the four markers were