Goal To research the major factors affecting medical undergraduates' employment.Method In combination with quantity and quality,we reasonably analyzed the factors affecting the employment of Grade 2006 undergraduates in a Medical University in Chongqing.Result The major factors consist of the inadequate knowledge、the increased condition admission、hidden rule and the unreasonable objects.Conclusion Medical universities should try their best to adapt to the development of the society and medical students should try to become the useful talents.

Objective To evaluate the image quality of dynamic three-dimensional contrast enhanced ultrasonography(3D-CEUS) in liver tumors.Methods Twenty-five patients were examed with 2D-CEUS and dynamic 3D-CEUS.Contrast-enhanced computed tomography or magnetic resonance imaging(CECT/MRI) were performed early or late.Two readers reviewed the images of both modalities and graded the images according to diagnostic criteria as follows:tumor blood fusion in arterial phase(unclear-score 0,moderate-score 1,clear-score 2),tumor boundry and relationship with periphery tissues (unclear score 0,moderate-score 1,clear-score 2).The concordance between the two modalities for showing liver tumors was evaluated by Kappa test.Results Twenty-three of 25 danymic 3D-CEUS were displayed successfully versus total objects in CECT/ MRI.Among them,for showing blood fusion,16 lesions scored 2,7 lesions scored 1,2 lesions scored 0 in danymic 3D-CEUS,meanwhile 18 lesions scored 2,7 lesions scored 1,0 lesion scored 0 in CECT/MRI,the Kappa value was 0.65.For showing tumor boundry and relationship with peripherytissues,16 lesions scored 2,7 lesions scored 1,2 lesions scored 0 in danymic 3D-CEUS,meanwhile 21 lesions scored 2,4 lesions scored 1,0 lesion scored 0 in CECT/MRI,the Kappa value was 0.52.Conclusions Danymic 3D-CEUS was shown to be useful for displaying tumor blood fusion,boundry and relationship with periphery tissues in single liver tuomor,the concordance between dynamic CEUS and CECT/MRI for single liver tuomor was fair.For huge liver tumor and multi-tumors,3D-CEUS can not give overall information.

Objective To observe the efficacy and safety of arginine vasopressin receptor antagonist tolvaptan for treating hyponatremia caused by syndrome of inappropriate secretion of antidiuretic hormone (SIADH).Methods Six patients diagnosed with SIADH were enrolled in this study.Four cases were allocated to tolvaptan group (oral tolvaptan 15-60 mg/d,the dosage was adjusted based on the level of serum sodium).Two cases were allocated to regular treatment group (liquid was limited 1 000 ml/d,intravenous drip was less than 3％ sodium chloride and/or oral salt capsule 10-15 g/d several times was adjusted based on the level of serum sodium).Data of the level of serum sodium at 4,7 d,baseline value of serum sodium,serum sodium at the first normal time,24 h urine and weight change were collected.Safety assessment was given before and after treatment,including medical history,physical examination,electrocardiogram,laboratory tests,and incidence of adverse events.Results The level of serum sodium in tolvaptan group increased from the first day of the treatment.During the period of treatment,serum sodium at 4 d increased 22,16,14,11 mmol/L compared with the baseline value respectively.No obvious change of sodium was observed in regular treatment group compared with the baseline value.For 7 d treatment,serum sodium level increased 14,13,14,13 mmol/L in tolvaptan group compared with the baseline level respectively.Only 2 cases in regular treatment group increased 4 mmol/L,and sodium level in regular treatment group did not reach the lower limit of normal level of serum sodium.In tolvaptan group,all patients urine output increased after 1 d treatment and began to stabilize in 3 d.24 h urine putouts were much more than 1 500 ml during treatment.Urine putouts 780-1 400 ml were observed in regular treatment group.There was no difference before and after treatment.Although weight dropped after treatment in the two groups,weight in tolvaptan group fell obviously.In the two groups,there was no difference in blood pressure and heart rate before and after treatment.There were no serious complications and adverse events.Conclusions Compare with regular treatment,arginine vasopressin receptor antagonist is more effective therapy because it can correct the SIADH in patients with hyponatremia and reduce water retention.It also has a good security.

Objective:To discuss the role of clinical pharmacists in avoiding, eliminating and alleviating the effect of medical dis-putes caused by adverse drug reaction ( ADR) and provide reflections and suggestions for the disputes. Methods:Clinical pharmacist participation in the treatment of one case of dispute caused by serious adverse drug reaction was described and analyzed. Results:Clini-cal pharmacists provided opinions and suggestions for the dispute, and promising effect was obtained. Conclusion: Clinical pharma-cists should have excellent medical knowledge and good communication skills, and medical personnel should closely monitor patients in order to avoid medical disputes caused by ADR.

Objective To retrospectively analyze the relationship of the classification and risk stratification in senile hypertension with benign prostatic byperplasia (BPH).Methods Totally 376 male senior patients,including 233 senile hypertensive patients and 143 non-hypertensive patients as a control,were enrolled in this study.There were 35 cases of hypertension at level 1,82 cases at level 2,116 cases at level 3.Based on risk stratification of hypertension,there were 3 cases of low-risk,28 cases of medium risk,75 cases of high-risk,127 cases of very high risk.All candidates accepted the International Prostatic Symptom Score (IPSS) assessment before the treatment.Fasting blood glucose (FBG),total cholesterol (TC),triglycerides (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C) and prostate specific antigen (PSA) were determined.Body mass index (BMI) and prostate volume (PV) were calculated.Relationship of classification and risk stratification in hypertension with BPH were analyzed.Results The levels of systolic blood pressurc (SBP),diastolic blood pressure (DBP),body weight,BMI,FBG and TC were higher (t=3.883,2.498,2.161,3.399,2.200,2.370,P＜0.05 or P＜0.01),while serum HDL-C were lower (t=2.036,P＜0.05) in hypertensive patients than in control group.Compared with the control group,IPSS and PV was increased (t =3.432,3.381,both P＜0.01) in hypertension group.Risk rate of hypertensive patients with BPH was 2.03 times (95％CI:1.33-3.11,P＜0.01) as compared with control group.In hypertensive patients,PV and IPSS were higher in level 2 or 3 grade group than in level 1 group (F=6.890,7.576,all P＜0.01).PV and IPSS in high risk and very high risk groups were enhanced as compared with those in low-medium risk group (F=30.608,19.804,all P＜0.01).Pearson analysis showed that PV was positively correlated with SBP,FBG and TC(r=0.223,0.251,0.305,all P＜0.05),while negatively correlated with HDL-C(r =-0.235,P＜0.05).Similarly,IPSS was positively correlated with SBP,DBP and FBG (r=0.396,0.273,0.224,all P＜0.01),while negatively correlated with HDL-C (r =-0.288,P＜ 0.01).Conclusions High incidence of BPH appears in the elderly men with hypertension.The increased PV and IPSS coexist with conventional risk factors of essential hypertension.Development of BPH is closely related to higher blood pressure and risk stratifications of hypertension.

Objective To explore the effects of amlodipine,perindopril and valsartan on plasma adiponectin and retinol binding protein 4 in elderly patients with essential hypertension.Methods From March 2007 to July 2010,238 elderly patients with essential hypertension were selected and 193 cases completed this study.Patients were randomly divided into 3 groups:amlodipine group (n=68),perindoprilgroup (n=60) and valsartan group (n=65).Patients in each group were treated with amlodipine,perindopril and valsartan respectively for at least 12 weeks.The changes in blood pressure,heart rate,body height,body mass index (BMI),abdominal circumference,waist circumference (WC),levels of blood lipids,plasma adiponection and retinol binding protein 4 were observed before and after treatment.Results Compared with pre-treatment,systolic blood pressure in 3 groups were significantly decreased after treatment (all P＜0.01).There were no significant differences in blood pressure among 3 groups after treatment (all P＞0.05).Compared with pre treatment,plasma adiponectin level was significantly increased in perindopril group and valsartan group after treatment [(7.4±1.8) μg/L vs.(8.3± 1.8) μg/L,(7.5±1.7) μg/L vs.(8.4±1.9)μg/L,both P＜0.01].Plasma adiponectin level was higher in perindopril group and valsartan group than in amlodipine group after treatment [(8.3±1.8) μg/L vs.(7.6±1.8) μg/L,(8.4±1.9) μg/Lvs.(7.6±1.8) μg/L,both P＜0.05].Compared with pretreatment,plasma retinol binding protein 4 level in 3 groups were all decreased after treatment,and the decrements had significant differences in perindopril group and valsartan group (both P＜0.01) but had no difference in amlodipine group (P＞0.05).Plasma adiponectin retinol binding protein 4 levels were lower in perindopril group and valsartan group than in amlodipine group after treatment[(36.6± 14.2) μg/L vs.(42.7± 13.8) μg/L,(36.3±14.1) μg/L vs.(42.7±13.8) μg/L,respectively,both P＜0.01].Conclusions Perindopril and valsartan play important roles in cardiovascular protection beyond the antihypertensive effects by increasing plasma adiponection level and decreasing plasma retinol binding protein 4 level in elderly patients with hypertension.

This thesis mainly expounds the design ideas and the realization methods of medical statistics question database management system.Specifically speaking,the function modules,data structure and business processes of the system are designed based on the analysis of questions,test papers and the needs of system functions.We choose Visual Basic 6.0 to develop the system interface,establish the question database with Access 2003,and make use of Word 2003 to output documents.This system can achieve the separation of teaching and testing effectively which can make examinations more normal and scientific.

Objective To investigate the mental health status and related personality type of psychological clinic adoleScent in general hospital and provide data for psychology treatment and intervention.Methods 219 adolescence consulters in 2006 were tested by symptom checklist(SCL-90) and eysenck personality questionnaire(EPQ).The caseswere separatedthree age groups,A group(16～20 years old),B group(21～25 years old),C group(26～30 years old)and disposed by SPSS 13.0.Results All factor scores of SCL-90 in psychological clinic adolescents were higher than those of youth norm in China(P＜0.01).The scores of female consulters were significant higher than those of male in depression(P＜0.05).The incident rate of mild mental obstacle(factor score＞2)in 3 age groups were significant different.The incidence rate of B and C groups were higher A group(P＜0.01).The factor scores were positive associated with P in EPQ and negative associated with L in EPQ.The obsession score of SCL-90 was negative associated with E in EPQ.Conclusions The mental health status of psychological clinic adolescents was not as good as norm adolescents.In psychological consulting and psychological health service,measures in different age and different personality could help build up healthy personality and effectively promote the development of mental health.

Objective To explore the significance of serum cystatin C (Cys C)and β2-microglobulin (β2-MG) levels in blood and urine samples in hypertension grading and risk stratifying. Methods One hundred and thirty six cases with primary hypertension were enrolled into the study and classified into three grades and four risk stratifications. The serum Cys C levels were determined by ELISA assay. The blood and urine β2-MG were measured by radioimmunoassay. The serum BUN, Cr concentration were measured by the automatic biochemical analyzer. Results The positive rates of urine β2-MG were the highest index in patients with grade 1 (32%) and low risk hypertension( 8% ) ,followed by serum Cys C levels( grade 1 hypertension 24% ) ,compared with other indices( Ps ＜ 0. 05 ). With the blood pressure elevating, as well as the risk stratification increasing,serum Cys C level and the blood, urine β2-MG levels increased gradually by grading and stratifications (Ps ＜0. 05 or Ps ＜0. 01 ). We also found linear regression relationship between serum Cys C ,urine β2-MG levels and the risk stratifications of hypertension( r =0. 851 and r =0. 469 respectively,Ps ＜0. 01 ). The significant changes of serum BUN,Cr were only found in patients with grade 3 or very high-risk hypertension. Conclusion Joint detection of serum Cys C and urine β2-MG may help to detect early glomerular and tubular dysfunction in primary hypertension patients. Serum Cys C and blood, urine β2-MG levels are also related with the occurrence and development of hypertension,which show clinical significance in hypertension prognosis.

Objective:To explore the clinical characteristics of patients with pituitary thyrotropin-secreting adenoma and evaluate the effect of preoperative short-acting octreotide treatment on hyperthyroidism.Methods:A retrospective analysis was performed in 40 patients with pituitary thyrotropin adenoma diagnosed in Beijing Tiantan Hospital from January 2008 to January 2018. The general data, laboratory examinations and imaging findings were reviewed and analyzed. The clinical effect of preoperative octreotide on hyperthyroidism was evaluated.Results:The age of onset year of the 40 patients (male: female = 24∶16) was (30.5±5.1) years. Among them, 35 patients (87.5%) were with macroadenoma. The most common symptoms were thyroid hypermetabolism syndrome, followed by headache, dizziness, visual field damage and hypogonadism. The thyroid function of 30 patients (75%) recovered to normal within 3-5 days after the octreotide treatment. The total effective rate of the octreotide was 90.0%. The level of free thyroxine (FT 4) before treatment in patients with more than 10 times of effective cumulative dose was significantly higher than that in patients with less than 10 doses. Conclusions:Thyroid hypermetabolism syndrome and pituitary occupying effect are the most common clinical manifestations of thyrotropin-secreting adenoma. Preoperative octreotide treatment can effectively control hyperthyroidism. The level of FT 4 is a crucial factor affecting the efficacy of octreotide.