Objective To understand the grade point average (GPA) of degree courses and its in-fluence factors in Master postgraduates in China. Method A cross-sectional study was carried out to collect the data on GPA and the student information in the management system of postgraduates who graduated from Graduate School of Public Health from 2013 to 2015. SPSS 20.0 was used to describe the basic situa-tion, and the data were analyzed by one-way ANOVA, Pearson correlation analysis and multivariate analysis of variance. Results During 3-year, totally 213 Master students were graduated with the average GPA of (3.19±0.30). The female had higher GPA than the male subjects [(3.24±0.29) vs. (3.05±0.29), F=17.11, P=0.000], those enrolled by the recommendation than those enrolled by the graduate entry examinations [(3.36±0.25) vs. (3.11±0.28), F=39.36, P=0.000], those graduated from the university of 985 were better than the graduate students from other universities [(3.30±0.29) vs. (3.11±0.28), F=22.14, P=0.000], those with the academic degree than those with the professional degree [(3.31±0.25) vs. (2.99±0.27), F=72.38, P=0.000], and there was a negative relationship between the total credits and GPA of degree courses (r=-0.48, P=0.000). Further, sex, enrollment way, undergraduate university, and total credits of degree courses were independent influence factors under multivariate analysis of variance (all P<0.05). Conclusion These master graduates in medicine have better GPA of degree courses and it can be statistically related to sex, enrollment way, undergraduate university, and total credits of degree courses. Some measures should be developed to enroll more students from better university, improve the master programs, and raise the quality of graduate education management.

Objective To evaluate the efficacy of minimally invasive technique by retroperitoneal approach in the treatment of severe acute pancreatitis with peripancreatic necrosis.Methods The clinical data of 10 patients with severe acute pancreatitis combined with peripancreatic necrosis who underwent retroperitoneal drainage by aspirating and placing tube under B ultrasound guidance on the basis of routine therapy in the First Affiliated Hospital of University of South China from January 2016 to September 2016 were analyzed.Results All of the 10 patients successfully underwent puncture.Drainage was good after puncture and tube placement in 7 patients.The amylase activity was normal within 3 ～ 7 days,and the symptoms of abdominal pain and bloating were alleviated in 2 ～ 4 days.Among them,3 cases had poor drainage after catheterization due to a large necrotic area,and the percutaneous nephroscope was performed to remove the necrotic tissue of the pancreas.Bacteria was detected in the drainage fluid of 7 patients.The complications of pneumothorax,hemothorax and organ injury were not found in all the patients.The average hospitalization time was 19.4 days (10 ～ 34 days).Conclusions Minimally invasive retroperitoneal approach is safe and effective in curing severe acute pancreatitis with peripancreatic necrosis with good efficacy,which is worth for clinical recommendation and application.

Objective To observe the expression of novel URB gene in the differentiation display of 3T3-L1 preadipocytes and the effects of interleukin-6 (IL-6) and pioglitazone (PIO) on URB mRNA expression in 3T3-L1 adipocytes at different times. Method The 3T3-L1 adipocytes were treated with IL-6 and PIO under different concentration and different time phase, and real-time fluorescence monitoring RT-PCR was conducted to measure the URB mRNA level. Fat droplets were verified by oil red O staining. Results 1. URB mRNA level was increased gradually in the whole differentiation process. 2. The expression levels of URB mRNA was decreased along with the treatment of IL-6 in a dose-dependent manner in 3T3-L1 preadipocytes and adipocytes. 3. PIO increased the level of URB mRNA in 3T3-L1 adipocytes, and the reducing effect of IL-6 on URB mRNA could be corrected by PIO. Conclusion URB may be an important adipocytokin which affects energy metabolism and may work as a pharmacological gene target in the future.

Objective To study the T/P rate and smoothness index of Candesartan Cliexetil on slight and middle essential hypertension. Methods 50 patients with slight and middle essential hypertension were treated by Candesartan Cliexetil 8mg taken orally everyday,the course of treatment was 4 weeks. 24h ambulatory blood pressure monitoring(ABPM) was given before and after treatment, the T/P rate and smoothness index were calculated. Results Four weeks after treatment, 24h SBP(148.2±10.7) mm Hg and 24 h D BP (97.6±6.5) mm Hg, dSBP(152.5±9.8) mm Hg and dDBP(96.0±5.3) mm Hg, nSBP(138.3±7.6) mm Hg and nDBP(89.2±8.3) mm Hg, SBP load (87.5±12.2) % and DBP load (36.48±26.4) % with pre-treatment (130.2±7.2) mm Hg, (79.5±7.8) mm Hg, (133.4±7.2)mm Hg, (81.8±6.6)mm Hg,(121.9±7.3) mm Hg, (72.1±7.4) mm Hg, (84.7±9.9)%,(26.7 ±8.3) % have significant difference(P < 0.01). T/P rates were SBP 70% and DBP 63%. Smoothness indexes were SBP(1.21±0.82) and DBP(1.13±0.51). Conclusion Candesartan cilexetil in the treatment of essential hyper-tension is safe and effective,can get a good T/P ratio and smoothness index.

Evidence has shown that the abnormal expression of specific microRNAs (miRNAs) is associated with the occurrence,development and prognosis of pancreatic cancer,which is the potential target of forecast about invasion and metastasis of pancreatic cancer.There is close relation between miRNAs and biological characteristics of pancreatic cancer invasion and metastasis.Therefore,miRNAs are expected to become the new research targets of the mechanism of invasion and metastasis of pancreatic cancer.

Clinical practice record manual contains the information about medical students' clinical studying process, clinical teaching process and the concept of clinical teaching management. First, we should design and optimize clinical practice record manual and then collect and analyze the relevant data. In addition, we should give the analysis to the students, teachers, clinical departments and hospitals on time, and at the same time, get their feedback. Through these steps, we can find and solve the problem efficiently and promote the quality of teaching, learning and management of clinical internship, so as to improve the clinical teaching quality control standard.

ObjectiveTo evaluate the clinical outcomes of anterior lumbar discectomy and interbody fusion with cage under laparoscopic assistant.MethodsFrom January 2006 to June 2009,37 cases with degenerative low back pain were entered the study,including 22 males and 15 females with an average age of 43.7 years(range,16-55).The responsible discs were determined according to the three dimensional computed tomography of artery and vein angiography of anterior lumbosacral spine and discography,including L5S1 in 21 cases,L4-5 in 11,L3-4 in 2,L2-3 in 2,and L1-2 in 1.All cases underwent anterior lumbar discectomy and interbody fusion with cage under laparoscopic.ResultsThe operation time was 100 min in average (range,60-140),the blood loss was 120 ml in average(range,50-300).There was no case with severe complications of retrograde ejaculation and injury of great vessels or nerves.Delayed intestinal obstruction was discovered in two intraperitoneal route patients.The average follow-up time was 18.7 months(range,6-35).According to the back pain grading criteria of Chinese Medical Association Orthopedics Society of Spine Group,the results were excellent in 23 patients,good in 11,and fair in 3.The interbody fusion was obtained in 3 months later in 23 cases and 6 months later in 12 cases.Cage subsidence occurred in 2 cases in 6months after operation,in which the height loss of intervertebral space was 1.3 mm and 1.9 mm,but no obvious symptoms of discomfort.No fixation displacement or loosening occurred.ConclusionThe anterior discectomy and interbody fusion by internal fixation with laparoscopic technique is feasible with low complications rate,less trauma and shorter bedtime.Postoperative ileus by abdominal approach is relatively common.The surgeons experience and the anatomy of artery and vein of anterior lumbosacral spine should be considered before the choice of surgical approach.

Objective To evaluate the effect of enteral nutritional support for the liver cancer patients with precise hepatetomy under fast track process model. Methods 82 patients were prospectively randomized into enteral nutrition group (n = 41) and parenteral nutrition (n = 41). The hemoglobin (HB), total protein (TP), albumin (ALB) and total lymphocyte count (TLC) were measured on 3 days before operation and 7 days after operation respectively. The two groups were compared in terms of time for anal exhaust and defecation after surgery , the postoperative hospital stay, the gastrointestinal adverse reactions and complications after surgery. Results The nutrition and immunity indicators on day 7 after operation were significantly poorer and lower than on day 3 before operation in the parenteral nutrition group (P<0.05); the declines of TP and ALB were significantly contained in the enteral nutrition group (P<0.05). The time for anal exhaust and defecation in the enteral nutrition group was advanced 15.1 h and 27.9 h on average, compared to the parenteral nutrition group and control group, respectively. The rate of adverse reaction was significantly lowered (17.3%vs. 40.4%, P<0.05). The rate of complications in the enteral nutrition group was significantly lower than the parenteral nutrition group (P>0.05). Conclusion Enteral nutritional support under fast track process model for the liver cancer patients undergoing precise resection could improve clinical outcome.

This paper is based on conflicting issues in clinical teaching between undergraduates and residents, also around cultivating goals on clinical competency. In order to enhance medicine-education collaboration and conception of continue education and improve clinical teaching management system for integration of undergraduates and residents, five measures should be put into practice. First, define the re-sponsibility of physicians at all levels. Then, accord training standards for clinical teachers' admission. Next, accord clinical teaching norms and documents. In addition, clinical teaching assistants are selected from intermediate physician for guiding clinical teachers. Finally, explore the integration of clinical teaching mood for training between undergraduates and residents, to promote the connection of clinical teaching for graduates and residents.

ObjectiveTo investigate the expression of Axin2 in pancreatic cancer cells, and to observe the influence of Axin2 on the proliferation, invasion, and migration of human pancreatic cancer cells (PANC-1). MethodsQuantitative real-time PCR was used to measure the expression of Axin2 in pancreatic cancer cell lines with different invasive abilities (PANC-1, Mia PaCa-2, and BxPC-3) and immortalized normal pancreatic cells (H6C7). PANC-1 cells with low expression were transfected with over-expressed Axin2 plasmid by transient transfection. MTT assay, Transwell assay, and scratch assay were used to determine the proliferation, invasion, and migration of cells transfected with over-expressed Axin2. One-way analysis of variance was used for comparison between multiple groups, and SNK-q test was used for comparison between any two groups. ResultsThe relative expression levels of Axin2 in PANC-1, BxPC-3, Mia PaCa-2, and H6C7 cells were 0.13±0.01, 0.42±0.05, 0.24±0.011, and 1.00±0.00, respectively, and PANC-1 cells had the lowest expression level of Axin2, with significant differences compared with the other cells (all P＜0.05). When PANC-1 cells were transfected with over-expressed Axin2 plasmid, the cells in the over-expression group had a significant increase in the expression level of Axin2 compared with those in the blank group and the negative control group (both P＜0.05). Compared with those in the non-transfection group and the blank group, PANC-1 cells in the over-expression group showed significant reductions in the proliferation, invasion, and migration abilities. ConclusionThe expression of Axin2 is down-regulated in pancreatic cancer cell lines and decreases with the increasing invasion ability, suggesting the role of tumor suppressor gene. High expression of Axin2 can reduce the proliferation, invasion, and migration abilities of PANC-1 cells.