Clinical medical postgraduate education is an important part of higher education in China.We analyzed the current status,major problems existed,direction of the reform and the prospect in the training system.Unifying cultivation criterion,diversifying form of academic degree system,making selection standard strict for advisors and decreasing the proportion of research work for doctors were considered as the effective measures to address these issues.

Objective:To explore the relationship between college students' online game addiction tendency and learning burnout,and find the differences between online game addicts and other types of addicts.Method:With the Learning Burnout Scale,revised Chinese Internet Addiction Scale's Revision,Questionnaire of Internet Addiction Tendency,and 420 college Students as the subjects,analysis of correlation and stepwise regression analysis were employed to analyze the related factors of learning burnout.Result:There were significant difference in the gender(?2=21.855,P

Objective To explore the hospitalization expenses and its related factors of injury cases in Shenzhen city in 2006,and to provide basis for the expense control in future.Methods The medical expense proportion was calculated on 7 180 injury cases with hospitalization data from Shenzhen injury surveillance system,ANOVA and multivariate regression analysis were used to determine the influencing factors for the expenses.Result The medical expenses of injury inpatients in Shenzhen were 3 835.65 RMB/case and 437.86 RMB/case/day.36.10% and 20.27% of the total expenses were attributed to medication and therapy,respectively.The expense per day was correlated strongly with the level of hospital,length of stay,age,method of payment and injury location.Conclusions The disease burden of injury was higher than that of other diseases,Hospitalization expenses can be effectively controlled by taking strategies,such as enhancing the care and treatment before hospitalization,shortening the duration of hospitalization,avoiding infection in hospital and so on.

Objective To investigate the epidemiologic characteristics of injuries of children aged 0 ~14 yrs. Methods Described analysis was used to analyze the epidemiologic characteristics about the age, gender, injury type and cause in children 0~14 years old who visited in emergency department of hospitals form 2006 to 2007. Results During the study period, 16 124 injured children were collected. the rank of injuries type were contused/abrased wound (44.41%), open injury (36.10%), sprain (12.81%), bone fracture (3.25%) and burn/scald injury (1.49%); the cause of injuries were fall down (55.24%), animal injury (21.49%) , blunt injury (8.47%) and traffic injury (6.96%); The common place of injury occurred were at home (53.66%), public and resident place (18.01%), road/street (11.73%) and school (10.70%). The gender ratio was 1.94, the median age was 6 years, the male injury was decrease with the age increase, but so wasn't the female. Conclusion Injury gradually becomes the key health problem and influences the children health. The effective measures should be taken in term of the epidemiology characteristics of the injuries among children at 0-14 to prevent and control injury occurring. The health education of preventing injury occurring and behavior drawback should be conducted as early as possible to raise awareness of injury issues among children in the kindergartens and promote them growing healthily.

Objective To investigate the relationship between serum prealbumin (PA) and inflammation in acute myocardial infarction (AMI) patients. Methods A prospective observational study was conducted. AMI patients hospitalized in the cardiovascular department of the General Hospital of Chinese People's Armed Police Forces from June 2014 to June 2016 were enrolled in the study. At the same time, healthy cases were enrolled as control. Venous blood was taken from patients at admission. Serum PA was detected by immune projection turbidimetry method and high-sensitivity C-reactive protein (hs-CRP) was measured by latex enhanced immune turbidimetry. High-sensitivity cardiac troponin T (hs-cTnT), and interleukin (IL-6, IL-8) was measured by electrochemical luminescence method. Creatine kinase-MB isoenzyme (CK-MB) was detected by rate method. PA, inflammatory factor and myocardial enzyme were compared between two groups. The correlation between PA and inflammatory factors was analyzed by Pearson linear correlation; The diagnostic value of PA was analyzed by receiver operating characteristic (ROC) curve. Results 173 AMI patients and 86 healthy controls were enrolled in the study. There were no significant differences in gender, age, history of smoking, hypertension and diabetes. Compared with the control, the levels of serum PA in AMI patients was lower [PA (g/L): 0.215±0.056 vs. 0.280±0.057], hs-CRP, IL-6, IL-8, hs-cTnT and CK-MB were higher [hs-CRP (mg/L): 6.63±3.52 vs. 2.25±1.45, IL-6 (ng/L): 38.03±22.43 vs. 6.13±3.38, IL-8 (ng/L): 295.61±98.70 vs. 17.24±7.31, hs-cTnT (μg/L): 4.789±2.874 vs. 0.009±0.008, CK-MB (U/L): 244.48±165.54 vs. 12.20±5.24], the difference was statistical significant (all P < 0.01). It was shown by Pearson correlation analysis that the levels of PA were negatively related to hs-CRP, IL-6 and IL-8 (r = -0.562, -0.591, -0.548, all P <0.05). The PA level had no correlation with hs-cTnT and CK-MB (r = -0.018, -0.149, both P > 0.05). It was shown by ROC curve analysis that area under ROC curve (AUC) of PA for diagnosis of AMI was 0.783±0.039, and the 95% confidence interval (95%CI) was 0.706-0.860 (P < 0.05). When the cut-off value was 0.190 g/L, the sensitivity was 29.63%, and the specificity was 62.22%. Conclusion PA may be involved in the inflammatory process of AMI and had a diagnostic value for AMI.

ObjectiveTo evaluate the efficacy and safety of Sirolimus (SRL) in immunosuppression following liver transplantation. Methods SRL was applied in 21 patients totally.Indication for adoption was Tac-related nephrotoxicity (4/21), suspiciously Tac-related hepatoxicity (8/21), Tac overdose (3/21), renal insufficiency pre-operation (2/21), or cancer (4/21). Median follow-up was 25. 4 months. Results SRL provided an adequate prophylaxis against rejection in all study patients, with one case of acute rejection. Sirolimus was Withdrawn in 2 cases due to its sideeffect. Tat-induced hepatoxicity in 6 cases and nephrotoxicity in 3 cases were relieved significantly.Conclusions SRL given alone appears to be an effective primary immunosuppressant regimen fororthotopic liver transplantation patients. Early conversion contributes to significant improvement of Tac-related hepatoxicity and nephrotoxicity.

Objective To investigate the expression of MTSS1 in cholangiocarcinoma tissue and its relationship with the prognosis of patients.Methods The specimens of bile duct of 49 patients with hilar cholangiocarcinoma who received surgical excision at the Eastern Hepatobiliary Surgery Hospital from January 2003 to December 2005 were collected.Tissue microarrays of the 49 samples of hilar cholangiocarcinomas and the 10samples of adjancent normal bile duct epithelial tissue were constructed.The expression of MTSS1 was detected by the immunohistochemical staining.The pcDNA3.1-MTSS1 was transferred into the RBE cells and the abilities of proliferation of REB cells were measured by MTT assay.The patients were followed up via out-patient examination and telephone till May 2012.The measurement data were analyzed using the t test,and the count data were analyzed using the chi-square test,the survival curve was drawn by the Kaplan-Meier method,the survival was analyzed using the Log-rank test,and multivariate analysis was done using the COX regression model.Results The results of immunohistochemical staining showed that the expression rate of MTSS1 was 10/10 in the adjacent normal epithelial tissue of bile duct,while 59.2％ (29/49) in the cholangiocarcinoma tissues.The proliferative rate of cholangiocarcinoma cells transfected with MTSS1 was 1.55 ±0.05,which was significantly lower than 2.32 ±0.08 of cholangiocarcinoma cells without transfection of MTSS1 (t =4.454,P ＜ 0.05).Gender,age,TNM stage,T stage,differentiation,neural invasion and diameter of tumor did not influence the expression of MTSS1 (x2=0.211,3.471,0.507,0.507,0.368,0.882,0.660,P ＜ 0.05),while lymph node metastasis influenced the expression of MTSS1 (x2=10.436,P ＜ 0.05).All the patients were followed up for 1-59 months,and the median time for follow-up was 16 months.The median tumor-free survival time was 17.9 months in patients with positive expression of MTSSI,and 11.3 months of patients with negative expression of MTSS1,with no significant difference (Log-rank value =3.707,P ＞ 0.05).The median survival time was 34.9 months in patients with positive expression of MTSS1,which was significantly longer than 18.7 months of patients with negative expression of MTSS1 (Log-rank value =5.671,P ＜0.05).Multivariate analysis showed that MTSS1 was not the independent risk factor influencing the prognosis of patients (x2 =0.406,P ＞ 0.05).Conclusions The expression of MTSS1 is decreased in cholangiocarcinoma tissue,which negatively correlates with lymph node metastasis.MTSS1 could be used as a biomarker in predicting the prognosis of patients with cholangiocarcinoma.

Currently,there is a worldwide increase in the incidence and mortality of intrahepatic cholangiocarcinoma (ICC),but the etiology of ICC remains unclear.Recent efforts suggest an etiological role of hepatitis B virus (HBV)infection in ICC,and this article reviews the relationship between chronic HBV infection and the risk and prognosis of ICC.

Objective To evaluate effect of humanized nursing on psychological state of patients with chronic urticaria receiving autohemotherapy. Methods 58 cases with chronic urticaria in our hos-pital were randomly divided into the observation group and the control group with 29 cases in each group, the control group was treated with conventional care, the observation group received conventional care combined with humanized nursing. The anxiety, depression and satisfaction degree were compared for these two groups and the data went through χ2 test and t test. Results The score of self- rating anxiety scale (SAS) and serf-rating depression scale (SDS) of the observation group was significantly lower than that of the control group, the satisfaction rate of the observation group was significantly higher than that of the con-trol group. Conclusions Application of humanized nursing in patients with chronic urticaria receiving autohemotherapy can reduce their anxiety and depression and has pivotal significance on treatment of pa-tients with chronic urticaria.

Objective To investigate the efficacy and safety of cool-tipped saline-irrigated catheter ablation of epicardial accesso-ry pathway in the patients after failure of conventional radiofrequency ablation .Methods 30 patients with epicardial accessory path-way after failuer of conventional radiofrequency ablation were included in this study ,among them ,25 cases of the left accessory pathway and 5 cases of the right accessory prathway used the cool-tipped catheter for conducting ablation through the endocardium (ventricular side or atrial side) or coronary sinus .Results All patients achieved success ,no intraoperative and postoperative related complications occurred .Conclusion The cool-tipped saline-irrigated catheter ablation of epicardial accessory pathway is effective and safe in the patients after failure of conventional radiofrequency ablation ,which may improve the success rate of epicardial acces-sory pathway ablation .