Objective To evaluate the medical students' medical professionalism.Methods Totally 1200 medical college students from first grade to fourth were randomly selected to do the self-designed questionnaire of medical occupation spirit using the method of cluster sampling.Principal component analysis was applied to do data processing and analysis.Results ①Two principle components were extracted,the first principal component included the attitude on the personal contact with patient,attitude on the in-depth clinical practice aiming at improving the ability of doctor-patient communication,attitude on playing multiple roles in contacting patient and the understanding of the physician-patient relationship.The second principal component included the working attitude toward history collection,the sense of pride when be praised “proficiency” and the attitude towards difficult operations.② The scores of medical occupation spirit for medical students of first grade to four grade were:-4.4226,-0.0343,-5.1397,0.6827.The score was the highest in grade three medical students followed by grade two and grade one.Conclusion Unstable development trend was observed in medical occupation spirit among medical students and due attention should be paid.Strengthening the medical studenl occupation spirit education and training should focus on two aspects:the subjective aspect,namely active communication and exchange with patients who have subjective dynamic consciousness; the objective aspect,namely the attitude towards the grasp of professional skills.

The unresectable gastric cancer refers to be unable to accept radical gastrectomy because of advanced stage,which is mainly treated with adjuvant chemotherapy,and obtains only poor prognosis in the past.In recent years,however,some scholars found that the unresectable gastric cancer cases which were treated with systematic chemotherapy,radiochemotherapy,interventional therapy,hyperthermic intraperitoneal peroperative chemotherapy and so on,could be converted into resectable (radical D2 gastrectomy) cases successfully,and their survival time and quality of life are promoted significantly.The conversion therapy for unresectable gastric cancer provides a novel surgical strategy for the comprehensive treatment of part of the advanced gastric cancer patients.

The unresectable gastric cancer refers to be unable to accept radical gastrectomy because of advanced stage,which is mainly treated with adjuvant chemotherapy,and obtains only poor prognosis in the past.In recent years,however,some scholars found that the unresectable gastric cancer cases which were treated with systematic chemotherapy,radiochemotherapy,interventional therapy,hyperthermic intraperitoneal peroperative chemotherapy and so on,could be converted into resectable (radical D2 gastrectomy) cases successfully,and their survival time and quality of life are promoted significantly.The conversion therapy for unresectable gastric cancer provides a novel surgical strategy for the comprehensive treatment of part of the advanced gastric cancer patients.

Purpose/Significance To explore the application and predictive accuracy of various models in predicting the risk of ather-osclerosis in diabetic patients.Method/Process Based on the biochemical data table from the"Diabetes Complications Warning Dataset"provided by the National Population Health Science Data Center,MATLAB software is used to construct risk prediction models for diabe-tes-induced atherosclerosis.The models are built by using k-nearest neighbors(KNN),decision trees,backpropagation(BP)neural networks,and Naive Bayes algorithms,and which are subjected to comparative analysis.Result/Conclusion In terms of effectiveness,the predictive accuracy of Naive Bayes algorithm is the highest(61.6％),followed by the decision tree model(58.2％),the KNN mod-el(57.7％),and the BP neural network model(55.9％).The results of the confusion matrix and the receiver operating characteristic(ROC)curve indicate that the Naive Bayes model performs best.When comparing the models in terms of effectiveness,performance and stability,the Naive Bayes model is superior.

OBJECTIVETo analyse different factors related to the occurrence of bladder neck contracture (BNC) and to find possible ways of reducing this complication.

METHODSAll putative factors and the numbers of BNC cases were studied with statistical analyses in 1,017 cases that had undergone transurethral resection of the prostate (TURP).

RESULTSThe morbidity of BNC after TURP was significantly higher than that of open operations. Small size of the prostate, longer time of operation, higher power in resection and prostatitis were factors of BNC.

CONCLUSIONProperties of the prostate and electrical current injuries of resection are the primary factors of BNC. The selection of patients and techniques of TURP are most important in decreasing the morbidity of BNC.

Aged ; Aged, 80 and over ; Contracture ; etiology ; prevention & control ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; prevention & control ; Transurethral Resection of Prostate ; adverse effects ; Urinary Bladder

Objective: To establish a rabbit unstable bladder and Partial Bladder Outlet Obstruction (BOO) model, and to study on urodynamic changes. Methods: 30 male New Zealand rabbits were divided into control group and operative group. After 8 weeks, urodynamic changes were determined after they were anaesthetized by ketamine and droperidol. Results: Prominent changes of Main urodynamic parameters were found between the operative group and control group. The incidence rate of unstable bladder was 60%. Conclusion: The method of establishing rabbit model of Partial BOO is successful. It provides a platform for the study on the changes of pathology and pathophysiology of human chronic partial BOO and treatment of this kind of diseases.

Objectives To investigate the clinical feature and surgical procedures of gastric stump carcinoma (GSC) and to identify the prognostic factors which influence survival rate of GSC patients.Methods Clinical data of 167 patients who underwent R0 resection for gastric stump carcinoma at Chinese People's Liberation Army General Hospital between January 1990 and December 2012 was collected.There were 144 male and 23 female cases.The clinicopathological features of GSC patients were compared between those who underwent initial surgery for benign disease (GSC-B group,78 cases) and for gastric cancer (GSC-M group,89 cases).The analysis of therapeutic methods and survival time were also performed.t-test was used to compare the quantitative data between two groups.Pearson x2 test was used to compare the various clinicopathological characteristics between the two groups.Kaplan-Meier method was used to analyze the survival rate.Multivariate survival analysis was based on the Cox proportional hazard model.Results Compared with GSC-M group,the interval time between initial gastrectomy and surgery in GSC-B group was longer ((28.2 ± 10.2) years vs.(10.8 ± 1.0) years,t =15.902,P =0.001).There were 56 patients (71.8％) who received Billroth Ⅰ reconstruction in GSC-B group,and 49 patients (55.1％) who received Billroth Ⅱ reconstruction in GSC-M group,the difference of anastomosis method between the two groups was statistically significant (x2 =25.770,P =0.001).Compared with GSC-M group,the tumor of GSC-B group was usually located at the anastomotic site (x2 =6.975,P =0.031).The overall 1-,3-,and 5-year survival rates of the 167 patients were 87％,60％,and 41％.The 5-year survival rates for TNM stages Ⅰ,Ⅱ,and Ⅲ were 65％,43％,and 22％,respectively (P =0.001).Multivariate analysis showed that small intestinal or esophageal infiltration (HR =1.957,95％ CI:1.096 to 3.494,P =0.023),tumor location (HR =1.618,95％ CI:1.104 to 2.372,P =0.014),and TNM stage (HR =2.307,95％ CI:1.708 to 3.118,P =0.001) have independent effect on survival.The metastasis rates of perigastric lymph nodes,jejunum anastomosis and mesenteric lymph nodes were very high (56.3％ and 65.2％,respectively).Conclusions The GSC appears earlier in patients with gastrectomy for malignant disease than those with benign disease.Appropriate curative resection including residual lymph node dissection is very important to improve the prognosis.Small intestinal or esophageal infiltration,tumor location,and TNM stage have independent effect on survival.

Objective To study effect of targeted nursing cooperation on complications of endoscopic thyroidectomy.Methods A total of 104 patients with endoscopic thyroidectomy in our hospital were divided into study group and control group by random number table method,with 52 cases in each group.Control group conducted conventional nursing for endoscopic thyroidectomy,study group conduced targeted nursing cooperation on the basis of the control group.Operation time,postoperative volume of drainage,length of hospital stay,and intraoperative complications were compared.Results No significant differences in operation time and volume of drainage between two groups were found(P ＞0.05);Incidence rate of complications and length of hospital stay were lower than that in the control group (P ＜ 0.05).Conclusion Targeted nursing can effectively reduce incidence rate of complications in endoscopic thyroidectomy,speed up the recovery,and had no significant effect on operation time and postoperative volume of drainage,so it is suitable for clinical promotion.

Objective To study effect of targeted nursing cooperation on complications of endoscopic thyroidectomy.Methods A total of 104 patients with endoscopic thyroidectomy in our hospital were divided into study group and control group by random number table method,with 52 cases in each group.Control group conducted conventional nursing for endoscopic thyroidectomy,study group conduced targeted nursing cooperation on the basis of the control group.Operation time,postoperative volume of drainage,length of hospital stay,and intraoperative complications were compared.Results No significant differences in operation time and volume of drainage between two groups were found(P ＞0.05);Incidence rate of complications and length of hospital stay were lower than that in the control group (P ＜ 0.05).Conclusion Targeted nursing can effectively reduce incidence rate of complications in endoscopic thyroidectomy,speed up the recovery,and had no significant effect on operation time and postoperative volume of drainage,so it is suitable for clinical promotion.

Objectives To investigate the clinical feature and surgical procedures of gastric stump carcinoma (GSC) and to identify the prognostic factors which influence survival rate of GSC patients.Methods Clinical data of 167 patients who underwent R0 resection for gastric stump carcinoma at Chinese People's Liberation Army General Hospital between January 1990 and December 2012 was collected.There were 144 male and 23 female cases.The clinicopathological features of GSC patients were compared between those who underwent initial surgery for benign disease (GSC-B group,78 cases) and for gastric cancer (GSC-M group,89 cases).The analysis of therapeutic methods and survival time were also performed.t-test was used to compare the quantitative data between two groups.Pearson x2 test was used to compare the various clinicopathological characteristics between the two groups.Kaplan-Meier method was used to analyze the survival rate.Multivariate survival analysis was based on the Cox proportional hazard model.Results Compared with GSC-M group,the interval time between initial gastrectomy and surgery in GSC-B group was longer ((28.2 ± 10.2) years vs.(10.8 ± 1.0) years,t =15.902,P =0.001).There were 56 patients (71.8％) who received Billroth Ⅰ reconstruction in GSC-B group,and 49 patients (55.1％) who received Billroth Ⅱ reconstruction in GSC-M group,the difference of anastomosis method between the two groups was statistically significant (x2 =25.770,P =0.001).Compared with GSC-M group,the tumor of GSC-B group was usually located at the anastomotic site (x2 =6.975,P =0.031).The overall 1-,3-,and 5-year survival rates of the 167 patients were 87％,60％,and 41％.The 5-year survival rates for TNM stages Ⅰ,Ⅱ,and Ⅲ were 65％,43％,and 22％,respectively (P =0.001).Multivariate analysis showed that small intestinal or esophageal infiltration (HR =1.957,95％ CI:1.096 to 3.494,P =0.023),tumor location (HR =1.618,95％ CI:1.104 to 2.372,P =0.014),and TNM stage (HR =2.307,95％ CI:1.708 to 3.118,P =0.001) have independent effect on survival.The metastasis rates of perigastric lymph nodes,jejunum anastomosis and mesenteric lymph nodes were very high (56.3％ and 65.2％,respectively).Conclusions The GSC appears earlier in patients with gastrectomy for malignant disease than those with benign disease.Appropriate curative resection including residual lymph node dissection is very important to improve the prognosis.Small intestinal or esophageal infiltration,tumor location,and TNM stage have independent effect on survival.