Objective To investigate the status quo and characteristics of medical students'job choosing view,to analyze the reasons and to propose countermeasures.Methods Questionnaires on job choosing view concerning job choosing cognition,ideals,method,motivation and values were conducted among 1700 medical students in Shandong University.Data entry and statistics were done by SPSS 17.0.Difference was analyzed by t-test and ANOVA.Results Significant differences were showed in sex,whether being the only-child in the family,father's education and family's economic status(P＜0.05).Conclusions Medical students'job choosing views are characterized by professional,highly expected,diversified and utilitarian,which is caused by society,school and family.Therefore,much importance should be attached to improving educational environment,making educational objective clear and constructing educational content system.

Hepatoblastoma (HB) is the most common malignant tumor of the liver in children,and it is most prevalent in children under 5 years old.The overall prognosis of childhood HB has been improved significantly due to multidisciplinary team approach consisting with surgical resection and combination chemotherapy.Nevertheless,the clinical outcomes of metastatic and relapsed HB remain to be poor.This paper makes a brief review on the pathogenesis,diagnosis and treatment of HB.

Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system.The biomarkers that are tested in cerebrospinal fluid (CSF) is important for diagnosis,prognosis and treatment efficacy of MS.Therefore,CSF tests are essential in MS patients.This review summarized and discussed the CSF biomarkers in MS,including the clinical widely used biomarkers and research on potential biomarker candidates.

Objective: To evaluate the polysomnology results along with mandibular titrated advancement using oral appliance to treat obstructive sleep apnea and hyponea syndrome(OSAHS).Methods: Several electronic databases (PubMed, Embase, Cochrane Library, CNKI, VIP, and Wanfang) were systematically searched up to September 2015.There was no restriction of language or source of information.All randomized clinical trials (RCT) and before-after trials (BAT) comparing at least two different mandibular advancements were included.Two independent reviewers selected the studies, extracted data and evaluated risk of bias by quality assessment.Data were pooled using a fixed-effects model, and the summary effect measure was calculated by risk ratio (RR) and 95%CI.Meta-analysis was performed using RevMan 5.3 software.Results: Two RCTs and five BATs were included in the review.Among the five BATs, two of them were randomized, while the other three were not.Outcomes including apnea hypopnea index (AHI), oxygen desaturation index (ODI), success rate (reduction of AHI or ODI >50%), normalization rate (AHI or ODI<10/h) were assessed in this review.Based on the trial design and quality assessment, four studies were included for meta-analysis.No significant difference in the success rate was found between the group with 50% of the maximal mandibular advancement (MMA) and the group with 75% of MMA [I2=0%, RR=0.93, with 95%CI (0.80, 1.09)].No significant dif-ference in the normalization rate was found between the 50% of MMA and 75% of MMA groups [I2=45%, RR=0.85, with 95%CI (0.68, 1.06)].Subgroup analysis displayed that the severity of OSAHS before treatment was a potential factor affecting the normalization rate.Conclusion: Based on current available evidence, the success rate and normalization rate for treating OSAHS in the patients with 75% MMA were not found to be significantly higher than those with 50% MMA.Due to small simple size in this meta-analysis, the results of the present study should be interpreted with caution.Further prospective studies are needed to strengthen the evidence.

Objective To analyze the risk factors of Gram‐negative bacterial blood‐stream infection in ICU for conducting the risk evaluation and guiding medication .Methods The inpatients were diagnosed with Gram‐negative bacterial blood‐stream infec‐tion in ICU of the Renmin Hospital of Wuhan University from January 2013 to December 2014 were retrospectively surveyed and analyzed .The risk factors of blood‐stream infection caused by Gram‐negative bacteria were analyzed and screened by the Logistic re‐gression analysis method .Results A total of 172 case‐times of blood‐stream infection occurred in ICU during this period ,including 93 case‐times of Gram‐negative bacterial infection .The Gram‐negative pathogenic bacteria were Acinetobacter baumanii ,Klebsiella pneumoniae ,Acinetobacter calcoaceticus baumanii ,E .coli ,pseudomonas aeruginosa ,etc .Except E .coli was mainly originated from community acquired infection ,other bacteria were mainly originated from nosocomial infection .In order to differing from other pathogenic bacterial blood stream infection ,the Logistic regression analysis results showed that the independent risk factors of G‐negative bacterial blood‐stream infection in ICU had serum PCT levels over 10 .0 ng/mL (OR= 60 .52 ,P= 0 .001) ,receiving the therapy of carbapenem and third generation cephalosporins (OR=16 .09 ,P=0 .03) ,hospitalization duration less than 2 weeks be‐fore suffering from disease (OR=13 .79 ,P=0 .03) and digestive system basic disease(OR=12 .94 ,P=0 .01) .Conclusion Gram‐negative bacterial blood‐stream infection in ICU of the Renmin Hospital of Wuhan University is mainly caused by multi‐drug resist‐ant bacteria .Serum PCT level over 10 .0 ng/mL ,hospitalization duration less than 2 weeks before infection ,receiving the therapy of carbapenem and third generation cephalosporin and basic diseases of digestive system are the independent risk factors influencing the occurrence and diagnosis of blood‐stream infection .

Objective To explore the value of dual-source CT monoenergetic-plus imaging in the diagnosis of early gastric cancer. Methods Imaging data of 2 6 cases with pathologically proven early gastric cancer who underwent dual-energy scanning were analyzed retrospectively.Monoenergetic-plus images with energy levels at 40 keV,50 keV,60 keV and 70 keV were reconstructed by using an advanced monoenergetic software (syngo.via.VA30A,Dual energy Mono+).Contrast-to-noise ratio (CNR)of the lesion,image noise,overall image quality score and lesion conspicuity score were com pared between different monoenergetic-plus images and conventional polychromatic images at 1 2 0 kVp.Results The CNRs (3 .2 4 ± 0 .7 6 ,2 .9 4 ± 0 .9 2 ,2 .4 7 ± 0 .7 9 ,2 .3 7 ± 0.98 and 1.22±0.40 respectively)and image noises [(32.7±1.82)HU,(25.6±2.61)HU,(20.30±2.1 7)HU,(1 7.03±2.1 5)HU and (18.15±2.12)HU respectively]among 40 keV,50 keV,60 keV,70 keV and 120 kVp groups all had statistical differences (F =24.654 and 227.05,P <0.01).The CNR in 50 keV group was higher than that in 60 keV,70 keV and 120 kVp groups,but similar to that in 40 keV group (P >0.05).The SD value in 50 keV group was lower than that in 40 keV group,but higher than that in other three groups (P <0.05).The overall image quality score (3.08±0.27,3.65±0.49,3.31±0.47,3.23±0.43 and 3.1 5±0.37,respectively) and lesion conspicuity score (4.15±0.67,3.92±0.48,3.27 ±0.45,3.08±0.27 and 3.04±0.20)among the five groups all had statistical differences (Z =25.343 and 70.426,P <0.05).The overall image quality score of 50 keV group was higher than that of the other four groups (P <0.05).Lesion conspicuity score in 50 keV group was higher than that in 60 keV,70 keV and 120 kVp groups and similar to that in 40 keV group (P =0.1 52).Conclusion The 50 keV monoenergetic-plus images can increase the CNR value of early gastric cancer while maintaining the overall image quality.

Objective To investigate the effects of treadmill training at different intensities on neurological function and expression of kalirin-7 in rats after cerebral ischemia-reperfusion,and the possible mechanism.Methods Sixty Wistar male rats were randomized into a model group,a routine training group,an intensive training group and a sham-operation group (n =15 for each group).A middle cerebral artery occlusion/reperfusion (MCAO/R) model was established in all the rats of the first three groups.The model group and sham group did no motor training,while the utine training group did treadmill training once daily,and the intensive training group did treadmill training twice a day.On the 3rd,7th and 14th day,Zausinger scores was used to evaluate the neurological deficit;reverse Transcription PCR (RT-PCR) and Western blot were adopted to detect the expression of kalirin-7 and kalirin-7 mRNA in the peri-ischemic brain tissues respectively.Results The average Zausinger scores of the model group and 2 training groups were significantly lower than that of the sham-operation group at all time points;on the 7th and 14th days,the average score of the intensive training group was significantly higher than that of the outine training group.Moreover,the expression of kalirin-7 and kalirin-7 mRNA in the MCAO rats were significantly lower than that in the sham-operation group.On days 7 and 14,the expression of kalirin-7 in the intensive training group was significantly higher than that of the routine training group,which was still significantly higher than the model group.On day 14,the expression of kalirin-7 mRNA in the intensive training group was significantly higher than that of the routine training group,which was still significantly higher than the model group.Conclusion The intensive training is superior to routine training in promoting neural functional recovery and expression of kalirin-7 in rats with cerebral ischemia-reperfusion.

Objective To explore the relationship between expected drop and postpartum depression,analysis of influence factors of postpartum depression.Methods Chinese version of Postpartum Support Questionnaire and Edinburgh Postnatal Depression Scale were used to investigate 411 puerpera of 42-56 days postpartum by the convenience sampling method.Results The incidence rate of postpartum depression was 17.03％ (70/411).The correlation coefficient r between the actual situation of postpartum social support and the score of each dimension and the score of Edinburgh Postpartum Depression Scale was 0.157 to 0.247 (P ＜ 0.01).The correlation coefficient r between the postpartum social support expectation drop and the Edinburgh Postpartum Depression Scale score was 0.173 to 0.230 (P ＜ 0.01).Regression analysis showed postpartum depression was related to emotional support,nursing mode,registered permanent residence and gender expectations for baby.Conclusions The positive rate of postpartum depression is still higher.How to reduce the incidence of postpartum depression is still a problem to be solved.According to the characteristics of social support and maternal postpartum to evaluate the importance of targeted social support can reduce the incidence of postpartum depression.

Objective:To investigate the differentially expressed miRNAs in serum collected post operation and compared these miR-NAs with those collected pre-surgery among patients suffering from glioblastoma multiform (GBM) and undergoing regular clinical fol-low-up. These miRNAs may be potential biomarkers for the post-operative evaluation of patients with GBM. Methods:Forty-eight pa-tients with GBM and clinical pathological diagnosis were enrolled in this study. In the initial biomarker screening stage, total RNAs were extracted and subjected to Solexa sequencing to select miRNAs with significantly altered expression pre-and post-operation. Some of these differentially expressed miRNAs were chosen and verified through TaqMan probe-based qRT-PCR assay. A t-test was performed to determine the miRNAs that satisfied the two criteria, namely, fold change>2 and P<0.05. All of the patients were fol-lowed-up, and survival data were collected. The patients were then classified into two groups, namely, long-and short-survival groups, on the basis of the median of the miR-30e expression levels in the sera collected post-operation. Kaplan-Meier method and Log-rank test (SPSS version 19.0, IBM) were employed to determine the possible relationships between miR-30e expression levels in the sera collected post-operation and patients' overall survival. Results: Solexa revealed 63 differentially expressed miRNAs. Four miRNAs, namely, miR-26b, miR-30e, miR-129-3p, and miR-206, were selected on the basis of previous and present findings. These miRNAs were then verified in the RT-qPCR phase. Among these miRNAs, only miR-30e was significantly upregulated post-operation. The serum miR-30e expression level post-operation was not significantly associated with the overall survival of the patients. A low miR-30e expression level corresponded to prolonged survival. Conclusion:miR-30e was upregulated in the sera collected post-operation from patients with GBM. This miRNA may be negatively related to the tumor load of these patients. The miR-30e expression level in the serum col-lected post-surgery serum was not significantly associated with overall survival. Therefore, miR-30e may serve as a novel potential non-invasive biomarker for the post-operative evaluation of patients with GBM.

Objective To observe the evaluation of early chemoradiotherapy efficacy in uterine cervical cancer by different b-value combination.Methods Thirty uterine cervical cancer patients who were treated with chemoradiotherapy received conventional MRI and diffusion weighted imaging (DWI) before treatment,after 2 weeks treatment and after treatment.The patients were divided into complete remission (CR) group (15 cases),partial remission (PR) group (9 cases),stable disease (SD) group (6 cases) according to the changes in tumor size after 9 months of treatment.The tumor size and apparent diffusion coefficient (ADC) of uterine cervical cancer were measured at each examination among the 3 groups.All ADC were calculated with b =0,600 s/mm2 and b =0,1000 s/mm2.According the receiver operating characteristic (ROC) curve,chemoradiotherapy efficacy and prognosis value of different b-value of ADC chart in uterine cervical cancer were compared.Results There were no significant differences in ADC of b =0,600 s/mm2 ADC chart and b =0,1000 s/mm2 ADC chart before treatment and after 2 weeks treatment in the 3 groups (P＞ 0.05).ADC increase rate after 2 weeks treatment in CR group was significantly higher than that in PR group and SD group (0.35 ± 0.10 vs.0.22 ± 0.10 and 0.21 ± 0.08,0.28 ± 0.08 vs.0.14 ±0.04 and 0.16 ± 0.02,P ＜ 0.05).There was no significant difference between PR group and SD group (P ＞0.05).The decrease rates of tumor diameter after 2 weeks treatment in CR,PR and SD group were 0.36 ±0.18,0.33 ± 0.17 and 0.24 ± 0.09,there were no significant differences (F=1.151,P ＞ 0.05).After 2 weeks treatment,at b =0,600 s/mm2 ADC chart,when liminal value of ADC was 0.211 × 10-3 mm2/s,ROC area under curve was 0.976,sensitivity was 85.6％,specificity was 100.0％; at b =0,1000 s/mm2 ADC chart,when liminal value of ADC was 0.181 × 10-3 mm2/s,ROC area under curve was 0.979,sensitivity was 85.6％,specificity was 100.0％.The accuracy of two kinds of ADC chart evaluation of uterine cervical cancer early chemoradiotherapy efficacy was higher,and the effect was similar.Conclusion The ADC increase rate after 2 weeks treatment can be used to predict the early chemoradiotherapy efficacy of uterine cervical cancer,and the value of two kinds of ADC chart of different b-value is similar.