Aiming at the difficult employment situation of marketing students of higher vocational medicine,we has made an objective analysis of the strengths and weaknesses as well as opportunities and threats based on the trend analysis tools and weigh the advantages and disadvantages to help graduates overcome the deficiencies of individual employment process and find out the existing disadvantages of school,which can provide reference for improving the employment situation of higher vocational medicine marketing.

ObjectiveTo investigate the effect of subtotal gastrectomy on glucose metabolism in patients with gastric disease combined with diabetes mellitus.MethodsThe clinical data of 126 cases with gastric disease combined with diabetes mellitus receiving subtotal gastrectomy were analyzed retrospectively,including subtotal gastrectomy Billroth Ⅱ type 69 patients (Billroth Ⅱ type group),subtotal gastrectomy Billroth Ⅰ type 57 patients(Billroth Ⅰ type group).The fasting blood glucose,postprandial blood glucose before surgery and 1,3,6 months after surgery and the improvement of glucose metabolism were compared.ResultsThere was no significant difference in the fasting blood glucose,postprandial blood glucose before surgery and 1,3,6 months after surgery in Billroth Ⅰ type group (P ＞0.05).The fasting blood glucose,postprandial blood glucose 3,6 months after surgery [ (10.7 ±2.9 ),(10.4 ± 2.3 ) mmol/L and (12.4 ± 2.6),(12.0 ±3.2) mmol/L] were higher than those before surgery and 1 month after surgery [(14.1 ±3.2),(13.4 ±3.8) mmol/L and(19.0 ±3.9),(18.1 ±4.3) mmol/L] in Billroth Ⅱ type group with significant differences (P ＜ 0.05 or ＜ 0.01 ).The improving rate of glucose metabolism in Billroth Ⅰ type group [ 7.02％(4/57) ] was lower than that in Billroth Ⅱ type group [ 92.75％(64/69)] with significant difference(P ＜ 0.01 ).ConclusionsSubtotal gastrectomy has obvious effect on improving glucose metabolism in patients with gastric disease combined with diabetes mellitus.The use of subtotal gastrectomy Billroth Ⅱ type is prior to subtotal gastrectomy Billroth Ⅰ type.

Objective To investigate the effect of levothyrocine-thyroxine 4 (L-T4) replacement therapy on cognitive status in elderly patients with subclinical hypothyroidism (SCH).Methods One hundred and twenty elderly patients with SCH were selected and treated with thyroid hormone replacement therapy for 6 months.The thyroid functions and cognitive impairments were tested for all the subjects before and after the therapy.Results After 6 months of thyroid hormone replacement therapy,the level of thyrotropic hormone was significantly lower than that of before herapy((15.21 ± 1.78) mU/L vs.(3.46 ± 0.37) mU/L,t =6.417,P =0.0083));The neuropsyehological test performance in patients with hypothyroidism showed statistically significant improvements in clock drawing test,iconic memory,block design,complex graphics recall and delayed recall,trail making A,word list learningl,recall and recognize,forward and backward digital span,verbal fluency,and digital symbol from WAIS-RC ((8.74 ± 1.08) vs.(9.63 ± 1.32),(6.14 ± 1.03) vs.(8.47 ± 1.38),(30.36 ± 7.27) vs.(36.42 ±8.54),(13.71 ± 1.05) vs.(14.87 ± 1.38),(11.21 ± 1.13) vs.(13.56 ±1.34),(11.36 ± 1.27)vs.(13.06 ±1.47),(5.27 ±0.84) vs.(6.54 ±1.03),(63.13 ±12.09)vs.(54.63 ±10.07),(3.64 ± 1.07)vs.(4.91 ±1.32),(5.27 ±0.84) vs.(6.54±1.03),(8.52±1.16) vs.(9.83 ±0.96),(8.01 ± 0.83) vs.(8.94 ± 1.08),(4.04 ±0.57)vs.(5.37 ±0.75),(11.21 ± 1.03) vs.(13.43 ± 1.23),(33.46 ± 8.72) vs.(38.06 ± 9.58),t =13.907,11.027,12.093,16.374,10.361,11.536,8.794,-10.617,9.601,8.794,17.814,7.913,12.415,13.992,10.128 respectively,P =0.028,0.039,0.036,0.029,0.042,0.040,0.048,0.042,0.045,0.048,0.027,0.048,0.038,0.032,0.041 respectively).Conclusion The treatment of thyroid hormone for the edlerly patients with SCH has positive effects on theimprovement of mild cognitive impairment.

Objective To explore the clinical effect and adverse reaction on hysteromyoma patients treated with mifepristone of different periods.Methods Forty-seven patients with conservative treatment were treated with mifepristone of 10 mg/d for 9 months,and 1 period was 3 months.Uterine volume,fibroid volume and hemoglobin (Hb) were detected after each period,and clinical effect and adverse reaction were also observed.Results All patients were completed 3 periods,and clinical symptoms improved.Uterine volume and fibroid volume reduced gradually,and Hb increased gradually during treatment.Uterine volume and fibroid volume reduced by 41.54％ and 46.53％ respectively.All indicators had significant changes at first period and second period,compared with without treatment and first period gradually (P ＜ 0.05).There was no significant difference in adverse reaction among different periods (P ＞ 0.05).Conclusions The clinical effect on hysteromyoma treated with mifepristone of long-period was effective,and adverse reaction did not significantly increase.Long-period treatment with mifepristone provide a conservative treatment for near menopausal hysteromyoma patients.

Objective To retrospectively analyze clinical data of 207 patients with gynecologic malignancy.Methods All cases were diagnosed from 2010 to 2012,and were divided into four groups by ages (≤20-year-old age,20-40-year-old age,40-60-year-old age and ≥60-year-old age).Their clinical characters were reviewed and compared.Results The 40-60-year-old age group had the greatest number of cases for the entire cohort 49.8％ (103/207).The most common primary site of the ≤20-year-old age group was ovary (75.0％).Cervix 36.4％(24/66) and ovary 30.3％(20/66) were the common primary site of the 20-40-year-old age group.Endometrium,cervix and ovary were common in the 40-60-year-old age group with 27.2％,26.2％,23.3％,respectively.Ovary,endometrium and cervix were common in the last group with 29.4％,26.5％ and 20.6％,respectively.In the ≤20-year-old age group,the germ cell was the most common histology among ovarian malignancies (66.7％),and the epithelial tumor was the most common tumor in the other groups.Conclusions Carcinoma of cervix,ovary and endometrium are the most common gynecologic malignancies and 40-60-year-old age is the high-risk age.We should strengthen the health education and physical examination for young women.

Objective To explore the applicated value of Doppler ultrasound,X-ray mammography and MRI in early diagnosis and differential for breast cancer.Methods 182 cases examine femaled patients,which were hospitalized to breast lumps as the object of study,they were confirmed by Doppler ultrasound,X-ray mammography and MRI three checks.Caccording to the patient after surgery,the pathology results were used to diagonosed the value of the three detection methods.Results 182 patients with breast cancer and 143 cases(78.7％),benign tumors and 39cases(21.3％),the sensitivity of MRI was significantly higher than the other two,three associated with the accuracy of the examination results was significantly higher than that of each individual(P ＜0.05),the difference was statistically significant.Conclusion Doppler ultrasound,X-ray mammography and MRI are used in breast cancer in the early diagnosis,which have their own advantages,the combination can increase the accuracy to a certain extent.

The changes of serum amino acid metabolism of rat following partial (69%) hepatectomy were investigated by measuring twenty amino acids in sera from blood collected from hepatic vein, portal vein, inferior vena cava and abdominal aorta 72 hours following surgical intervention. The results were as follows:1. The total concentrations of amino acids in sera obtained from above mentioned blood vessels were significantly elevated, especially in that from portal vein.2. The total amount of amino acid released from splanchnic organs accunted for 87% of the total amount of amino acid uptaken by regenerating liver. Both total amounts were significantly increased.3. The enhanccd essential amino acid uptaken by regenerating liver resulted in significant decrease of molar ratio of essential to nonessential amino acids in aortic serum.4. The molar ratio of the branched chain amino acids, valine, leucine and isoleucine, to the aromatic amino acids, phenylalanine and tyrosine in aortic serum was significantly declined, this was due to increased release of tyrosine by splanchnic organs and decreased uptake of this amino acid by regenerating liver.5. The uptake of branched chain amino acids by peripheral tissues was significantly inhibited and their uptake by regenerating liver was significantly increased. Thus, the regenerating liver was well supplied with branched chain amino acids.6. The release of alanine by splanchnic organs was significantly increased and its uptake by liver was simultaneously increased. Therefore, abundant raw matererial was supplied for glyconeogenesis to meet the energy need for rapidly proliferating hepatocytes.

Congenital cataracts is the leading cause of visual disability in children worldwide.With the evolution of molecular biological technique,the researches of inherited congenital cataract mainly focus on localization and fuction characterization of the disease-associated gene,including crystallin,connexin,major intrinsic protein gene,etc.And great progress has been made for such genes in eye development,age-related cataract,epigenetics study.Thus,great attention must be paid to the functional research about congenital cataract candidate gene.

Refractory glaucoma is one of the main blinding diseases in ophthalmology.Glaucoma drainage device implantation has become one of the main methods of refractory glaucoma.It has been widely used in clinic because of its advantages of safety,effectiveness and less complications.After a large number of clinical applications and innovative development of minimally invasive glaucoma surgery,glaucoma drainage device implantation shows its good treatment prospects.In this paper,the structural features of glaucoma external drainage device (Molteno,Schocket,Baerveldt,Human aqueous drainage,Krupin,Ahmed,Joseph,Whites,Optimed drainage device) and microin vasive glaucoma surgery (MIGS) (Ex-PRESS drainage device,Xen Gel Stent,CyPass Micro-Stent,Ab interno trabeculectomy trabectome,Hydrus Schlemm canal scaffold,iStent trabecular micro-bypass stent,SOLX Gold Shunt) were summarized.The drainage device implantations for glaucoma in the role of the refractory glaucoma were reviewed.

Recent researches have shown that resectable pancreatic cancer can benefit from post-operative adjuvant chemoradiation, regardless its surgical margins, tumor size, lymph node involvement and the level of cell differentiation. Several phase Ⅱ clinical trials indicated a good tolerance to preoperative chemoradiation. Although there is no gold standard for treating locally advanced unresectable pancreatic cancer, gemcitabine-based chemotherapy or chemoradiation therapy can increase survival rate compared with best supportive care.