Objective To discuss the correlation between nutritional megaloblastic anemia and homocysteine,in order that e-valuate the application of homocysteine in some aspects that detection and treatment of megaloblatic anemia.Methods The study was divided into three groups,included case group (MA group,n=192,including megaloblatic anemia of vitamin B12 deficiency,n=60;megaloblatic anemia of folic acid deficiency,n=69;megaloblatic anemia of folic acid and vitamin B12 defi-ciency,n=63),matched group (heathy persons,n=200)and treated group (persons who recovered from megaloblatic ane-mia,n=192).Results The difference on homolevel in plasma between case group and matched group had statistical sidnifi-cance (t=3.56,3.21,2.78,P <0.01).The difference on homocysteine level in plasma between treated group and matched group had no statistical sidnificance (t=1.23,0.98,0.77,P >0.05).The Hcy levels of folic acid deficiency vitamin B12 de-ficiency,vitamin B12 deficiency and folic acid and vitamin B12 deficiency had no statistical sidnificance (t=1.42,P >0.05). Conclusion The homocysteine level of patients who had nutritional megaloblatic anemia higher than heathy persons.High level of homocysteine had correction between the nutritional megaloblatic anemia.The lack of some nutrition facters (eg:fo-lic acid,vitamin B12)can lead to high homocysteine disease.Detecting the change of homocysteine level in plasma can guide the treatment of nutritional megaloblatic anemia.

Objective To survey the current situation and influencing factors of willingness to attend assistant general practitioner training among junior medical college students in Yunnan Province.Methods A questionnaire survey and interview on the willingness to attend the training of assistant general practitioner was conducted from May 2017 to June 2017 in Yunnan Province,1 800 students from 6 junior medical colleges were selected as participants by stratified cluster sampling method.Results A total of 1 800 questionnaires were distributed and 1 710 were collected,of which 1 634 were valid with a recovery rate of 95.00％ and an effective rate of 95.56％.The results showed that 43.21％ (706/1 634) participants were not aware of the relevant training policies,while there were significant differences among participants in the different grades and types of college (public or private) (Z=-0.899,8.658,-13.954;P＜0.05);83.17％ (1 379 / 1 634) participants were willing to sign up for an assistant general practitioner training after graduation,while there were significant differences among participants in different ethnic groups,grades,household register sites,types of college,and family income (P＜0.05).Total of 1 300 (79.56％) chose to work as a general practitioner in rural grassroots institutions after graduation,and 984 (60.22％) chose to become a specialist after graduation.Unconditional logistic regression analysis showed that the types of medical college,attitude towards the training policy,the intension to work in grassroots level or to work in private hospitals were influencing factors for willingness to attend the assistant general practitioner training among medical students(B=1.654,3.764,1.361,-0.569;P＜0.05).Conclusion The survey shows that the policy awareness and the willingness to attend assistant general practitioner training for student in junior medical college in Yunnan Province are not high,and the policy publicity and the career guidance need to be strengthened.

Small for gestational age (SGA) infants are more likely to experience neurocognitive impairments compared to appropriate for gestational age (AGA) infants. This paper reviews recent research on the neurocognitive development of SGA children. SGA can lead to a "brain-sparing effect" due to growth restriction, which may affect cerebral blood flow and brain structure. However, this does not guarantee normal brain development. Restrictive blood flow can result in changes in brain structure, such as reduced total white matter and gray matter volume in various brain regions, including the cerebral cortex, hippocampus and cerebellum, ultimately leading to decreased head circumference. SGA children also exhibit lower scores in all neurocognitive domains, including intelligence, attention, memory, and executive function. This may result in poor academic performance and an increased risk of social, behavioral, and neurological problems, such as cerebral palsy, epilepsy, visual and hearing impairments, as well as comorbidities like attention deficit hyperactivity disorder(ADHD), autism spectrum disorder(ASD), anxiety, depression, and schizophrenia. Several risk factors for SGA-related neurocognitive impairments have been identified, including gestational hypertension, abnormal gestational weight, smoking, and catch-up growth. Studies have shown that the best interventions to improve cognitive dysplasia include nutrient supplementation, continued breastfeeding, high-quality education, and appropriate early intervention (responsive parenting) are effective in improving cognitive outcomes for SGA children.