This article identified the main problems in current medical education and demonstrated the necessity to implement the outstanding doctor cultivation plan.The author proposed that medical education for outstanding doctors should set defined goals,reform current cultivation models and improve clinical practice as well as culture ability and capability to function internationally.Several ongoing cultivation plans for outstanding clinicians in domestic medical colleges and universities were also discussed.

Objective:To evaluate the safety and importance of temporary artificial cardiac pacemaker during non-cardiac perioperative period.Methods:Forty-eight hospitalized surgery patients with bradycardia were implanted temporary cardiac pacemaker in cardiac catheter room.Results:91.6% patients were anesthesiaed and operated under the protection of artificial cardiac pacemaker.And 43.1% patients passed ICU early times.Conclusion:Old-aged patients with bradycardia who required surgical intervention were implanted routinely with temporary artificial cardiac pacemaker preoperatively.It was the temporary artificial cardiac pacemaker that not only enhanced the safety of anesthesia and operation,reduced occurrence of serious arrhythmia even sudden death surrounding operation period,also relieved distress and economic burden.

0.05).3.The more cardiovascular risk factors,the more serious coronary artery disease.Conclusion:Besides BMI,conventional risk factors of cardiovascular contribute to coronary heart disease in this area,and they play an important and independent role in occurrence and progression of coronary artery disease.

Objective:To investigate the relationship between serum adiponectin and high sensitivity C - reactive protein( hsCRP) in patients with acute coronary syndrome ACS). Methods; Serum adiponectin were measured by enzyme linked immunosorbent assay in patients with acute myocardial infarction(n =41 ) .unstable angina pectoris(n = 27) , stable angina pectoris(n =22) and control group (n =20) . Their serum hsCRP were measured by scatter velocity turbidimethy. All subjects were confirmed by coronary angiography. Results ; Serum adiponectin concentrations in ACS group were significantly lower than those in SAP group) P

Objective To get a view of the participation, motivation and barrier of voluntary activities in medical graduates, and to provide valuable advices for improving such behaviors. Methods The convenience sample method was used in medical graduates in 2014 and the total sample was 348. The data of voluntary service were collected by self-designed questionnaire, including whether partici-pating in voluntary service, times, types, motivations and barriers. SPSS 20.0 were used in statistic analysis and data were processed by description analysis and χ2 test. Results The effective response rate is 80.7%(281). The proportion of the post graduated students participation in voluntary activities is 65.8%(185), however, only 13.4%(28) claimed such activities more than 3 times. The proportion of participation in male, student leaders and party members were higher than those female, non-student leaders and non-party members, the different is statistically significant (P<0.05). The proportion of medical related voluntary activities is 52.6%. The primary motivation of voluntary behaviors is social responsibility (30.1%), while the primary obstacle is lack of medium (39.50%)and limitation of personal time and energy (30.0%). Conclusions The participation and persistence of voluntary activity in graduated students are not high enough. The colleges need to strength the organization and management of voluntary activities and focus on social responsible education, inspire and guide the postgradu ate students to participate in voluntary activities persistently by using their specialties.

Objective To explore the main risk factors related to birth defects to provide the scientific basis for making the best prevention policy and implementing the effective interventions .Methods Totally 21 domestic research articles on the risk fac‐tors of birth defects were comprehensively analyzed by the meta analysis method ,including accumulated 6 112 patients and 15 741 control cases .The articles were screened preliminarily according to inclusion and exclusion standard ,and then the fixed and random effects model were selected according to the homogeneity test .The merged results were performed the chi‐square test .Results The main merged results OR values of single‐factor‐analysis were as follows:the family history of birth defects 36 .22 ,early pregnant in‐fectious disease 5 .62 ,early pregnancy exposure to chemicals 4 .19 ,paternal smoking 3 .89 ,contact sedatives during pregnancy 3 .19 , pregnancy complication 2 .94 ,high protein food during pregnancy 0 .37 ;the main merged results OR values of multiple‐factor‐analy‐sis were as follows :early pregnancy infectious disease 7 .65 ,poor prenatal mental state 5 .44 ,early pregnancy fever 4 .70 ,early preg‐nancy exposure to toxic chemical 3 .90 ,history of abortion 3 .59 ,supplement of multivitamin during pregnancy 0 .45 .Conclusion The main risk factors of birth defects in our country are family history of birth defects ,early pregnancy infectious disease ,early pregnancy exposure to chemicals ,paternal smoking and pregnancy complication;the protective factors are eating more high protein food during pregnancy ,supplement of multivitamin during pregnancy and taking folic acid during pregnancy .

Objective To explore the necessity and effect of the motivational interviewing/MIcurriculum in medical school students. Methods Helping smoking cessation in standard patients with coronary heart disease was assumed as the expected goal. MI was carried out for medical school students to master basal knowledge and skills of MI and help using MI methods in persuading smoking quitting. The teaching mode of MI curriculum was comprised of a lecture series and small group dis-cussion with videotaped practice in role plays. Motivational Interviewing Treatment Integrity (MITI) scoring tool was applied to assess the teaching effect of MI curriculum with students' performance videotapes. Questionnaire was used to evaluate the quality and efficacy of the MI curriculum, and SPSS 13.0 was used to t test measurement data. Results Analysis of the MITI scores showed students had general mastery of MI knowledge. Nevertheless, they did not reach recommended professional profi-ciency level. The scores of empathy and MI spirit in global ratings were (4.11 ±0.32) and (5.82 ± 0.17), respectively (recommended level, 6 score). In the videotape evaluation of behavior counts, MI adherentreached (70.96%±24.34%) (recommended level, 90%). Open question reached (31.42%±8.51%) (recommended level, 70%). Total refection counts were (7.84±3.22) counts per video (recom-mended level, 10). The standard questions recommended in MI for behavior change were better used by students. 93.75%and 87.50%students used ranking questions to evaluate the importance and con-fidence of smoking quitting. Nevertheless, the exploration questions about importance and confidence were less used to know the reason behind their ranking . The results of questionnaire showed that 83.33%students felt MI curriculum effective to help them improve confidence and skills in counseling with patients. 97.91%students thought the mastery of MI methods as an important skill for physicians to have. Conclusion The teaching practice of MI curriculum in medical school students is necessary and feasible with good teaching results. It is worth for professional counseling regarding unhealthy be-havior change in patients.

Objective To evaluate the incidence of surgical site infection (SSI)in patients with colorectal cancer and identify the risk factors of SSI.Methods A total of 392 patients who underwent colorectal cancer resection at the First Affiliated Hospital of Chongqing Medical University between September 2012 and September 2013 were included and analyzed in terms of the presence of SSI.SSI risk factors were identified by both univariate and multivariate analysis.Results The overall incidence of SSI was 23.0%.Univariate analysis showed that duration of operation above 75 th percentile,colostomy,surgical procedure, type of surgical incision,and American Society of Anesthesiologists (ASA)score were significantly associated with higher risk of SSI (P <0.05).Binary logistic regression suggested that duration of operation above 75 th percentile (P = 0.000,OR =3.017),colostomy (P =0.008,OR=2.642),Contaminated incision (P =0.016,OR=3.311)and laparoscopic surgery (P =0.016,OR=0.523)were significantly different in terms of presence or absence of SSI.Conclusions Duration of operation above 75th percentile,colostomy and contaminated incision are independent risk factors,while laparoscopic surgery is a protective factor for SSI in patients with colorectal cancer.

The cardiovascular disease, accompanied by psychological disorder frequently, often re-quiresphysical and mental (double heart) treatment. The clinical teaching of cardiovascular graduate stu-dents is very important for cultivating qualified cardiovascular doctors. According to present situation, we improved the diagnosis rate and the doctor-patient communication skills by the strengthening of learning thedouble heart theory, the analysis ofdouble heart typical cases, and the clinical practice of double heart medical model. Accordingly, we enhanced the consciousness of double heart, which is helpful to reducing the conflicts between doctors and patients, promoted the rational use of medical resources, and fi-nally promoted the application ofdouble heartmedical model in clinical practice.

Objective To analyze the risk factors of congenital heart disease(CHD) in China by using the meta‐analysis method to provide reference for etiology study and prevention of CHD .Methods The Chinese literature database such as CBM , VIP ,CNKI ,Wan Fang were retrieved from 2005 to 2015 for collecting the related literatures ,then the collected literatures were screened ,performed the information extraction ,quality evaluation and merged analysis by using the Stata12 .0 software .Results In this study ,37 articles were included ,including 20 provinces (municipalities and autonomous regions) ,8 588 cases in the case group and 12 479 cases in the control group;a total of 21 risk factors(5 pre‐pregnant factors and 16 gestational factors) were included . Conclusion All 21 risk factors include 4 pre‐pregnancy factors ,15 gestational factors and 2 factors which not be verified .The top 3 risk factors and their OR values with 95% CI were gestational diabetes 5 .80(2 .72-12 .37) ,contacting the occupational risk factors 5 .14(3 .30-8 .00) ,advanced age before pregnancy 4 .96(1 .45-16 .97) .Not considering to be as the risk factors and their OR value with 95% CI are high body mass index before pregnancy 1 .32(0 .99 -1 .75) ,living near street during pregnancy 1 .36(0 .50-3 .71 ) .