Currently seeking for employment of students of basic medical sciences has become a serious challenge.In this report,some important factors that affect the employment are analyzed,such as the students' qualities,the reputation of school,the opinion to occupation,concerned information and so on.Some responding strategies are proposed such as guaranteeing the students' qualities,strengthening reformation and employment tutoring principles,all those ways help the students to face the situation reasonably and build the right employment opinion to better their choice of occupation.

Objective To investigate the clinical effect of restrictive episiotomy in low risk primipara.Methods 100 full-term pregnant women with low risk primipara were divided into observation group and control group according to random number table,50 cases in each group.The patients in the observation group were treated with restrictive episiotomy.The perineum,the second stage of labor,hospitalization time and cost,postpartum sexual life were compared between the two groups.Results In the observation group,the proportion of perineal incision (22.0％ vs.82.0％) was less than that in the control group,the proportion of perineal pain (4.0％ vs.26.0％) was lower than that in the control group,the incidence rate of first degree laceration(38.0％ vs.6.0％) was higher than that in the control group,the differences were statistically significant (x2 =36.058,9.490,14.918,allP ＜ 0.05).The hospitalization time of the observation group was significantly shorter than that of the control group [(3.15 ±0.78)d vs.(3.84 ± 0.98)d],the cost of hospitalization of the observation group was significantly lower than that ofthe control group[(1 814 ± 356) yuan vs.(1 999 ± 387) yuan],the differences were statistically significant (x2 =2.397,3.895,2.488,all P ＜ 0.05).The recovery time of sexual life in the observation group was significantly shorter than that in the control group[(45.6 ± 16.5)d vs.(72.5 ± 23.6)d],and the incidence rate of coital pain was lower than that of the control group (6.0％ vs.24.0％),the differences were statistically significant (x2 =6.606,6.353,all P ＜ 0.05).Conclusion Restrictive episiotomy in low risk primipara has good effect,it is conducive to postpartum recovery.

Objective To explore the clinical value of flow cytometry( FCM) and DNA automated cell image analyzer ( AICM) in determine the character of ascites and pleural effusion.Methods This was a cross-sectional study.203 ascites and pleural effusionsamples were random selected from PLA hospital inpatients between August 2013 to June 2014 .The DNA content of sediment cells were detectedthrough the FCM and AICM respectively benign and malignant disease were differentiated according the counts and proportion of aneuploid cells.The sensitivity, specificitywere calculated byROC curves.Results The sensitivity, specificity and accuracy of flow cytometry cell in detectingtumor cells were 78.6%,80.0% and 79.2%%, while the sensitivity, specificity and accuracy of image analyzer were 83.5%,78.6% and 81. 3%respectively.When FCM and AICMwere combined ,the sensitivity, specificity and accuracyincreased to 92.2%, 86.3% and 89.6%.Conclusions Compared toconventional cytology test, the sensitivity and specificity were significantly high when the two methods were combined .Therefore, the combination method can be used to assist in clinical identification of the nature of ascites and pleural effusion and to help the diagnosis of disease.

ObjectiveTo evaluate the clinical efficiency and safety of cefmetazon in the prevention Department of General Surgery,First People's Hospital,Shanghai Jiaotong University,Shanghai 200080,Chinaand or treatment of infections in general surgery. MethodsA multicenter,prospective and open-labeled trial was conducted. In the prevention group,1700 patients were enrolled in clean-infection surgery,cefmetazon was given 1 g iv half an hour before the surgery started,and 1 g iv twice daily after the surgery for 3 days.Clinical response was evaluated in terms of both cure ( disappearance of pre treatment symptoms)and pathogen. In the treatment group,897 patients were diagnosed as peritonitis, cholecystitis and cholangitis,the patients were given cefmetazon 2 g iv twice a day for 7 - 14 days,clinical response and microbiological efficacy were assessed.ResultsIn prophylactic group,1449 patients were finally included.The clinical efficacy was 100％ (1449/1449).In the treatment group,a total of 897 patients were enrolled,and 110 patients failed for assessment of clinical efficacy,787 patients were included in the PPS population,the clinical efficacy was 90.7％ (714/787); Bacterial eradication rate was 92％ (46/50).Adverse reaction rates in prevention group and treatment group were 1.3％ (22/1700) and 1.2％ (11/897),including mild nausea and vomitting.ConclusionsCefmetazon is effective and safe in prevention and treatment of Postoperative infections in general surgery.

Objective To investigate the application effect of integrated classroom teaching model oriented by cases in teaching of oral nursing care, and seek a new teaching model, to improve the clinical comprehensive ability of nursing students. Methods Totally 287 undergraduate nursing students of Wenzhou Medical University were selected as the research object, and were divided into the control group and the observation group randomly. The control group adopted the traditional teaching method, while the observation group adopted the integrated classroom teaching model oriented by cases. The autonomous learning ability, critical thinking ability and satisfaction of nursing students between two groups were compared by questionnaire. Results There were no differences between two groups in nursing students′ autonomous learning ability and critical thinking ability before teaching (P>0.05), but after teaching, the scores of autonomous learning ability and critical thinking ability of students in the observation group were significantly higher than those of students in the control group (P<0.05). The students′ satisfaction towards teaching in the observation group (91.97±11.37) was significantly higher than that of the control group (84.43±10.12) (P=0.006). The examination results of oral care clinical ability in the observation group (83.47±8.19) were significantly higher than that in the control group (71.86±6.23) (P=0.001). Conclusions The integrated classroom teaching model oriented by cases can increase nursing students′ autonomous learning ability, critical thinking ability and clinical practice ability, and improve the learning enthusiasm and comprehensive ability of nursing students.

Objective To investigate the effect of dexmedetomidine combined with esketamine on the quality of postoperative recovery in patients undergoing laparoscopic gastric volume reduction surgery.Methods A total of 136 patients undergoing laparoscopic gastric volume reduction surgery,including 41 males and 95 females,aged 18-64 years,BMI 30-45 kg/m2,ASA physical status Ⅱ or Ⅲ,were random-ly divided into four groups:dexmedetomidine combined with esketamine group(group DE),esketamine group(group E),dexmedetomidine group(group D),and control group(group C),34 patients in each group.In groups DE and D,a loading dose of dexmedetomidine 0.5 μg/kg was infused intravenously over 10 minutes before induction,followed by a continuous infusion of 0.4 μg·kg-1·h-1 until 40 minutes before the end of surgery.In groups DE and E,a loading dose of esketamine 0.5 mg/kg was injected intra-venously at induction,followed by a continuous infusion of 0.1 mg·kg-1·h-1 until 40 minutes before the end of surgery.Equal volumes of normal saline were given to group C at the same time points.The 40-item quality of recovery scores(QoR-40)24 hours before surgery and 24 hours after surgery were recorded.The dosage of intraoperative propofol and remifentanil,the dosage of dezocine within 24 hours after surgery,ex-tubation time after surgery,the time of first getting out of bed and the time of first anal exhaust after surgery were recorded.The resting visual analogue scale(VAS)pain scores were recorded at the moment of extuba-tion,2,6,12,and 24 hours after surgery.The occurrence of postoperative adverse reactions such as nausea and vomiting,agitation,hypoxemia,and pneumonia were recorded.Results Compared with group C,the QoR-40 scores in groups DE,E,and D were significantly increased 24 hours after surgery(P<0.05),the dosage of intraoperative propofol and remifentanil,the dosage of dezocine within 24 hours after surgery were significantly reduced,the time of first getting out of bed and the time of first anal exhaust after surgery were significantly shortened in group DE(P<0.05),the resting VAS pain scores at the moment of extubation,2,6,and 12 hours after surgery were significantly decreased in groups DE and E(P<0.05),the resting VAS pain scores at the moment of extubation and 2 hours after surgery were significantly decreased in group D(P<0.05).Compared with group D,the QoR-40 scores were significantly increased 24 hours after sur-gery,the dosage of intraoperative propofol was significantly reduced,and the resting VAS pain scores 2,6,and 12 hours after surgery were significantly decreased in group DE(P<0.05).Compared with group E,the QoR-40 scores were significantly increased 24 hours after surgery,the dosage of intraoperative propofol was significantly reduced,and the resting VAS pain scores 2,6 hours after surgery were significantly de-creased in group DE(P<0.05).There were no statistically differences in resting VAS pain scores 24 hours after surgery,and the occurrence of postoperative adverse reactions among the four groups.Conclusion Dexmedetomidine combined with esketamine relieves postoperative pain,enhances the quality of postoper-ative recovery,and promotes rapid rehabilitation in patients undergoing laparoscopic gastric volume reduction surgery.

Objective:To investigate the application of radar chart in perioperative nursing risk assessment of elderly patients with spinal fractures.Methods:Elderly patients with spinal fractures who were admitted and treated in a hospital from January 2018 to August 2019 were selected and they were divided into the control group ( n=41) and the observation group ( n=46) . In the control group, nursing routine was used for single risk assessment. Patients in the observation group filled in the self-made risk comprehensive assessment and measure sheet and drew the radar chart, which was used as the front page of the assessment in combination with each single assessment sheet. The pain scores, risk prevention and health education effects and satisfaction degree of nursing risk prevention service of patients were compared between two groups. Incidence of pressure injury, pulmonary infection, acute hypotension and complications were recorded and compared between the two groups. Results:The pain score and the incidence of nursing related complications in the observation group were lower than those in the control group while the awareness rate of risk prevention and health education knowledge were higher than those in the control group. The differences were statistically significant ( P<0.05) . Conclusions:The application of radar chart in perioperative nursing risk assessment of elderly patients with spinal fractures can visualize multiple risks assessments, standardize pain management in elderly patients, reduce the occurrence of nursing related complications and improve the risk prevention and health education effects and nursing service satisfaction.

Objective:To investigate the efficacy and safety of intravenous thrombolysis and antiplatelet therapy in patients with stroke warning syndrome (SWS), as well as influencing factors of the outcome in patients with SWS.Method:Patients with SWS admitted to the 521 st Hospital of Ordnance Group from June 1, 2018 to December 31, 2023 were retrospectively included. Some patients were treated with ateplase intravenous thrombolysis, followed by oral antiplatelet therapy; some patients only received antiplatelet therapy. The main outcome measure was the modified Rankin Scale score at 90 days after onset, with a score of 0-2 defined as good outcome. Results:A total of 35 patients with SWS were included, including 26 males (74.3%) with an age of 58.29±11.06 years. Nineteen patients (54.3%) received intravenous thrombolysis, and 27 (77.1%) had good outcome at 90 days. There was no statistically significant difference in demographic, baseline data, and good outcome between the intravenous thrombolysis group and the antiplatelet therapy group. One patient had new stroke and one had transient ischemic attack in the intravenous thrombolysis group. There were statistically significant differences in ABCD2 score, systolic blood pressure, low-density lipoprotein cholesterol, fasting blood glucose, highest National Institutes of Health Stroke Scale (NIHSS) score at onset, and symptom duration between the good outcome group and the poor outcome group (all P<0.05). Conclusions:The efficacy of intravenous thrombolysis is similar to that of antiplatelet drugs alone in treating SWS. ABCD2 score, systolic blood pressure, low-density lipoprotein cholesterol, fasting blood glucose, highest NIHSS score at onset, and duration of symptoms may be influencing factors for the outcome of patients with SWS.

Objective To investigate the effects of nalbuphine combined with dexmedetomidine on postop-erative recovery quality and pain in patients who undergoing laparoscopic bariatric surgery.Methods A total of 169 patients who underwent laparoscopic bariatric surgery at our hospital were included and divided into control group(group C),nalbuphine group(group N),dexmedetomidine group(group D),and nalbuphine combined with dexme-detomidine group(group ND)using randomised numerical table method.Group C received intravenous injection of saline,group N and group ND received intravenous injection of nalbuphine before the end of the surgery,and group D and group ND received pumping of dexmedetomidine before anesthesia induction and during surgery.Compare the postoperative recovery quality score(QoR-40),hemodynamics at different time points,visual analogue scale score(VAS),sedation-agitation scale(SAS),first time out of bed activity and exhaust time,and incidence of nausea and vomiting among four groups.Results The postoperative QoR-40 scores of patients in group ND were better than those in group C and group N(P<0.05),and the QoR-40 scores in group D were better than those in group C(P<0.05).MAP and HR were more stable during the awakening period in group ND and group D(P<0.05).Compared with group C,patients in all three groups had lower VAS scores and SAS scores(P<0.05)and consumed less remedial analgesic medication(P<0.05).In terms of adverse reactions,the incidence of postoperative nausea,vomiting and coughing in the group ND was lower than that in the group C(P<0.05).Conclusion The combination of nalbuphine and dexmedetomidine could improve the quality of postoperative recovery and pain in patients under-going laparoscopic bariatric surgery,reduce hemodynamic fluctuations during the patients′ recovery period,reduce the incidence of nausea and vomiting,and improve the patients′ prognosis.

Objective To provide scientific evidence to identify and confirm severe acute respiratory syndrome (SARS) by laboratory detection.Methods Multiple clinical specimens were collected serially and systematically from the 4 suspected SARS patients, which occurred between Dec.2003 to Jan.2004 in Guangdong Province. The samples were tested by serologic and molecular methods.Results IgM or IgG antibodies against SARS-CoV were detectable after 6—8 days of the onset in four patients. The four-fold or greater rising in antibodies was clearly detected in three of the four patients, while the fourth patient’s seroconversion was from negative to positive. The results analysed by enzyme-linked immunosorbent assay( ELISA), immunoflourescence assay (IFA), and neutralization test were highly correlated. SARS-CoV RNA was just detected in 3 throat swab specimens from case 1 by real-time PCR. M, N and S genes were amplified by reverse transcriptase polymerase chain reaction (RT-PCR) from the positive samples. Sequencing results showed that they were SARS-CoV gene segments, and most closely matched SARS-CoV gene sequences were isolated from civet cats in Guangdong Province. Nevertheless, SARS-CoV was not isolated from any samples of the 4 patients.Conclusion Based on these results, the 4 reported cases were laboratorily confirmed as SARS cases.