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 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.

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.

Over the past decade,the treatment of lung cancer gradually develops to individulized molecule targeted therapy for certain driver gene from chemotherapy based on histological features.High-throughput sequencing (HTS) technology has many advantages,such as higher throughput,shorter running time,less cost and so on.Further mining analysis to the massive data generated by HTS can reveal the mechanism of the development of lung cancer at genome level and seek new driver gene as the target of targeted therapy,it also can identify the gene alternatives that confer resistance to certain targeted therapy.

Varieties of chemotherapeutic regimens based on fluorouracil have been recently developed.This review summarized widely used regimens of fluorouracil based chemotherapy in this decade.The common side effects,their mechanisms and clinical prevention and symptomatic treatment for these adverse reactions were also discussed.Therefore,this review will provide guidance for regimen selections,and improve the efficacy and safety of chemotherapy.In addition,the detailed information and data presented in this paper may be helpful in the development of new chemotherapy regimens.

China ; Humans ; Poisoning ; prevention & control ; Public Health ; Public Health Administration ; World Health Organization ; Wounds and Injuries ; prevention & control

Total 1049 new cases of blindness were detected by visual acuity survey in a population aged 68 or above in Changning District of Shanghai from 2003 to 2008. Among all eases 21.5% were age-related macular degeneration (AMD) blindness, with a trend of ascending from 17.7% in 2003 to 29. 9% in 2008. Most of the cases were classified as grade 3 (56. 9% ) or grade 4 (41.3%) of blindness. AMD has become one of the leading causes of blindness at present and should be the key eye disease for prevention of blindness.

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.