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.

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.

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.

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.

Objective: To research the application of dynamic-network probation in combination with traditional clinic probation in surgical practice teaching. Methods:Sixty four people in the undergraduate 2012(1, 2 session) set as the experimental group. 40 people in the undergraduate 2012(biochemical class) set as the control group. The traditional clinic probation was applied to the control group. The traditional clinic probation was applied to the control group. The dynamic-network probation in combination with traditional clinic probation was applied to experimental group. The teaching effects were evaluated and compared roundly. Results:The teaching effects of experimental group was significantly better than control group in all respects (x2=7.512, x2=6.797, x2=7.778, x2=4.768, x2=8.541;P<0.05). Satisfaction ratio of experimental group was significantly higher than that of control group in all respects of surgery teaching (x2=4.475, x2=5.900, x2=5.005, x2=5.904, x2=4.502; P<0.05). The examination performance of experimental group was significantly better than control group in theoretical knowledge and clinical skills testing (t=25.840, t=19.319;P<0.05). Conclusion:Dynamic-network probation in combination with traditional clinical probation has a great effect on surgical practice teaching and worth to be applied.

Objective:To establish a determination method for isoniazid and vitamin B6 tablets by HPLC. Methods: The proce-dure was performed on an Agilent Eclipse Plus C18 (250 mm × 4. 6 mm,5 μm) column at 30℃ and the detection wavelength was 291 nm. The mobile phase was composed of 0. 1% triethylamine [ in which 20 mg sodium 1-octanesulfonate was added and the pH value was adjusted to (3. 0 ± 0. 05) by phosphoric acid] and methanol (70∶30) at a flow rate of 1. 0 ml·min-1 , and the injection volume was 10 μl. Results:The linear range of isoniazid and vitamin B6 was within the range of 2. 535-50. 700 μg(r=1. 000 0)and 0. 137-2. 735 μg(r=1. 000 0), respectively. The mean recovery was 99. 57%(RSD=0. 89%) and 99. 59%(RSD=0. 43%) (n=9), re-spectively. Conclusion:The method is specific, accurate, sensitive and simple, which is applicable in the quality control of isoniazid and vitamin B6 tablets.

Objective To observe the clinical effects of coronoid process of ulna osteotomy and bilateral anatomic locking plate on humerus condyle comminuted fracture in the elderly.Methods 17 elderly patients with humerus condyle comminuted fracture were collected in department of orthopaedics in our hospital from July 2005 to December 2013 and graded into C2 (6 cases) and C3 (11 cases) according to the standard of the American society for the prevention of bone trauma.All patients were treated by coronoid process of ulna osteotomy and bilateral anatomic locking plate and accessed by Mayo elbow performance score (MEPS) at the last follow-up.Results Postoperative incision in all patients were healed,and X-ray showed fracture healing occurred at 10 to 24 weeks after coronoid process of ulna osteotomy (average of 14 weeks).No iatrogenic ulnar nerve injury and nonunion were found at the follow-up.The MEPS were excellent in 13 cases,well in 3 cases,ordinary in 1 case,and the excellent and good rate was 94.1％.Conclusions Coronoid process of ulna osteotomy and bilateral anatomic locking plate in the treatment of humerus condyle comminuted fracture in the elderly have good clinical effects with many advantages such as exposure clearly,early elbow joint function exercise and avoiding the aggravation of elbow joint osteoarthritis.