Freedom of learning is quite rational and reasonable in higher education due to the essential nature of higher education, the mental and physiological conditions of college students and the great significance of itself. Under the background of the current situation of higher education popularization, the problem of learning freedom is beginning to be more serious. The author thinks that breakthroughs should be achieved from both the ideological and institutional aspects and there always exists a contradiction between the free choice of the students and the regulations of the university or the society. So in this sense, the freedom of learning of college students is a kind of limited freedom.

The “fear of mistakes and failures” is the psychological state of being scared by the potential mistakes and failures,and therefore dare not to try and explore.This kind of fear is extremely harmful to the creative development of college students.The college students' “fear of mistakes and failures” can be caused by a lot of social issues.The paper is intended to analyze this kind of psychological phenomenon and then put forward the countermeasures to get rid of it.

Aging ; Arteriosclerosis ; pathology ; Blood Vessels ; pathology ; Cellular Senescence ; Humans ; Medicine, Chinese Traditional

Objective Serum abnormal prothrombin (PIVKA-Ⅱ) level was detected in pancreatic cancer patients and its clinical value in diagnosing and treating pancreatic cancer was explored.Methods A total of 112 pancreatic cancer patients,28 benign pancreatic diseases patients and 79 healthy controls were collected from Cancer Hospital of Hubei Province.Serum PIVKA-Ⅱ level was determined by chemiluminescent immunoassay (CLIA).CEA and CA19-9 level was detected by electrochemiluminescence immunoassay (ECLIA).Receiver operation characteristic (ROC) curve was drawn and the cut-off value was set.The sensitivity,specificity and accuracy were calculated.Results PIVKA-Ⅱ level in 112 pancreatic cancer patients was 39.0 (22.61,137.67)U/L[median (quartile range)],which was significantly higher than that in 30 patients with benign pancreatic disease [23.0 (17.32,29.67) U/L] and 79 healthy controls [21.21 (17.9,25.12) U/L].The differences were statistically significant (P＜0.01).However,there was no significant difference between benign pancreatic disease patients and healthy controls.ROC analysis showed that area under curve(AUC) for PIVKA-Ⅱ,CEA and CA19-9 was 0.793,0.707 and 0.849.The cut-off value for discriminating pancreatic cancer was established at 32.4,4.7 and 27.0 U/L for PIVKA-Ⅱ,CEA and CA19-9.The sensitivity was 61.6％,38.0％ and 66.1％,and the specificity was 86.3％,96.3％ and 89.9％,and the accuracy was 71.7％,62.3％ and 75.0％,respectively.The sensitivity,specificity and accuracy of PIVKA-Ⅱ combined with CEA and CA19-9 was 90.2％,76.0％ and 84.3％.The sensitivity was obviously higher,while the specificity was lower.Serum PIVKA-Ⅱ level was associated with advanced tumor stage.There were 20 patients who were followed up.PIVKA-Ⅱ level in 15 cases were decreased after surgery or interventional therapy (50.6 U/L vs 110.5 U/L,P ＜0.001),which was increased in 4 of the five cases who received palliative care to a various degree.Conclusions PIVKA-Ⅱ detection could benefit the diagnosis and prognosis monitoring of pancreatic cancer.

Circulating tumor cell ( CTC ) testing is characterized by its invasiveness, sampling convenience and facility for real-time monitoring.The booming detection technologies based on physical or immunological features, as well as the subsequent molecular analysis of CTCs including subtype classification, single cell sequencing and in vitro culture, has greatly enriched our comprehension of CTCs and cancer heterogeneity.Meanwhile, a great of researches have demonstrated the significance of CTCs testing in the clinical practice of cancers involving aspects of early diagnosis, treatment monitoring and prognosis.

ObjectiveTo constructe the quality-evaluation index system of clinical teaching of operating room. MethodsThe quality-evaluation indicator system was constructed using literature study and Delphi. Then the Precedence Chart and Analytic Hierarchy Process was adopted to ensure the index's weight. ResultsThe scale was formed by 5 items of level 1 and 21 items of level 2 of the index system. ConclusionThe index system has high reliability,which can be confirmed from experts' authority degree, their attentive involvement and the concentrating degree of the views. The Quality-Evaluation Index System ( QEIS ) is constructed which can be used to evaluate clinical teaching of operating room.

Objective To preliminary investigate and summarize the experiences of maintaining renal function and caring the cardio preoperative patients who have renal insufficiency (renal failure stage). Methods The treatment and cared for five cardio preoperative patients who had renal insufficiency were studied, those patients had been hospitalized in Peking University People′s Hospital for cardiac surgeries from June 2013 to January 2016. Results All the five patients had received preoperative renal maintenance, none of them got severe acute renal failure, and four of them had to get regular hem dialysis treatment after discharging. One of them died because of heart failure. Conclusions Renal insufficiency is a high risk for cardiac surgeries, however, it is not a contraindication for cardiac surgeries. Preoperative evaluation, preoperative caring and the application of CRRT can reduce the complications and improve the prognosis.

The need for special medical services are described and analyzed from the connotation of the characteristics of several types and models,in the hope of providing reference for the study of special need of medical services.

Alzheimers disease(AD) is one of dementia diseases in the world. There are two main pathological hallmarkers in AD patients, one is ?-amyloid peptide, the other is neurofibrillary tangles. This paper reviews researches on targets for drug discovery for Alzheimers disease that had been supported by the National Nature Science Foundation of China in recent ten years.

Psoriasis is a chronic, recurrent, and inflammatory skin disease induced by multiple factors. Its typical clinical manifestation is scaly erythema or plaques, which can cause various complications such as metabolic syndrome, cardiovascular disease, and inflammatory arthritis, seriously affecting the quality of life of patients. A deep understanding of the pathogenesis of psoriasis is helpful to discover new therapeutic targets and develop effective new therapeutic drugs, thus having important clinical significance. This manuscript reviews the new advances in the pathogenesis and drug research of psoriasis in recent years.