Venous thromboembolism is a serious complication of the patients undergoing orthopaedic surgery.Effective diagno-sis and assessment are important methods to predict venous thromboembolismand decrease the incidence of venous thromboenbolism . This paper summaries the advantages and disadvantages of subjective and objective assessment tools to help doctors and nurses find the patients with high risk in the early stage,take individual prevention,and decrease the incidence of venous thromboembolism.

Objective Early identification of deep vein thrombosis(DVT) risk in patients with joint arthroplasty helps to reduce the incidence of DVT.The study aimed to investigate the effectiveness of Autar risk assessment model in assessing DVT risk in patients with joint arthroplasty.Methods 72 patients with DVT from 10 hospitals from November 2014 to February 2016 were selected as the case group, and 144 non-DVP patients who hospitalized during the same period served as the control group.The medical history, laboratory tests and other related clinical data of the patients were collected, and Autar risk assessment scale was used to evaluate the patients.Multiple logistic regression was applied to analyze the relationship between the risk scale of DVT and the risk of DVT formation.Results 216 patients were included in the research.The Autar score of DVT patients (17.09±2.83) in case group was higher than that of control group (14.25±2.46) and the difference is of statistical significance(P<0.05).The area under the ROC curve of Autar scale in case group was 0.789 (95％CI: 0.719, 0.858,P<0.05).When the ROC curve cutoff point was 15, the sensitivity and the specificity of Autar scale were 88.57％ and 57.90％ respectively.In Autar scale, the main risk factors of DVT incidence were age≥70 years old, BMI≥30, strict bed rest, varicose veins, lower limb injuries and orthopedic surgery.The result of logistic regression analysis showed the difference of Autar risk rating between these two groups was of statistical significance(P<0.05).In comparison with low risk group, the DVT risk of patients with joint arthroplasty at medium risk was of no significant difference (OR=1.178, 95％ CI: 0.733-1.490, P=0.053) while that of patients with joint arthroplasty at high risk was of significant difference (OR=5.536, 95％ CI:3.577-7.132, P<0.001).Conclusion Autar DVT risk assessment scale assessed patients with joint arthroplasty at high risk are high risk group of DVT.The risk of DVT increases with the risk rating in patients with joint arthroplasty.Therefore, Autar risk assessment scale can be applied in the assessment of DVT risk in patients with joint arthroplasty.

Objective To examine the status of and factors influencing medical students' mental health.Methods The China undergraduates' mental health scale and an information questionnaire developed by the authors were administered on 1 205 students selected from Grade 1-3 in chnical medicine,anesthesia,and medical diagnostic programs using cluster sampling.Results The level of medical students' somatization,a~nxiety,depression,social withdrawal,irritabihty,and obsession was higher as compared to the norms for general undergraduates in China.Female medical students showed higher scores than males on 4 aspects:somatization,anxiety,depression,and obsession.Additionally,those belonging to minority nationalities showed higher scores on social withdrawal,irritability,and impulse as compared to those with the Han nationality.Further,students with low professional identity had higher scores on somatization,anxiety,depression,inferiority,irritability,and social withdrawal as compared to those with high professional identity.Conclusion Medical students' mental health is not optimal;therefore,it needs to be addressed by educational departments and educational works.Thus,mental health education,professional counseling,and appropriate interventions need to be conducted for medical students.

Objective To explore advantages of laparoscopic sphincter preserving surgery for ultra low rectal cancer . Methods From April 2006 to January 2015, we performed laparoscopic sphincter preserving surgery in 108 cases of ultra-low rectal cancer.After laparoscopic mesorectal resection and lymph node dissection were completed , transection of the rectum was performed with the Endo-GIA at 2 cm from the lower margin of the tumor .The right lower abdomen main operation port was expanded to remove the lesion and introduce the stapler base .The proximal colon was returned and the pneumoperitoneum was re-established .A colorectal end-to-end anastomosis was conducted through the anus by using a carliber 29 circular stapler . Results Laparoscopic operation was successfully accomplished in all the 108 cases.No conversion to open surgery was required .No operative mortality was encountered . The operation time was 68 -145 min ( mean, 104 min ) , the intraoperative blood loss was 10 -100 ml ( mean, 40 ml ) , the postoperative flatus time was 1-3.5 d (mean, 2.3 d), and the number of removed lymph nodes was 8-37 (mean, 12.5).There were 98 patients followed up for 6-62 months (mean, 24.6 months).No tumor metastasis or recurrence was found . Conclusion Laparoscopic total mesorectal excision of ultra low sphincter preserving operation is feasible .

Objective To find out the changes of voice in different noisy background by computer acoustic analysis.Methods 25 young people with normal hearing and normal vocal cords were selected.Sustained /a/ and /i/ were recorded in three different background:quiet, white band noise and speech noise. The software of Multi Speech and Doctor Speech were used. Testing parameters included: Fo, mean amplitudes, standard deviations of amplitudes,F 1, F 2.Results Fundamental frequencies of noisy groups were significantly higher in male-/a/, female-/a/ and female-/i/.F 1 of noisy groups were significantly higher in male-/a/, male-/i/ and female-/i/.Conclusion Fo and F 1 of normal people can be changed by noise of backgroud.

Objective To find the frequencies of FcγRIIIA polymorphisms in Chinese people and the potential role of these polymorphisms(SNPs) in systemic lupus erythermatosus(SLE) and lupus nephritis(LN).Methods The investigation covers 324 unrelated Chinese SLE patients and 319 controls.FcγRIIIA F158V polymorphism was genotyped by specific primer-polymerase chain reaction(PCR).Results The frequency of F allele of FcγRIIIA polymorphism is 60.8% in Chinese people.FcγRIIIA polymorphism revealed a significant difference of both genotype and allele distribution in SLE patients and controls.LN patients have a significant increase in carrier frequency of the FF genotype, while the VV genotype reveals a significant decreased risk of early onset of LN.ConclusionsFcγRIIIA polymorphisms is potentially related with SLE in Chinese people.The homozygous FF genotype of FcγRIIIA might be the risk factor for LN, while the homozygous VV genotype might be the protective factor for late onset lupus nephritis.

This study is based on the requirements of the construction of applied undergraduate colleges and development of excellent doctor education training pilot project of the ministry of education. The situation of higher medical education and the requirement of health career development are analyzed. The medical talents training mode of three oriented which is taking the post competency of medical students as the frame is constructed. This paper expounds the background proposed by training mode from the internal drive, external drive and project boosting. With the national education policy as the basis, the theoretical basis of the international advanced education teaching idea, theory and standard is explained. The connotation of the training mode is revealed by the humanistic quality education, professional quality training and physical and psychological quality cultivating. The evaluation strategy of clinical medical per-sonnel training standards, index system, the implementation approach and evaluation methods which have certain feasibility and timeliness is established.

ObjectiveTo evaluate the reliability and validity of Chinese version of Postoperative Pain Assessment Nursing Practice Questionnaire (PPA-NPQ).MethodsA forward-backward translation procedure was followed to develop the Chinese version of PPA-NPQ.A total of 258 surgical nurses were investigated by the revised Chinese version dimensions of PPA-NPQ,then the results were tested on reliability and validity by SPSS17.0.ResultsThe cronbach's α of the Chinese version of PPA-NPQ was 0.889.The split- half coefficient and testretest reliability of PPA-NPQ were 0.729,0.875 respectively ; the Cronbach's a,split- half coefficient and test-retest reliability of each sub-scale were ranged from 0.820-0.857,0.797-0.862,0.846-0.902 respectively.The correlation between each sub-scale and total scale were ranged from 0.704-0.818 (P ＜ 0.01 ).ConclusionThe revised Chinese PPA-NPQ is reliable and valid,and can be used to test the level of postoperative pain assessment practice by surgical nurse.

Objective To investigate the effect of curcumine on the expression of matrix metalloproteinase-9 (MMP-9) in human umbilical vein endothelial cell (HUVEC). Methods HUVEC were cultured and identified in vitro .After cultured with curcumine at different concentration for 24 hours, the expression of MMP-9 in HUVEC was detected by cytoimmunochemical staining method and ELISA . Results All concentrations of curcumine can restrain the expression of HUVEC after co- culturing with the cells for 24 hours. The inhibitory effect got stronger with the increase of the concentration of curcumine. Conclusion The curcumine can depress the expression of matrix metalloproteinase-9 in HUVEC obviously.

Objective To evaluate the therapeutic effectiveness of postoperative hemorrhage of cholejejunal or pancreato - jejunal anastomotic stoma after pancreato - duodenectomy by the way of fibercholedochoscopy. Meth- ods The drainge tube was extracted out of choledochojejunal anastomotic stoma. And fibercholedochoscopy was in- serted in fistula to affirm hemorrhagic position of choledochojejunal or pancreato - jejunal anastomotic stoma. And then local coagulation and microwave solidifying was proceeded with. Local spray of Galla - chineses compound solution was performed for hemostasis. Results We succeeded in hemorrhage of four choledochojejunal and six pancreato - jejunal anastomotic stoma One failed for frequent hemorrhage in pancreato - jejunal anastomotic stoma. Conclu- sion Fibercholedochoscopy is the first selective and effective method in the diagnosis and treatment of postoperative hemorrhoge of pancreato - jejunal or choledochojejunal anastomotic stoma after whipple operation.