Based on reviewing briefly the development of the general education both in China and United States,selecting respectively a university as the example,the article has analyzed comparatively curriculum programs of general education between the two schools.Aimed at existing problem,from curriculum content carding,structure optimizing,teaching operating and evaluation of the effect,the article has proposed new thinking of reform on the general education of higher institutions.

By analysing the new requirements of higher medical education curriculum in the new era,making curriculum changes of Nanjing Medical University as an analysed object,the arti-cle analyses the existing problems and shortcomings of China's current medical education course system,puts forward optimizing the course system further by running clear thinking,construction of composite course system,innovating teaching methods,strengthening the building of teaching mate-rials,the establishment of curriculum assessment mechanisms.

As an important force in the process of China’s public medical education, private higher medical education is faced with severe challenges at the same time the development is made. On the basis of analyzing the development situation of private higher medical colleges and the deep space of development, the article promotes suggestions of the healthy development of private medical colleges, by macro-coordination from the government, private schools running orderly, improving the quality of education, and social support.

Objective To explore the relationship between CRP and glucose metabolism in advanced solid tumor patients. Methods 32 advanced stage malignant tumor patients with mild pain took celecoxib 200mg/qd orally, the plasma level of CRP, FBS, FINS, IR were measured before taking drug and 5 days later. Results CRP is well related with FINS, IR, P level, CRP[(8.17?1.76) mg/L vs (4.37?0.65) mg/L], P(876?123)pmol/L vs (621?145) pmol/L], FINS[(14.23?7.21) ?U/L vs (9.83?3.37) ?U/L] and IR [(3.2?1.01) vs (1.9?0.78)] all were improved significantly after taking celecoxib. Conclusion CRP has some relationship with abnormal glucose metabolism in advanced stage malignant tumor patients, taking celecoxib may improve this abnormal glucose metabolism.

Different varieties of Terminalia chebula Retz. were identified by DNA finger prints, andat the same time, some problems encountered during the application of RAPD for the identification ofTCM were studied. The polymorphic features of DNA finger prints of different species were compared.Results of the study showed that they were differently related in heredity which can provide a basis for thedifferentiation of one species from the other. Means for the solution of problems arised during RAPD ap-plication were suggested. It was concluded that RAPD is an effective method to identify T. chebula from itsconfusable varieties.

With the increasing demand for rehabilitation medical care, medical education has taken on the important mission of cultivating high-quality rehabilitation talents for "Healthy China", and it is necessary to make attempts to explore the reform of rehabilitation majors in line with social needs and develop a professional layout that fits better with social needs. After more than 20 years of development, a certain scale has been formed for the establishment of rehabilitation majors, but the analysis of related data has revealed the problems such as mismatch of professional disciplines, mixed attributes of professional institutions, and unstable quality of talent training. Based on the setting of rehabilitation majors in the catalogues of undergraduate majors in colleges and universities adjusted and promulgated in 1998, 2012, and 2020 and the addition of majors in different types of colleges and universities in each catalogue, this article summarizes the rules, trends, and characteristics of the development of rehabilitation majors in higher education institutions in China and discusses the current status and existing problems of such majors, so as to provide a theoretical reference for the optimization and adjustment of rehabilitation majors in China.

Objective: To analyze the status of occupational medical examination (OME) institutions in Guangdong Province and the critical control points affecting their future development. Methods: A total of 211 OME institutions registered in Guangdong Province were selected as the research subjects. Their current statue was investigated, and the risk assessment of their future development was carried out based on hazard analysis and critical control point theory. Results: The OME institutions were mainly concentrated in the Pearl River Delta, accounting for 72.0%. The public and private medical and health institutions accounted for 70.6% and 29.4% respectively. The filing rates of different OME categories from high to low in the order were physical factors, chemical factors, dust, other, radiation factors, biological factors (P<0.01), and the filing rates were 89.6%, 88.6%, 84.8%, 63.0%, 7.1% and 1.0%, respectively. The rates of excellence in the field assessment from high to low in the order were hearing atlas analysis personnel, lung function examination operators, chest film reading personnel, chief examination physician, technical director, quality director (P<0.01), and the rates of excellence were 49.4%, 26.2%, 20.6%, 10.8%, 8.2% and 4.6%, respectively. A total of 37 institutions did not submit OME information, of which 23 institutions did not carry out OME work after filing. The required diagnosis rate and confirmed diagnosis rate of suspected occupational diseases in 2020 were 34.3% and 55.3%, respectively. In 2021, the detection rate of suspected occupational diseases was only 1.1‰. Among the institutions with biological monitoring records, 64.1% did not participate in external quality assessment program in laboratory, and the unqualified rate of 38 participating institutions was 55.3%. The risk assessment results show that the future development of OME institutions needs to focus on private institutions, institutions that have not reported OME information, institutions that have missed diagnosis and missed reporting of suspected occupational diseases, institutions that have not participated in external quality assessment program in laboratory and core personnel such as quality managers, technical leaders, and main inspection physicians. Conclusion: OME institutions in Guangdong Province show the characteristics of centralized filing category, centralized filing region and centralized filing institution nature. Combined with the potential risks of OME institutional capacity building, it is necessary to implement classified management, strengthen information construction, supervision and management, implement post responsibilities, and promote the high-quality development of OME institutions.

Objective To analyze the epidemic status of newly diagnosed occupational diseases in Guangdong Province during the “13th Five-Year Plan” period, and scientifically evaluate the critical risk factors for occupational disease prevention and control. Methods The data of newly diagnosed occupational diseases reported by internet in Guangdong Province from 2016 to 2020 was collected from Report Card of Occupational Diseases using Occupational Diseases and Health Hazard Factors Monitoring Information System under China Disease Prevention and Control Information System. Data was used to determine the epidemic status and identify key risk factors. Results A total of 4 846 cases of occupational diseases were reported in Guangdong Province during the “13th Five-Year Plan”period, with an increase rate of 39.13% compared with the “12th Five-Year Plan” period (3 483 cases). The annual distribution of newly diagnosed occupational disease cases showed a trend of increasing and then declining. The top five percentage on types of occupational diseases were occupational noise-induced deafness, occupational silicosis, occupational chronic benzene poisoning, other occupational pneumoconiosis and occupational hand-arm vibration disease, accounting for 45.23%, 16.28%, 11.52%, 7.92% and 4.60%, respectively. Cases from the Pearl River Delta region accounted for 92.76%, while five non-Delta cities had “zero reported cases”. Regarding industry sector, cases were primarily concentrated in manufacturing, construction, and mining, accounting for 84.21%, 5.49% and 3.59%, respectively. Regarding industry categories, cases were concentrated in metal products, non-metallic mineral products, manufacturing of cultur, education, art, sports and entertainment goods, manufacturing of computer, communication and other electric devices, and manufacturing of specialized equipment, accounting for 11.70%, 10.17%, 8.60%, 7.82%, and 4.81%, respectively. A total of 196 enterprises (accounting for 7.39%) reported an average of three or more new cases per year, while 19 enterprises (accounting for 0.72%) reported an average of ten or more cases per year. Conclusion The epidemic status of occupational diseases in Guangdong Province showed a “triple concentration” characteristic in disease types, regions, and industries during the “13th Five-Year Plan” period. Particular attention should be paid to epidemic status of occupational noise-induced deafness, occupational silicosis, occupational chronic benzene poisoning, other occupational pneumoconiosis, and occupational hand-arm vibration disease, and also pay special attention to the prevention and control of occupational diseases in the Pearl River Delta region, cities with “zero reported cases”, manufacturing industry and occupational disease-prone enterprises.

Objective To analyse and compare the effects and safety of early use (in emergency room, intravenous loading followed by infusion) with bolus injection during primary PCI of tirofiban, on post-procedural TIMI flow and 30d clinical outcomes. Methods Seven hundred and seven patients with acute STEMI treated by primary PCI in Ruijin hospital were retrospectively and enrolled screened. Among them, 86 patients with single bolus intra-coronary injection of tirofiban (25 μg/kg) during the procedure were served as observation group. Baseline, angiographic, PCI features and rate of major adverse cardiac events (MACE) at 30 d follow-up were compared with those received early intravenous infusion of tirofiban (10ug/kg bolus followed by 0.15μg/(kg·min) intravenous infusion)(control group, n=239). Results Compared with control group, patients in observation group were older[(63.8±11.4) vs. (57.9±8.8), P=0.01], had higher prevalence of hypertension (58.6%vs. 51.0%, P=0.005), multivessel disease (57.0%vs. 34.3%, P<0.001), and female in gender (40.7%vs. 25.1%, P=0.006). Post-procedural TIMI flow in culprit vessel and TMP grade were comparable between the two groups (P=0.66 and P=0.48, respectively). Reduction in TIMI minimal bleeding events were found in the observation group (2.3%vs. 9.6%, P=0.03). MACE free survival rate at 30d clinical follow-up was similar between the two groups (P=0.48). Conclusions Single bolus intra-coronary injection of tirofiban exerts similar effects in post-procedural TIMI flow, TMP grade in culprit vessel and 30d clinical outcomes compared with early use in emergency room with intra-venous loading and infusion, nevertheless, intra-coronary injection resulted in significantly reduced TIMI minimal bleeding events. Prospective, randomized clinical study is mandatory to prove our current results.

Objective To analyze the problems found in the on-site quality assessment of occupational medical examination (OME) institutions in Guangdong Province. Methods A total of 150 OME institutions were selected as the research subjects from Guangdong Province in 2023 using a random number table method. The on-site quality assessment was conducted by listening to reports, meeting discussion, on-site inspection, data review and human-machine assessment. The relevant assessment results were analyzed. Results Occupational disease prevention and treatment institutes (institutes, centers) and disease control and prevention centers (hereinafter referred to as "occupational prevention institutions"), public hospitals, and private institutions accounted for 8.7%, 51.3%, and 40.0% respectively. The top three categories of registered inspections were physical factors, chemical factors and dust, accounted for 98.0%, 96.7% and 96.0%, respectively, among the 150 OME institutions. A total of 1 063 rectification items were identified, and the average number of rectification items identified per occupational prevention institutions, public hospitals and private institutions was four, six and nine, respectively. The rectification rates of the four modules of quality assessment from high to low were OME work quality control, quality management system, organizational structure, and OME information reporting, accounted for 53.2%, 23.3%, 13.7% and 9.7%, respectively. The coincidence rate from high to low of occupational reporting of noise-exposure, dust-exposure, and other hazard-exposure was 92.5%, 91.1%, and 93.4%, respectively. The on-site failure rate of quality control director, technical director, chief physician, pneumoconiosis film reader, audiometry reader and pulmonary function examination operator accounted for 15.3%, 12.7%, 8.0%, 6.7%, 6.0% and 2.7%, respectively. Institutions capable of conducting registered and partially registered OME accounted for 90.7% and 6.0%, respectively. The five institutions that were unable to conduct registered OME were private institutions. A total of five private institutions were found to be suspected of illegal and irregular activities. Conclusion The problems of OME in the on-site quality assessment of OME institutions in Guangdong Province were mainly quality control. Private institutions had more prominent problems in various aspects. It is necessary to strengthen the training of key personnel such as technical directors, quality control directors, and chief physicians.