In order to meet the modern needs in medical talent education and bring up highly qualitfied medical talent,Medical College of Shantou University has aggressively and effectively conducted exploration and practice on high medical education,and developed a new teaching model for bringing up medical talent under with high quality the strategies of "Reform of Course System" and "Innovation of Teaching Model".The new teaching model is designed to bring up excellent clinicians with innovative spirit and proficient basic skills.It keeps up with the global ideal of high medical education,and it is an originated teaching model in China with Chinese characteristics and a unique style of Medical College of Shantou University,which will make a positive and significant impact on Chinese high medical education.

Objective To define the value of DCE and DWI in assessing malignant and benign lesion in periamapullary regions . Methods The data of dynamic contrast enhancement magnetic resonance imaging (DCE‐MRI) and diffusion‐weighted imaging(DWI) of 43 patients (32 malignant and 11 benign lesions) were analyzed retrospectively ,who have been diagnosed as biliary strictures in ampullary regions .One radiologist compared the signal intensity of DCE‐MRI and DWI of malignant and benign periamapullary le‐sions .Two other radiologists assessed data of DCE‐MRI and data of combined DCE‐MRI and DWI from those periamapullary lesions respectively .And then we compared the diagnostic sensitivity and specificity of each type of data by receiver operating characteristic (ROC) curve analysis .Results Malignant and benign periamapullary lesions showed no statistically significant difference on DCE‐MRI;Malignant periampullary lesion were more frequently appeared hyperintense than benign lesions on DWI ,and hypointense on ADC (P<0 .001) .Diagnostic accuracy improved from 84 .4% to 96 .9% and 87 .7% to 96 .6% for both reviewers after adding DWI on diagno‐sis of malignant periampuullary lesions .Conclusion The combination of DCE‐MRI and DWI can improve the diagnostic accuracy for differentiating malignant from benign strictures in the periampullary region .

It is necessary to pay attention to the quality of mass higher education.We should adapt the evaluation system of higher education to the needs of its managerial system reform and healthy development.The cognition of that can help us to build higher education evaluation system with Chinese characteristics,which not only fits the national condition but also reflects the general rules of this system.

Innovative education on business venturing at medical colleges and universities is a need of both the time of knowledge economy and the socialization of medicine.Innovative venturing education is a new model to cultiv ate high-caliber medical talents with wide social perspective,profound knowledge,creativity and entrepreneurship.Approaches to implementing such education in the transition of educational model may include enhancing cultural and sociological education,promulgating venturing practices in medical field,establishing favorable at mosphere for innovative venturing education,fostering English language skills in the whole process,emphasizing clinical practices,setting up effective competency assessment system and establishing a high-caliber faculty team.

Objective To discuss the mode of onset,clinical characteristics,treatment and prognosis of children with granulocyte sarcoma (GS),in order to provide guidance for early diagnosis and effective treatment of GS.Methods Six cases of children with GS diagnosed at the Department of Hematology,Children's Hospital Affiliated to Soochow University between June 2009 and June 2014 were analyzed,the data including the mode of onset,clinical manifestation,diagnosis,treatment and outcome.Results There were 2 cases with a painless mass onset (1 case was 2 years old,characterized by right waist mass,about 10 cm × 5 cm;the other case was 6 years old,characterized by axillary lump,about 2 cm × 3 cm),and both of them received surgical removal of the tumor,then the postoperative tumor was examined by pathologic and immunohistochemical method,and at last the primary granulocyte sarcoma was diagnosed.The third case was a 7 years old girl,she was onset characterized by scalp lump,about 2 cm × 3 cm,and was diagnosed by the pathologic and immunohistochemical method,and changes in hematological system appeared a month later and acute myeloid leukemia(AML) was confirmed by bone marrow examination.The onset ages of other 3 cases were in 10 months,1 year and 7 months,13 years and 3 months old respectively,characterized by scalp lump (about 2 cm × 3 cm),spinal canal tumor (about 1.0 cm × 1.5 cm),intracranial tumors (6.0 cm × 4.9 cm),with AML occurring at the same time,which was confirmed by surgical pathology,immunohistochemistry and bone marrow cell morphology,immune classification,chromosome,and fusion gene diagnosis.Four cases were hematopoietic malignancies by pathology,2 cases of then belonging to small round cell tumor.The immune pathology showed 5 cases of myeloperoxidase positive,CD68-positive,3 cases of CD43-positive,CD123-positive.All children CD3,CD20 levels in all children were negative.Four cases underwent surgery combined with chemotherapy,other 2 cases received surgery and then gave up treatment,1 case discontinued follow-up 3 months later,and the other case died of intracranial hemorrhage after 3 months,which induced by thrombocytopenia.The treated 4 cases were followed up 3 to 58 months,and all had disease-free survival.Conclusions Children with GS have low incidence and non-specific diagnostic criteria,its diagnosis depends on immune pathology,and the treatment is mainly in accordance with AML program for high-dose chemotherapy.The systematic chemotherapy helps to prolong overall survival;at the same time,the hematopoietic stem cell transplantation with bone marrow may help to improve the prognosis.

Griscelli syndrome type Ⅱ (GS2) is a rare disease, and patients with GS2 are susceptible to secondary haemophagocytic lymphohistiocytosis (HLH). GS2 accompanied by secondary HLH has a dangerous clinical course, high mortality, and a high miss-diagnosis rate.In this paper, the pathogenesis and prognosis of a case confirmed as GS2 with secondary HLH by gene screening were reported, so as to improve diagnosis and treatment of this disease.The patient had clinical manifestations of silver hair and eye lashes, recurrent pulmonary infection, contiuning high fever, significantly increased ferroprotein levels and decreased fibrinogen levels.Besides, RAB27A gene homozygous mutations were found in the patient, originating from her parents (p.P126Qf3*3 frameshift mutation). This finding confirmed the diagnosis of GS2.The patient underwent transplantation of marrow stem cells from her father since the father-daughter HLA was 7/10.The follow-up results showed that the patient was still alive and healthy 2 years after transplantation.

Objective To optimize the processing condition of the extraction of Baphicacanthis cusiae ( Nees) Bremek. roots polysaccharides ( BCP) by ultrasound technology, and to provide the basis for the further development and study of BCP. Methods The extraction temperature, extraction time, liquid-solid ratio were used as the influence factors, and the yield of polysaccharides from Baphicacanthis cusiae roots was used as the evaluation index. On the basis of single-factor test, 3-factor and 3-level Box-Behnken test was designed for quadratic polynomial regression equation of the yield of polysaccharides. And then the response surface methodology was used for the optimization of process condition. Results The optimum extraction condition was as follows: extraction temperature was 60℃, extraction time was 35 min, and liquid-solid ratio was 24.5∶1 (V∶m, mL·g-1). Under the optimal condition, the yield of polysaccharides was 83.7 mg·g-1. Conclusion The method is simple, rapid and highly efficient, which will provide experimental basis for the development and application of Baphicacanthis cusiae roots polysaccharides.

Objective:To meet the demand of medical system for talents, the training of medical students' competency has become a new direction of medical education. This study aims to evaluate the effectiveness of training quality in medical graduates through the competency scale.Methods:Taking "attitude", "skill" and "knowledge" as the evaluation dimensions, the competency development was divided into four levels of "state", "explain", "apply" and "transfer", and we proposed the competence concept of "A.S.K.-SEAT" and formulated an evaluation scale. Questionnaires and behavior event interviews (BEI) were conducted in medical graduates of Shantou University in 2018. Reliability and validity of the questionnaire were evaluated and current situation of different competency items were analyzed.Results:A total of 155 questionnaires were collected with good reliability and validity, and 15 graduates participated in BEI. A total of 21 A.S.K. competency items (including five basic competency items and two discriminating competency items) and SEAT textual descriptions were finally established.Conclusion:A.S.K.-SEAT scale can provide valid references for the competency evaluation of medical graduates.

Background: Millions of patients undergo cardiac surgery each year. The red blood cell distribution width (RDW) could help predict the prognosis of patients who undergo percutaneous coronary intervention or coronary artery bypass surgery. We investigated whether the RDW has robust predictive value for the 30-day mortality among patients in an intensive care unit (ICU) after undergoing cardiac surgery. Methods: Using the Medical Information Mart for Intensive Care-IV Database, we retrieved data for 11,634 patients who underwent cardiac surgery in an ICU. We performed multivariate Cox regression analysis to model the association between the RDW and 30-day mortality and plotted Kaplan–Meier curves. Subgroup analyses were stratified using relevant covariates. Receiver operating characteristic (ROC) curves were used to determine the predictive value of the RDWs. Results: The total 30-day mortality rate was 4.2% (485/11,502). The elevated-RDW group had a higher 30-day mortality rate than the normal-RDW group (P < 0.001). The robustness of our data analysis was confirmed by performing subgroup analyses. Each unit increase in the RDW was associated with a 17% increase in 30-day mortality when the RDW was used as a continuous variable (adjusted hazard ratio = 1.17, 95% confidence interval, 1.10–1.25). Our ROC results showed the predictive value of the RDW. Conclusions An elevated RDW was associated with a higher 30-day mortality in patients after undergoing cardiac surgery in an ICU setting. The RDW can serve as an efficient and accessible method for predicting the mortality of patients in ICUs following cardiac surgery.

Background: Millions of patients undergo cardiac surgery each year. The red blood cell distribution width (RDW) could help predict the prognosis of patients who undergo percutaneous coronary intervention or coronary artery bypass surgery. We investigated whether the RDW has robust predictive value for the 30-day mortality among patients in an intensive care unit (ICU) after undergoing cardiac surgery. Methods: Using the Medical Information Mart for Intensive Care-IV Database, we retrieved data for 11,634 patients who underwent cardiac surgery in an ICU. We performed multivariate Cox regression analysis to model the association between the RDW and 30-day mortality and plotted Kaplan–Meier curves. Subgroup analyses were stratified using relevant covariates. Receiver operating characteristic (ROC) curves were used to determine the predictive value of the RDWs. Results: The total 30-day mortality rate was 4.2% (485/11,502). The elevated-RDW group had a higher 30-day mortality rate than the normal-RDW group (P < 0.001). The robustness of our data analysis was confirmed by performing subgroup analyses. Each unit increase in the RDW was associated with a 17% increase in 30-day mortality when the RDW was used as a continuous variable (adjusted hazard ratio = 1.17, 95% confidence interval, 1.10–1.25). Our ROC results showed the predictive value of the RDW. Conclusions An elevated RDW was associated with a higher 30-day mortality in patients after undergoing cardiac surgery in an ICU setting. The RDW can serve as an efficient and accessible method for predicting the mortality of patients in ICUs following cardiac surgery.