Objective:To investigate the cognitive status of socialist core value among medical students, and to provide reference for the core value education in medical colleges and universities. Methods: 1024 medical students were selected with random cluster sampling method, and the socialist core value was investigated using self-designed questionnaire. Results:It was shown that 69 percent of medical students recognized the importance of socialist core values, but the contents had not been mastered. Social atmosphere, medical student's own short-coming and school education were all the factors leading to the weakness of socialist core values. Conclusion:It is quite necessary to cultivate medical students′socialist core values. Class, school, and society should play the main role to guide the medical students to establish the correct socialist core value.

Objective To explore the clinical efficacy of trastuzumab combined with vinorelbine therapy in the treatment of advanced breast cancer with human epithelial growth factor receptor-2 (HER-2) positive.Methods From April 2010 to April 2013,91 advanced breast cancer patients who failed in the paclitaxel therapy received trastuzumab plus vinorelbine (45 cases,vinorelbine group) or capecitabine (46 cases,capecitabine group).The treatment efficacy,toxic effects and 3-year survival rate in two groups were compared.Results The clinical benefit rate in two groups had no significant difference (P ＞ 0.05),but objective response rates in vinorelbine group was higher than that in capecitabine group:44.44％(20/45) vs.23.91％(11/46),and there was significant difference (P =0.039).The toxic effects in two groups had no significant difference (P ＞ 0.05).The 3-year survival rate in two groups had no significant difference (P =0.252).Conclusions In the treatment of HER-2 positive advanced breast cancer,trastuzumab plus vinorelbine or capecitabine shows no significant differences in adverse reaction or in 3-year survival rate.However,trastuzumab plus vinorelbine shows better objective response rate compared with trastuzumab plus capecitabine.

Objective:To investigate the medical students' cognition of ethical issues in assisted reproductive technology (ART) and discuss the importance of ethical education in medical colleges and universities.Methods:A questionnaire survey about the ethical cognition of assisted reproductive technology was conducted among 632 medical students.The questionnaire included the donation and management of gametes and embryos,and offspring problems.Results:Medical students agreed with most of the current ART-related laws and regulations.however,44.8％ of medical students considered that criteria of donating eggs should be relaxed,such as allowing women who do not receive ART treatment be paid for eggs.In addition,a total of 39.0％ of medical students supported the legalization of surrogacy technology in china.Conclusion:Medical students exists a certain misunderstanding in egg donation and surrogacy technology.We should give more training to medical students in ethical knowledge.In addition,our country can supplement and perfect the current laws and regulations to a certain extent.

Objective To investigate whether clinical,endocrine,and sonographic characteristics of infertile women with polycystic ovary syndrome (PCOS) could predict the ovarian response to clomiphene citrate (CC) medication.Methods A prospective study was conducted,85 women with PCOS were given CC 50 mg per day for 5 days.In the case of an absent response,doses were increased to 100 daily in subsequent cycles.Clinical,endocrine,and sonographic characteristics were compared between responders and nonresponders.Results The cycle history (oligomenorrhea or amenorrhea) and antral follicle count (AFC) were significantly different in responders from those in nonresponders (P ＜ 0.05).There were no differences in age,serum testosterone,follicle stimulating hormone (FSH),luteotropic hormone (LH),body mass index (BMI),insulin resistant index (HOMA-IR),and glucose and insulin levels between the two groups (P ＞ 0.05).In addition,multivariate logistic regression analysis indicated that cycle history and AFC were the predictors of ovarian response to CC treatment.Conclusions The cycle history and AFC can be used as the simple and effective parameters to predict ovarian response to CC treatment in PCOS patients.

Objective To investigate tasks of nursing staff in gross-root medical institutions in China and to provide references for management in nursing human resource in gross-root medical institutions.Methods Stratified sampling method was used to recruit nnrses from seven geographical areas and two types of gross-root medical institutions.Nursing tasks were measured using the Questionnaire of Nursing Tasks among 1450 nurses.Results For nursing tasks in gross-root medical institutions,comprehensive evaluation and rate of implementation for tasks related to medical treatment had highest scores of 12.72±3.49 and 3.47±0.72,respectively.Comprehensive evaluation and rate of implementation for tasks of satisfying patients' basic needs had lowest scores of 6.98±4.74 and 2.04±1.02,respectively.There were significant differences in rate of implementation of tasks related to medical treatment and other activities among nurses with different job titles(P＜0.05).Significant differences were found in implementation of overall nursing tasks,assessment & evaluation tasks,health education,communication activities,ethics & law activities,and other activities between nurses from community health centers and town health centers(P＜0.05).There was no significant difference in tasks related to medical treatment between nurses from community health centers and town health centers,and significant differences were found in overall nursing tasks and other seven dimensions(P＜0.05).Conclusion Nurses from gross-root mcdical institutions have characteristics of being young,having low job titles,and having low educational level.Nursing tasks related to medical treatment and activities guaranteeing patient safety are most frequently conducted in gross-root medical institutions.Nurses with higher job titles tend to perform less tasks related to medical treatment,and more other aetivities.Nurses from community health centers have higher frequency of implementing nursing tasks and higher scores for evaluating significance than nurses from town health centers.

OBJECTIVE: To improve the outcome of treatment in patients with craniocerebral firearm wound. METHODS: Prospectively and retrospectively reviewed a series of 93 patients presented to the Xi-Jing Hospital of Fourth Military Medical University with a diagnosis of craniocerebral firearm wound during a period of 27 years from July 1970 to July 1997. All the patients had acute craniocerebral firearm wound. Of these, it consisted of 81 males (87.1%) and 12 females (12.9%) ranging from 3 months to 58 years in age (median 24.6 years). The lesion included 16 tangential wounds, 58 tubular wounds and 19 through-and-through wounds. The cases were urgent and in serious and unstable condition. All the patients underwent surgical intervention and aggressive perioperative management in the neurosurgical intensive care, including resuscitative protocols. RESULTS: After emergency treatment and operation, 9 cases died (9.7%). Follow-up studies at three months postoperative showed that 56 cases (66.7%) had made good recovery. Rates of moderate disability, severe disability or vegetative state in this series were 19.0%, 10.7% and 3.6%, respectively. Long term follow-up studies (median 5.5 years) found that 42 (50.0%) were capable of resuming their occupation. CONCLUSIONS: Craniocerebral firearm wounds are often severe, needing urgent treatment for the patients. Timely, proper and thorough initial debridement are crucial for avoiding rapid neurological deterioration.

Objective To evaluate the effect of nutritional risk screening and interventions on postoperative nutritional status in patients with oral cancer. Methods A total of 83 oral cancer patients with mild or moderate nutritional risk rated by patient-generated subjective global assessment(PG-SGA) from January 2015 to June 2017 were randomized into an experimental group(43 cases) and a control group (40 cases). The patients in the experimental group received 2-week nutritional intervention before the operation,while the patients in the control group received routine preoperative treatment and diet guidance. The biochemical measurements of postoperative nutritional indicators, peripheral blood immunoglobulin indicators, postoperative complications and hospital stays were compared between the two groups. Results The levels of prealbumin, retinol- binding protein, total lymphocyte count and transferrin were (218.5±34.6) mg/L, (23.5±4.3)μg/L, (1.82±0.45)×109/L, (2.07±0.63 )μg/L on the day of admission in the experimental group, and at 1 day before the operation were (237.3±36.5) mg/L, (27.7±4.8)μg/L, (2.02±0.39)×109/L, (2.43±0.54)μg/L, there was no significant difference(P<0.05). IgM, IgG, IgA at 1 day before the operation were significantly higher than those on the day of admission in the experimental group(P<0.05), and the levels of prealbumin, retinol-binding protein, total lymphocyte count,transferrin, IgM, IgG, IgA and body mass index at 8 days after the operation in the experimental group were significantly higher than those in the control group(t=1.574-3.418, P<0.05). The total rate of postoperative complications was 11.6％(5/43) in the experimental group, 30.0％(12/40) in the control group, and there was significant difference between the two groups (χ2=6.840, P<0.01). The incidence of infection-associated complications such as pneumonia and incision infection was 7.0％(3/43) in the experimental group, 20.0％(8/40) in the control group, and there was significant difference between the two groups (χ2=5.096, P<0.05). Conclusions Preoperative nutritional support can effectively improve the perioperative nutritional status,decrease postoperative complications and operative risk in esophageal cancer patients with mild or moderate nutritional risk.

Two cases of pregnant women with lumbar disc herniation causing neurologic deficits are reported. The first case received percutaneous endoscopic discectomy following the cesarean section; and the second case underwent micro-discectomy in the left lateral position under local anesthesia at 23-week gestation. After surgery, satisfactory outcomes were obtained in both cases. The management of these two cases indicates that the disc surgery is a safe procedure for patients during pregnancy.