Objective To explore college students'achievement motivation level at basic medical education stage and its influencing factors.Method Achievement motivation scale and open questionnaire were applied in 223 college students at basic medical education stage.The effect of multiple influential factors on achievement motivation was analyzed from the perspectives of pursing for success and avoiding errors by multiple linear regression.Results The results showed that 70.4％ students had low achievement motivation level.Multiple factors had linear regression relation with Ms and Mf(RMs=0.644,RMf=0.898).Academic self assessment and learning attitude can increase the motivation for success significantly(P＜0.001).Performance evaluation and learning objective can significantly increase the motivation for avoiding errors(P＜0.001).Conclusion The study and application of achievement motivation can improve education quality at basic medical education stage.

The complications of extracorporeal membrane oxygenation ( ECMO ) include technical relevance complications and physical relevance complications. The former mainly includes dysfunction of oxygenation,cannula-related problems,technical relevance hemolysis,blood clots of oxygenator or rest of the circuit. The latter includes hemorrhage and embolism,culture-confirmed infection,renal failure and neurologic complications. One of the most reported complications of ECMO is hemorrhage. It′s important for reducing mortality and improving prognosis through stricting with the indications of ECMO,strengthening team cooper-ation,closely clinical monitoring and early identifying complications. In this paper,we introduced complica-tions of ECMO as well as how to prevent and treat it.

Malnutrition occurs as a result of inadequate nutrient intake,malabsorption and altered me-tabolism in pediatric liver failure. Malnutrition may be associated with a poor outcome. The current evidence indicates that the provision of adjunctive nutritional support ( parenteral nutrition or enteral nutrition or nutri-tional supplements) to patients with a variety of liver diseases. It may be reasonable to start enteral nutrition in 5 to 7 days in acute liver failure or hepatic coma. According to individualized appropriate nutritional evalu-ation,the metabolic demand,to provide appropriate nutritional support in pediatric liver failure.

Lung cancer is one of the most common malignant tumors in the world.Non-small lung canc-er( NSCLC) accounts for approximately 85%,but its pathogenesis has not been elucidated.As a family of soluble enzymes,matrix metalloproteinases(MMPs)can degrade the constituents of the extracellular matrix(ECM)and the basement-membrane,members share common structural features and are responsible for the relative specific sub-strates.Some researches show that the matrix metalloproteinases 7(MMP-7)involve in the invasion and metasta-sis of NSCLC,the expression of MMP-7 in the tissue of NSCLC is significcantly higher than that in adjacent tis-sues,and the MMP-7 plays important roles in prognosis evaluation of NSCLC patients.Therefore this paper sum-marize the domain structure,function,regulation and research in NSCLC about MMP-7.

As the newest anti-vascular endothelial grown factor (VEGF) drug,alfibercept binds to all forms of VEGF-A,VEGF-B, and PIGF.So far, intravitreal injection of alfibercept has already been used to treat certain opthalmological diseases, such as neovascular age-related macular degeneration, polypoidal choroidal vasculopathy, central retinal vascular occlusion, diabetic macular edema, corneal neovascular,and retinopathy of prematurity.In this article,we contrasted alfibercept to the other anti-VEGF drugs, conducted a review of the recent research progress of alfibercept in opthalmological diseases and introduced the questions which still need to be solved and the probably research direction of alfibercept in the future.

From April 2011 to October 2013,68 patients scheduled for complex hepatobiliary and pancreatic surgery underwent full-thickness suturing of abdominal incision with subcutaneous negative pressure drainage.There was no such complications as wound dehiscence or sinus formation.Except for 2 cases of wound infection,primary healing was achieved.Two infected cases were followed up for 1 year and there was incisional hernia.The full-thickness suturing of abdominal incision plus subcutaneous negative pressure drainage could prevent postoperative wound infection and promote wound healing.And this simple and practical approach is worthy of wider clinical application.

Objectives To explore the relationship of serum miR-30a and cardiac function in children with congenital heart disease (CHD), and the diagnostic value of serum miR-30a to heart failure. Methods From January 2013 to June 2013, 65 children with CHD were enrolled, and divided into the HF group (patients with heart failure, n=40) and the Non-HF group (patients without heart failure, n=25) according to modified Ross score. The serum miR-30a expression level was quantified by real-time PCR. Left ventricular ejection fraction (LVEF) was tested by echocardiography. The correlation between miR-30a and modified Ross score and LVEF were evaluated with Spearman's analysis. The area under the receiver-operating characteristic (ROC) curve for miR-30a was examined. Results The expression level of miR-30a in HF group was higher than that in Non-HF group, the LVEF was lower in HF group than that in Non-HF group (all P<0.001). The serum miR-30a level was positively correlated with modified Ross score (r=0.63, P<0.01) and negatively correlated with LVEF (r=-0.32, P<0.01). According to ROC analysis, the AUC of miR-30a for detection of HF was 0.7440. Conclusion The expression level of serum miR-30a was closely correlated with the cardiac function, which can be as a biomarker for indicating the heart failure in CHD.

Ambulatorybloodpressuremonitoring(ABPM)providesmoreextensiveclinical information than clinical casual blood pressure. It can effectively identify w hite coat hypertension and masked hypertension and is superior to clinical casual blood pressure in predicting stroke risk. Both daytime and nighttime systolic blood pressures are the independent predictors of stroke, and the predictive value of nighttime systolic blood pressure is higher. In addition, ABPM can also be used to evaluate the blood pressure response and control during the primary and secondary stroke prevention. This article review s the application of ABPM in stroke prevention.

Objective To search the effective approach of diagnosis for primarygallbladder carcinoma.Methods A retrospective analysis on clincal pathological data was made for 28 cases of primary gallbladdercarcinoma treated in our hospital from April,2002 to August,2007.Results The presenting symptom of 24 patients was right upper abdominal pain and chief complaint of 3 patients was jaundice.The accurate diagnosis rate preoperative was 96.43%.42.86%of the patients was accompanied with gallstone.In this study,the long-term survivor was in Nevin's Stage Ⅱ.The 1-year overal survival rate was 38.46%.Conclusion The primary gallbladdercarcinoma has no typical symptom.The check of imageology is very important.It is important for enhancing early diagnosis rate to pay more attention to the exist of gallbladdercarcinoma and screen patients in acceptable crowd by combining B-mode ultrasonography with tumor markers, such as CA199,CEA,and so on.

The paper summarized the current situation of diagnosis and treatment of pancreatic endocrine tumors (PETs)in China.In recent sixty years, we understand PETs more deeply, and have all kinds of imaging technique to localize the tumors.It makes more cases having been diagnosed.Operation is the most important and the first choice of treatment.The concept of minimal-invasion runs through the surgical procedure.Multi-model strategy is used in therapy for malignant PETs with liver metastasis.Basic research is focused in mechanism and early diagnosis and it helps the clinical practice.Specialization and co-operation are emphasized in the development of PETs diagnosis and treatment.