The author has analysed the current employment situation for clinical medicine graduates,the reasons for the difficulty of employment and solutions,so that the basis and the reference can be provided for us to carry out guiding work of clinical medicine graduates.

Because of the short education system,active and effective entrance education will produce a great impact on both the life of the medical college students and their long-term development.We should not only understand and analyze the views and cognition of the students but put forward a proposal to their entrance education as well,which will provide basic and reference that can develop the entrance and the political thought education better.

Objective To observe the effects of ganglioside and piracetam in improving the neurological function in patients with hypertensive cerebral hemorrhage.Methods Ninety-six patients with hypertensive cerebral hemorrhage Were randomly divided into 2 groups,ganglioside group(48 patients)and piracetam group(48 patients).Ganglioside group used the amount 40mg ganglioside mixed with sodium chloride injection(100ml,concentration 0.9%),and the piracetam group uesd piracetam(20g)mixed with the same injection.Both the patients of the 2 groups were given intravenous drip once a day,then after continuous 3 weeks,the general information and the improvement of nerve were observed.Results The effective rate and excellent rate of ganglioside group were remarkably higher than piracetam group,there was significant difference between the two groups(P＜0.05).Conclusion Ganglioside was better than pimcetam in improving clinical symptoms and the neurological deficit of the patients with hypertensive cerebral hemorrhage.

Objective:To investigate YKL-40-mediated inflammation in human bronchial epithelial cells and analyzed the soluble factors secreted by bronchial epithelial cells exposed to YKL-40 that were responsible for increasing proliferation and migration of primary normal human bronchial smooth muscle cells (BSMCs).Methods:YKL-40-induced inflammation was assayed in two human bronchial epithelial cells (BEAS-2B cell line and primary human bronchial epithelial cells ,namely HBECs).In addition,we treated BEAS-2B cells and HBECs with YKL-40,and added the conditioned culture media ( YKL-40-BEAS-2B-CM) and ( YKL-40-HBECs-CM) to BSMCs.The proliferation and migration of BSMCs were determined by premixed WST-1 cell proliferation reagent and QCM chemotaxis migration assay ,respectively.Results: Bronchial epithelial cells treated with YKL-40 resulted in a significant increase of IL-8 production,but have no effect about RANTES ,Eotaxin and TNF-α.YKL-40-BEAS-2B-CM and YKL-40-HBECs-CM induced IL-8 was found to further stimulate proliferation and migration of BSMCs ,and the effects were inhibited after neutralizing IL-8.Conclusion:Through investigating the interaction of airway epithelium and smooth muscle ,our findings implicate that YKL-40 may be involved in the inflammation of asthma by induction of IL-8 from epithelium,subsequently contributing to BSMCs proliferation and migration.Moreover, inhibition of IL-8 signaling is a potential therapeutic target for YKL-40-induced inflammation and remodeling of asthma.

Objective To evaluate the effectiveness of transcatheter arterial chemoembolization(TACE) combined with radiofrequency ablation(RFA) and TACE combined with 125I interstitial brachytherapy in the treatment of primary hepatocellular carcinoma(HCC) and to compare the results of the two therapies.Methods Fifty patients with HCC underwent TACE and RFA during laparotomy and 34 patients received TACE and radioactive 125I particle seeding.Four weeks after the procedure,dynamic enhanced CT or MR scanning was performed for a check.If the lipiodol deposit was poor,TACE was repeated.Follow-up check was made at regular intervals to observe the results.Results One month after the treatment,the local control rate of the tumor for TACE +RFA and TACE + 125I particle seeding combination therapy was 98.0% and 97.1%,respectively.No statistically significant difference existed between the two therapies.Conclusions Both TACE combined with RFA or with 125I particle seeding are effective therapies for HCC,which can be regarded as an ideal alternative therapy for patients who have failed to respond to TACE alone.

AlM: To investigate and evaluate the prevalence of xerophthalmia among aerospace science and technology staff and its influencing factors for the eye health guidance.
METHODS: The staff underwent physical examination in our examination center from September 2013 to June 2014 were preliminary screened, and those patients with symptoms of dry eye were investigated with questionnaires and diagnosed by basic lacrimal secretion test ( Schirmer l ) , breakup time of tear film ( BUT ) test and fluorescein ( FL) staining test .
RESULTS: There were 606 complaints of dry eye symptoms of the 1 000 premiers, distributed in random (60. 6%), and 432 employees were diagnosed (43. 2%). The positive rate of dry eye was 71. 3%. The causes of xerophthalmia, besides of gender, age, also include a variety of factors such as air-conditioner, heating, video terminals, sleep time, etc.
CONCLUSlON: Dry eye, an epidemic disease, has a variety of symptoms and complex etiology, the main causes of aerospace science and technology staff with dry eye is working environment and some local factors. We can give appropriate health guidance according to the different factors. Meanwhile the relevant series of dry eye screening should also be taken as a routine examination in ophthalmic examination.

Objective To enhance patients' abilities in self-management. Methods We used the nursing project method to analyze reasons and develop standard process of follow-up management and health education. A retro-spective analysis of 84 patients with stage 3 to 4 CKD was performed by nursing project method. This analysis compared the changes after the intervention program,including the ability of self-management,follow-up,medication and diet compliance,and the control rate of physiological indicators. Results By comparison with the intervention before and after,there were significant improvements in each dimension of self-management ability (P<0.001),follow-up, medication and diet compliance were significantly improved(P<0.05),and there were significant improvements in the control rate of systolic pressure and blood uric acid(P<0.001),the differences were statistically significant. Conclusion The application of nursing project can improve self-management ability,the compliance of follow-up,medication and diet as well as physiological indicators in patients with stage 3 to 4 CKD.

Objective To examine the effects of intravenous thrombolysis with Tissue-type plasminogen activator (rt-PA) combined with mild hypothermia therapy on patients with acute cerebral infarction and further investigate under?lying mechanism for the treatment of cerebral infarction. Methods Sixty cases of cerebral infarction patients were random?ly divided into three groups with 20 patients in each group:①The control group was given rt-PA intravenous thromboly?sis;②The treatment group 1:intravenous thrombolytic therapy combined with local mild hypothermia treatment for 12 h;③The treatment group 2:intravenous thrombolytic therapy and local mild hypothermia in the treatment of 24 h. We col?lected NIHSS score before and after thrombolytic therapy, patient monitoring (ICP) changes during thrombolytic therapy, March (MRS) score and complications during follow-up after thrombolysis, The serum levels of SOD and MDA were as? sessed before and after thrombolytic therapy. Results NIHSS score was lower in both treatment group 1 and treatment group 2 than in the control group (P<0.05) at 72 h, 7 d, 14 d after thrombolysis. MRS was lower in both treatment group 1 and treatment group 2 than in the control group (P<0.05) at 3 months after thrombolytic therapy. MRS were lower in treat?ment group 2 than in the treatment group 1 (P<0.05). ICP in treatment group 1 and the concentration of MDA in treat?ment group 2 were lower, compared with control group (P<0.05) at 24 h, 72 h and 7 d after thrombolysis. ICP was lower in treatment group 2 than treatment group 1 at 7d after thrombolysis. The concentration of SOD was higher in treatment groups than in control group (P<0.05) at 24, 72 h and 7d after thrombolysis. ICP and MDA concentration were lower in treatment group 2 than in treatment group 1(P<0.05) at 72h and 7d after thrombolysis. The concentration of SOD was higher in treatment group 2 than in the treatment group 1 at 7 d after thrombolysis (P<0.05). There was no significant dif?ference in adverse events and mortality among groups (P>0.05). Conclusion Rt-PA intravenous thrombolysis combined with mild hypothermia treatment can improve the prognosis of patients with cerebral infarction without increasing the inci?dence of adverse reactions. In addition, thrombolysis combined with mild hypothermia 24 h has better effect than with mild hypothermia 12 h. The beneficial effects may be accomplished by reducing oxidative stress reaction.

Objective To explore the potential of breast cancer stem cells in differentiating into vascular endothelial cells and participating in the angiogenesis of breast tumor.Methods The expressions of mutant P53, CD31 ,VEGF and Her-2 amplification in tumor blood vessels were detected and the single cell suspension of breast cancer was prepared.CD44+/CD24-/low cells were selected and cultured in culture system.The expressions of CD31 and CD105 on endothelial cell surface were detected by EGM-2 endothelial cell culture medium.The ability of uptake of acetylated low-density lipoprotein was measured.The endothelial cells were cultured in vitro to observe their vascular structure.Results The expressions of CD31,VEGF and mutant P53 were found in paraffin sections of breast cancer tissue samples, and they were arranged along the vessel lumen or blood vessel sphere. Immunofluorescence showed that CD31 and DAPI signals were expressed intravascularly in breast cancer tissues. Four samples of Her-2 positive amplification and 9 cases of non-amplification were detected in the samples.The successful separation of breast cancer stem cells was carried out by immunomagnetic sorting.The percentage of CD44+ cells in the pre-sorting cells was (7.5±2.6)% and that of CD44+ cells was about (94.3±4.7)% after magnetic sorting (P<0.05).The ratio of CD24+ cells was (48.2±9.4)% before sorting,and that of CD24+ cells was (4.3±1.6)% after immunomagnetic bead sorting.The proportion of CD105+ cells in mammary gland cells was (4.5±0.9)% and the proportion of CD31+ cells was (6.2±1.3)%.After cultured for three generations,the percentages of CD105+ cells and CD31+ cells were (79.6±9.3)% and (84.1±10.7)%,respectively (P<0.05). DiL-Ac-LDL could be phagocytized by endothelial cells cultured in endothelial cell culture system.Vessel-like structure was found in the endothelial cell group while the control group did not have the tendency of vascular changes.Conclusion Breast cancer stem cell-derived endothelial cells differentiate into endothelial cells in vitro and have the ability of vascular formation,suggesting that breast cancer stem cells may be involved in the formation of tumor blood vessels.

OBJECTIVETo explore the effect of Peitu Shengjin Recipe (PSR) on nutritional states and immune functions of stable phase chronic obstructive pulmonary disease (COPD) patients.

METHODSTotally 62 stable phase COPD patients were randomly assigned to the treatment group (30 cases) and the control group (32 cases). All patients inhaled Seretide (50/500 µg), twice per day. Besides, patients in the treatment group additionally received PSR, one dose per day. After three months of treatment, the COPD assessment test (CAT) score, the index of nutritional states [including body mass index (BMI) , thickness of skin fold (TSF), mid-arm muscle circumference (MAMC), serum albumin, serum prealbumin], and immune functions (including IgA, IgM, and IgG) were compared between the two groups.

RESULTSBy the end of the treatment, the CAT score decreased more obviously in the treatment group than in the control group (P < 0.05). The improvement of BMI, TSF, MAMC, serum albumin, and serum prealbumin was better in the treatment group than in the control group (P < 0.05). IgM and IgG also increased more in the treatment group (P < 0.05). There was no statistical difference in IgA between the two groups (P > 0.05).

CONCLUSIONSAdditionally use of PSR could improve nutritional states and immune functions of stable phase COPD patients to some extent. Meanwhile, it also could improve their health related quality of life.

Body Mass Index ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Nutritional Status ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; immunology ; Quality of Life ; Serum Albumin