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.

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 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.

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.

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 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.

Background and purpose:Nowadays, about therapy of laryngeal carcinoma, people are paying more and more widely attention to ifnding out how to improve quality of patients’ life besides radical surgery. For glottic laryngeal carcinoma which invading anterior commissure or bilateral vocal cord, we performed modiifed frontolateral partial laryngectomy or modiifed cricohyoidoepiglottopexy, and contrastive analyzed the therapeutic efifcacy of the two ways. Methods:Sixty cases patients of glottic laryngeal carcinoma who treated in Hunan Provincial Tumor Hospital during 2005 to 2010, which invaded the anterior commissure or bilateral vocal cord, were randomly attributed to two groups as A and B;30 patients of group A were underwent modiifed frontolateral partial laryngectomy and repaired with bilateral sternohyoid muscle lfap, 30 patients of group B were treated by modiifed cricohyoidoepiglottopexy. Follow-up time of each patient was 5 years postoperation and clinical data were retrospectively analyzed. Results:The 5-year survival rate was 86.7%in group A as well as 83.3%in group B, and there was no statistical difference between two groups (P=0.718). Pronunciation function:22 cases in group A and 21 cases in group B whose pronunciation function can be competent in the noisy environment, and can pronounce“a”and“i”vowel;8 cases in group A and 9 cases in group B can pronounce only a“ha”,“hi”sound, that couldn’t communicate with others in a noisy environment. There was no statistical difference in pronunciation function between the two groups (P=0.774). Incidence of deglutition disorder 4 weeks postoperation:group A was 0 (0/30), group B was 16.7%(5/30), and the difference between the two groups was statistically signiifcant (P=0.026);average time of extubation postoperation:group A was (10±2.3) d, group B was (20±4.6)d, and the difference between the two groups was statistically signiifcant (P=0.0000);recurrence rate of dyspnea after extubation:group A was 16.7%(5/30), group B was 0 (0/30), and there was statistically signiifcant difference between the two groups (P=0.026). Conclusion: For the glottic laryngeal carcinoma which invading anterior commissure or bilateral vocal cord, there was no statistical difference in 5-years survival rate and function of pronunciation between modified frontolateral partial laryngenctomy and modified cricohyoidoepiglottopexy postoperation. The former had less postoperative deglution disorder, earlier extubation time, and to some extent, alleviated the suffering of the patients, but part of these patients needed secondary surgery due to dyspnea which resulted by radioactive tissue adhesion after extubation. The latter had more serious deglution disorder postoperation, longer recovery time, and relatively longer time to extubating, showed no again dyspnea after extubation, and had more extensive adaptation disease. In a word, each way of operation has its advantage respectively.

Adenocarcinoma ; metabolism ; secondary ; surgery ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; secondary ; surgery ; Colectomy ; Colonic Neoplasms ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Keratin-18 ; metabolism ; Liver Neoplasms ; metabolism ; secondary ; surgery ; Male ; Middle Aged ; alpha-Fetoproteins ; metabolism