The reform in cultivating professional-degree programs in Clinical Medicine Education contributes to the transformation of training mode, which surpasses the connotative bounds of the inherent education management. The personalized training of students has made it more challenging for both the tutor and the faculty to involve in education management, the effectiveness of which is highly valued due to the pressing need for sound medical ethics. Furthermore, the development of information technology calls for the reform of education management as well as the emphasis of student-centered approach. This article summa-rizes the existing problems of current education management mode for master degree programs of profes-sional clinical medical education. In addition, a three-level management system composed of medical experts is brewed and put forth. This system, based on compensation and restraint, assessment and incentive, ser-vice as well as security, is meant to facilitate the training of application-oriented medical talents.

Objective To analyze the clinical characteristics of patients with acute pancreatitis (AP) in Jiangxi Province.Methods From 2007 to 2012,the data of 2 625 hospitalized patients diagnosed as AP were retrospectively analyzed.The changes of composition in gender,age and etiology during 2007-2009 time period and 2010-2012 time period were compared.Mann Whitney U test was performed for non-normal distribution measurement data analysis and x2 test was for count data analysis.Results Among the 2 625 patients with AP,from 2007 to 2009 there were 1 028 cases and 1 597 cases in the period 2010 to 2012.The ages of the patients in these two period were 50(38,61) and 50 (40,63) years old,respectively.There was statistically significant difference in the age distribution between these two period (U=783 635.5,P＜0.05).Biliary factor was the most common cause of AP in the two time period 2007 to 2009 and 2010 to 2012,which accounted for 55.9％ (575/1 028) and 62.9％ (1 005/1 597),respectively,and the difference was statistically significant (x2=12.778,P＜ 0.01).Alcoholic AP accounted for 1.9％ (19/1 028) and 7.3％ (117/1 597),respectively,hyperlipidemic AP were 14.0％ (144/1 028) and 17.7％ (283/1 597),and idiopathic AP were 22.0％ (226/1 028) and 5.9％ (94/1 597),all the differences were statistically significant (x2 =38.204,6.330 and 151.416,all P＜0.05).In male patients,biliary AP accounted for 52.4％ (732/1 398),which was lower than that of female patients (69.1％,848/1 227),and the difference was statistically significant (x2 ＝76.524,P＜0.01).Alcoholic AP and hyperlipidemic AP accounted for 9.0％ (126/1 398) and 21.4％ (299/1 398) in male patients,which were significantly higher than those of female patients (0.8％,10/1 227; 10.4％,128/1 227),and the differences were statistically significant (x2 89.396 and 57.585,both P＜0.01).Biliary AP accounted for 79.9％ (631/790) in elderly group,which was higher than that of non elderly group (51.7％,949/1 835),and the difference was statistically significant (x2＝182.720,P＜0.01).In elderly group hyperlipidemic AP and alcoholic AP accounted for 2.5％ (20/790) and 1.3％ (10/790),which were significantly lower than those of non-elderly group (22.2％,407/1 835; 6.9％,126/1 835),and the differences were statistically significant (x2 =156.524 and 35.262,both P＜0.01).Conclusions The middle-aged and elderly people are the vulnerable population of AP.Biliary factor is the most common cause of AP,especially in the female and elderly.The proportions of hyperlipidemic AP and alcoholic AP both significantly increase,in the male higher than that of the female and in the non-elderly higher than that of the elderly.The proportion of idiopathic AP significantly decreases.

Objective To investigate the long-term safety and efficacy of the domestic biodegradable drug-eluting cor?onary stents (BuMA) in treating coronary heart disease (CHD). Methods Patients (n=440) who received BUMA stents were designated as observation group while patients (n=460) received Resolutestents were designated as control group. The base?line clinical characteristics, extend of pathological change shown by Coronary Arteriography (CAG),the procedure of percu?taneous coronary intervention were similar between these two groups. The patients were followed up for a mean of 24 ± 4 months;the primary endpoint was the occurrence of definite or probable stent thrombosis;secondary endpoint was major ad?verse cardiac events (MACEs) including complex end such as recurrent angina, acute non-fatal myocardial infarction, death, target vessel revascularization (TVR); other endpoints include all- cause mortality, cardiac death, myocardial infarc?tion (MI), target lesion revascularization (TLR), non-target vessel revascularization and stroke. Some patients were lost dur?ing follow up, which include 5 in observation group and 26 in control group. Results Patients in observation groups were in?serted with 615 stents while patients in control group were implanted with 614 stents, both groups with average of implanting 1.41 stent/case. There are no statistical significance differences in the primary endpoint [1.4%(6/435) vs 1.8%(8/434), χ2=0.087], secondary endpoint [12.3%(54/435) vs 10.8%(47/434),χ2=0.524] and other endpoints between the two groups. Con?clusion These data suggest that domestic biodegradable drug-eluting coronary stents (BuMA) are with good long-term safe?ty and efficacy.

Pancreatic necrosis (IPN) is a serious complication of acute pancreatitis (AP), with a mortality reported to be as great as 32.0%. At present, it is considered that patients with proven or suspected infected necrotizing pancreatitis, invasive intervention (i.e. percutaneous catheter drainage, endoscopic transluminal drainage/ necrosectomy, minimally invasive or open necrosectomy) should be delayed where possible until at least 4 weeks after initial presentation to allow the collection to become 'walled-off'. With the development of endoscopic technology, endoscopic transmural (stomach or duodenum) drainage and necrosectomy has been recommended as one of the preferred methods for walled-off necrosis. This article introduces the diagnosis and evaluation of the walled-off necrosis ; the indications, operation procedures, postoperative evaluation and management of postoperative complications of endoscopic transmural drainage and necrosectomy. At last, the research progress of endoscopic drainage and debridement in recent years was introduced.

Objective:To explore the effectiveness of comprehensive care and help system to promote the rehabilitation of patients with depression,through the case study of 1 typical college student with depression.Method:Through the establishment of the community network support system:teacher's home visits and talk,professional counseling,love and support from dormitory roommates,classmates and relatives,we provided a three-in-one community comprehensive support system and comprehensively used health education,social support,cognitive therapy and other methods,in order to promote the rehabilitation of patients with depression.Results:Through the systematic and scientific comprehensive care,the patient basically freed from the shadow of depression and put into the clinical practice with a positive attitude.Conclusion:Comprehensive Care Education is possible to promote the rehabilitation of college students with depression.

Subcortical ischemic vascular disease (SIVD) is considered to be the most important and common cause of vascular cognitive impairment (VCI). If patients with subcortical ischemic vascular cognitive impairment (SIVCI) and subcortical vascular cognitive impairment (sVCI) can be found early, it is possible that vascular dementia (VaD) can be identified before occurrence and even reverse the process. Recent studies have shown that resting-state functional magnetic resonance imaging (rsfMRI) may provide the objective basis for the diagnosis of SIVCI. This article reviews the application of rsfMRI in the diagnosis of SIVCI.

Objective To investigate the aassociation of a microRNA-137 (miR-137) polymorphism, single nucleotide polymorphism (SNP) rs1625579, with neurocognitive function in patients with schizophrenia. Methods A total of 250 patients with schizophrenia were included in this study. The positive and negative syndrome scale (PANSS) was used to evaluate patients. The brief assessment of cognition in schizophrenia (BACS) scale was used to determine neurocongnitive functions in patients. Blood samples of patients were collected, and SNaPshot technique was used to compare the neurocognitive functions of different genotypes of rs1625579. Results The genotypes of TT, GT and GG were 221 (88.4%), 28 (11.2%) and 1(0.4%). There was no significant difference in PANSS score between TT genotype carriers and G allele (GG+GT) carriers. The detection of BACS showed that the digit sequencing score was significantly lower in patients with TT genotype than that of G allele (GG+GT) carrier ( P<0.05). There were no significant differences in other scores of BACS evaluation between two groups of patients. Conclusion The miR-137 polymorphism influences the working memory performance of schizophrenic patients in Chinese Han population.

Objective:To evaluate the efficacy of postoperative radiotherapy (PRT) for dermatofibrosarcoma protuberans (DFSP).Methods:A systematic review and meta-analysis of articles published before February 23, 2019 were conducted. A total of 655 studies were retrieved consisting of 195 DFSP patients. Among them, 50 cases were assigned into the PRT group and 145 cases in the surgery alone (SA) group. The recurrence rate was statistically compared between two group.Results:Meta-analysis showed that the recurrence rate in the PRT group was significantly lower than that in the SA group (8% vs. 24.1%, OR=0.28, P=0.010). The recurrence rate of patients with positive margins in the PRT group was significantly lower compared with that in the SA group (8% vs. 61.5%, P=0.002). The recurrence rate of patients with negative margins in the PRT group had a decreasing trend than that in the SA group (6% vs. 21.6%, P=0.205). Conclusions:The recurrence rate of surgery combined with PRT is lower than that of SA. The recurrence rate of patients with positive margins is higher than that of those with negative margins. For patients with positive margins, PRT can decrease the recurrence rate. The recurrence rate trends to decline in patients with negative margins after receiving PRT.

Objective To assess the clinical value of 18F-FDG PET/CT for the prediction of postoperative recurrence and metastasis in patients with NSCLC.Methods Eighty-five patients (64 males,21 females; average age:58.0 years) with NSCLC were enrolled.All patients underwent 18 F-FDG PET/CT within one week before surgical operation and 3 months after the operation.The diagnosis of recurrent cancer and metastasis was confirmed by pathologic findings,other imaging modalities and clinical follow-up.The diagnostic efficacy of PET/CT was calculated and the predictors for postoperative recurrence and metastasis were analyzed.x2 test and two-sample t test were used for statistical analysis.Results Among 85 patients,43 had recurrence and metastasis post operation.The postoperative recurrence and metastasis were detected by 18F-FDG PET/CT in 9.3％(4/43) within 6 months,30.2％(13/43) within 1 year,76.7％(33/43) within 2 years and 97.7％(42/43) after 2 years.The sensitivity,specificity,accuracy of 18F-FDG PET/CT for the detection of recurrent tumor and metastasis were 97.7％ (42/43),95.2％ (40/42),96.5％ (82/85) respectively.The preoperative cancer staging,size and SUVmax of primary tumor were significant factors for the prediction of postoperative tumor recurrence and metastasis within 2 years (x2 =12.360,t=3.281 and 2.465,all P＜0.05),but not gender,age or pathological findings (x2 =0.639,0.012 and 3.800,all P＞0.05).Conclusions 18F-FDG PET/CT has an important role for the detection of postoperative recurrence and metastasis in patients with NSCLC.Preoperative cancer staging,size and SUVmax of the primary tumor might be the predictive factors for postoperative tumor recurrence and metastasis within 2 years.

Objective To explore the clinical characteristics and influencing factors of primary nephrotic syndrome (PNS) combined with hypercoagulability in children. Methods The clinical data of 57 children with primary PNS were analyzed retrospectively. The clinical features and treatment were compared among high coagulation state group, non high coagulation state group and control group (20 children). At the same time, the differences between the simple nephrotic syndrome group (SNS) and nephritic syndrome group (NNS) in hypercoagulable state were analyzed. In addition, the correlation analysis was performed. Results Among 57 patients, there were 50 patients in high coagulation state group and 7 in non high coagulation state group. There was no significant difference in gender, age and clinical manifestations between two groups (P>0.05). The platelet (PLT) count, platelet aggregation (PCT), albumin (Alb), fibrinogen (Fib), D-dimer (D2) were significantly higher than those in the control group, and there were statistically significant differences (P all<0.01). There were significant differences in the levels of PLT, Fib, D2 and complement C4 between hypercoagulable state group and non hypercoagulable state group (P all<0.05). There were significant differences in HCT, TC, LDL, PT and complement C3 levels between SNS group (n = 32) and NNS group (n =18) in 50 patients with high coagulation state (P<0.05). There was positive correlation between HCT and complement C3 (r=0.30, P<0.05), while there was no correlation between PLT and other indices (P>0.05). All of the 57 patients were improved and has no thrombosis after the treatment. Conclusion Children with primary PNS were usually associated with different degrees of hypercoagulable state, and PLT, Fib, D2 could be used as reference indices for the severity of hypercoagulable state, and the activation of complement system might be related to the occurrence and development of hypercoagulable state.