Based on the educational structure theory, the difference between mass education and elite education is probed at the macroscopic level to make it clear that the essence of Physician education and training program of excellence is elite education for occupational purposes; at the mi-croscopic level the orientation of English teaching for the class ofexcellent physicians is determined as English for occupational purposes. Moreover, the curriculum system of medical English is designed, and teaching materials associated with clinical medicine are selected, the language laboratory simulat-ing hospital scenes is constructed, and the transboundary team of teachers is built comprising university teachers and doctors in hospitals. At the level of individual, the competency model of English forexcellent physicianshas been developed, English competence requirements in medical industry being clearly established . In a word , the study of macrostructure points out the direction and target of English teaching for excellent physicians; the study of microstructure perfects the mode of English teaching forexcellent physicians;and the study of individual structure indicates the ultimate foothold of English education forexcellent physicians. Three aspects are integrated into an organic whole.

Innovation of cultivation mode and concepts for medical English should be suited to the requirements of making university academically outstanding by its individualized school-running,requirements of strengthening distinguished majors as well as needs for qualified medical English graduates.Through combining undergraduate tutorial system of lower grades with undergraduate tutorial system of higher grades,continuing implementing concepts of team cooperation,strengthening holistic education concept and guiding the development of students' individual personality and academic study based on stages,tutors and tutorial team can play their central roles in the training and molding of qualified medical English undergraduates,ultimately realizing the unity of process cultivation and objective cultivation.

In accordance with students' learning needs and future professional development, individualized practices of formative assessment are analyzed in terms of diverse evaluators, accumula-tive learning contents, after-class tutoring, thus to maximize student's learning potentials, to be capa-bility-oriented, to make students highly qualified and competent for their future clinical position and academically developed. Additionally, the assessing competence of teachers is vital to the successful implementation of formative assessment. Importantly, each medical university can explore further into the practice of formative evaluation, based on the orientation of itself.

Objective To observe the preventive effects of puerarinon development of deep vein thrombosis (DVT) in elderly women with osteoporosis after hip replacement. Methods 100 elderly women with osteoporosis who scheduled for femoral head arthrolastybetween January 2012 and January 2014 in Cangzhou Central Hospital were selected and then randomly divided into a study group (n=50) and a control group (n=50). The control group received routine anti?inflammatory and anticoagulant therapy ,while the study group received intravenous drip of puerarinof 400 mg mixed with 5%glucose liquid 500 ml daily for 15 days as a treatment course. After the treatment, DVT incidence rate ,change of early diagnostic indexes and hemorheology were compared with their baselines. Results DVT incidence rate was significantly lowerin the study group than in the control group (8.0%vs. 24.0%, P<0.05). Ascompare with the control group,thromboxane A2/prostacyclin,plasma homocysteine and hemorheology?were significantly reduced (P < 0.05). Conclusions Puerarin has a preventive effect for deep vein thrombosis in elderly women with osteoporosis after hip replacement.

Objective To explore the influence factors of poor myocardial perfusion in patients with ST-segment elevation myocardial infarction( STEMI) after primary percutaneous coronary intervention(PCI). Methods One hundred and forty-three patients with first STEMI who were on admission from April 2010 to May 2014 and underwent primary PCI within 12 hours were enrolled as our subjects. According to the sum-ST-segment resolution(sumSTR)and TIMI myocardial perfusion grade(TMP)after primary PCI,all patients were divided into well myocardial perfusion group( sumSTR ≥ 50% or TMP 2 - 3 grade)and poor myocardial perfusion group(sumSTR < 50% and TMP 0 - 1 grade). The influence factors between two groups were collected and analyzed,including sex,age,pain to balloon time,blood pressure on admission,left ventricular ejection fraction,leucocyte count,neutrophil ratio(NR),high-sensitivity C-reactive protein(hs-CRP),blood lipid,and the history of hypertension,diabetes mellitus. Results The leucocytes count,NR,hs-CRP in patients of poor myocardial perfusion group were(11. 60 ± 3. 57)× 109 / L,0. 84 ± 0. 06 and 9. 80 ± 11. 37 mg/ L,higher than those in well myocardial perfusion group((9. 51 ± 2. 59)× 109 / L,0. 77 ± 0. 11 and(3. 83 ± 5. 58)mg/ L),and the differences were significant(t = 3. 497,P = 0. 001;t = 3. 390,P = 0. 001;t = 3. 973,P < 0. 001). Multiple linear regression analysis showed that neutrophil ratio was independent risk factor of sumSTR in STEMI patient after primary PCI(P = 0. 000). Conclusion The increase of leucocyte count,NR and hs-CRP are related to the poor myocardial perfusion after primary PCI. The increase of neutrophil ratio is an independent risk factor of poor myocardial perfusion.

Objective:To explore the current situation of emotion labor among emergency nurses and to analyze its influence on job engagement.Methods:From May to August 2018, this study selected 448 emergency nurses from 6 ClassⅢ general hospitals in Beijing as subjects by convenience sampling. All nurses were investigated with the General Information Scale, Emotional Labor Scale (ELS) and Utrecht Work Engagement Scale (UWES) . SPSS 22.0 was used to data entry and analysis. T test, variance analysis, Pearson correlation was used to single factor analysis, and multiple hierarchical regression was used to influencing factor analysis. Results:Among 448 emergency nurses, the total average scores of ELS and UWES were (3.94±0.75) and (3.43±0.69) respectively. There were statistical differences in the scores of UWES among emergency nurses with different genders and posts ( t=-2.048, -4.553; P<0.05) . Pearson correlation analysis showed that surface acting and expression of emotions in ELS had negative correlations with dimensions in UWES among nurses with statistical differences ( r=-0.108--0.330, P<0.05) ; deep acting in ELS had positive correlations with dimensions in UWES with statistical differences ( r=0.220-0.256, P<0.01) . Hierarchical regression analysis showed that deep acting positively predicted job engagement, and surface acting negatively predicted job engagement which explained 17.9% of the variance of job engagement. Conclusions:Emergency nurses of Class Ⅲ general hospitals have middle level of emotion labor and upper middle level of job engagement. Nursing managers should pay more attention to emotion labor of nurses and improve the job engagement by emotion labor so as to improve the nursing service quality.

Objective: To evaluate the biomechanical effects of combined use of miniscrew and clear aligner in different kinds of loading condition on the en-mass retraction of maxillary anterior teeth. Methods: 3 D finite element models of the maxillary bone with miniscrews and clear aligner were reconstructed using the method of reverse engineering with CBCT data of an adult patient who had maxillary first premolars extracted. The orthodontic force was loaded by (1) clear aligner, (2) clear aligner and 1. 47 N force of retraction at appliance and (3) clear aligner and 1. 47 N force of retraction at canine, respectively. Results: Under the working condition of (1), (2) and (3), in sagittal direction, the displacement difference of crown and root of the maxillary central incisor was 1. 12 E-02 mm, 1. 29 E-02 mm and 9. 62 E-03 mm respectively, the displacement of the first molar crown was-2. 49 E-02 mm, -2. 09 E-02 mm and-2. 00 E-02 mm respectively; in vertical direction, extrusion of the maxillary central incisor was 1. 77 E-03 mm, 2. 93 E-03 mm and 6. 53 E-04 mm respectively. Conclusion: The working condition (3) is more advantageous to control the torque of incisors and to save the anchorage of posterior teeth, and more effective to control the extrusion of the incisors.

The teaching design of medical humanities English with humanistic spirit as its core makes use of the rain classroom platform to make the important teaching links from pre-class, in-class, and post-class an organic whole, promoting each other. By selecting medical humanities materials, learning English language and various second classes, we can guide students to strengthen their thinking on medical humanities, thus combining humanistic spirit with language skills to improve students' humanistic quality and meet the development needs of higher education in medical colleges.

To explore the reconstruction and practice of medical English education in medical colleges and universities in China, totally, 23 deans of foreign language schools of medical universities and teachers in charge of English for Medical Purpose from prestigious universities where students have access to multidisciplinary education were interviewed via WeChat respectively. Additionally, a valid questionnaire survey was collected of 2 270 medical undergraduates in Xi'an Medical University, thus to evaluate feedback related to medical English education. In terms of medical English education, medical colleges and universities have such commonly shared disadvantages as insufficient medical knowledge of medical English teachers, imbalance between medical teaching and medical education, insufficient humanistic education in medical English teaching, poor integration of language and medicine science, ineffective coordination and matching between curriculum teaching and education objectives. Advisably, mixed mode of medical English education and teaching system in medical colleges and universities should be restructured. As for the development of English teachers for Medical Purpose, the synergy between medical English teachers in medical colleges and clinicians in affiliated hospitals should be developed via cooperative lesson preparation and classroom teaching characterized by hospital-school collaboration. Also, concerning teaching approaches and education and teaching objectives, the mixing of online and offline teaching should be adopted to achieve the objectives of making students be intellectually, competently, and emotionally qualified for future post. Last, medical English discipline should be prioritized to provide support for medical English education and teaching. The teaching and research competence of medical English teachers is the key factor for medical English education and teaching in medical colleges and universities. Importantly, integration of academia and medical industry needs to be deepened to facilitate the integration of medical industry, education and research, thus to ensure the development of high-quality medical talents with good mastery of English and medical English talents with good mastery of medicine in the fields of medical diplomacy and medical aid in African countries.

This paper mainly introduced the current status of quality of life among patients after bariatric and metabolic surgery at home and abroad including different assessment tools,changes and influencing factors of quality of life after surgery so as to provide a reference for medical staff of China to improve the quality of life of patients after bariatric and metabolic surgery and develop a specific assessment tool.