While the number of the enrolled postgraduate students is continuously increased and the various reforms go in depth, there appear some new problems and contradictions in the education of doctorial students.Among those problems,the lack of the doctorial student resource,especially the lack of the excellent doctorial student resource,is the most prominent problem that re- stricts the progress of the doctorial student education.In order to solve these problems,this article analyzes the factors influencing the resource of the students and put forward the strategy to deal with these factors.

Adolescent ; Adult ; Aged ; Female ; Humans ; Intervertebral Disc Displacement ; therapy ; Lumbar Vertebrae ; Male ; Manipulation, Spinal ; methods ; Middle Aged ; Pressure

Objective To investigate the therapeutic effects and toxic effects of radiochemotherapy versus chemotherapy alone in patients with advanced gastric cancer after gastrectomy.Methods A total of 183 patients with stage Ⅱ-Ⅳ (M0) gastric cancer,who received treatment after gastrectomy from 2004 to 2010,were included in the study.Of the 183 patients,64 received radiochemotherapy after gastrectomy,and 119 received chemotherapy alone after gastrectomy.The survival rates and hematological and gastrointestinal toxic effects were compared between the two groups;survival difference was also analyzed after the patients were stratified by TNM stage,number of metastatic lymph nodes,and extent of lymph node dissection (D0,D1,and D2).The Kaplan-Meier method was used for calculating survival rates,and the log-rank test was used for survival difference analysis and univariate prognostic analysis;the chi-square test was used for comparing toxic effects between the two groups.Results The follow-up rate was 87.8％ ;72 patients were followed up for at least 3 years,and 29 patients for at least 5 years.The 1-,3-,and 5-year survival rates for the radiochemotherapy group were 86％,62％,and 55％,respectively,as compared with 77％,53％,and 43％ for the chemotherapy group (P =0.079).There were no significant differences in grade 3-4 hematological and gastrointestinal toxic effects between the two groups (P =0.363 and 0.617).The univariate analysis showed that radiochemotherapy had a significantly better survival benefit than chemotherapy alone in patients with stage ⅢB-Ⅳ (M0) gastric cancer,patients who underwent D0 lymph node dissection,and patients with more than 6 metastatic lymph nodes (P =0.022,0.025,and 0.021).Conclusions Compared with chemotherapy alone,radiochemotherapy tends to improve survival in patients with gastric cancer after gastrectomy,and its toxic effects are tolerable.The patients with stage ⅢB-Ⅳ (M0) gastric cancer,patients who undergo D0 lymph node dissection,and patients with more than 6 metastatic lymph nodes can benefit from radiochemotherapy.

OBJECTIVETo investigate nephroprotective effects of a mixture of 8 L-amino acids on renal ischemia-reperfusion injury and its effects on renal endothelin-1 (ET-1).

METHODSThe mixture of 8 L-amino acids includes glycine, alanine, threonine, serine, valine, leucine, isoleucine and proline. Acute ischemic renal injury was induced by clamping renal pedicle for 45 minutes in rats. Sixty male Sprague-Dawley rats were randomly divided into 3 groups: a sham-operated group (Group A, n=8), a control group (Group B, n=26) and an amino acid-treated group (Group C, n=26). Amino acids were infused at a rate of 1 ml x 100g(-1) x h(-1) I hour before ischemia and during 3 hours of the whole reperfusion. The serum creatinine values, BUN levels, creatinine clearance, urine sodium and potassium excretion, urine lactate dehydrogenase (LDH), the rate of urine flow and histological examination were measured. Renal ET-1 levels were assayed with radioimmunological assay (RIA) RESULTS: The creatinine clearance was 471.0 microl/min+/-121.5 microl/min in Group C and 227.0 microl/min+/-27.0 microl/min in Group B 3 hours after reperfusion, P<0.01). The urine flow rate was 63.6 microl/min+/-15.2 microl/min in Group C and 24.3 microl/min+/-7.7 microl/minin Group B, P<0.01) 1.5 hours after reperfusion. The serum creatinine was 85.0 microl/min+/-7.7 micromol/L and BUN concentration 11.4 mmol/L+/-3.9 mmol/L in Group C and 112.7 micromol/L+/-19.5 micromol/L and 20.7 mmol/L+/-6.6 mmol/L respectively in Group B after 24 hours of reperfusion (P<0.05). The mean histological score by standards of Paller in kidneys was 108.7+/-15.7 in Group C, and 168.8+/-14.8in Group B (P<0.01). The renal ET-1 levels 15 minute and 3 hours after reperfusion were 7.2 pg/mg+/-0.8 pg/mg and 9.6 pg/ml+/-1.0 pg/ml in Group C, and 10.1 pg/ml+/-2.8 pg/ml and 13.0 pg/ml+/-2.7pg/ml in Group B (P<0.01).

CONCLUSIONSThe mixture of 8 L-amino acids can provide remarkable protection against renal ischemia-reperfusion injury in rats. This may associate with attenuation of renal ET-1 disorder.

Amino Acids ; pharmacology ; Animals ; Antineoplastic Combined Chemotherapy Protocols ; Blood Urea Nitrogen ; Creatinine ; urine ; Endothelin-1 ; analysis ; Glomerular Filtration Rate ; Kidney ; blood supply ; L-Lactate Dehydrogenase ; urine ; Male ; Radioimmunoassay ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; prevention & control

Objective To analyze alterations in electrocardiogram (ECG) of adenosine test in 99Tcm-MIBI myocardial perfusion imaging(MPI)SPECT study. Methods A total of 641 patients were in cluded in the study. The patients each underwent 99Tcm-MIBI MPI with adenosine test. The ECGs were taken before, during, and after adenosine infusion. Results In all, abnormal ECGs were found in 205(32.0%) patients. During adenosine infusion, 20.6%(132/641) of patients suffered from arrhythmia,29.5%(39/132) had atrial premature beats, 34. 1% (45/132) had premature ventricular beats, and 6. 1% (8/132) had sinoatrial block. In addition, 5.3% (7/132) had first-, 24.2% (32/132) had second-, and 0.8%(1/132) had third-degree atrioventricular block (AVB). After adenosine infusion, 4.4%( 28/641) of patients suffered from arrhythmia, 57.1% (16/28) had atrial premature beats, 39.3%(11/28) had premature ventricular beats, and 3.6% (1/28) had sinoatrial block. The perfusion images showed ischemia in 36 patients and infarction in 8 patients. Adenosine infusion was terminated in 39 patients (6. 1%) because of poorly tolerated side effects. However, no death or acute myocardial infarction occurred in the study. Conclusions Adenosine pharmacologic test for 99TcmMIBI MPI may result in relatively high incidence of arrhythmia in ECG monitoring.

Objectives To explore the characteristics of status and different populations of prehospital death associated with acute coronary events among young adults in Beijing.Methods Data of acute coronary events of hospitalization or death were obtained from the Hospital Discharge Information System from Beijing Public Health Information Center and Death Register System from Beijing Center for Disease Control in Beijing.The total case fatality rate of acute coronary events and proportion of prehospital coronary heart disease (CHD) death were compared upon gender,area,occupation and marital status among people aged between 25-45 years old.Results A total of 3489 cases were identified during 2007 to 2009 with acute coronary events ( male:3183,female:306),with a mean age of (40.5 ± 4.3 ) years old.The 3-years' overall mortality was 26.0％,with female's higher than male's (51.0％ vs 23.6 ％,P ＜ 0.05 ) ; and it was higher in rural area than in urban areas (28.9％ vs 22.9％,P ＜0.05).Ninety-five percent of death due to acute coronary events occurred prehospital,with the proportion of 95.2％ in male and 94.2％ in female. Among the people with different occupations, self-employed people had the highest rate of prehospital death.Majority of prehospital deaths (64.8％ ) occurred at home.Conclusion More than 90％ of deaths caused by acute coronary events among young adults aged between 25-45 years old occurred before been admitted into hospital,and the site of prehospital deaths was mainly at home.

OBJECTIVESTo investigate the correlation between mutation of GyrA and ParC genes and quinolone resistance in Neisseria Gonorrhoeae.

METHODSThe gene fragments of quinolone resistance-determining region (QRDR) in GyrA and ParC genes in 20 Neisseria gonorrhoeae strains clinically isolated in Wuxi, China, were sequenced, and the susceptibility of the 20 strains to quinolone was examined by agar diffusion method.

RESULTSThe mutations at the Asp95 point in GyrA gene were found in 20 strains. Of the 19 stains examined, 16 had mutations at the 86, 87, 88, 91 points in ParC genes.

CONCLUSIONSThe mutations of Asp95 in GyrA gene and Asp86, Ser87, Ser88, Glu91 in ParC gene contribute to quinolone resistance in Neisseria Gonorrhoeae.

Base Sequence ; DNA Gyrase ; genetics ; DNA Topoisomerase IV ; genetics ; Drug Resistance, Bacterial ; genetics ; Humans ; Molecular Sequence Data ; Mutation ; Neisseria gonorrhoeae ; drug effects ; genetics ; isolation & purification ; Quinolones ; pharmacology

Objective To study the effect of continuous quality improvement on the health education of treatment of tuberculosis in thoracic surgical.Methods Totals of 278 cases between January and December in 2010 received the conventional health education as the control group,and 297 cases between January and December in 2011 as observation group received for continued quality improved,through change shifts mode,provides personalized health education content,strengthening specialist knowledge and the communication skills training,take rectification measures and evaluation effect.After one year,patients' health status,complication incidence,satisfaction of nursing quality were evaluated and compared between two groups.Results The achieved rate of health status (93.9％ vs 87.1％) and satisfaction of nursing quality (94.6％ vs 86.3％) in observation group were significantly better than that in control group (x2 =8.01,P ＜ 0.01),as well as the complication incidence (12.1％ vs 20.1％,x2 =6.88,P ＜ 0.01).Conclusions Continuous quality improvement not only has a good role in promoting postoperative health status,and reduce the incidence of postoperative complications,thus can improve the prognosis of patients with quality of care and quality of life satisfaction.

Objective:The classification model of prognosis of elderly cancer patients in rural areas of Shaanxi province was constructed based on machine learning algorithm, and its effectiveness was verified, providing reference for early prognosis recognition and intervention treatment.Methods:Using a multicenter, cross-sectional survey method and convenience sampling method, 597 elderly cancer patients in rural areas hospitalized in 9 different medical institutions (Shaanxi Cancer Hospital and its member units of specialty alliance) in Shaanxi Province from July to August 2022 were selected as the research objects, and a variable database of "basic information", "self-care ability", "symptoms", "comprehensive needs" and "quality of life" of elderly cancer patients in rural areas was established. Machine learning and statistical analysis were carried out to explore the important prognostic characteristics of elderly cancer patients in rural areas, and a prognostic classification model for elderly cancer patients in rural areas was constructed and verified.Results:The 597 valid questionnaires were ultimately collected.Among the 597 elderly cancer patients in rural areas, 207 were males and 390 were females, aged (69.56 ± 8.84) years. The results of cluster exploration showed that the prognosis of elderly cancer patients in rural areas was divided into three categories: good, medium and poor. The areas under the working characteristic curves of the subjects in good, medium and poor were 0.84, 0.79 and 0.69, respectively. The results of characteristic exploration showed that 10 indicators of "whether accompanied by metastasis", "distress", "sadness", "numbness", "eating", "walking", "fatigue", "forgetfulness", "fun of life" and "relationship with others" were important characteristic indicators of prognosis evaluation of elderly cancer patients in rural areas. There were statistically significant differences among the 10 important characteristic indicators in the three categories of prognosis of rural elderly cancer patients ( χ2=21.07, H values were 18.51-144.38, all P<0.01). There were statistically significant differences in the three categories of "comprehensive needs", "quality of life", "self-care ability" and "symptoms" ( H values were 519.40, 40.80, 103.69, all P<0.01). Conclusions:The construction and verification of a prognostic classification model for elderly cancer patients in rural areas based on machine learning algorithm can effectively explore the important characteristic indicators and prognostic classification of elderly cancer patients in rural areas, and provide basis and guidance for clinical medical staff to make individualized plans.

Objective To understand the medication compliance,family care and their correlation in patients with chronic hepatitis B. Methods From January to Decemeber 2016,two hundred and seventy-six chronic hepatitis B patients from a class III grade A infectious disease hospital in Nantong were selected as the research object by convenient sampling method. They were investigated by the medication compliance questionnaire and the family care index questionnaire. Results Chronic hepatitis B patients with good medication compliance accounted for 48.91%,the family care score was(7.82±2.38)points. Pearson correlation analysis showed negative correlation between the medication compliance of patients and family care(r=-0.173, P < 0.05). There were significance differences in medication compliance among different age,gender, occupation,cultural level,monthly income,medical payment(χ2=27.45,8.42,13.36,24.76,10.65,18.38;P < 0.05). There were significant differences in family care scores among patients of different age,gender, occupation,marital status,monthly income and method of medical payment(t=7.41,2.52,4.96,6.88,5.65, 11.26;P<0.05). Conclusions The medication compliance and family care of chronic hepatitis B patients still needs to be further improved. It is necessary to strengthen the multi family-oriented nursing intervention,and improve medication compliance and family care so as to delay progression and improve quality of life of patients.