Objective To explore the decision-making process of medical students who turned the major from the medicine to other majors,and the related factors that hindered them continuing to study the medicine.Methods According to the design of interpretative phenomenon logical analysis,semi-structured in-depth interviews were used to collect the data.Participants were six undergraduate students who had moved from medical major to another major.Interviews were recorded on audio-tape with the students' permission and then transcribed verbatim.The transcribed interviews were analyzed according to six steps of interpretative phenomenological analysis.Results Even if the participants had left the medical major,they still expressed a strong sense of professional identity for the doctor.However,they also admitted that the professional process of medicine students was very hard and tired,and couldn't get the equal return for their payment.They thus were lack of confidence for the future.Some of the participants talked about the fact that they had been curious about the future of medical students.Internet and seniors were the main avenues for obtaining job-related information,but they were often plagued by the negative information.Education about career adaptation should be carried out as soon as possible,to strengthen the professional identity of medical students,and enhance their ability to defend against negative information,which could help to deal with the status of high turnover rate for medical students.Conclusion Based on the students' perspective,exploring the decision-making process of turning major for medical students will contribute to the educators taking effective strategies to improve the students' career identity,stabilize their professional thought,and reduce the loss of the medical students.

Objective To approach the feasibility of the development and routinely carrying out of gynecological analgesia. Methods A total of 286 pregnant women, 58 were primiparae with full-term fetus and 228 were for mid-term delivery or induced abortion, were enrolled in present study. The combined lumbar-epidural analgesia (CLEA) and the patient-controlled epidural analgesia (PCEA) were given to the primiparae and the ones for mid-term delivery, and the intravenous anesthesia was given to those for induced abortion. Results Among the primiparae and the ones for mid-term delivery, VAS scores were rapidly reduced from 87.7?12.5 and 51.1?14.1 to 8.7?8.8 and 10.6?6.2, respectively, within 3 minutes by CLEA, the effective rates of analgesia were 94% and 100%, respectively. For all of them the Bromage evaluation was in 0 degree. After the induction of labor, no algesia memory existed in the women for induced abortion, the operative time was 15.28?2.57 minutes, the dosage of propoful was 162.9?39.8 mg (about 3mg/kg), and the dosage of fentanyl was 0.05 mg. The incidence of hypotension after intravenous anesthesia was 5.8%. Conclusions Intravenous anesthesia with propoful may remit the panic and fearful sense of pregnant women to induced abortion, and reduce the pain during operation. It is suggested to develop widely and carry out routinely the intravenous anesthesia as an effective and safe technique in gynecological analgesia.

Objective To discuss application of evidence-based nursing in nasopharyngeal carcinoma patients undergoing radiotherapy. Methods Evidence-based nursing was used in 33 nasopharyngeal carcinoma patients undergoing radiotherapy. Results After evidence-based nursing, all the patients actively cooperated with the doctors and nurses, lived through the treatment process smoothly, and radiotherapy complications were reduced or avoided. Conclusions Evidence-based nursing is an idealized nursing method which could reduce or avoid the complications and alleviate the pain of patients and improve the quality of nursing.

Objective To observe the difference of vascular endothelial growth factor (VEGF) and myeloperoxidase (MPO) between diabetic and non-diabetic patients with maintenance hemodialysis (MHD),and to explore whether it was associated with duration of hemodialysis.Methods A total of 120 patients with MHD were divided into diabetic group (40 cases) and non-diabetic group (80 cases) according to the primary disease.The blood samples from the patients before dialysis were selected to test the serum VEGF and plasma MPO and other indicators.The blood samples from April 2012 to March 2013 were labeled diabetic group 1(40 cases) and non-diabetic group 1 (80 cases).The blood samples from April 2013 to March 2014 were labeled diabetic group 2 (40 cases) and non-diabetic group 2 (80 cases).Results The serum VEGF and plasma MPO levels were (74.63 ± 47.43) ng/L,(300.63 ± 235.37) μ g/L in diabetic group 1,and (63.69 ± 43.23) ng/L,(275.35 ± 216.32) μ g/L in non-diabetic group 1,and there were significant differences between two groups (P ＜ 0.05).The serum VEGF and plasma MPO levels were (83.32 ± 40.38) ng/L,(414.12 ±265.52) μg/L in diabetic group 2,and (70.89 ±39.74) rig/L,(289.45 ±202.85) μg/L in non-diabetic group 2,and there were significant differences between two groups (P ＜ 0.05).The correlation analysis showed that VEGF was positively correlated with MPO in diabetic group 1 and diabetic group 2 (r =0.632 and 0.763,P ＜ 0.05),and VEGF was positively correlated with MPO in non-diabetic group 1 and non-diabetic group 2 (r =0.610 and 0.713,P ＜ 0.05).Conclusions Compared with those in non-diabetic MHD patients,VEGF and MPO levels are significandy higher in diabetic MHD patients.In non-diabetic MHD patients and diabetic MHD patients,VEGF and MPO levels will rise gradually with duration of hemodialysis.The expressions of VEGF and MPO are associated with each other.

Purpose To investigate the diagnosis and differentail diagnosis of metastatic small cell carcinoma of bone in needle biopsy, especially for the differentail diagnosis with Ewing sarcoma of bone. Methods Clinicopathological informations of 11 cases of metastat-ic small cell carcinoma and 20 cases of Ewing sarcoma were collected, and markers for differentail diagnosis were detected in two groups by immunohistochemistry of EnVision. Results The positive rates of CD99 and FLI-1 were 27. 3% and 54. 5% in metastatic small cell carcinoma group, while the positive rate of CK was 15. 0% in Ewing sarcoma group. Patient′s age, single lesion, expression of CK, vimentin, CD99, FLI-1, CD56 were significantly different in two groups. Conclusions Metastatic small cell carcinoma and E-wing sarcoma share similar histopathologic features in needle biopsy, no single immunohistochemical marker can specifically distinguish small cell carcinoma from Ewing sarcouma. The correct diagnosis should comprehensive analyze clinicopathologic characters and a se-ries of immunohistochemical markers.

Heat stroke (HS) is a life-threatening illness characterized by core body temperatures above 40 ℃ coupled with central nervous system (CNS) dysfunction, including delirium, convulsions, and/or coma. Its morbidity has increased dramatically in the past few decades. Multiple organ dysfunction syndrome (MODS) is not only the most serious complication of HS, but also the leading cause of deaths. Understanding the pathogenesis, characteristic and advancement pattern of MODS caused by HS will have a profound effect on the clinical treatment, research and mortality decrease. The pathogenesis, injury characteristic of each system and organ, and treatment methods were summarized in this review so as to deepen the clinical recognition of this disease.

Objective To explore the effect of lentiviral delivery green fluorescent protein in different brain regions on the transfection of dentate gyrus neurons.Methods Lenti-pSyn-EGFP was stereotaxic injected into dentate gyrus (DG),Cornu Ammonis 1 (CAl) of hippocampus and medial entorhinal cortex (EC) of rats.All animals were perfused with 4％ paraformaldehyde.Their brains were cut into 30 μm sections which were performed with Nissl fluorescent staining.Results The resuts showed that the GFP positive cells in DG area of DG,CA1,EC,DG-EC groups were (18.0± 1.0),(17.0±0.6),(17.3±0.6),(18.3±0.6) respectively,and there was no statistical difference among each group(P＞0.05).Conclusion Lentivirus delivery in EC and CA1 both can transfect DG neurons.This is a useful method to transfect dentate gyrus neurons instead of injecting lentivirus into DG directly and avoid the lesion of DG.

Objective To investigate the effect of low 1evel laser treatment (LLLT) on periodontal clinical index,high-sensitivity C-reactive protein (hs-CRP) and metabolic control in patients of type 2 diabetes mellitus combined chronic peridontitis.Methods Nighty patients with type 2 diabetes combined chronic peridontitis were divided into three groups:initial periodontal therapy (group A),initial therapy combined with LLLT (group B) and control group (group C).The periodontal clinical parameters including periodontal probing depth (PD),clinical attachment loss (CAL),sulcus bleeding index (SBI),hs-CRP,HbA1c and fasting blood glucose (FBG) were tested before and at three months after therapy.Results The periodontal clinical parameters (PD,CAL,SBI) and hsCRP in group A and B improved significantly compared with that of group C after therapy (P＜0.05),with group B had more significant difference (P＜0.01).For the levels of HbA1c and FPG,group A and B showed downtrend,and more obvious outcome was detected in group B (P＜0.05).Conclusions LLLT can effectively improve periodontal status,hs-CRP levels and metabolic control of patients with type 2 diabetes combined with chronic peridontitis,and thus to prevent the occurrence of diabetes complications.

Objective To investigate the anti-rotavirus effect of Gegen Qinlian decoction on rotavirus (RV)-inducing diarrhea neonatal mice model, and provide evidences for pharmacological and pharmacodynamic studies. Methods Neonatal diarrhea mice model of Kunming family infected with RV-Wa was developed. Symptom, diarrhea ratio and severity level, histological changes of neonatal mice’s small intestine and lung was assessed after Gegen Qinlian decoction (0.78 g/kg) treatment. Results Diarrhea ratio, diarrhea severity level, histological changes of neonatal mice’s small intestine and lung were obviously decreased after Gegen Qinlian decoction (0.78 g/kg) treatment. Conclusion Gegen Qinlian decoction has anti-rotavirus effect on RV induced diarrhea.

With the social development,the number of obese people is increasing.Recent studies have shown that obese women to have breast cancer disease's risk is higher than normal body weight,and etabolic disorders growing threat to human health.Estrogen,aromatase have contributed to the occurrence and development of breast cancer after menopause.AMPK is a negative regulator of aromatase,it can inhibit proliferation of cancer cells by metabolic pathways.What's more metformin,resveratrol inhibited proliferation by this route has been confirmed in breast cancer cells.Here,the author do an overview of the role of obesity-related factor for postmenopausal breast tissue estrogen synthesis and metabolic abnormalities affect aromatase expression in breast.