Objective:To investigate the employment status of graduates from standardized residency training in Hubei Province, China and provide strategies for improving the quality of medical education after graduation.Methods:A cross-sectional survey was conducted in August 2022. Graduates from the first and second batches of 29 national standardized residency training bases in Hubei Province from 2017 to 2022 were surveyed using an online questionnaire. A total of 4 344 valid responses were collected, with a response rate of 95.78%. The survey was conducted online using a self-designed questionnaire titled "Employment Status Survey of Residency Training Graduates in Hubei Province".Results:Among the graduates, 3 505 (80.69%) were directly employed after completing the training, while 428 (9.85%) were unemployed. The primary reason for unemployment was ongoing job searching or application processes (268, 62.61%). Of the employed graduates, 3 082 (87.63%) worked in hospitals, including 1 799 (58.37%) in grade A tertiary hospitals, 485 (15.74%) in grade B tertiary hospitals, and 618 (20.05%) in grade A secondary hospitals. A total of 2 936 (83.48%) graduates worked in physician positions aligned with their training specialties, while 500 (14.22%) worked in physician positions unrelated to their training specialties. Additionally, 1 349 (38.35%) graduates reported that their current income met their personal consumption needs, while 2 138 (61.65%) stated that their income barely met or failed to meet their needs. Moreover, 2 466 (70.12%) graduates felt that their current work status generally met their expectations, while 968 (27.52%) reported that it fell below their expectations. Of the graduates, 2 927 (67.40%) believed that the residency training significantly helped them perform their current jobs, whereas 1 417 (32.60%) perceived the training as providing limited or moderate assistance.Conclusions:The re-employment rate of residency training graduates in Hubei Province is relatively high. However, the recognition of standardized residency training and the salary levels of re-employment are relatively low.

Objective:To investigate the employment status of graduates from standardized residency training in Hubei Province, China and provide strategies for improving the quality of medical education after graduation.Methods:A cross-sectional survey was conducted in August 2022. Graduates from the first and second batches of 29 national standardized residency training bases in Hubei Province from 2017 to 2022 were surveyed using an online questionnaire. A total of 4 344 valid responses were collected, with a response rate of 95.78%. The survey was conducted online using a self-designed questionnaire titled "Employment Status Survey of Residency Training Graduates in Hubei Province".Results:Among the graduates, 3 505 (80.69%) were directly employed after completing the training, while 428 (9.85%) were unemployed. The primary reason for unemployment was ongoing job searching or application processes (268, 62.61%). Of the employed graduates, 3 082 (87.63%) worked in hospitals, including 1 799 (58.37%) in grade A tertiary hospitals, 485 (15.74%) in grade B tertiary hospitals, and 618 (20.05%) in grade A secondary hospitals. A total of 2 936 (83.48%) graduates worked in physician positions aligned with their training specialties, while 500 (14.22%) worked in physician positions unrelated to their training specialties. Additionally, 1 349 (38.35%) graduates reported that their current income met their personal consumption needs, while 2 138 (61.65%) stated that their income barely met or failed to meet their needs. Moreover, 2 466 (70.12%) graduates felt that their current work status generally met their expectations, while 968 (27.52%) reported that it fell below their expectations. Of the graduates, 2 927 (67.40%) believed that the residency training significantly helped them perform their current jobs, whereas 1 417 (32.60%) perceived the training as providing limited or moderate assistance.Conclusions:The re-employment rate of residency training graduates in Hubei Province is relatively high. However, the recognition of standardized residency training and the salary levels of re-employment are relatively low.

Objective To explore the mechanism of ferroptosis induced by endoplasmic reticulum stress(ERs)in acute respiratory distress syndrome(ARDS).Methods In order to determine the effects of LPS on oxidative stress and Fe2+level of mouse capillary alveolar epithelial cells(MLE12 cells),the cells were treated with LPS(0,1,2,5 μg/ml)for 24 h.To verify the role of ferroptosis in lipopolysaccharide(LPS)-induced cell death,MLE12 cells were divided into control(Con)group,iron removal inhibitor(Fer-1)group,LPS group and LPS+Fer-1 group.LPS+Fer-1 group was pretreated with 10 μmol/L Fer-1 for 6 h,then the cells were exposed to 5 μg/ml LPS for 24 h.Con group was treated with solvent DMSO for 24 h.Fer-1 group was pretreated with 10 μmol/L Fer-1 for 6 h,and then treated with DMSO for 24 h.The cells in LPS group were exposed to 5 μg/ml LPS for 24 h.The MLE12 cells were divided into three groups:Con+Vector group,Con+sequence similarity family 134 mem-ber B(FAM134B)group,LPS+Vector group and LPS+FAM134B group.After transfected with vector or FAM134B overexpression plasmid for 48 h,the cells were exposed or not exposed to 5 μg/ml LPS for 24 h.Cell vi-ability was measured by CCK-8.The levels of malondialdehyde(MDA),glutathione and iron,the protein levels of ferroptosis markers[cyclooxygenase 2(PTGS2),glutathione peroxidase 4(GPX4)]and ERs markers[glucose reg-ulatory protein 78(GRP78),activated transcription factor 4(ATF4)and C/EBP homologous protein(CHOP)]were measured in different groups.In order to further confirm the results of in vitro cell experiments,40 mice were randomly divided into Con+Vector group,Con+FAM134B group,LPS+Vector group and LPS+FAM134B group,with 10 mice in each group.LPS-induced sepsis models were established in LPS+Vector group and LPS+FAM134B group,and the levels of GPX4 and ERs in lung tissue were evaluated by immunofluorescence staining and protein blot.Results LPS treatment increased the levels of PTGS2 and MDA,and decreased the levels of GPX4 and GSH in MLE12 cells in a dose-dependent manner.Compared with LPS group,the cell viability,GPX4 and GSH levels in LPS+Fer-1 group increased significantly(P<0.05),while the PTGS2 protein level and MDA level decreased significantly(P<0.05).Compared with LPS+Vector group,LPS+FAM134B group significantly increased cell viability(P<0.05),decreased PTGS2 protein level(P<0.05)and increased GPX4 level(P<0.05).At the same time,the level of MDA in LPS+FAM134B group was lower than that in LPS+Vector group(P<0.05),and the level of GSH was higher than that in LPS+Vector group(P<0.05).In animal experiment,compared with LPS+Vector group,the expression levels of 4-HNE,ATF4 and CHOP in lung tissue of LPS+FAM134B group decreased significantly(P<0.05),and the expression levels of GPX4,FAM134B group in-creased significantly(P<0.05).Conclusion LPS induces ferroptosis and ERs in MLE12 cells in a dose-depend-ent manner.Activating the endoplasmic reticulum autophagy associated FAM134B receptor helps to inhibit ERs and alleviate cell ferroptosis.

Objective:To investigate the efficacy of acupuncture therapy combined with rhubarb applied to the umbilicus in the treatment of constipation in patients with stage IV-V diabetic nephropathy.Methods:Ninety stage IV-V diabetic nephropathy patients with constipation, who received treatment in Wenzhou Hospital of Traditional Chinese Medicine from December 2019 to December 2020, were included in this study. They were randomly assigned to receive either routine treatment (control group, n = 45) or routine treatment plus acupuncture therapy combined with rhubarb applied to the umbilicus (study group, n = 45). Serum motilin, gastrin, and somatostatin levels and orocecal transit time pre- and post-treatment were compared between the two groups. The constipation severity was evaluated using the Constipation Severity Scale (CSS). Quality of life was evaluated using the Patient Assessment of Constipation Quality of Life Questionnaire. Clinical efficacy was compared between the two groups. Results:The somatostatin level and orocecal transit time post-treatment in the study group were (13.66 ± 4.24) ng/L and (80.58 ± 10.11) minutes, respectively, which were significantly lower than those in the control group [(19.31 ± 6.13) ng/L, (87.16 ± 12.04) minutes, t = 5.08, 2.80, both P < 0.05]. Serum motilin and gastrin levels post-treatment in the study group were (281.07 ± 41.16) ng/L and (181.07 ± 35.16) ng/L, respectively, which were significantly higher than those in the control group [(259.64 ± 39.83) ng/L, (162.65 ± 32.83) ng/L, t = 2.51, 2.56, both P < 0.05]. The scores of the Constipation Severity Scale and the Patient Assessment of Constipation Quality of Life Questionnaire post-treatment in the study group were (10.66 ± 3.14) points and (60.14 ± 13.64) points, respectively, which were significantly lower than those in the control group [ (15.31 ± 4.13) points, (71.61 ± 14.72) points, t = 6.01, 3.83, both P < 0.05). Total response rate was significantly higher in the study group than in the control group (97.78% vs. 80.00%, χ2 = 5.51, P < 0.05). Conclusion:Acupuncture therapy combined with rhubarb applied to the umbilicus can be used to treat constipation in patients with stage IV-V diabetic nephropathy. The combined therapy can adjust the secretion of gastrointestinal tract-related hormones, shorten orocecal transit time, improve clinical symptoms, and improve clinical efficacy and quality of life.

Objectives:To investigate the clinical outcomes of long agonist protocol in predicted hyper responders, and to explore the risk factors associated with hyper ovarian response in these patients.Methods:In this retrospective case-control study, 664 predicted hyper responders were included. All patients were from Reproductive Center of Fujian Maternity and Child Health Hospital, and were in treatment during January 1, 2016 and June 1, 2019. Logistic regression was applied to screen out the independent risk factors of hyper ovarian response. The prediction accuracy of the independent risk factors was evaluated by calculating the area under the receiver operating characteristic curve (AUC).Results:Totally 10 (1.51%) of all patients occurred poor ovarian response, 356 (53.61%) of all patients achieved normal ovarian response, and 298 (44.88%) of them got hyper ovarian response. The rate of moderate-to-severe ovarian hyperstimulation syndrom (OHSS) from normal response group [3.09% (11/356)] was significantly lower than that from hyper response group [8.39% (25/298), P=0.003]. The rate of clinical pregnancy per transfer showed no statistical significance between the two groups ( P>0.05). The miscarriage rate was more than two times in normal response group compared with high response group, but without statistical significance ( P>0.05). Multivariate logistic regression analysis showed that luteinizing hormone (LH) level on human chorionic gonadotropin (hCG) injection day was negatively correlated with the occurrence of hyper ovarian response. The AUC of LH level on hCG injection day was 0.594. LH level on hCG injection day ≤1.0 IU/L was an independent risk factor of hyper ovarian response. Conclusion:Long agonist protocol is a good option for predicted hyper responders. LH supplementation might be helpful in controlled ovarian stimulation to reduce the incidence of hyper ovarian response.

Objectives:To investigate the clinical outcomes of long agonist protocol in predicted hyper responders, and to explore the risk factors associated with hyper ovarian response in these patients.Methods:In this retrospective case-control study, 664 predicted hyper responders were included. All patients were from Reproductive Center of Fujian Maternity and Child Health Hospital, and were in treatment during January 1, 2016 and June 1, 2019. Logistic regression was applied to screen out the independent risk factors of hyper ovarian response. The prediction accuracy of the independent risk factors was evaluated by calculating the area under the receiver operating characteristic curve (AUC).Results:Totally 10 (1.51%) of all patients occurred poor ovarian response, 356 (53.61%) of all patients achieved normal ovarian response, and 298 (44.88%) of them got hyper ovarian response. The rate of moderate-to-severe ovarian hyperstimulation syndrom (OHSS) from normal response group [3.09% (11/356)] was significantly lower than that from hyper response group [8.39% (25/298), P=0.003]. The rate of clinical pregnancy per transfer showed no statistical significance between the two groups ( P>0.05). The miscarriage rate was more than two times in normal response group compared with high response group, but without statistical significance ( P>0.05). Multivariate logistic regression analysis showed that luteinizing hormone (LH) level on human chorionic gonadotropin (hCG) injection day was negatively correlated with the occurrence of hyper ovarian response. The AUC of LH level on hCG injection day was 0.594. LH level on hCG injection day ≤1.0 IU/L was an independent risk factor of hyper ovarian response. Conclusion:Long agonist protocol is a good option for predicted hyper responders. LH supplementation might be helpful in controlled ovarian stimulation to reduce the incidence of hyper ovarian response.

Objective:To explore the characters of CDU imaging anatomy and results of clinical application of perforating branch of median cubital vein, and to find the evidence of utilizing perforating vein to establish high level hemodialysis access.Methods:From November, 2016 to October, 2019, 150 median cubital veins in 75 persons were observed by CDU. And the inner diameter and length of the perforating branch were measured Perforating branches of median cubital vein were categorized with ultrasonic imaging anatomy. Thirty-eight chronic kidney failure patients who can not build forearm fistulas were operated by end-to-side anastomosis between perforating branch vein and brachial artery to build hemodialysis access. The blood flow of fisultas was measured,the mature period of fisultas was recorded. The length of available vessels of fisultas was measured and the long-term utilization rate of fisultas was counted.Results:Perforating branch of median cubital vein was always located in a little below elbow near brachial artery, the rate of occurrence was 94.0%. It was sent out at intersection of veins. There were 4 types of perforating vein in image-anatomy. There was no significant difference in vessel length and vessel inner diameter between different types ( P>0.05) ; All the 38 patients with mature fistulas could meet the needs of hemodialysis. The available vascular length of fistulas in type I and type II patients was better than that in type III ( P<0.01), and the long-term utilization rates of fistulas in type I, type II and type III were 84.6%, 85.7% and 72.7%, respectively. There was no significant difference in blood flow and mature period between different types ( P>0.05) . Conclusion:It is most safe and reliable to use the type I and type II of perforating branch of median cubital vein to make the high level fistulas , which can provide a safe and efficient hemodialysis access for the patients with forearm vascular drain, elderly diabetes patients and difficult fistulas with repeatedly thrombosis.

Objective To explore the diagnostic value of high frequency three-dimensional (3D) ultrasound in breast masses.Methods Seventy-seven cases of breast lesions were selected by 2D ultrasonic scan,and all the cases had been examined by 3D ultrasound and accepted surgical treatment in Shenzhen People's Hospital.With pathological results as the gold standard for diagnosis,the convergence sign in diagnosis of breast masses was used as malignant standard for 3D ultrasound coronal plane.The sensitivity and specificity were analyzed of 3D ultrasound in the diagnosis of benign and malignant breast tumors.Results A total of 77 cases of breast lesions included 46 malignant and 31 benign.3D ultrasound convergence sign was used to judge the benign and malignant breast tumors with statistical significance (x2 =26.790,P ＜ 0.01).The diagnostic sensitivity and specificity were 69.7％,and 90.3％,respectively.Conclusions High frequency 3D ultrasonography has certain value in differential diagnosis of benign and malignant breast tumors,and has important significance for the formulation of treatment plan.

Objective To prepare Integrin αvβ3/CCR2 dual targeted microbubble,test physical-chemical properties,enhancement effect and targeting ability in vitro.Methods The dual targeted microbubbles (MBdual-target )with FITC labled iRGD and PE labled CCR2 were prapared,and non-target microbubbles as control (MBcontrol ) were prapered.Physical and chemical properties of two groups of microbubbles were tested,connectivity of peptides/antibodies and microbubbles were detected by fluorescence microscope and flow cytometry instrument.Enhancement effect and the stability of two groups of microbubbles was observed and compared in vitro.The affinity of MBdual-target and MBcontrol for bEnd.3 cells was investigated with light and fluorescent microscope.Results ①The particle size of MBdual-target was (0.93±0.23)μm,with no statistically significant difference compared with MBcontrol (P >0.05).②MBcontrol showed no fluorescent,while MBdual-target showed both clear green and red light,under fluorescent microscope.③There was no significant difference of gray scale of enhancement between MBdual-target and MBcontrol in vitro.④ It was showed that MBdual-target adhered to bEnd.3 cells in vitro experiment.Conclusions Integrinαvβ3/CCR2 dual targeted targeted microbubbles was successfully prepared and proved having good enhancement effect and targeting ability in vitro.

Objective To investigate the application potentiality of dynamic three-dimensional contrast-enhanced ultrasound (3D-CEUS) in showing vascular patterns of hepatic tumors.Methods Total of 65 hepatic tumors were examined with two-dimensional contrast-enhanced ultrasound (2D-CEUS) and dynamic 3D-CEUS and make statistical comparison between two imaging modes in aspects of enhancement patterns,spatial relationships of tumors and vascularity of different hepatic tumors.Results Dynamic 3D-CEUS showed the same enhancement patterns with 2D-CEUS.However,Dynamic 3D-CEUS was superior to 2D-CEUS in the display of spatial relationships of hepatic tumors and vascularity(P ＜0.05).The vascularity between benign and malignant hepatic tumors was statistically significant (P ＜ 0.05).Conclusions Dynamic 3D-CEUS is a useful technique in the differential diagnosis of hepatic tumors as well as 2D-CEUS,and dynamic 3D-CEUS displays the spatial relationship of hepatic tumors and vascularity more visually and comprehensively,which provides additional beneficial information for the diagnosis and therapy of hepatic tumors.