Objective:To investigate the current status of knowledge, attitude, and practice in career planning among medical students and its influencing factors, and to facilitate the education of medical career planning.Methods:The convenience sampling method was used to distribute a self-made questionnaire, and related data were gathered from 295 medical students in Wuhan, China. SPSS 26.0 was used to perform analyses of related categorical variables, including descriptive statistics, univariate tests, rank-sum tests, and the binary logistic regression analysis.Results:The results showed that the medical students with good performance of career planning knowledge, attitude, and practice accounted for 68.48%, 87.12%, and 54.92%, respectively. Major, grade, professional satisfaction, and professional learning objectives were influencing factors for career planning knowledge among the medical students ( P<0.05); the intention for laboratory participation, the basis for major selection, and professional learning objectives were influencing factors for career planning attitude ( P<0.05); grade, internship experience, and professional learning objectives were influencing factors for career planning practice ( P<0.05). Conclusions:Related measures should be adopted to strengthen career planning education for medical talents, such as perfecting the whole-process and multi-agent career planning guidance system, stimulating the enthusiasm of students, and clarifying professional learning objectives.

Objective:To investigate the current status of knowledge, attitude, and practice in career planning among medical students and its influencing factors, and to facilitate the education of medical career planning.Methods:The convenience sampling method was used to distribute a self-made questionnaire, and related data were gathered from 295 medical students in Wuhan, China. SPSS 26.0 was used to perform analyses of related categorical variables, including descriptive statistics, univariate tests, rank-sum tests, and the binary logistic regression analysis.Results:The results showed that the medical students with good performance of career planning knowledge, attitude, and practice accounted for 68.48%, 87.12%, and 54.92%, respectively. Major, grade, professional satisfaction, and professional learning objectives were influencing factors for career planning knowledge among the medical students ( P<0.05); the intention for laboratory participation, the basis for major selection, and professional learning objectives were influencing factors for career planning attitude ( P<0.05); grade, internship experience, and professional learning objectives were influencing factors for career planning practice ( P<0.05). Conclusions:Related measures should be adopted to strengthen career planning education for medical talents, such as perfecting the whole-process and multi-agent career planning guidance system, stimulating the enthusiasm of students, and clarifying professional learning objectives.

The paper reported a case of brachial artery ligation treatment of arteriovenous graft infection with arteriovenous graft exposure and bleeding. Based on the experience of vascular access center and the review of relevant literature, the causes and treatment options of this complication were analyzed, and the feasibility and safety of brachial artery ligation were elaborated for the treatment of this complication, to provide references for clinical diagnosis and treatment.

Background::Familial hypercholesterolemia (FH) is underrecognized, and its association with coronary artery disease (CAD) remains limited, especially in China. We aimed to investigate the prevalence of FH and its relationship with CAD in a large Chinese cohort.Methods::FH was defined using the Make Early Diagnosis to Prevent Early Death (MEDPED) criteria. The crude and age-sex standardized prevalence of FH were calculated based on surveys of the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project during 2007-2008. The associations of FH with incident CAD and its major subtypes were estimated with the cohort-stratified multivariate Cox proportional hazard models based on the data from the baseline to the last follow-up (2018-2020).Results::Among 98,885 included participants, 190 participants were defined as FH. Crude and age-sex standardized prevalence and 95% confidence interval (CI) of FH were 0.19% (0.17%–0.22%) and 0.13% (0.10%–0.16%), respectively. The prevalence varied across age groups and peaked in the group of 60–<70 years (0.28%), and the peak prevalence (0.18%) in males was earlier, yet lower than the peak crude prevalence in females (0.41%). During a mean follow-up of 10.7 years, 2493 cases of incident CAD were identified. After multivariate adjustment, FH patients had a 2.03-fold greater risk of developing CAD compared to non-FH participants.Conclusions::The prevalence of FH was estimated to be 0.19% in the participants, and it was associated with an elevated risk of incident CAD. Our study suggests that early screening of FH has certain public health significance for the prevention of CAD.

Background::Familial hypercholesterolemia (FH) is underrecognized, and its association with coronary artery disease (CAD) remains limited, especially in China. We aimed to investigate the prevalence of FH and its relationship with CAD in a large Chinese cohort.Methods::FH was defined using the Make Early Diagnosis to Prevent Early Death (MEDPED) criteria. The crude and age-sex standardized prevalence of FH were calculated based on surveys of the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project during 2007-2008. The associations of FH with incident CAD and its major subtypes were estimated with the cohort-stratified multivariate Cox proportional hazard models based on the data from the baseline to the last follow-up (2018-2020).Results::Among 98,885 included participants, 190 participants were defined as FH. Crude and age-sex standardized prevalence and 95% confidence interval (CI) of FH were 0.19% (0.17%–0.22%) and 0.13% (0.10%–0.16%), respectively. The prevalence varied across age groups and peaked in the group of 60–<70 years (0.28%), and the peak prevalence (0.18%) in males was earlier, yet lower than the peak crude prevalence in females (0.41%). During a mean follow-up of 10.7 years, 2493 cases of incident CAD were identified. After multivariate adjustment, FH patients had a 2.03-fold greater risk of developing CAD compared to non-FH participants.Conclusions::The prevalence of FH was estimated to be 0.19% in the participants, and it was associated with an elevated risk of incident CAD. Our study suggests that early screening of FH has certain public health significance for the prevention of CAD.

Objective:To analyze the psychological stress of infertile patients after COVID-19 epidemic and its related factors by Chinese version of the perceived stress scale (CPSS).Method:The basic information, reproductive history, impact of the epidemic, psychological status of patients undergoing assisted reproductive technology at the General Hospital of Northern Theater Command from March 29, 2021 to April 29, 2021 were collected by questionnaire. According to CPSS, group comparison and correlation analysis were used to explore factors related to patients' psychological stress.Results:A total of 251 valid questionnaires were received. The average CPSS score of the patients was 22.43±7.07. During the epidemic, about 33.86% (85/251) of the infertility patients postponed the fertilization plan; there were significant differences in the psychological stress among patients of different genders, occupations, and postponed fertilization plans at different stages of fertilization ( P=0.001, P=0.005, P=0.002). There was no significant difference in CPSS score between infertile patients who delayed treatment or not ( P>0.05). Correlation analysis showed that the perceived stress of patients was negatively correlated with their age, income, and delay duration ( r=-0.192, P=0.002; r=-0.323, P=0.001; r=-0.282, P=0.009). Among all patients who delayed treatment, patients with higher CPSS score would restart treatment sooner; most of the infertile patients knew little about the vaccine. Conclusion:The COVID-19 epidemic has caused a certain impact on the psychological pressure of infertile couples who accepted treatment in our hospital. The psychological care for infertile patients is particularly important. In the future, in order to dispel the doubts of infertile patients about the vaccine, we should pay attention to the correct scientific promotion of the COVID-19 vaccine during the treatment process.

Objective:To analyze the psychological stress of infertile patients after COVID-19 epidemic and its related factors by Chinese version of the perceived stress scale (CPSS).Method:The basic information, reproductive history, impact of the epidemic, psychological status of patients undergoing assisted reproductive technology at the General Hospital of Northern Theater Command from March 29, 2021 to April 29, 2021 were collected by questionnaire. According to CPSS, group comparison and correlation analysis were used to explore factors related to patients' psychological stress.Results:A total of 251 valid questionnaires were received. The average CPSS score of the patients was 22.43±7.07. During the epidemic, about 33.86% (85/251) of the infertility patients postponed the fertilization plan; there were significant differences in the psychological stress among patients of different genders, occupations, and postponed fertilization plans at different stages of fertilization ( P=0.001, P=0.005, P=0.002). There was no significant difference in CPSS score between infertile patients who delayed treatment or not ( P>0.05). Correlation analysis showed that the perceived stress of patients was negatively correlated with their age, income, and delay duration ( r=-0.192, P=0.002; r=-0.323, P=0.001; r=-0.282, P=0.009). Among all patients who delayed treatment, patients with higher CPSS score would restart treatment sooner; most of the infertile patients knew little about the vaccine. Conclusion:The COVID-19 epidemic has caused a certain impact on the psychological pressure of infertile couples who accepted treatment in our hospital. The psychological care for infertile patients is particularly important. In the future, in order to dispel the doubts of infertile patients about the vaccine, we should pay attention to the correct scientific promotion of the COVID-19 vaccine during the treatment process.

Objective:To explore risk factors of death in type A intramural hematoma (IMH) patients with conservative therapy and provide important information for clinical risks stratification and decisions-making.Methods:This retrospectively study enrolled 130 patients diagnosed with type A IMH in the first CT examination at Fuwai Hospital of Chinese Academy of Medical Sciences and only received conservative therapy between September 2009 and June 2018. Baseline clinical and CT characteristics were recorded. All patients enrolled were followed up. The endpoint was aortic disease-related death, patients were divided into endpoint group and non-endpoint group according to whether or not an endpoint event occurs. Difference between two groups of normally distributed continuous variables, non-normally distributed continuous variables and categorical variables were tested by independent sample t test, Mann-Whitney U test and chi-square test or Fisher′s exact test, respectively. Independent risk factors related to outcomes were assessed with Cox regression analysis and survival analysis. Results:In baseline CT data, the mean value of the maximum aortic diameter (MAD) was (49.2±6.9) mm, and the median value of the maximum hematoma thickness (MTH) was 11.0 (8.5, 13.2) mm. There were 56 and 30 patients with ulcer-like projection (ULP) and intramural blood pool (IBP), respectively, which including 36 patients with ULP of ascending aorta, 51 patients with pericardial effusion and 50 patients with pleural effusion. During a median follow-up time of 1 050 (242, 1 949) days, 26 patients experienced aortic disease-related death. Compared with non-endpoint group patients, patients who experienced aortic disease-related death showed older age and larger MAD( t=2.363, 3.640, P=0.020,<0.001), higher proportion of aortic atherosclerosis, ULP and pericardial effusion (χ 2=5.275, 6.596, 9.325, P=0.022, 0.010, 0.002).In Cox regression multivariate analysis shows that aortic atherosclerosis [hazard ratio (HR)=3.48, P=0.043], ULP (HR=2.66, P=0.019) and pericardial effusion (HR=2.49, P=0.030) were independent risk factors for aortic disease-related death. Conclusions:Aortic atherosclerosis, ULP and pericardial effusion are independent predictors of subsequent aortic disease-related death for type A IMH patients with conservative therapy, identifying these risk factors is helpful for further risk stratification and decisions-making.

Objective To explore the effect of intravenous dexmedetomidine (0.4 μg·kg 1 ·h 1) on the recovery period in obese patients undergoing laparoscopic Roux-en-Y surgery.Methods Thirty patients (ASA Ⅰ to Ⅱ,body mass index ≥ 30 kg/m2) presenting for laparoscopic Roux-en-Y surgery under general anesthesia were randomly assigned 1:1 to the dexmedetomidine group (group D) or control group (group C).Dexmedetomidine was infused at 0.4 μg·kg-1·h-1 at the beginning of the operation and was discontinued 30 minutes before the end of the surgery in group D.Simultaneously,normal saline was infused at 0.4 μg· kg-1· h-1 in group C.The two groups received the same method of induction and maintenance anesthesia.The intraoperative variables measured included heart rate (HR),mean blood pressure (MBP),low frequency (LF),high frequency (HF),LF/HF ratio extubation time,Silverman-Andersen score (SAS) at the time of extubation,level of agitation during the recovery period,and adverse events.Results HR,MBP,and LF/HF of group C were higher than the baseline values and that of group D (P ＜ 0.05) during the recovery period.LF was higher in group C those in group D (P ＜ 0.05) during the recovery period.MBP was lower than the baseline values (P ＜ 0.05) and SAS at the time of extubation and level of agitation during the anesthesia recovery period were lower in group D (P ＜ 0.05) than in group C.There was no significant difference in HF and extubation time between the two groups (P ＞ 0.05).Conclusion Infusion of dexmedetomidine during anesthesia in obese patients may improve the quality of emergence from anesthesia without increasing the duration of the anesthesia recovery period.

Objective: To investigate the clinicopathological features and prognosis of malignant peripheral nerve sheath tumors (MPNST). Methods: We retrospectively reviewed the clinical data of MPNST patients who were treated at Cancer Institute & Hospital, Chinese Academy of Medical Science from January 1999 to January 2016. A total of 140 patients with 66 male and 74 female with MPNST were enrolled in the study. The median age was 40 at the time of diagnosis. Survival analysis were estimated by Kaplan-Meier method and Log rank test. Multivariate analysis were estimated by Cox proportional hazards regression model. Results: The median follow-up time was 43.0 months. The 3- and 5-year overall survival (OS) rates were 56.4% and 48.6%, respectively. The 3-year local recurrence (LR) rate and distant metastasis (DM) rates were 42.9% and 49.3%, respectively. Univariate analysis showed that the tumor location, AJCC stage, S-100, radiotherapy and margin status affected 5-year OS rate (all P<0.05). The tumor location, AJCC stage, S-100, Ki-67 staining, margin status, radiotherapy and chemotherapy affected 3-year LR rate (all P<0.05). The tumor location, AJCC stage, S-100, Ki-67 staining and margin status affected 3-year DM rate (all P<0.05). Multivariate analysis showed that the tumor location, AJCC stage, S-100 were independent factors for 5-year OS rate (all P<0.05). The tumor location, Ki-67 staining and chemotherapy were independent factors for LR (all P<0.05) while the AJCC stage, margin status and Ki-67 staining were independent factors for DM (all P<0.05). Conclusions MPSNT is an aggressive tumor with poor prognosis. Multiple factors were identified in this study. Patients with the tumor located at head and neck, advanced AJCC stage and negative S-100 usually have a low 5-year overall survival rate. Patients with the tumor located at head and neck, Ki-67 staining ≥ 20% and without chemotherapy had a higher tendency of local recurrence. Poor prognosis factors for DM were advanced AJCC stage, positive margin and Ki-67 staining ≥ 20%.