ABSTRACT
Objective:To investigate the quality of 5-year medical undergraduates in China,analyze the influ-ence factors and put forward relevant policy suggestions. Method:By stratified random sampling,there are 24 medi-cal colleges or universities in northeastern, eastern, central, southern and southwestern China were included. Ac-cording to access the official websites,the enrollment data of 5-year medical undergraduates were collected. Result:The percentile of medical students'average score in entrance examination was around 33.46% ~56.32% in the first batch. There are significant difference among areas about the quality of medical undergradnates. Conclusion:At pres-ent,the quality of the 5-year medical undergraduates is good. Because high quality students unwilling to apply for clinical medicine,the quality of students declined. For this question,the suggestions are to improve enrollment sta-tus,school finical support,medical environment and doctors' welfare.
ABSTRACT
BACKGROUND: The purpose of this study was to examine the safety and efficacy of cannulation of the innominate artery with a side graft in arch surgery. METHODS: Between January 2004 and March 2009, 46 patients received arch surgery under hypothermia circulatory arrest (HCA) and hemispheric antegrade cerebral perfusion (HACP). There were 36 men and 10 women with an average age of 48.0 +/- 12.8 years. Thirty-four patients had type A aortic dissection. Four patients had type B aortic dissection. The remaining 8 patients had aortic aneurysm involving the ascending aorta and arch. The innominate artery was free of diseases in all patients. The diameter of the innominate artery was 12.1 +/- 1.6 mm (range, 9 to 16 mm). An 8-mm vascular graft, which was anastomosed to the innominate artery in an end-to-side manner, was used for arterial cannulation. Ascending aorta and arch replacement in combination with open stent-graft implantation was conducted in 42 patients. Four patients received open stent-graft implantation through the aortic arch only. RESULTS: The aortic cross-clamp time was 87.2 +/- 36.0 minutes. The lowest nasopharyngeal temperature was 21.0 +/- 3.6 degrees C. The HCA and the HACP time was 29.6 +/- 14.0 minutes. The HACP flow was 8.3 +/- 2.3 mL x kg(-1) x min(-1). Five patients (10.9%) had temporary postoperative neurologic dysfunction. There was no permanent neurologic dysfunction. Three patients died within 30 days postoperatively, and the 1-month mortality rate was 6.5%. All of the surviving patients were followed for 24.9 +/- 18.0 months (range, 1 to 63). There were no deaths or severe complications during the follow-up. CONCLUSIONS: Cannulation of the innominate artery with a side graft is safe and effective in arch surgery.