The effect of the Formative evaluation on the medical student＇s career emotion, practicing skills and social adaptation

With the development of the knowledge economy, social professional quality of talent has an increasingly demanding. Medical students is China＇ s medical and health undertakings reserve personnel, it plays an important role for better protection of people＇ s health by strengthening vocational personality training medical students and improving professional quality. Therefore, we must pay attention to the medical student＇ s career awareness, ethics, professionalism, career aspirations and career interests of education on medical students to develop a healthy personality of the medical profession, and lay the foundation for the sustainable development of medical and health services.

Testosterone and Its Bioactive Components Are Associated with Libido and the Metabolic Syndrome in Men

Background: Some evidence has shown that the prevalence of hypoactive sexual desire and erectile dysfunction (ED) is associated with testosterone levels whilst higher levels of testosterone have been reported to increase the frequency of intercourse. Available evidence points towards an etiologic role for hypogonadism in the causation of diabetes, metabolic syndrome (Mets) and sexual dysfunction (SD) even though the exact pathophysiological linkage is yet to be fully elucidated. This study therefore sought to evaluate the impact of testosterone as well as its bioactive components on both the MetS and SD. Method: Diabetic men engaged in a stable heterosexual relationship for at least 2 years were recruited for this study. Participants were at least 18 years and provided an informed and signed consent to partake in this study. Fasting blood samples were taken from the participants for biochemical and hormonal assay. The participants were then evaluated using the Golombok Rust Inventory of Sexual Satisfaction for males (GRISS-M). Metabolic syndrome was assessed using the NCEP-ATP III, IDF and WHO criteria. All data analyses were performed using the SPSS software, version 11.0 systat, Inc. Germany and GraphPad Prism, version 5.0, San Diego California, USA. Results: The mean total, free and bioavailable testosterone as well as SHBG recorded among the participants was 7.10 ± 1.23 ng/ml, 0.10 ± 0.01 ng/ml, 7.01 ± 1.41 ng/ml and 4.33 ± 1.12 nmol/l respectively. Subjects with the MetS showed significantly lower SHBG levels in comparison with subjects without the MetS. Participants with raised triglyceride levels showed significantly lower levels of total, free and bioavailable testosterone when compared to participant without raised triglycerides. Participants with problems of avoidance and infrequency of sexual activity showed significantly lower levels of total, free and bioavailable testosterone when compared to participants without avoidance or infrequency problems. The +SD/+MetS group recorded the lowest SHBG levels. Conclusion: Testosterone and its bioactive components are associated with male libido as well as the metabolic syndrome. Low levels of free and bioavailable testosterone are true determinants of the MetS in men.

Alcohol Consumption Is Associated with Hypogonadism and Decreased Sexual Function in Ghanaian Diabetics

Introduction: Alcohol usage has largely been seen as a risk factor for the development of sexual dysfunction as well as erectile dysfunction. Others have reported that prolonged alcohol usage and abuse is compatible with normal sexual function in the absence of endocrinological problems as well as hepatic dysfunction. About seventy five (75) percent of alcoholics have various sexual difficulties with improvements in sexual functions occurring after treatment of alcoholism and psychosexual therapy. It is evident from the various reports over the years that mild and occasional alcohol usage is not as much implicated in the causation of SD and its other forms as heavy, addictive or dependent alcohol usage. Alcohol usage has also long been linked to hypogonadism, testicular atrophy as well as leydig cell toxicity. Alcohol induced hypogonadism has been reported to resolve after withdrawal of alcohol use. Since both diabetes and alcohol usage have been strongly associated with both hypogonadism and sexual dysfunction, it is logical to expect that diabetics who frequently consume alcohol will have a worsened hypogonadal state and sexual function. This research therefore seeks to provide evidence of an association between alcohol consumption in diabetics and a worsened sexual dysfunction in comparison to diabetics who did not consume alcohol. Methods: Type II diabetic patients attending the Diabetic Clinic at the Maamobi General Hospital between the periods of January 2010 and March 2011 were consecutively recruited for this study. Diabetics with other known endocrinological diseases and physical disabilities were excluded from the study. Sexual function was assessed using the GRISS-M. Early morning fasting samples were used in lipid and testosterone profile assays. Results: Study participants who consumed alcohol recorded higher levels of triglycerides and LDL-Cholesterol. They also recorded significantly lower levels of bioavailable testosterone. Furthermore they also recorded higher scores for impotence, premature ejaculation, non-sensuality and infrequency but lower scores for avoidance and were about six times more likely to be infrequent in their sexual activity in comparison with those who did not consume alcohol. Conclusion: Alcohol consumption among diabetic males is associated with hypogonadism and has an impact on several domains of male sexual function. Diabetic males should be advised to avoid alcohol abuse in order to facilitate the management of diabetes associated sexual dysfunction.

Develop an Air Emission Inventory for Potential Point Sources in Northern Key Economic Zone and Simulate Its Impacts on Air Quality in Hanoi City,Vietnam

The Northern Key Economic region of Vietnam is a dynamic economic center that is an important economic locomotive of the North and the whole of Vietnam.In this area,large industrial parks are concentrated,attracting many large FDI projects.Key industries:cement production,cars-motorcycles,electronics,...Economic development entails environmental problems.The industrial sector has been identified as the number one driving force driving the growth of Hanoi city and neighboring provinces.Therefore,industrial development is one of the main causes of environmental pollution.In addition,the growth rate of industry in neighboring provinces significantly affects the air quality in Hanoi city.Some factories in Vinh Phuc,Hung Yen,Bac Ninh and Hai Duong provinces have large sources of gas emissions,potentially affecting air quality around Hanoi city.Monitoring results show that air pollution in Hanoi city is mainly caused by dust pollution,especially PM2.5 superfine dust.This is a very harmful dust to health;it is necessary to determine the cause and control solution.Therefore,the objectives of this study are:(1)inventory of potential emissions sources for industrial activities in the northern key economic region around Hanoi;(2)Simulate air spread by AERMOD model to get an overall picture of the industrial impact of surrounding provinces in Hanoi city;(3)Propose solutions to manage air quality for the city in the coming time.Simulation results for pollutants with the highest concentration of NOx for 1 hour,24 hours and the average of the year is 7.94;1.02;0.222(μg/m3);of CO for 1 hour and 8 hours are 27.616;8.89(μg/m3);of SO2 for 1 hour,24 hours and the average of the year is 4.005;0.288;0.038(μg/m3);of PM2.5 for 1 hour,24 hours and the average of the year is 0.32;0.023;0.003(μg/m3);of PM10 in 1 hour,24 hours and year average are 1.03;0.074;0.098(μg/m3).

Livedo Reticularis in a Patient with EBV Mononucleosis

A 23-year-old woman with serologically confirmed EBV mononucleosis presented with fever, exudative pharyngitis, periorbital and lid edema, cervical lymphadenopathy, and splenomegaly. Two weeks after the onset of symptoms she developed a generalized symmetrical reticular eruption of unbroken hexagons characteristic of livedo reticularis that resolved over several weeks as her condition improved. To our knowledge, this is the first reported case of livedo reticularis to occur in a patient with EBV mononucleosis.