Microglia play a crucial role in inflammation after cerebral ischemia.A large number of studies have shown that microglia are highly plastic cells that can assume different phenotypes and functions in response to specific microenvironmental signals.Microglia can be polarized into the classically activated proinflammatory M1 phenotype or the alternatively activated anti-inflammatory M2 phenotype,and play different roles in ischemic injury.Irnhibiting M1 while stimulating M2 may be a new approach for the treatment of ischemic stroke.

Objective To understand the situation of procrastination and its influencing factors in medical students.Methods The general procrastination scale (GPS),general self-efficacy scale (GSES),achievement motivation scale(AMS),self-esteem scale (SES),self-rating depression scale (SDS) and self-rating anxiety scale (SAS) were applied to 531 medical students,and the influence factors were analyzed with correlation analyses,hierarchical regression and path analysis of SPSS 16.0 and Amos 5.0.Results (1) The scale score of procrastination was between 31-93 and the average score was 55.54±9.68.96.1％ students showed different degree procrastination,with the moderate-severe degree ones accounted for 45.3％.(2)Procrastination was positively correlated to anxiety(r=0.331) and depression(r=0.415),but negatively correlated with self-efficacy(r=-0.247) and selfesteem(r=-0.328).(3)The hierarchical regression revealed that self-efficacy,self-esteem,and depression could significantly predict procrastination,which increased the explained variance 6.1％,6.1％ and 6.3％ respectively.(4) Path analysis showed that the self-esteem had direct effect on procrastination (path coefficient 0.12);self-efficacy had indirect effect on procrastination through self-esteem (path coefficient 0.21).Depression had direct effect on procrastination (path coefficient 0.34) and indirect effect to the procrastination through the self-esteem (path coefficient 0.50).All the fitting indices reached statistical standards.Conclusion Procrastination was common in medical students and self-efficacy,self-esteem,depression had direct or indirect effect on it.

Inflammation plays an important role in the pathophysiological mechanism of acute ischemic stroke.CD200 expressed in neurons interacts with CD200 receptor (CD200R) on microglia cells.It can inhibit microglia activation and alleviate the inflammation after cerebral ischemic injury.This article reviews the roles of CD200 and CD200R in the activation of microglia after cerebral ischemia.

OBJECTIVE To estimate the prevalence of nosocomial infections(NI)and the use of antibacterials in pediatric department,find the problems in management of hospital infection and provide the scientific basis for formulating prevention and control measures.METHODS By bed-visiting and patients' medical records checking,we filled out unified case questionnaire.All patients were investigated on August 22,2007.RESULTS Of the 86 patients investigated,the prevalence rate of NI was 4.65%.There were 19 kinds of antibiotics used daily.The daily antibiotics use rate was 95.35%;all of the infection sites were in upper respiratory tract and delivering rate of bacterial culture was only 14.63%.CONCLUSIONS Management and training should be strengthened on antibacterial drug in the pediatric department.The reasonable use of target antibiotics could prevent the abuse ment.

Objective:To examine the effects of heart rate control during hospitalization on short-term prognosis of heart failure in elderly patients.Methods:As a prospective study, 150 elderly patients with heart failure were selected from the Department of Geriatrics, Qilu Hospital of Shandong University.The subjects were divided into an experimental group and a control group by digitally generated random numbers, with 75 individuals in each group.Both groups received conventional anti-heart failure therapy during hospitalization, but patients from the control group had doses of heart rate control drugs adjusted every 2-4 weeks, with no special requirement for the heart rate before hospital discharge.In contrast, patients from the experimental group were given heart rate control drugs with timely dose adjustment to achieve more proactive heart rate control, aiming for a rate <70 beat/min, as long as heart failure symptom improvement and good volume management could be maintained.Values of cardiac function indexes were compared between the two groups at discharge and 6 months after discharge.Heart failure readmission rates within 6 months, cardiovascular disease mortality rates and the incidences of composite endpoint events after readmission due to heart failure aggravation were compared between the two groups.Treatment safety was also evaluated.Results:There was no statistical difference in blood pressure, heart rate, N-terminal pro-B-type natriuretic peptide(NT-pro-BNP), left ventricular ejection fraction(LVEF), left ventricular end systolic diameter(LVESD), or left ventricular end diastolic diameter(LVEDD)between the two groups at admission( P>0.05), and there was no statistical difference in the average length of hospitalization between the two groups( P>0.05). The experimental group had a lower average heart rate and diastolic pressure than the control group at discharge and 6 months latter[at discharge: (61.6±4.2)beat/min(1 mmHg=0.133 kPa) vs.(78.0±7.1)beat/min, (62.1±10.4)mmHg vs.(66.1±10.2)mmHg; at 6 months: (64.7±12.1)beat/min vs.(71.8±11.2)beat/min, (62.8±11.2)mmHg vs.(68.6±10.2)mmHg; P<0.05 or P<0.01]. NT-pro-BNP in the experimental group was significantly lower than that in the control group at discharge[(1 706±1 408)ng/L vs.(2 806±3 812)ng/L, P<0.05]. The absolute values of changes in LVEF(ΔLVEF), LVESD(ΔLVESD)and LVEDD(ΔLVEDD)after 6 months in the experimental group were significantly higher than those in the control group[ΔLVEF: (0.08±0.09) vs.(0.02±0.09), P<0.05; ΔLVESD: (-5.82±7.44)mm vs.(-1.63±6.07)mm, P<0.01; ΔLVEDD: (-2.76±5.52)mm vs.(-0.86±4.44)mm, P<0.05]. The rate of readmission and the incidence of composite endpoint events within 6 months in the experimental group were significantly lower than those in the control group[21.3%(16 cases) vs.36.0%(27 cases), P<0.05]; 25.3%(19 cases) vs.44.0%(33 cases), P<0.05.There was no significant difference in all-cause mortality between the two groups( P>0.05). Conclusions:For elderly patients with heart failure, proactive active heart rate control during hospitalization and a rate <70 beat/min before discharge will improve cardiac function indexes and lower the rate of readmission with exacerbation of heart failure, cardiovascular disease mortality and the incidence of composite end-point events after readmission.This strategy has good safety and is beneficial for short-term prognosis.