Neonatal is separated from the maternal by clamping the umbilical cord after delivery.And traditionally,the clinical practice is clamping the umbilical cord immediately after delivery.With the futher study of optimal timing of umbilical cord clamping,the effect of delayed umbilical cord clamping attracts more and more attention.This paper discussed about the subject of the early and late effect of delayed umbilical cord clamping on neonatal.We found that a briefly delay in clamping the umbilical cord increased the placental transfusion and blood volume,decreased the prevalence of anemia,promoted the stability of circulation and internal environment,without adversely affecting health of neonatal.

Occupation career decision-making is affected by personal factors and environmental factors. Medical students should improve individual decision making , maintain physical and mental health , study hard, enhance their comprehensive ability, strengthen ideology cultivation and social prac-tice, recognize themselves and find reasonable fixed position by taking occupation career decision factors into consideration, which lay a solid foundation for success of occupation career decision making.

ObjectiveTo explore the clinical effect of edaravone combined with Shuxuetong in treatment of elderly patients with acute cerebral infarction.Methods120 cases of acute cerebral infarction,according to the different treatment methods,were divided into two groups.The conventional treatment was given in two groups,the control group plus Chuanqiong hydrochloride injection,and the observation group adopted edaravone and Shuxuetong.The clinical efficacy,activities of daily living(ADL) and neurological deficit score were compared between two groups.ResultsThere were 25 cases of basic recovery,18 cases of significant progress,progress in 12 cases in the observation group,total effective rate was 91.7％ (55/60),the control group was 75.0％ (45/60),the difference was statistically significant ( x2 =6.86,P ＜ 0.05 ).Observation group had statistically significant difference than the control group between ADL and neurological deficit scores ( all P ＜ 0.05 ).ConclusionOn the basis of conventional therapy,the use of edaravone combined with Shuxuetong for acute ischemic stroke patients could significantly promote the recovery of neurological function and was worthy of promotion.

Objective To investigate the clinical characteristics of congenital cholangiectasis,the classification of choledochectasia and its complications. Methods Sixty-eight patients with congenital cholangiectasis admitted to Nankai hospital of Tianjin from Jan. 2000 to Dec. 2009 were retrospectively studied. The patients were classified using Todani method. The clinical presentation,complications and development were compared among patients with different types. Results In 68patients, type Ⅰ , Ⅳa and Ⅳb were accounted for 47. 1%, 35.3%, 17.6%,respectively. Wheraes type Ⅱ , Ⅲ and Ⅴ were not found. The complications included cholecystitis (67.6%) and bile duct stone (70. 6%). Biliary stricture and gallbladder atrophy were accounted for 26.5% and 17.6%,respectively. Pancreatitis was found in 8.8% patients, biliary cirrhosis in 5.9% patients,carcinogenesis in 23.5 % patients, fatty liver steatosis in 11.8 % patients, cholecystic polyps in 17.6 %patients, slight spleen enlargement in 14.7% patients, hepatic cyst in 8. 8% patients, renal cyst in 2.9% patients. Conclusions Tyep Ⅰ is commonly found in congenital cholangiectasis, and the next is the type of Ⅳa, but no type of Ⅱ , Ⅲ or Ⅴ is found. The common complications are cholecystitis and bile duct stone. Carcinogenesis is found in 25 % patients.

Objective To analyze the clinical features of Takayasu′s arteritis (TA) and to evaluate the usefulness of 2D color Doppler flow imaging (2D CDFI) and digital subtraction angiography (DSA) in diagnosing TA.Methods Fifty eight patients with TA were analyzed.In 26 cases,the 2D CDFI findings were compared with that of DSA.Results ① One hundred and eighty two peripheral arteries were involved in 58 patients including 176 arteries with stenosis or occlusion,mainly with aortic arch syndrome and left side involved.② Compared with DSA,2D CDFI had a higher sensitivity (88%) in diagnosing stenosis and occlusion of vessel cavity in aorta and its main branches,and had a positive predictive value of 100% and anegative predictive value of 0% respectively.Conclusion 2D CDFI has some outstaning features as non invading,safety,cheapness and so on in diagnosing TA,compared with DSA that is usually used as "the gold standard" for the definitive diagnosis of this disease.2D CDFI is able to depict vessel wall thickening,which is a major pathologic feature of the disease and it is suitable for long term repeated follow up.

Objective　To evaluate the diagnostic value of 99Tcm-HL91 in experimental tumor and inflammation models comparing with 99Tcm-MIBI. Methods　Three kinds of solid neoplasm bearing mice (Ehrlich carcinoma bearing mice, H22 carcinoma bearing mice and human ovarian COC1 neoplasm bearing nude mice) and two inflammation models (chemical and bacterial inflammation) underwent static whole body planar imaging at 1 and 4 hours after injection of 99Tcm-HL91. Two kinds of neoplasm bearing mice (Ehrlich carcinoma bearing mice,H22 carcinoma bearing mice) and two inflammation models (chemical and bacterial inflammation) underwent static planar imaging after injection of 99Tcm-MIBI, at early phase (10～20 minutes) and delayed phase (2 h). All of the mice were sacrificed at 4 h. The tumors, or inflammatory lesions, blood and contralateral normal muscles served as controls were removed, weighted and the radioactivity was measured. ROIs were drawn around tumor, inflammatory lesions and contralateral muscles in planar images, and the radioactivity ratios of target (tumor or inflammatory lesions)-to-blood (T/B), target-to non target (contralateral muscles) i.e. T/NT were calculated. Results　Neoplasms were clearly visible in planar images at 1 and 4 h after injection of 99Tcm-HL91 in all tumor models. At the same time inflammatory lesions could not be seen clearly. Neoplasms were seen in delayed phase in 99Tcm-MIBI group, but it was not easy to distinguish them from inflammation. The T/B ratios and T/NT ratios of 99Tcm-HL91 tumor model groups were significantly higher than that of 99Tcm-MIBI tumor model groups. The T/NT ratios of tumors were significantly higher than that of inflammatory lesions in 99Tcm-HL91 groups. Conclusion　Compared with 99Tcm-MIBI imaging, 99Tcm-HL91 is of much more diagnostic value in detection of certain solid neoplasms, and can distinguish neoplasm from inflammation.

Objective To explore the daily management mode of hygienic materials of locomotive logistics unit. Methods Through the method of building deposit area and buffer area in regular depot, hygienic materials with validity regulation such as drugs could be included in hospital regular inventory manage ment; the hygienic materials were dynamically replaced according to the hospital's daily cost. Results Under the condition of ensuring the adequateness of hygienic materials, the method was able to meet the validity requirement and avoid wasting as well. Conclusion Hospitals have favorable condition and professional management in reserving different types of hygienic materials. As it costs time to assemble materials, this management mode is more suitable for the management of hygienic materials of locomotive logistics unit.

Objective:In order to look for a good method for preparation of hemorrhagin antiserum. Methods: Three kinds of hemorrhagins including AaH Ⅰ, AaH Ⅱ, and AaH Ⅳ were purified from Agkistrodon acutus venom according to predecessors's methods and crude AaH Ⅰ, AaH Ⅱ and AaH Ⅳ were obtained. Preparation electrophoresis was used to purify AaH Ⅰ,AaH Ⅱand AaH Ⅳ further. As for an hemorrhagin, six different dyeing methods were used to dye PAGE gel and the gel contained hemorrhagin was obtained respectively. The ground gel contained hemorrhagin was used to immune mice and its antiserum was obtained. Antiserums quality was tested through ELISA test and neutralization of the hemorrhagic activities of corresponding hemorrhagin. Results:Effective IgG concentration in different antiserum was different and effective IgG made through non toxic type protein fast stain reagent kit was higher than others. Conclusion:Non toxic type protein fast stain reagent kit is the best dyeing method among the six dyeing methods.

Objective To establish an HPLC method to measure four flavonoids ( baicalin, wogonoside,baicalein and wogonin) in shenyan siwei granules by quantitative analysis of multi-components with single marker ( QAMS ) . Methods Agilent ZORBAX SB-C18 column(4. 6 mm × 250 mm,5 μm) was used. The mobile phase was composed with methanol and 0. 4% phosphoric acid solutionat at 1. 0 mL·min-1 flow rate with gradient elution. The detection wavelength was 278 nm. Baicalin was used as the internal reference substance. The relative correction factors ( RCF) between the baicalin and the other three flavonoids were established to detect the quantitation of baicalin and calculate the quantitation of the other three constituents. The external standard method was used for quantitating the four constituents, and the method was evaluated by comparing to the quantitative results between external standard method and QAMS method. Results The results of QAMS method had no significant difference with those of external standard method. Conclusion It is feasible and accurate to control the quality of shenyan siwei granules with QAMS.

There are several main topics in acute myelogenous leukemia at the 57th American Society of Hematology annual meeting, including the optimization about induction and consolidation chemotherapy for AML, the investigation of targeted drugs in AML first line therapy, the marker for AML MRD monitoring, the differentiation drugs, such as tamibarotene in APL, the definition about refractory AML, the induction therapy for blastic plasmacytoid dendritic cell neoplasm (BPDCN). This article reviewed the research progress of AML in the 57th ASH annual meeting.