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.

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.

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 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.

The antimicrobial abuse has become an indisputable fact as well as a global public health concern.At the 2016 G20 summit in Hangzhou,the issue of antimicrobial resistance was also put on the agenda of world leaders.This paper analyzed the status quo of global antimicrobial resistance.With reference to the report Tackling drug-resistant infections globally: final report and recommendation written by British Lord Jim O′Nell published in May 2016,the main influencing factors of antimicrobial resistance were described.In addition,this paper proposed countermeasures for antimicrobial resistance,including carrying out large-scale promotional activities,improving global public health conditions,reducing antimicrobial use in agriculture,strengthening the global surveillance of antimicrobial resistance,developing new treatment products for infectious diseases,and building a new pattern of global response.

Objective To investigate the curative effect of modified Danggui Shaoyao Powder in the treatment of patients with chloasma and the effect on the expression of cyclooxygenase-2 (COX-2) and nuclear factor E2 (Nrf2) in serum.Methods90 cases of patients with chloasma treated in the hospital were selected as the subjects.According to different treatment methods, the patients were divided into the control group (treated with routine western medicine, n=48) and the study group (treated with modified Danggui Shaoyao Powder, n=42).The clinical efficacy, changes of cytokines (serum COX-2 and Nrf2), patch pigment regression.ResultsAfter treatment, the total effective rate of the study group was significantly higher than that of the control group (90.48% vs 72.92%) (P<0.05).After treatment, COX-2, patch pigment regression scores in the two groups were significantly lower than those before treatment, and Nrf2 was significantly higher than that before treatment.The changes were more significant in the observation group than the control group (P<0.05).ConclusionModified Danggui Shaoyao Powder is significant effective in the treatment of chloasma.It can effectively promote the regression of pigment, reduce the skin lesion area and improve the quality of life of patients.The mechanisms may be related to effectively reducing COX-2 and increasing Nrf2.

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.

The etiology of pulmonary fibrosis is complex. The occurance and development of this disease involve many cell signal transduction pathways, including MAPK signaling pathway, JAK-STAT signaling pathway, Smad signaling pathway, PI3K-Akt signaling pathway, NF-κB signaling pathway and so on. Numbers of experiments have shown that intervention in signal transduction pathways with TCM can delay the progression of fibrosis, which provides good therapeutic methods for this disease. This article reviewed study on TCM intervention in different signal transduction pathways in the pulmonary fibrosis in China.

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.