[Alstract] The harmonious dormitory interpersonal relationship of medical students will be of great significance to the development of college students' physical and mental,academic and construction of harmonious campus,medical environment.At present,there are four characteristics of building a harmonious medical students' dormitory interpersonal relationship:the atmosphere of dormitory culture construction is not strong,management and intervention system is not sound,the bodies of interpersonal relationship education are insufficient,and the degree of recognition is lower.The paper puts forward building the education model of one core,two wings,three combinations,the three culture as the core,university quality education and college vocational education as the two wings,combining themselves,parents,school,to provide a theoretical basis and practice guidance to establish a harmonious dormitory interpersonal relationship.

0.05). Conclusions Ultrasound contrast agent Levovist improves signal of blood flow obviously. It increases the diagnostic accuracy for intracranial aneurysms and the level of confidence.

Objective To observe characteristic imaging of traumatic arteriovenous fistulas(TAVF) and to evaluate the methods of differential diagnosis of TAVF by Doppler ultrasonography. Methods Eleven patients suffering from TAVF were selected to have the examination of Doppler ultrasonography. The blood flow of arteriovenous fistulas, diameter, morphology and blood flow character of affected vessels were observed. Spectral of fistula and affected vessels were analyzed and compared with the healthy side. Results Localization of arteriovenous fistulas was observed directly in eight patients, which presented as intercepted wall of the affected vessels and irregular mosaic flashes flowing towards enlarged vein from artery. Pulsed wave Doppler showed unilateral continuant spectral with maximum velocity 300-390 cm/s when sampled in the fistula. Spectral analysis of proximal arteries of the fistula revealed high velocity and low resistance. Arterialized flow pattern was observed in affected veins. Proximal veins of the fistula revealed arterialized spectral with high velocity and low resistance. Reversed centrifugal blood flow was observed in the distal veins of the fistulas in 4 cases. Conclusions Unilateral shunt in both diastole and systole in the fistula and arterialized flow with high velocity in veins are characteristic presentation of TAVF. Color Doppler ultrasonography has great value in confirming diagnosis and differential diagnosis of TAVF.

OBJECTIVE:To provide basis for the further implementation of the national essential medicine system in township hospitals. METHODS:By issuing questionnaires,an investigation was made on the basic information of township hospitals imple-menting“Health Ⅺ project”in Heilongjiang Province before and after the implementation of the national essential medicine system. Prescriptions of 4 days in 2008 and 2012 were extracted,statistically compared and analyzed by using random system cluster sam-pling medication rationality was evaluated. RESULTS:40 questionnaires and 3 173 prescriptions were recycled during the investiga-tion in 2009,and 40 questionnaires and 4 197 prescriptions were recycled in 2013. Compared with the township hospitals in project areas in 2008,the proportion of practice(assistant)physicians per township hospitals and the average number of beds were respec-tively increased by 1.5%and 4.6 in 2012. The average kind of prescription drugs was decreased from 2.9 kinds to 1.7 kinds,the us-age rate of infusion was decreased from 46.5%to 30.6%,antibiotics was decreased from 61.5%to 40.0%,two or more kinds anti-biotics was decreased from 18.9% to 4.8%,hormone was decreased from 11.9% to 4.2% and the rate of combined use of antibiot-ic and hormone was decreased from 9.2% to 2.8%;the drug expenditure of each outpatient service and hospitalization was respec-tively decreased 19.1% and 16.4%. There were significant differences(P<0.05). CONCLUSIONS:After the implementation of na-tional essential medicine system,the medication rationality of township hospitals in project areas has made great improvement,es-pecially on the aspects of prescription drug number,the combined usage rate of antibiotic and hormone,the usage of hormone and the drug expense burden,which reaches the policy targets;although the infusion rate and the usage of antibiotic show great im-provements,there are still some gaps between the current situation and the policy targets;the obvious decrease of the average drug expenditure of each service doesn’t make a relative decrease of the average expenditure of each medical service,which has a little increase.

Objective To report a case of primary breast T-cell lymphoblastic lymphoma/leukemia (T-LBL/ALL) and study its clinico-pathological features and treatment,to improve the recognition of T-LBL/ ALL.Methods A case of primary breast T-LBL/ALL was reported and reviewed the literatures.Results The female patient was 17 years old,was diagnosed as primary breast T-LBL/ALL who presented with multiple bilateral breast masses and left axillary lymph node enlargement for two months.The patient was treated with modified BFM-90 and achieved complete remission.The patient was in complete remission 12 months after diagnosis at present and till in follow-up.Conclusion Primary breast T-LBL/ALL is very rare and highly aggressive with bad prognosis.T-cell lymphoblastic leukemia chemotherapy regimens is often effective.

OBJECTIVE:To provide reference for the further implementation of national essential medicine system of township hospitals. METHODS:5% township hospitals in a province were collected as sample by using random cluster sampling method, and statistics,comparison and evaluation was made by issuing questionnaires to get health resources distribution status,health ser-vice status and income and expenditure status before(in 2009 and 2010)and after(from 2011 to 2013)the implementation of na-tional essential medicine system of township hospitals. RESULTS:Totally 46 township hospitals were surveyed and totally 46 ques-tionnaires of township hospitals were recycled. Average number of beds in township hospitals increased from 15.1 beds in 2009 to 19.4 beds in 2013. Average annual outpatients increased from 11 200 in 2009 to 16 100 in 2013,and average number of hospital discharge increased from 644 in 2009 to 924 in 2013. The proportion of government financing to total income increased from 25.9% in 2009 to 47.1% in 2013,proportion of drug income to the total income decreased from 54.9% to 29.7%,drug profit rate decreased from 25.5% to 3.7%,and proportion of township hospital under deficit decreased from 17.4% to 4.3%. Average time that residents see a doctor in township health center increased from 0.47 in 2009 to 0.74 in 2013,and cost of average hospitaliza-tion and outpatient drugs decreased from 805 to 718 and 28.1 to 24.1,respectively. CONCLUSIONS:The implementation of nation-al essential medicine system has no negative effect on outpatient service,but first inhibits then promotes the inpatient services. Na-tional essential medicine system has effectively cut down the financial burden of drugs,but it has no effect on total health burden. It is difficult to realize the excessive rapid rise of health ex-pense by the single implementation of essential medicine sys-tem,and it needs comprehensive reform,collaboration and in-teraction of medicine and health to effectively relieve the prob-lem of“expensive ill”.

Produced by bone cells and stored in the matrix.bone ceil growth factor can contribute to the regulation of bone growth.Gene regulation has its role in bone development.Many factors of this kind have been founded recently.They play their role during the bone formation and absorption processes in the way of autocrine and paracrine.The genes of core binding factor α_1(Cbfα_1)and estrogen receptor α(Erα)have been the recent years'hot factors that are related to the bone development,Gene polymorphism refers to variation on gene level which often occurs in the non-coding domain or the domain bearing no important regulatory function in gene order.This article reviewed the research status of the relation between Cbfα_1 and Erα gene polymorphism with bone development.

At present, the clinical skills training process for ultrasound medicine professional postgraduates is still facing many problems, such as inadequate guidance from tutors, little accumulation of clinical knowledge and practice, not solid basic ultrasonic skills, imperfect assessment system, and disconnection between scientific research and clinical practice. Analyzing the cause of problems, combining with the characteristics of ultrasound medicine and our experience in the clinical skills training process, we have put forward targeted solutions, such as building a complete and efficient training team, attaching importance to rotation and cultivation of relevant clinical departments, realizing teaching objectives by different levels and stages, establishing a perfect management, supervision and assessment system, paying attention to the combination of clinical and scientific research ability, so as to improve the quality and efficiency of clinical skills training process of ultrasound medicine.

Purpose The mean pulmonary artery (MPAP) has been widely used as an important parameter to diagnose and evaluate pulmonary hypertension (PH).The purpose of this paper is to compare the efficacy of two methods in evaluating PH,including estimating pulmonary artery systolic pressure (PASP) using Doppler ultrasonography to measure tricuspid regurgitation (TR) velocity,and directly using the peak velocity of TR.Materiasl and Methods From January 2012 to June 2013,eighty patients with left-to-right shunt congenital heart diseases (CHD) planned for closure procedure in Tangdu Hospital of the Fourth Military Medical University and the General Hospital of Shenyang Military region were included in this prospective study,who underwent right heart catheterization to measure pulmonary artery pressure,and underwent Doppler ultrasonography to measure the peak velocity ofTR.Results Using catheter-measured MPAP of≥ 25 mmHg as diagnostic reference,the false positive rate was 62.96％,and the false negative rate 0％ when the estimated PASP of ＞30 mmHg determined by TR method was used to diagnose PH.There was high diagnostic agreement when peak velocity of TR was used to diagnose PH.When 320 cm/s and 340 crn/s were used as diagnostic cutoff values,false positive rates were 14.81％ and 7.41％,and false negative rates were 15.91％ and 20.45％,respectively.Conclusion In patients with left-to-right shunt CHD,peak velocity of TR measured on echocardiography can be used to diagnose PH which overcomes the high false positive rate in estimation method.It is more suitable to diagnose PH when the MPAP is used as the diagnostic criterion.

This study was aimed to observe effect of pomegranate leaf tannin and ellagic acid on primary rat adipocyte differentiation and lipid metabolism-related factor expression. Primary rat preadipocyte was in vitro cultured to observe the effect of pomegranate leaf tannin and ellagic acid on lipid fat cells as well as mRNA expression of its related factor. The results showed that pomegranate leaf tannin and ellagic acid had obvious inhibition effect on fat formation in fat cells. It had certain inhibition effect on activities of lipoprotein lipase (LPL) and glucose-3-phosphate dehydrogenase (GPDH). It promoted fat decomposition and reduced intracellular lipid content. It upregulated PPARγ and fatty acid-binding protein (aP2). It downregulated obese (ob) gene level. It was concluded that pomegranate leaf tannin can inhibit fat generation of fat cells and promote fat metabolism. Ellagic acid was its main active ingredient, which had the same effect as pomegranate leaf tannin.