To survey the time management disposition of the medical postgraduates,the Time Management Disposition Scale were used on 774 medical postgraduates for investigation in 2009. The difference of medical postgraduate from the countryside,towns and cities on time management disposition is not significant ( P＞0.05 ) ; Students of different gender have significant difference ( P＜0.05 ). The female postgraduates cultivation on time management disposition needs to be strengthened.

Objective To evaluate the effect of continuous spinal anesthesia with a "catheter-over-needle" system which diminished the leakage of CSF through the hole in the dura alongside the inserted catheter and minimizes the risk of post-dura-puncture headache. Methods Sixty ASA Ⅰ - Ⅱ patients aged over 60 yr, scheduled for transurethral prostatectomy, were randomly divided into two groups of 30 patients in each group: group I continuous spinal anesthesia (CSA); group Ⅱ continuous epidural anesthesia(CEA) . Catheter was placed at L2-3 or L3-4. Both groups received 0.5% bupivacaine for surgery. A loading dose of 1.5-2.5 ml (groupⅠ ) or 8-13 ml (group Ⅱ) was given. If the surgery exceeded 2 h a third of the loading dose was injected. For postoperative analgesia a mixture of 0.125% bupivacaine + 0.0006% fentanyl was used. In group I the PCA setting was loading dose 0.5ml, background infusion at 0.5 ml/h, bolus dose 0.5 ml and lock-out interval 8 min. In group Ⅱ the loading dose was 2 ml followed by background infusion at 2 ml/h and bolus dose was 2 ml with lock-out interval of 15 min. Onset time and level of analgesia were recorded during surgery and VAS pain score and movement of lower extremities (modified Bromage score) were assessed. Postoperative PCA was maintained for 50 h. Results The demographic data including age, height and body weight were comparable between the two groups. There was no significant difference in the duration of surgery between the two groups. The onset of block was significantly faster in group I (3.5 ?2.3) min than that in the group Ⅱ (9.5 ?3.4) min. Motor blockade was less intense in group Ⅱ as assessed by modified Bromage score. Analgesia was more satisfactory in group I as less patients received fentanyl and droperidol iv during surgery in group I . Thetotal amount of bupivacaine used during postoperative analgesia was significantly less in group I , only about one-fifth of the total amount used in group Ⅱ. Two patients complained of headache in group I but in group Ⅱ there was also one patient complaining of headache. Conclusion Continuous spinal anesthesia has the advantage of faster onset of block, better analgesia, more intense motor block with less local anesthetic.

AIM: To set up a fingerprint analysis of Xintongning Capsules (Radix Notogenseng......) by TLC. METHODS: Silica gel G plate was adopted with developing underlayer of chloroform ethylacetate methanol water (15:40:22:10) under 10℃ resting overnight, 10% solution of H 2SO 4 in ethanol sprayed with and ginsenosides Rb 3 was used as standard substance. RESULTS: The result had 5 common spots. CONCLUSION: This method is accurate, reliable and provides a means for controlling the qualities of Xintongning Capsules.

Objective To observe and compare efficacy and safety of vinorelbine (NVB) plus ifosfamide (IFO) (NI regimen) and NVB plus cisplatin(DDP) (NP regimen) in treatment of metastatic breast cancer.Methods 82 cases of recurrent and metastatic breast cancer after the failure of treatment with anthracyclines and taxanes,40 cases were treated with NI regimen (NVB 25 mg/m2,day 1,day 8,IFO 1.2 g/m2,day 1,day 2,day 3),and the other 42 cases received NP regimen (NVB 25 mg/m2,day 1,day 8,DDP 25 mg/m2,day 1,day 2,day 3).Both groups were constituted of 21 days one cycle.After 2 cycles of chemotherapy,the response rate and side effects were evaluated.Results All 82 cases were evaluated for objective response.The total response rate of NI group and NP group were 52.50 ％ (21/40) and 57.14 ％ (24/42).There was no significiant difference (P ＞ 0.05).By analysis of the correlative factors,the total response rate in treatment of triple-negative breast cancer of NI group was 43.75 ％ (7/16),and that of NP group was 44.44 ％ (8/18).The two rates were also approximative (P ＞ 0.05).Main side effects were both bonemarrow suppression and gastrointestinal reaction.Bonemarrow suppression rate at grade Ⅲ-Ⅳ of NI group [57.5 ％ (23/40)] had no significant difference compared with that of NP group[57.14 ％ (24/42)] (P ＞ 0.05).But grade Ⅲ-Ⅳ gastrointestinal rate of NI group [7.50 ％ (3/40)] was significantly lower than that of NP group [26.19％(11/42)](P ＜ 0.05).Conclusion NI regimen in treatment of advanced breast cancer is effective,and it shows a similar response rate compared with NP regimen.Also it is effective for triple negeative breast cancers.The toxicity can be tolerated,and the gastrointestinal reaction rate of NI regimen is lower.NI regimen is a good choose in treatment of advanced breast cancer.

Objective:To observe the acoustic characteristics of glottal stops produced by patients with cleft palate.Methods:Twenty boys with cleft palate who were judged to be glottal-stop-producers and 20 normal peers were included. In their own way, all the children were asked to produce following sounds: /iu/ /pai/ /t′u/, /s/ /k′/ /p′u/ /t′u/, /tA/ /ku/ and /i/ /k′u/ /ti/ /suan/. Then the speech spectroanalysis and the comparison were performed by one investigator.Results:The acoustic characteristics of glottal stops changed a lot when they substitute or accompany with different oral stops, which included the emergence of spikes, changes of voice onset time, the formant transitions and spetroanalysis of spikes. Conclusion:The acoustic changes of glottal stops are complicated. Every single aspects of acoustic analysis should be considered in the identification of the acoustic characteristics.

Objective:To observe the expression of cell adhesion molecule CD44 in lung tissue of rats with asthma.Methods:32 SD rats were randomly divided into 4 groups:the normal group and the model group,8 rats in each group.The asthmatic model was established by repeated inhalation of ovalbulium.The expression of CD44 in lung tissue of rats was detected by semi-quantitatively reverse transcription-polymerase chain reaction(RT-PCR) and by means of immuno-histochemical staining.Differential leukocytes counts(neutrophils,eosinophils,and lymphocytes) in bronchoalveolar lavage fluid(BALF) were performed after staining with wright staining.Results:The expressions of CD44 increased one week after OVA challenge(P

Objective To investigate the resuscitation outcome after a short period of mild hypothermia in porcine model of prolonged ventricular fibrillation (VF).Methods Fourteen male healthy domestic swine weighting 34 to 36 kg were used.VF was induced electrically and maintained untreated for 11 mins,followed by manual cardiopulmonary resuscitation (CPR) procedure.Two investigators initiated chest compression and bag-valve mask ventilation in pattern of 2 min rotation.A biphasic wave of 120 J electric defibrillation (ED) was attempted 6 mins after CPR.If there was no return of spontaneous circulation (ROSC),CPR was restored and ED was delivered when necessarily.Resuscitation was considered unsuccessful if absence of ROSC for 12 mins.However,if ROSC occurred,animals were randomly (random number) diveded into normothermia (NT) group and hypothermia treatment (CH) group.Animals in CH group were immediately cooled by using intravenous infusion of ice-cold saline and surface cooling.Core temperature was reduced to 32-34 degrees centigrade within 120 mins and maintained at this level for 2 h.Active rewarming was completed within 2 h until baseline body temperature was reached.Data of hemodynamic variables,blood-gas analysis and blood lactate before VF of two groups were recorded.Meawhile,cardiac output (CO),heart rate and Tc after ROSC were recorded.Neurological defect scores (NDS) were evaluated every 24 h until 96 h after ROSC.Variables were compared using either Fisher test or repeated measures analysis of variance,followed by Bonferroni for multiple comparisons.A two-sided P value ＜0.05 was regarded statistically significant.Results There was no significant difference in body weight,mean arterial pressure,CO,pH,pressure of end-tidal carbon dioxide (ETCO2) and lactate between groups before VF.In the period of CPR,there were also no significant difference in total resuscitation time,first shock success rate,ROSC rate,shock ROSC rate,total number of shock and doses of epinephrine.However,animals in CH group survived longer time than that in NT groups [(96.00 ± 0.00) hvs.(49.71 ±43.65) h,P=0.031].Meanwhile,the survival rate of 96 h was significantly higher in CH than that in NT (P ＜ 0.05).For neurological function,there was a obviously better NDS in CH group than that in NT group within ROSC 96 h (P ＜ 0.05).Conclusion Even a short duration of 2 hour mild hypothermia could improve resuscitation outcome in porcine model of 11 minute VF.

OBJECTIVE To investigate the Gram-negative bacterial resistance of clinical isolates in September, 2004 from 13 hospitals which are members of Anhui Center for Surveillance of Bacterial Resistance. METHODS Antimicrobial susceptibility of clinical non-repeated isolates was tested by agar dilution method and the results were analyzed. RESULTS Of 347 clinical isolates from 13 hospitals, 251 were Gram-negative organisms including 33 species. Gram-negative organisms were different resistant to piperacillin, cefotaxime, ceftriaxone, cefuroxime, ciprofloxacin and levofloxacin, respectively, but the resistance rates to lactams and their inhibitors compounds, such as cefoperazone/sulbactam and piperacillin/tazobactam, and imipenem/cilastatin were all under 10%. CONCLUSIONS Bacterial resistance is still or even a more serious clinical problem than before. There is a valuable surveillance of bacterial resistance.

Objective To explore the expressions of smooth muscle actin (SMA) - a and CD44 mRNA in the lungs of rats with asthma in different stages. Methods The asthmatic rat model was established by repeated exposing the animal to aerosolized ovalbumin (OVA). After being sensitized, the rat was subjected to laboratory test. Semi - quantitatively reverse transcription- polymerase chain reaction (RT- PCR) was used to analyze CD44 and a - SMA mRNA of lung tissue. Differential leukocytes(neutrophils, eosinophils, and lymphocytes) counts in bronchoalveolar lavage fluid (BALK) were performed after Wright staining. Results The expressions of CD44 and ? - SMA mRNA increased after OVA challenge 1 week (P

Excess energy has become a main reason for increasingly serious human health hazards. Excess energy, mainly ectopically deposits in the liver, pancreas and other organs in the form of triglycerides, and produces chronic oxidative, nitrosative stress (ONS) , and fat toxicity, resulting in insulin resistance and impaired insulin secretion, and further impaired glucose regulation (Pidan). By combining Chinese medical pathogeneses and symptoms analyses, authors found this process has features of Gan disease transferring to Pi. Based on a number of related guidelines and clinical practice, we demonstrated treating sputum and stasis by the same method was one treatment method for intervening liver disease transferring to spleen in metabolic diseases. This idea helps to organic integrating prevention and treatment of major metabolic diseases including non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus, which can improve clinical effectiveness and efficiency of Chinese medicine.
Diabetes Mellitus, Type 2 ; therapy ; Early Intervention (Education) ; Humans ; Insulin ; Insulin Resistance ; Metabolic Diseases ; Non-alcoholic Fatty Liver Disease ; Risk Factors ; Triglycerides