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 explore the clinical and laboratory characteristics of langerhans cell histiocytosis (LCH) in children, so as to improve diagnosis level and decrease misdiagnosis rate.Methods Twenty-five cases of LCH from Jan.1996 to Feb.2006 were analyzed by retrospective study. The clinical data were collected and abstracted for information regarding clinical symptom, physical sign, laboratory examination, imaging,pathology,diagnosis and treatment.Results Some laboratory findings in hemogram, bone marrow examination and chest X-ray were non-specific.The X-ray characteristic of skeleton was osteolysis. Computerized tomography and magnetic resonance imaging were important in defining the extent of lesion in fundus cranii and sella.Seven cases were examined for anti-Epstein-Barr virus(EBV) IgM, 3 cases were positive;5 and 3 cases out of 10 cases showed humoral and cellular immunity abnormality,respectively. The misdiagnosis rate was 52%,1 case had been misdiagnosed for 7 years. Chemotherapy was effective in the future.Conclusions The clinical manifestations of LCH varies widely, leading to high rate of misdiagnosis.The etiology of LCH is unclear,and some of our patients show the evidence of EBV infection or immunity abnormality. Definitive diagnosis of LCH is based on pathology. Ultrastructure and immunophenotype should be done to improve diagnosis level.

Objective To systematically study solvatomorphism of indomethacin and provide a scientific basis for the quality control of the solvated impurities in this drug. Methods By changing the recrystallization solvent, solvent volume, recrystallization temperature, time and pressure, nine solvates and four non-solvated forms were discovered and prepared. The differential scanning calorimetry (DSC), thermogravimetric analysis ( TGA), X-ray powder diffraction ( PXRD) and infrared spectrometry (IR) were introduced for characterization analysis. Furthermore, the test of influencing factors was used to explore the stability of solvate crystal form and the crystal transformation rules among them. Results Nine solvates were prepared, which including two solvates reported for the first time in this work. Results showed that crystal forms of the 9 solvates have different types or proportions of crystal solvents according to the various results of DSC, TGA, PXRD and IR. Moreover, the nine solvates prepared in this work were metastable crystal forms which could be transformed to non-medicinal forms. Conclusion The composition, thermodynamic property and transformation rule of all the solvates are elucidated in this work. In addition, an effective method for qualitative or quantitative analysis of these solvates was established. The standard graphs and data were used as basic data and scientific basis for the solvate control in the manufacturing of indomethacin.

The diagnosis related groups( DRGs) method is applied in hospital management at both hospital and clinical department level. This technology enabled us to evaluate hospital medical services in general, objectively evaluate discipline development, and formulate individualized discipline guidelines, supporting scientific distribution of hospital resources. At the department level, the technology supported clinical departments in their discipline construction and quality management. The application of DRGs can improve fine management of hospitals.

Objective To study the expression of TrkB and c-fos in rat auditory cortex after long -term ad‐ministration of sodium salicylate and the mechanisms of salicylate ototoxiclty .Methods Normal adult rats were di‐vided into three groups :normal group without any treatment ,long -term treatment group given i .m .injections , 175 mg/kg ,twice daily at 9:00 am and 6 :00 pm for consecutive 14 days and the recovered group using the same method as the chronic group except that they were sacrificed 28 days after salicylate treatment ceased .After the de‐tection of ABR ,rats were sacrificed after deep anesthesia ,and the auditory cortexes were dissected rapidly .Real-time PCR and Western-blot were explored to detect the expression of TrkB and c-fos .Results The average ABR threshold of normal rats was 36 ± 2 .23 dB SPL .The average ABR threshold of long -term group was 41 .3 ± 3 .31 dB SPL ,which was significantly increased than normal group(P<0 .01) .The average ABR threshold of the recoveredgroup was 38 .6 ± 5 .51 dB SPL .There were no differences between the recovered group and normal group(P>0 . 05) .The expression of c-fos mRNA(1 .24 ± 0 .09)and protein(0 .70 ± 0 .12)in the long -term group were signifi‐cantly increased ,when compared with the normal group .The c-fos mRNA(1 .23 ± 0 .04)and protein(0 .68 ± 0 .08) expression in the recovered group were also significantly increased compared with the normal group .The expression of TrkB mRNA(1 .26 ± 0 .10)and protein(1 .85 ± 0 .17)in the long -term group were significantly increased ,when compared with the normal group .The TrkB mRNA(1 .23 ± 0 .07)and protein(1 .80 ± 0 .08)expression in the recov‐ered group were also significantly increased compared with the normal group .Conclusion The inereased expression of c-fos in the long -term group may be related to the enhancement of central auditory function .The inereased ex‐pression of Trk-B in the long -term group might be involved in instability of synaptic plasticity in tinnitus .

Objective To study the influencing factors,treatment and prevention of venous thromboembolic (VTE) in elderly patients with malignant tumor.Methods The clinical findings in forty elderly patients with malignant tumor combined with VTE from our hospital within 5 years were analyzed retrospectively.The risk,site,time,prevention and treatment of VTE in these tumor patients were analyzed and summarized.Results After active treatment,the positive efficacy response was obtained in 26 cases (65.0％),no-response in 14 cases (35.0％).Specifically,14 cases died,7 cases cured,and 19 cases were improved.Besides cancer and aging,the elderly tumor patients were considered as the high-risk group because of the risk factors including hypertension,diabetes,hyperlipidemia,pulmonary infection,surgery,radiation,chemotherapy and so on.D-dimer level was significantly increased in elderly malignant tumor patients with VTE.Venous thrombosis could occur at any stage.Venous thrombosis was found before tumor in 1 case.The most common site of DVT was the lower limbs,especially the left lower extremities (14 cases,35％).Most of internal carotid vein and upper limb vein thrombosis were associated with peripherally inserted central catheter (PICC) Conclusions The elderly patients with malignant tumor is the extremely high risk groups for venous thrombosis,and their quality of life and survival will be seriously impacted.Anticoagulant therapy through the whole process of treatment in patients with VTE is beneficial.The prevention and treatment of VTE play an important role in the tumor patients with risk factors such as chronic diseases,high D dimer level,radiation and chemotherapy,which should attract the attention of clinicians.

Papers on 1918 influenza virus published in 1995-2014 were retrieved from Web of Science.Institutional cooperation network, co-author network, and maps of hot key words, key word cluster, and reference co-citation were plotted using the VOSviewer.The study hot spots and their development trends were analyzed in an attempt to provide the key information for the prevention and control of influenza virus outbreak in the future.

ObjectiveTo explore the effects of fluoxetine on special learning and memory and serum S100B level in depressed model rats.MethodsAdult male SD rats were divided into six groups randomly according random digits table:control group ( A ),depressed model group ( B ),group of depressed model treated with single dose of fluoxetine for one day ( C ),group of depressed model treated with fluoxetine for one week (D),group of depressed model treated with fluoxetine for two weeks (E) and group of depressed model treated with fluoxetine for four weeks (F),ten rats in each group.Except control group,others were subjected to forced-swimming for four weeks,15 min a day.Fluoxetine (10 mg/kg) was given intragastric administration to group C-F before swimming everyday.Morris water maze ( MWM ) was used to measure the spatial learning and memory of rats.ELISA was used to determine the level of serum S100B.ResultsIn the hiding platform test of MWM,there was significant longer of escape latency (EL) in B group than that in A group(P ＜ 0.05 ).And the EL in all groups treated with fluoxetine became shorter with the prolonging of treatment.In the probe test,there were significant longer time in target quadrant in D,E,F than in other quadrant (F =5.162,P ＜ 0.01 ).The levels of serum S100B were lower in E,F groups ( E group ( 0.91 ± 0.23 ) ng/ml,F group ( 0.85 ± 0.21 ) ng/ml) than that in B group (( 1.26 ±0.61 )ng/ml,P＜0.05).ConclusionChronic administration of fluoxetine could improve the impairment of spatial learning and memory and reverse the increase of S100B level in serum of depressed model rats.

Objective To study the effect of Bi-level positive airway pressure (BiPAP) on hemodynamics in patients with the chronic obstructive pulmonary disease (COPD) combined coronary heart disease.Methods One hundred patients with COPD combined coronary heart disease treated by BiPAP ventilation were enrolled.The blood gas analysis and the hemodynamics were monitored and analyzed in patients with the COPD combined coronary heart disease before treatment and after BiPAP ventilation treatment for 2 hours,24 hours,72 hours and 1 week.Results PaCO2 decreased significantly after 2-hour's treatment by BiPAP ventilation( P ＜ 0.05) and the heart rate and systolic blood pressure also decreased significantly after 24-hour's treatment by BiPAP ventilation.The left ventricurlar ejection fraction( [ 65.63 ± 6.86 ] ％ vs.[ 56.21 ±5.26]％,P ＜ 0.05 )was significantly improved after BiPAP reatilation treatment for one week.The mean pulmonary arterial pressure ( [ 3.74 ± 0.96 ] vs [ 5.12 ± 1.12 ] kPa,P ＜ 0.01 ),angina pectoris ( [ 0.20 ± 0.01 ]time/d vs [ 0.69 ± 0.03 ] time/d,P ＜ 0.05 ) were significantly decreased.Conclusion COPD combined coronary heart disease patients may achieve an optimal effect by BiPAP ventilation.BiPAP ventilation has no impact on the hemodynamics in patients with the COPD combined coronary heart disease.