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 study inductively coupled plasma atomic emission spectrometry(ICP-AES) used to determine blood boron(B),and to investigate the level of B in blood of children in Nanjing.Methods ICP-AES was applied to determine the level of B in the blood of 1032 healthy children and 1364 children patients after using 1mol/L HNO_(3) to treat whole blood.Results Precision of this method was 1.60%-4.31%,and recovery ratio was 93.3%-98.9%.The level of B in blood of the 1032 healthy children was(41.8?16.7)?g/L and that in blood of the 1464 patients was(25.1-58.5)?g/L(77%).Conclusion Precision and recovery ratio determined by the method are high,so it can be used as a reference method to detect the level of B in blood.And it preliminarily determines the reference levels of blood B of children in Nanjing as ranging from 25.1-58.5?g/L(except children below 1 year old).

Objective To investigate the clinical value of thromboelastogram(TEG) in predicting the deep venous thrombosis(DVT) formation of bedridden senile patients and further explore the risk factors for hypercoagulability in those patients.Methods Patients lying on bed for at least 1 year because of alzheimer's disease,stroke and fracture,aged between 70 to 90 years old,were selected in the Geriatrics Department of Shougang Hospital of Peking University from February 2013 to February 2014.Those patients were divided by Clotting composite index(CI) measured with TEG,CI less than and equal to 3 was control group,CI more than 3 was hypercoagulable group.The patients were followed-up for one year to identify the formation of DVT.Logistic regression analysis was used to analyze the independent risk factors of elderly patients with high blood coagulation state in bed.Results Two groups of baseline blood clots elastic graph indicators:Angle(α) of solidification,CI,coagulation time(K),the biggest thrombosis(MA),blood coagulation reaction time(R) comparative differences were statistically significant(P<0.05).In view of the bedridden elderly patients of high coagulation state,according to the result of single factor analysis of related factors,high coagulation state revealed with age(P=0.047),history of diabetes(P=0.001),bed time(P=0.043),tumor(P=0.001),fracture(P=0.002),but unrelated with sex,blood lipids,blood pressure,alcohol consumption,left ventricular ejection fraction.The multivariate logistic regression analysis indicated that fracture(OR(95%CI):5.634(1.114~28.496),P=0.037),tumor(OR(95%CI):4.652(1.142~18.955),P=0.032) and diabetes mellitus(OR(95%CI):6.269(1.528~25.725),P=0.011) were independent risk factors for DVT.Conclusion The incidence of DVT in bedridden senile patients with hypercoagulability identified by CI is higher than those with normal coagulability.Tumor,fracture and diabetes mellitus are independent risk factors for DVT.

Objective To observe the effect of aminoguanidine by intraperitoneal injection on apoptosis of chondrocyte with osteoarthritis.Methods Totally 32 rabbits were divided into 3 groups at random.Both the experiment and the model groups were fixed by plaster cast in the right hind straighten limb,while the control group received no treatment.The experiment groups were injected with aminoguanidine in abdominal cavity,100mg/(kg?d),and the control groups were injected the same voluminal normal saline in abdominal cavity.At the 4th week,we killed 4 rabbits from the normal group,and 6 from the control group and the experiment group,respectively.At the 8th week,we put the rest to death.We drew the materials from each sample for pathological observation on the whole and under the light microscope by HE and immunohistochemical staining,and counted apoptosis cells by TUNEL for statistical analysis.Results Compared with the control group,the experiment group was more similar to the normal group in general observation and optical microscope observation by HE staining.Both iNOS positive expression cell by immunohistochemical staining and apoptosis cell calculation by TUNEL of the experiment group were fewer than those of the control group(P

Objective:To study percutaneous transhepatic gallbladder drainage(PTGD) under color Doppler ultrasound in critically ill patients with acute calculus cholecystitis.Methods:A paracentetic needl was stuck into the cholecyst after going straight through 1.5-2.5 cm hepar under color Doppler ultrasound.The operator took out the bullet core,put in a guide wire,extracted the needl,inserted a central venous catheter along the guide wire,and then drew out the bile and clusised the cholecyst with metronidazole until the extracted fluid was clear and bright.Results:PTGD immediately relieved the pain in the of upper right quadrant in all the patients.Body temperature and WBC descended obviously 24 hours and returned to normal 5 days after the operation. Conclusion:Color Doppler ultrasound guided PTGD,easy to perform and with few complications and high suness rate,is an returned effective and reliable procedure for critically ill patients who are intolerant of cholecystectomy or for whom the operation is difficult to perform.

Objective To study the effects of internal and external biliary drainage on inducible nitric oxide synthase (iNOS) mRNA expression of Kupffer cells and serum tumor necrosis factor-alpha (TNF-α) in rats with obstructive jaundice. Methods Forty-eight male Sprague-Dawley rats were randomly assigned to obstructive jaundice (OJ), sham operation (SH), internal biliary drainage (ID) and external biliary drainage (ED) groups with 12 each. Kupffer cells were isolated by in situ hepatic perfusion and digestion with collagenase type Ⅳ, and purified by cell culture attachment. The expression of iNOS mRNA of Kupffer cells was detected by reverse transcription polymerase chain reaction (RT-PCR) and the serum TNF-α concentration was measured using ELISA method. Results The serum TNF-α level was increased in OJ group[ (110.84±26.3) pg/ml ]compared with SH group [-(88.4±17.9) pg/ml, (P=0.045)]. The TNF-α level in ID group[ (89.8±28. 3) pg/ml ]was significantly lower than that in ED group[ (118.64±22.7) pg/ml, (P=0. 011) ]and OJ group (P=0. 059). Expression of iNOS mRNA of Kupffer cells was significantly higher in OJ group (0. 824± 0. 24) compared with SH group (0. 384±0.35,P=0. 005). After relieving the OJ, the iNOS mRNA expression in ED group (0. 974± 0.48) was not suppressed (P=0. 321). On the contrary, the iNOS mRNA expression in ID group was suppressed and significantly lower than that in ED group (0. 59±0. 35) (P=0. 016). Conclusions Internal biliary drainage is superior to external drainage in terms of reversing the elevated serum TNF-α and in suppressing the iNOS mRNA expression of Kupffer cells in rats with obstructive jaundice.

Objective To study the possible pathogenesis of TNBS (2,4,6-trinitrobenzenesulfonic acid)-induced inflammatory bowel disease (IBD) in a mouse model by analyzing histological changes in colon and the expression of cytokines and transcription factor RORγt related to T cell subsets in mesenteric lymph nodes.Methods Female BALB/c mice aged 6-8 weeks were randomly grouped into two groups: IBD model and normal control groups.The mouse model of IBD was established by treating mice with 200 μl of 5％ TNBS/50％ ethanol solution (1∶1) through intestinal instillation, while the mice in the normal control group were instilled with PBS.Pathological changes in colon samples of mice were observed.Real-time PCR was performed to detect the dynamic expression of Th1 cytokines (IL-2, IFN-γ and IL-12p40), Th2 cytokine (IL-4), Treg-related cytokine (IL-10), Th17 cell-related cytokines (IL-17, IL-21 and IL-23) and transcription factor RORγt in mesenteric lymph nodes.Results The mice in the model group begun to show abnormal vital signs such as diarrhea, loss of weight and reduced activity, and mild hyperemia of intestinal mucosa and edema from the third day after modeling.Slight lesions were observed in histological slices of colon tissues stained with hematoxylin and eosin (HE).The expression of IL-21, IL-23 and IL-17 at mRNA level were significantly increased, while the expression of other cytokines showed no significant change.On the sixth day after modeling, many pathological symptoms and intestinal mucosal lesions were aggravated, and marked infiltration of inflammatory cells was observed in histological slices of colon tissues, which indicated that the IBD model was successfully induced by TNBS.Compared with the control group, the IBD model group showed significantly enhanced expression of IL-2, IL-12p40 and IL-10 in mesenteric lymph nodes at mRNA level on the sixth day after modeling.Although the expression of IL-21, IL-23, IL-17 and RORγt at mRNA level on the sixth day were down-regulated to different extent as compared with those on the third day, they were still significantly higher than those of the control group.Conclusion Th17 cell-related cytokines play an important role in the early stage of TNBS-induced IBD.With the progression of the disease, both Th1 and Th17 cells are involved in the immunopathological injury of colon tissues.

Objective To analyze clinical differential diagnostics and medication law of CAI Lian-xiang of treating gynecological diseases from theChong-Ren;To provide references for clinical medication. Methods Medical cases of gynecological diseases treated by differential diagnostics from“Chong-Ren”from December 2013 to January 2015 in out-patient department of Xiyuan Hospital of CACMS by CAI Lian-xiang were collected. Excel2007 was used to establish the database, and the frequency and correlation analysis were made on the differentiation, treatment principles, treatment methods, medicine and medical combination by using the large data intelligent analysis system of Chinese medicine diagnosis and treatment. The results were confirmed with CAI Lian-xiang's academic thought and clinical experience. Results Totally 103 medical cases, 277 diagnosis times, 277 prescriptions and 92 kinds of Chinese materiamedica were included. Although different types of gynecological diseases from theChong-Ren treatment of specific treatment were different, all were related to liver, spleen and kidney;prescription contained 22 high-frequency medicines (>50 times), and the first three medicines were Cuscutae Semen 178 times (64.3%), Angelicae Sinensis Radix 167 times (60.3%), Paeonize Radix 158 times (57.0%). The association analysis results showed 9 combination of Tiaochongren medicine combination group, 11 Qiangchongren meidcine combination group, 4 Zichongren medicine combination group, and 4 Guchuanrenmediicne combination group. Conclusion CAI Lian-xiang believes that gynecological diseases are closely related to “Chong-Ren”, and treatment from“Chong-Ren”focuses on the adjustment and nourishment of liver, spleen and kidney. The data miningresults of medication law is accordance with the relevant academic thoughts, which can provide references for clinic.

Objective To investigate the relationship between compatibilities of prescriptions for treating stroke and their dynasty and resource distribution, provide decision support for clinical applications. Methods Totally 905 prescriptions were selected from Database of Chinese Medicine Prescriptions. Information of selected prescriptions was standardized. The frequency of single herbs appeared in the prescriptions was counted. The core herb groups of the prescriptions were calculated by Apriori algorithm, and categorized by different dynasties. The concept of classical value of prescriptions (CVP) was proposed to characterizing the degree of classical of prescriptions and revealing the law of development of the prescriptions for treating stroke. Results The selected prescriptions involved 1479 different herbs, which were picked from 245 medical books. The top 3 most frequently used herbs were Saposhnikoviae Radix (40.22%), Angelicae Sinensis Radix (36.69%) and Chuanxiong Rhizoma (32.71%). Totally 29 3-item core herb groups were obtained, and the top three actions of relieving exterior syndrome, invigoration and calming wind. With support values>80 (frequency), the main effect was relieving exterior syndrome. CVP of selected prescriptions was calculated and categorized by dynasties. The top 10 books with largest reappearing rate and their high frequent herbs, and the top 10 books with largest proportion of all selected prescriptions were obtained. Conclusion The basic law of prescriptions for treating stroke in different medical books was obtained. The dynasty distribution of CVP indicates that the research of Chinese medicine for stroke increasingly getting systematic and becoming more accurate in choosing herbs. The principles of choosing herbs to combine a prescription for treating stroke are similar among the collections of selected medical books.

Objective To determine the involvement of DNA demethylation in tumor necrosis factor-α(TNF-α)-induced matrix metalloproteinase 9 ( MMP9) expression in human epidermal keratinocytes. Methods Real-time RT-PCR, Western blot, and enzyme-linked immuno sorbent assay (ELISA) were performed to determine the mRNA and protein levels of MMP9 after human keratinocyte cell line (HaCaT) cells were treated with 10 ng/ ml TNF-α or 2. 5 μmol/ L DAC/ 300 nmol/ L TSA. Bisulfite sequencing PCR ( BSP) and Methylation-sensitive high-resolution melt analysis ( Ms-HRM) were used to detect significantly differentially demethylated CpG sites in the human MMP9 promoter region in cells exposed to TNF-α. Different sites methylation constructs of promoter-luciferase reporter gene were made to detect the influences of site-specific DNA demethylation on transcription activity of MMP9 promoter. Results Compared with PBS-treated control, TNF-α significantly increased the expression of MMP9 in HaCaT cells for indicated culture duration ( P < 0. 05 ). Real time PCR, Western blot, and ELISA analysis demonstrated that the mRNA and protein levels of MMP9 were increased initially, followed by a decline with prolonged incubation time. After TNF-α treatment, varied degrees of DNA demethylation occurred at 10 CpG sites in the promoter of MMP9, and the changes at the -36 bp site were statistically significant (P<0. 05). The demethylation at the -36 bp site greatly increased the transcription activity of MMP9. Conclusion TNF-α promotes MMP9 expression in HaCaT cells through inducing -36 bp site DNA demethylation on the promoter of MMP9.