Objective Propofol exposure during pregnancy impairs learning and memory of the offspring rats, but its definite mechanisms are not yet clear.This study is to assess the impact of propofol exposure during early pregnancy on the learning, memory, and the expression of histone deacetylase 2 (HDAC2) in the hippocampus of the offspring rats.Methods Twenty Sprague-Dawley rats at gestation days 5-7, weighing 270-320 g, were equally randomized into a propofol exposure and a saline control group.The offspring rats of the former group were again divided into a propofol SAHA (n=50) and a propofol DMSO group (n=47), and those of the latter into a control SAHA (n=48) and a control DMSO group (n=45).On postnatal day 30, the offspring rats were subjected to the Morris water maze (MWM) test at 2 hours after intraperitoneally injected with the HDAC inhibitor subcroylanilide hydroxamic acid (SAHA) at 90 mg/kg and equal volume of dimethyl sulfoxide (DMSO), respectively.Then all the animals were sacrificed and the hippocampal tissue harvested for determination of the expression of the HDAC2 protein by immunofluorescence staining.Results On the 5th and 6th days of the MWM test, the escape latency was significantly prolonged in the propofol DMSO group ([65.93±30.42] and [50.72±24.72] s) as compared with the control DMSO ([29.32±16.38] and [21.34±13.79] s) and the propofol SAHA group ([42.52±20.43] and [24.28±13.41] s) (P<0.05), while the platform-crossing frequency was markedly lower in the former than in the latter two groups (P<0.05).The expression of the HDAC2 protein remarkalby up-regulated in the propofol DMSO group (1.37±0.03) in comparison with the control DMSO (1.00±0.02) and the control SAHA group (0.99±0.03) (P<0.05).Conclusion Propofol exposure in early pregnancy impairs learning and memory of the offspring rats, which is associated with the up-regulated expression of the HDAC2 protein in the hippocampus.

Objective To introduce the techniques of scanning the common bile duct(CBD) in full length with laparoscopic ultrasonography through the sonic window dorsal to the first portion of the duodenum(FPD). Methods The lower segment of the CBD in 300 cases was scanned in full length through the sonic window dorsal to the FPD. Results In our series, 97.67% of the lower segment of the CBD can be visualized with simple techniques through sonic window dorsal to the FPD. Visualization in 25 cases were improved with injection of saline into the subhepatic space and extraction of gas from the stomach and duodenum. Conclusion Through the sonic window dorsal to the FPD and with simple techniques, the lower segment of the CBD in majority of our cases can be satisfactorily imaged in full length. Visualization can be improved in some individuals with injection of saline into the subhepatic space and extraction of gas from the stomach and duodenum.

Objective The value of laparoscopic ultrasonographic scanning (LUS) in laparoscopic cholecystectomy (LC) and the way of scanning extrahepatic biliary system were reported. Methods 80 patients with gallstone receiving LC had real－ time color Doppler LUS of the extrahepatic biliary system. Results The sonic picture of major extrahepatic bile duct could be clearly visualized by LUS. While the image of the part posterior to duodenum could also be seen satisfactory with the method modified by the authors. But viewing the image of exact cystic duct needs further study.Conclusion LUS gives distinct intraoperative sonographic images of extrahepatic bile ducts , thereby the operator can precisely locate the ducts without injurying them. LUS can be considered as an important and safe supplement to LC.

Objective To analyze Vitamin D nutritional status of children and their height growth relationship in Wanzhou dis-trict of Chongqing .Methods Electrochemiluminescence immunoassay method was used to detect serum 25 hydroxyvitamin D [25 (OH) D]concentrations in 2 727 Children from Wanzhou district of Chongqing ,analyzing the correlation of Vitamin D and children age ,gender ,height ,parental height and other factors .Results There was significant difference in serum level of 25(OH) D among different age groups(P<0 .01) ,there was significant difference between boys and girls among the same age groups of 5 months ,6 months ,4 years old ,5 years old .Children′s height consistented with the national average 4 -6 years ago in Wanzhou District ,but Since then ,gradually felled behind .After adjustment for age ,sex ,parental height ,measured seasonal and other factors ,serum 25 (OH) D concentration was positively correlated with height (r=0 .462 5 ,P<0 .01) .Conclusion 25(OH)D levels were closely re-lated with the development of children′s height .Thus ,children generally poor 25(OH)D nutritional status in Wanzhou district should arouse the attention of parents and clinicians .

Objective To observe the effect of meridian balancing on speech disorder in children with cerebral palsy. Methods 130 childrenaged 1.5~7 years old were divided into the control group (n=62) and treatment group (n=68). The control group received routine rehabilitationwhile the treatment group received meridian balancing in addition. Results The rate of improvement was 89.7% in treatmentgroup and 79% in control group (P<0.05). The rate was more for those with language retardation than with anarthria in the treatment group(P<0.01). Conclusion The meridian balancing is effective on speech disorder in children with cerebral palsy, especially for those with languageretardation.

Objective To explore the feasibility and efficacy of laparoscopic total mesorectal excision(TME) with preservation of anal sphincter for rectal cancer.Methods From October 2001 to March 2004,54(patients) with rectal cancer underwent laparoscopic total mesorectal excision(TME) with preservation of anal sphincter.In 51 of the 54 cases,the operation was completed laparoscopically,including 14 cases of(laparoscopic) anterior resection(AR) with the anastomosis level above the peritoneal reflection;20 cases of laparoscopic low anterior resection(LAR) with the anastomosis level more than 2cm above the dentate line;16 cases of laparoscopic ultralow anterior resection(ULAR) with the level of anastomosis within 2cm of the dentate line;and 2 cases of laparoscopic coloanal anastomosis(CAA) with the level of the anastomosis at or below the dentate line.whereas conversion to an open approach was required in three cases.Results The average operating time was 145 minutes(range 110~210min),and mean operative blood loss was 50 mL(range 30~80mL).Bowel function was restored and diet was resumed at 48 to 36 hours after operation.The average hospital stay was 9 days(range 7~14d).TME was completed successfully in 51 patients.Postoperative analgesics were used in 20 patients.No intraoperative or postoperative complications were(observed).Follow-up time was from 6~36 months in 51 patiebts,and there was no port-site or local tumor recurrence.Conclusions Laparoscopic TME is feasible and safe.It is a perspective technique with the(benefits) of minimally invasive technique and lower blood loss during operation,and rapid recovery.

Objective To analyze the influence factors of medical staff blood-bome occupational exposure by structural equation modeling,in order to improve medical staff of blood-borne occupational exposure protection performance of the system to provide the theory basis for operation.Methods The influence factors of medical staff blood-borne occupational exposure and their correlation were analyzed by exploratory factor analysis and structural equation modeling fitting.Results Model fitting was ideal,hospital decision-makers and department management directly affected the behavior intention of medical staff,department management greatly influenced by the behavioral intention to the medical personnel,path coefficient was 0.27.Hospital decision-makers of behavioral intention to the medical personnel directly affect smaller,path coefficient was 0.03,but its indirect impact on behavioral intention by department management.Behavioral intention of occupational exposure protection action,the path coefficient was 0.80,behavioral intention determined the basic medical personnel blood-borne occupational exposure protection behavior.Conclusions Hospital should improve the system of standards and to establish effective communication channels,at the same time enhance the care ability.Enforcement departments should improve the standard system,equipped with adequate safety equipment,for the medical staff to provide the best working environment,so as to improve the medical staff of blood-borne occupational exposure protection behavior compliance.

Objective To discuss the influence of individual cognitive on medical personnel blood-borne occupational exposure protection action from the angle of behavior operation.Methods Medical staff of 14 hospitals in zunyi were investigated by questionnaire designed based on the theory of health belief model,and analyzed the data by structural equation model.Results Sample data and the assumption model was ideal,the blood-borne occupational exposure protective behavior of medical staff could be explained variance of 87％ by susceptibility,severity,behavioral benefit and barrier cognition.The order of influencing factors from high to low were behavioral benefit,severity,behavioral barrier and susceptibility to cognition,and path coefficients were 0.39,0.27,-0.21,0.03.Conclusions Susceptibility,severity and behavioral benefit cognition have positive effection on protective behavior,the behavioral benefit cognition have more influence on blood-borne occupational exposure protective behavior of medical staff,and behavioral barrier cognition have negative effection,the results of health belief model can explain blood-borne occupational exposure protective behavior of medical staff better.

Objective To investigate the effects of dexmedetomidine on renal function in patients with hemorrhagic shock undergoing emergency surgery.Methods Sixty patients (27 males, 33 females) with hemorrhagic shock, aged 18-69 years, ASA physical status Ⅲ or Ⅳ, required emergency surgery under general anesthesia, were randomized into two groups (n=30 each): dexmedetomidine group (group D) and control group (group C).The patients in group D receiving a loading dose of dexmedetomidine (0.5 μg/kg within 10 min) after the induction of anesthesia followed by a continuous infusion rate of 0.4 μg·kg-1·h-1 till 30 min before the end of surgery, while those in group C received equal volume of normal saline.Venous blood were obtained immediately before beginning of surgery (T1), immediately after surgery (T2), 24 h after surgery (T3) and 72 h after surgery (T4) for detecting the concentrations of the serum creatinine (Scr) and blood urea nitrogen (BUN), the contents of neutrophil gelatinase-associated lipocalin (NGAL) and high mobility group box-1 (HMGB1).The range ability of the concentration of the serum Scr from T4 to T1 (ΔScr) and the content of the serum HMGB1 from T4 to T1 (ΔHMGB1) were also calculated and recorded.Hemodynamic index (including MAP, HR) and arterial blood gas results were recorded during surgery.Results Compared with T1, MAP, CVP and BE were increased, meanwhile, HR and Lac were decreased at T2, but there was no statistically significant difference between the two groups.No statistical difference was found in BUN at any time point between group D and group C.Compared with T1, Scr decreased in both groups at T2-T4.The ΔScr in group D was higher than that in group C at T4 (P＜0.05).The content of serum NGAL at T4 in group D was significantly dropped when compared with T1 (P＜0.01) and was lower than that in group C (P＜0.05).Compared with T1, the content of serum HMGB1 was significantly decreased in both groups at T2 (P＜0.05);the content of serum HMGB1 at T3 in group C was significantly increased and was higher than that in group D;the ΔHMGB1 in group C was higher than that in group D.Conclusion Hemorrhagic shock could induce acute kidney injury.Perioperative continuous infusion of dexmedetomidine facilitated renal function recovery after ischemia-reperfusion injury in patients with hemorrhagic shock through inhibiting the elevation of serum HMGB1.

Objective To explore the intervention effect of the combination of medicine and education on teachers and parents of children with attention deficit hyperactivity disorder (ADHD).Methods The students in Grade 1 to 3 of 6 public primary school (6～11 years old) were enrolled by stratified sampling method and randomly divided into the experimental group and the control group.All the students were screened for ADHD,and the children diagnosed with ADHD and their parents and teachers were enrolled into study as the research object.The children in the control group were given oral short-effect methylphenidate hydrochloride tablets and their parents underwent routine health education,while the parents and teachers in the experimental group were given both the routine health education and systematic training.Before and after training,the awareness rates of ADHD knowledge among parents and teachers were observed,and the clinical effects of two groups were compared.Results The control group included 71 children with ADHD,71 pairs of parents and 31 teachers,while the experimental group included 68 children with ADHD,68 pairs of parents and 34 teachers.The difference of general data between the two groups has no statistical significance (P＞0.05).Before intervention,there was no significant difference in awareness rate of ADHD knowledge among teachers and parents in the two groups (P＞0.05).After the intervention,the awareness rate of ADHD knowledge in teachers of the control group did not change obviously,while which in parents of the control group and the parents and teachers in the experimental group were significantly improved,and the improvement effect in the experimental group was significantly better than that of the control group (P＜0.05).The scores of the SNAP-Ⅳ scale in both groups were significantly decreased,and the scores of the experimental group were significantly lower than those in the control group.The significant rate and total effective rates of the experimental group were significantly higher than those in the control group (P＜0.05).Conclusion The intervention effect of combination of medicine and education on teachers and parents of children with ADHD is definite,which is worthy of further research.