Objective To investigate the incidence of brain injury and analyze the risk factors in very low birth weight infants (VLBWI),in order to explore methods to improve neurodevelopmental outcome.Methods This was a retrospective study in which we reviewed the incidence of brain injury in 326 VLBWI who admitted to our NICU from October 2007 to September 2014.The differences of general characteristics,high-risk perinatal factors,complications of prematurity and respiratory support in brain injury group (n =132) and no brain injury group(n =194) were analyzed,and Logistic regression was used to analyze the related risk factors.Results In 326 VLBWI,premature brain injury was observed in 132 cases(incidence of 40.49％).Hemorrhagic brain injury was observed in 80 cases(incidence of 24.54％,80/326),in whom total 66 cases (20.25％,66/326) with periventricular-intraventricular hemorrhage (PVH-IVH),41 cases with PVH-IVH grade Ⅰ-Ⅱ,25 cases with PVH-IVH grade Ⅲ-ⅣV.Non-hemorrhagic brain injury was observed in 52 cases (incidence of 15.95 ％,52/326),in whom 46 cases with periventdcular leukomalacia (14.11％,46/326).There were no statistically significant differences in general characteristics except gender differences between the two groups.Further analysis of the 28 factors including high-risk perinatal factors,premature complications and respiratory support between the two groups,showed that there were significant differences in 16 factors including asphyxia,chorioamnionitis,antenatal steroid use,neonatal respiratory distress syndrome,hypoxemia,apnea,pulmonary hemorrhage,patent ductus artedosus,hypotension,acidosis,hypocapnia,anemia,hyperglycemia,thrombocytopenia,high frequency ventilation and extrautedne growth retardation.Further binary Logistic regression analysis showed that antenatal steroids use was negatively correlated with brain injury,chorioamnionitis,acidosis,and patent ductus arteriosus were positively correlated with brain damage,the relative risks of premature brain injury was 0.108,7.222,3.045 and 4.565 respectively.Conclusion The mortality rate and the incidence of brain injury in VLBWI are still high.Chorioamnionitis,acidosis and patent ductus arteriosus are closely associated with premature brain damage.Antenatal steroids can prevent premature brain injury.We should pay much attention to these risk factors in the perinatal management of VLBWI,in order to decrease the incidence of premature brain injury.

Objective:To evaluate the anti-infective therapy in a patient with multi-site infections after brain surgery and explore the role of clinical pharmacist in the treatment. Methods:With the applications of PK/PD characteristics of drugs and the coping strategies of resistant , vancomycin combined with fosfomycin were used to treat the intracranial infection caused by methicillin-resistant Staphylococcus epidermidis with vancomycin MIC of 2 mg·L-1 , and the dynamic adjustment of antibiotics was applied to treat the pulmonary infection caused by two kinds of pathogens including MDR bacteria. Results:The intracranial infection was successfully controlled, the pulmonary infection was also under control, and the overall condition of the patient was significantly improved. Conclusion: In the medical team, clinical pharmacists should make full use of their advantages in drug characteristics to carry out clinical pharmaceutical care.

Objective To analyze the mechanism of pigment epithelium?derived factor(PEDF)regulation in lung cancer cell proliferation and migration by vascular endothelial growth factor(VEGF). Methods VEGF expression was observed after overexpression or silencing of PEDF. Proliferation and migration were analyzed by MTT and transwell assays. Real?time PCR and Western blotting were performed to investigate the mechanism underlying PEDF regulation of the VEGF/SRC/FAK pathways. Results PEDF could inhibit the proliferation and migration of A549 cells by VEGF. Conclusion PEDF can be considered as a potential therapeutic target for lung cancer.

Objective] To explore the theoretical origin, clinical application method, effect and practical significance of the treatment of ectopic pregnancy with blood stasis. [Method] From blood stasis on the treatment by promoting blood circulation to remove blood stasis, Yiqi Yangxue Huayu Shapei, expelling blood circulation, method to eliminate the disease, stage of treatment, a reasonable choice of promoting blood circulation and removing blood stasis drugs in the treatment of ectopic pregnancy. [Results] From blood stasis on the treatment of ectopic pregnancy, it can accelerate the beta HCG negative, and speed up the ectopic pregnancy mass absorption, clinical curative effect significantly, the greatest degree of protection of fallopian tube integrity, improve blood circulation, and tubal function recovery, increase after treatment the chances of conception. [Conclusion] Qi stagnation, blood stasis and Qi deficiency and blood stasis are ectopic pregnancy basic pathogenesis, less empirical abdominal blood stasis is the essence of its pathogenesis. The existence of blood stasis in ectopic pregnancy of each type and disease development of the whole process, in the occurrence of the disease, and occupies an important position in the development, promoting blood circulation and removing blood stasis is the basic treatment, should be in clinical dialectical treatment of the whole process of fusion.

Objective To investigate the application value of risk management in skin care of hospitalized neurosurgery patients. Methods 179 cases of hospitalized neurosurgical patients from January to December 2011 were chosen as research object.All the patients were divided into the observation group (91 cases,the risk management care group)and the control group (88 cases,the routine care group).The two groups accepted different nursing measures.The skin damage caused by medical factors,family factors and environmental factors for the two groups were taken for statistics and comparison. Results The patients with skin damage due to medical factors,family factors and environmental factors in the observation group were significantly lower than the control group,there was significant difference. Conclusions The application of risk management methods in skin nursing of hospitalized neurosurgery patients has good effect.It can reduce the rate of skin damage of patients significantly and is recommended widely used in hospitalized neurosurgery patients.

Objective To discuss the influence of individualized health education based on combination of TCM and western medicine on the life quality of patients with diabetes mellitus in order to supply novel idea and method for carried out education about diabetes mellitus. Methods Hospitalized patients (140 cases) were randomized into the control group and the test group with 70 cases in each group. Both groups received routine diabetes drugs treatment. The patients and their family members received individualized health education based on combination of TCM and western medicine during their hospitalization days and 6 months after discharge. SF-36 inventory and diabetes cognitive questionnaire was adopted to investigate the two groups. Results The diabetes cognitive degree of the test group was higher than that of the control group (P<0.01). Six items such as social function, systemic health, body pain, psychological health, vigor and emotional role function of the test group was different from those of the control group (P<0.05). Conclusion Individualized health education based on combination of TCM and western medicine contributed to the improvement of patients' life quality.

Objective To observe the expression changes of renal tissue Bax,Bcl-2 and caspase-3,to wxamine the correlation between the ratio of Bax to Bcl-2,caspase-3 and renal tubular cells apoptosis,and to investigate the role of caspase-related signal pathway.Methods Forty-eight male Wistar rats were randomly divided into three groups: control (CN,n=8),exhaustive swimming (ES,n=24) and inula britannica (IB,n=16) group.The rats of CN were quiet without swimming.The rats of ES swam to exhaustive state and were sacrificed at immediately(ESI),6 hour (ES 6 h) and 24 hour (ES 24 h) after exhaustive swimming respectively.The rats of IB took orally inala britannica at the dose of 25 ml/kg body weight at 24 h before swimming and then swam to exhaustive state.The rats of IB group were sacrificed at 6 hour (IB 6 h) and 24 hour (IB 24 h)after exhaustive swimming.The animal model of overtraining-induced acute kidney injury was developed by exhaustive swimming.The renal cell apoptosis was measured by the method of TUNEL.The expressions of Bax,Bcl-2,caspase-3 in renal tissue were observed by immunohistochemistry.The expression of caspase-3 protein was examined by Western blotting.The correlation between the ratio of Bax to Bcl-2 and caspase-3 was analysed by Pearson method,and the correlation between the ratio of Bax to Bcl-2,caspase-3 and renal tubular cell apoptosis was analysed by Spearman method.Results The number of renal tubular apeptotic cells was increased progressively in ESI to ES 24 h rats by TUNEL (P＜0.05).Immunohistochemistry staining showed that the ratio of Bax to Bcl-2 and caspase-3 in renal tubular cells were increased progressively at 0 h,6 h and 24 h after exhaustive swimming compared with control group (P＜0.05).The change of renal tissue caspase-3 was also revealved by Western blotting analysis.The ratio of Bax to Bcl-2 and caspase-3 in renal tubular cell was correlated positively (r=0.865,P＜0.05),The ratio of Bax to Bcl-2,and caspase-3 was also correlated positively to renal tubular cell apoptosis (r=0.674,r=0.837,P＜0.05) in ES rats.Pretreatment with inula britannica inhibited the up-regulation of the ratio of Bax to Bcl-2,caspase-3 and cell apoptosis in renal tubular cell induced by exhaustive swimming.Conclusion Overtraining can induce renal tubular cells apoptosis through activating caspase-related signal pathway by impairing the balance of Bax and Bcl-2,which may be one of the important molecular mechanisms of overtraining-induceed renal tubular cells apoptosis.

Objective: To investigate the coverage of enterovirus 71 (EV71) vaccine among children born between 2018 and 2021 in Ningbo City, Zhejiang Province, so as to provide insights into formulating EV71 vaccination strategy. Methods: Data pertaining to demography and EV71 vaccination among children born between 2018 and 2021 in Ningbo City were obtained from the Zhejiang Immunization Information Management System, and the coverage of vaccination, full-dose vaccination and timely vaccination of EV71 vaccine were analyzed. Results: Totally 416 176 children were born between 2018 and 2021, including 216 977 boys (52.14%) and 199 199 girls (47.86%). The coverage rates of vaccination, full-dose vaccination and timely vaccination was 61.50%, 58.70% and 32.53%, respectively. The coverage rates of vaccination, full-dose vaccination and timely vaccination among local children (71.43%, 70.04% and 40.24%) were higher than those among migrant children (54.05%, 50.18% and 26.73%; P<0.05). The coverage rates of vaccination, full-dose vaccination and timely vaccination among urban children (67.72%, 65.06% and 40.37%) were higher than those among rural children (54.11%, 51.14% and 23.21%; P<0.05). The coverage rates of vaccination were 54.98%, 61.24%, 65.10% and 66.72%, the coverage rates of full-dose vaccination were 52.16%, 58.72%, 62.44% and 63.39%, and the coverage rates of timely vaccination were 22.47%, 25.86%, 39.14% and 48.03% by the born year from 2018 to 2021, all showing increasing trends year by year (P<0.05). Conclusion The coverage of vaccination, full-dose vaccination and timely vaccination of EV71 vaccine appears a tendency towards a rise among the 2018-2021 birth cohorts in Ningbo City, while the coverage of timely vaccination need to be improved. Health education for EV71 vaccination should be enhanced for rural and migrant children.

Crimes which are committed by the doctors are getting even worse on the market of medical service.And the lack of occupational morality is one of the most important reasons.Medical service and moral risk coexist to the clinical adult-students from direct medical service.Thus,to understand the importance of moral risk as well as to fully explore the internal potential of the students is a significant subject for the adult education of clinical students.

Objective:To find out the apoptosis mechanism of HT-29 colon cancer cell induced by NDGA,the lipoxygenase inhibitor in vitro.Methods:We applied respectively:RT-PCR to detect colon cancer cell’s expression of 5-LOX messenger ribonucleic acid(5-LOXmRNA) and that of messenger ribonucleic acid about human telomerase reverse transcriptase(hTERTmRNA)respectively,confocal laser scanning electron microscope to examine intracellular free calcium.Results:Colon cancer cell lines HT-29 showed positive expression of 5-LOXmRNA.This expression became weaker following the rise of cell’s apoptosis and so were hTERTmRNA.Intracellular Free calcium increased following the rise of cell’s apoptosis.Conclusion:The apoptosis of tumor cell is caused by a combination of factors,with 5-LOX,telomerase and free calcium all active in the course.