Objective To study the clinical efficacy and adverse reactions of different blue-light and expo-sure patterns for the treatment of neonatal hyperbilirubinemia.Methods 127 neonates with hyperbilirubinemia were divided into cold-light illuminator blue-light irradiation group (group A, n=32), cold-light illuminator blue-light group intermittent irradiation group (group B, n=32), traditional blue-light irradiation group (group C, n=31) and traditional blue-light intermittent irradiation group (group D, n=32).The treatment course of the four groups was all 72 hours.The level of serum total bilirubin ( TBIL) , direct bilirubin ( DBIL) and auditory brainstem response before and after treatment in the four groups were respectively observed and compared.The adverse reactions associated with treatment were recorded and compared among the four groups.After 9 months of follow-up, the audi-tory brainstem response ( ABR) was respectively tested at 3 days, 3 months and 9 months after the treatment.Results The level of TBIL in the four groups after treatment were significantly decreased compared with that before treatment (p<0.01), and the level of TBIL in cold-light illuminator blue-light group was significantly decreased compared with that in traditional blue-light group ( p<0.05 ) .The total effectiveness in cold-light illuminator blue-light group was significantly higher than that in traditional blue-light group ( p<0.05) .The incidence of adverse reaction in cold-light illuminator blue-light group was significantly lower than that in traditional blue-light group ( p<0.01), and the incidence of adverse reaction in group C was significantly higher than that in group D (p<0.05).At day 3 after treatment, the abnormal rates of ABR in the cold-light illuminator blue-light group was significantly lower than that in the traditional blue-light group (p<0.05).After 3 months of treatment, the abnormal rates of ABR was insignificantly different among the four groups (p>0.05).The ABR in the four groups returned to the nor-mal after 9 months of treatment.Conclusion The therapy of the cold-light illuminator blue-light irradiation has significant clinical efficacy in the treatment of neonatal hyperbilirubinemia.It can effectively reduce the hearing im-pairment of neonates, and the incidence of adverse reaction and total effective rates are equivalent in therapeutic pat-terns of intermittent irradiation and continuous irradiation.

Objective To investigate the serological patterns of hepatitis B, understand the prevalence of hepatitis B infection in neonates, infants and preschool children based on hospital data in Zhejiang province and provide a basis for prevention and control of local pediatric hepatitis B infection. Methods Five serological markers were detected on electrochemiluminescence analyzer Roche E601. The results of all serological markers in children with hepatitis B from 2006 to 2010 were exported from laboratory information system and 24 892 (15 810 boys and 9 082 girls) cases were selected for further analysis according to the exclusion criterion including duplicate analysis, children older than 7 years and children living out of Zhejiang province. SPSS13.0 software and EXCEL 2003 were employed for statistical analysis in this study. Results Average HBV vaccination coverage rates among 15 413 boys and 8 840 girls were 99. 16%(98. 87% -99. 45%) and 99. 17% (98. 29% -99. 53%), respectively. Seventeen serological patterns of hepatitis B were observed, and "anti-HBs(+)alone"(64. 997%) was the dominant patterns followed by "negative" (18. 231%), "anti-HBc(+)anti-HBs(+)"(9.911%) and "anti-HBe(+)antiHBc(+) anti-HBs(+)"(4.395%), and the positive rates for other patters were 0. 004% -0. 992%. There were significant difference of detection rates for "anti-HBc(+)alone" and "anti-HBe(+)anti-HBs(+)"patterns between male and female (χ2=7.143,8.123, all P＜0.01), and there were no significant difference of detection rates for the other 15 patterns between male and female (all P ＞0.05). Ninety-four HBsAg positive cases were detected, accounting for 0.38%. Totally 19 899 anti-HBs positive cases were detected, accounting for 79.94%. Totally 16 187 cases were "anti-HBs(+) alone", accounting for 81.3%of the total anti-HBs(+) cases. The group of 1-2 years and 2 day-2 week had the highest and lowest rate for anti-HBs(+)alone respectively. The ratios in three groups with different anti-HBs levels (10-100 mIU/ml,100-1000 mIU/ml and ＞ 1000 mIU/ml) in 16 178 anti-HBs(+) children were 23. 64%, 27.66% and 13. 70%, respectively. Totally 3 904 cases with anti-HBc(+) were detected, accounting for 15.68%. The highest positivity rate and lowest positivity rate were in the group of 2-4 week and 3-4 week respectively. In total 1 565 cases with negative results, the lowest negativity rate and highest negativity rate were in the group of 9-12 month (3. 25%) and 6-7 age (36. 21%) respectively. Conclusions The dominant serological patterns of hepatitis B in local young children is "anti-HBs (+) alone" and most of the anti-HBs concentrations ranged from 100 to 1000 mIU/ml, followed by "negative". The total positive rate of HBsAg is mild. The rate of hepatitis B serological patterns in children is associated with ages but independent of gender. For interpretation of serological patterns of HBV in children below 12 months (especially in 3 months) the status of their mothers' HBV infection should also be taken into consideration.

Objective To investigate the effect of three-level network of vaccination on immunization rates of planned immunization vaccine,and provide science basis for planned immunization work.Methods Immunization rates of children in 131 villages under administration of Xiaolan People's Hospital of Zhongshan were investigated according to PPS from 2007 to 2010,and were compared before and after the establishment of three-level network of vaccination.Results After the establishment of three-level network of vaccination,rates of certification,and vaccination rates of OPV,DPT,and HBV were all increased significantly,vaccination rates of BCG were not raised obviously.Conclusions The establishment of three-level network of vaccination can increase immunization rates of planned immunization vaccine.

Objective To explore the effect of doxazosin on rabbit bladder compliance after partial bladder outlet obstruction. Methods A total of 40 male New Zealand white rabbits were randomized into 4 groups, with 10 rabbits in each group. Partial bladder outlet obstruction was established in groups B and C, while groups A and D underwent the same operation but without partial bladder outlet obstruction. On the day after the operation, groups C and D received oral administration of doxazosin. After 14 weeks, urodynamic examinations were carried out in all groups, and the bladder was weighted after cystectomy. Results Bladder weight was (3.2±0.9) g in group A, (14.1±2.3) g in group B, (5.0±2.0) in group C,and (2.9±0.5) g in group D. The bladder weight in groups B and C increased significantly compared to groups A and D (P＜0.01), group B increased significantly over group C (P＜0.01), and there was no significant difference between groups A and D (P＞0.05).The detrusor leak point pressure was (10.2±2.5) cm H2O in group A, (18.8±6.1) cm H2O in group B, (13.5±4.7) cm H2O in group C,and (11.6±3.6) cm H2O in group D. The detrusor leak point pressure in group B was significantly higher than group A, group D (P＜0.01) and group C (P＜0.05). There was no significant difference between group A, group C and group D (P＞0.05). The bladder compliance was (2.86±0.56) ml/cm H2O in group A, (1.22±0.39) ml/cm H2O in group B, (4.25±2.19) ml/cm H2O in group C,and (2.90±0.53) ml/cm H2O in group D. The bladder compliance was significantly decreased in group B compared to groups A and D (P＜0.01). Bladder compliance in group C was significantly higher than in groups A and D (P＜0.05), and there was no significant difference between group A and group D (P＞0.05). Conclusion Early use of doxazosin can delay the occurrence of lower bladder compliance after partial bladder outlet obstruction, thus protecting the storage function of bladder.

Objective To establish a drug-resistance cell line of human glioma with temozolomide ( TMZ) ,investigate its resistance mechanisms, and provide experimental evidence for optimal TMZ therapy. Methods A TMZ-resistant human glioma cell line,U251/TR,was established by stepwise exposure of human parental U251 cells to TMZ. Resistance index and cell viability were accessed by MTT assay. Western-Blot,RT-PCR,immunohistochemistry and immunofluorescence were used to detect MGMT expression for the analysis of resistance mechanism. Results A TMZ-resistant human glioma cell line,U251/TR,was developed after 8 months of stepwise induction with 0. 25-16. 00 μg·mL-1 TMZ. IC50 in U251/TR cells was approximately 7 times higher compared with that in U251 cells (P=0. 00 ). The MGMT expression was significantly increased in U251/TR cells compared with that in parental U251 cells (P=0. 00) . Conclusion A TMZ-resistant human glioma cell line,U251/TR,was established by stepwise exposure of human parental U251 cells to TMZ. The primary mechanism of TMZ resistance is associated with increased activity of MGMT.

Objective To evaluate the value of gemstone spectral imaging (GSI)and multi artifact reduction system(MARs)in re-ducing metallic implants artifacts,and find the best monochromatic images.Methods Twenty-one patients with metal implants in our hospital receievd GSI examination ,MARS reconstruction and polychromatic images(140 kVp).Eleven groups of monochromatic and MARS images were obtained from 40 keV to 140 keV every interval of 10 keV by the special GSI viewer ,respetively.Subjective image quality of two methods were assessed by 3 radiologists in consensus.For every patient one group monochromatic images and blend enery images were selected two heaviest artifacts level and no artifacts level,the CT value and the standard deviations(SD)value of the region of interest(ROI)were meatured of artifacts.Contrast-to-noise ratio(CNR)and artifacts index(AI)were also caculated and were analyzed with paired-t test.Results There was significant statistical differences of CNR between energy spectral images and blend energy images in energy level of 40 to 120 keV(P <0.05),while there was no difference in energy level of 130 to 140 keV (P >0.05),and the optimal CNR was acquired at the energy level of 70 keV(CNR=8.75±3.28).The value of AI for two mehtods has no difference in energy level scope 40 to 60 keV(P >0.05),there was significant statistical differences of AI between energy spectral images and blend energy images in energy level of 70 to 140 keV(P <0.05),and the lowest of AI(AI=26.95±9.64)was ac-quired at 1 10 keV images.Conclusion The energy spectral CT possess superiority in decreasing the artifacts and will provide high image quality in the metal implants.Gemstone spectral CT has great significance for postoperative patients with metal implants in imaging diagnosis.

Objective: To study the clinic and pathological features of leukoplakia of the larynx, and reduce canceration rate. Method: Seventy-four postoperative patients of leukoplakia of the larynx were followed up for four years by telephone or clinic service. Result: None of eighteen cases of pure leukoplakia was recurrence. Fifty-six ca-ses were leukoplakia with epithelial dysplasia histologically. Seven out of fifty-six postoperative cases occurred hoarseness; three out of fifty-six postoperative cases recured, and accepted twice or more operations successively; three out of fifty-six postoperative cases occurred canceration. Conclusion:Operation is the main means for the treatment of leukoplakia of the larynx, and the effect is comparatively well. The patients with histological epitheli-al dysplasia should be pay great attention because of their higher canceration rate, and enlarged operation ranges appropriately with the patient consent could effectually prevent recurrence or canceration during the early lesions. Close observation is important for these patients.

The derivatization towards the hydroxyl groups of steroid environmental endocrine disrupting chemicals,such as estrone(E1),17β-estradiol(E2),estriol(E3) and 17α-ethynylestradoil( EE2),with A,O-bis (trimethylsilyl) trifluoroacetamide ( BSTFA ) as derivatization reagent followed by gas chromatography-mass spectrometry(GC-MS) was studied. The effects of the amount of BSTFA,derivatization temperature and time on the derivatization of target compounds,as well as the stability of steroid derivatives,calibration curves,instrumental quantification limits were investigated. The cleavage mechanism of steroid derivatives characteristic fragment ions was also interpreted. The results showed that better derivatization results were obtained when the amount of BSTFA was 25 μL for 100 μL steroids standard mix solution at 0.01 g/L;it is unnecessary to heating in the derivatization,better results were obtained when the steroids were derivatized with BSTFA at room temperature (20℃) for 10 min. The derivatives of target compounds were stable because their relative response factors(RRFs) had no observable change when deposited at -20℃ for 48 h. Under the optimal conditions,good linear correlation was obtained and the instrumental quantification limit was 0. 3μg/L for E1 and E2,while it was 5μg/L for EE2 and E3.

Objective To observe and comparatively analysize the effect of intraperitoneal injection of hydrogen and hydrogen-rich saline in neonatal rats with hyperoxia-induced lung injury.Methods Sprague-Dawley(SD) newborn rats were randomly divided into six groups(n=10).air group(A),air+ hydrogen-rich saline group(B),air+hydrogen group(C),hyperoxia group(D),hyperoxia+hydrogen-rich saline group (E) and hyperoxia+ hydrogen group(F).The group A,B and C were exposed to air and group D,E and F were exposed to 95 ％ oxygen.The group B and E were intraperitoneally injected with hydrogen-rich saline (10 mL/kg,twice daily),while the groups C and F with hydrogen (10 mL/kg,twice daily).The group A and D were injected with normal saline(10 mL/kg,twice daily).Lung tissue and serum samples were collected on 15 d of experiment.The pathological changes of lung tissue and radiate alveoli count (RAC) were observed by HE staining.The content of HYP in lung tissue was detected by the alkaline hydrolysis method,serum SOD and MDA levels were measured.The expression of α-SMA in lung tissue was detected by immunohistochemistry SP method.Results Compared with the A group,RAC and SOD activities in the D group were significantly decreased,while the HYP and MDA levels and α-SMA expression were significantly increased.Hydrogen intervention could significantly alleviate these changes caused by hyperoxia.while intraperitoneal injection of hydrogen got better effect than intraperitoneal injection of hydrogen-rich saline.Conclusion Hydrogen can extenuate the indexes of hyperoxia-induced lung oxidative damage,impairment development and fibrosis to a certain extent.Intraperitoneal injection of hydrogen has slightly better effect than hydrogen-rich saline.

Objective Training a few medical students as standardized patients to teach and test other medical students'physical examination skills is a good way to compensate the deficient teaching resources and improve the medical students'clinical capabilities.Methods We spent 12 class hours to train 6 students as standardized patients.Then we used these 6 students'standardized patients to help the teacher to educate medical students in experimental group,while students in the control group only had traditional class under the construction of the teachers as before.At last,we collected their final physical examination skills'score.Results The final physical examination skill score of experimental group(85.78?5.89)is higher than that of control group(84.53?4.64)(P