0.05).Conclusion The elevation of GH involved in the pathogenesis of diabetic microangiopathy possibly by exacerbation of disorders of glucose and lipid metabolism.

Objective To investigate hepatitis B virus (HBV) mother-to-child transmission rate in hepatitis B virus surface antigen (HBsAg)-positive pregnant women.MethodsA total of 1355 HBsAg-positive pregnant women and their 1360 newborns (included 5 twins)were collected prospectively.All newborns received hepatitis B immunoglobulin (HBIG) 200 U intramuscularly within 6 hours of birth as early as possible,and were administered with routine 10 μg recombinant hepatitis B vaccine (at 0,1,6 months of birth).The venous blood HBV markers and HBV DNA levels were detected in all newborns at 0,7,12 months of age.The measurement data were analyzed by t test.Qualitative data were analyzed by chi square test,rank sum test or Fisher exact test.Results The intrauterine HBV infection rate of 1360 infants were 1.54％ (21/1360) during 12 months of follow-up.The rate of intrauterine infection in HBeAg positive mothers was significant higher than that of HBeAg negative mothers (4.44％ vs 0,χ2 =35.99; P＜0.05); the rate of intrauterine infection in HBV DNA positive mothers was significant higher than that of HBV DNA negativemothers (3.13％ vs 0,χ2 =21.84; P＜0.05).When maternal serum HBV DNA≥1 × 107 IU/mL,the rate of intrauterine infection was 6.01 ％,which was significantly higher than that of maternal serum HBV DNA＜ 1 × 107 IU/mL (χ2 =39.43,P＜0.05).ConclusionsAfter strict combined active-passive immunization,the rate of HBV intrauterine infection is 1.54％.When mothers are HBeAg positive or with high level of HBV DNA,the rate of HBV intrauterine infection increases significantly.Intrauterine infection is the main cause of failure in immunoblockade of HBV mother-to-child transmission.

AIM:To explore the characteristics of hepatitis B virus S gene mutation in the vertical transmission after active and passive vaccination .METHODS:Fifteen cases of immunoprophylaxis failure were enrolled in the study . HBV S gene (including pres-S and S) from the mothers, newborns before active and passive vaccination and 7-month-old infants with immunoprophylaxis failure were detected by PCR amplification .The characteristics of HBV S gene mutation were compared among the 3 groups.RESULTS: The genotype of HBV in the newborns and the infants was the same as that in the mothers .The frequencies of mutation in the 2 fragments of the HBV S gene had no significant difference between the 3 groups.The homology tree model based on HBV S gene was analyzed in the 3 groups, in which every group had their own cluster.There were 15 different mutation sites between 7 pairs of mothers and newborns .There were 3 different muta-tion sites between 3 pairs of newborns and infants (nt273A→A/G, nt512C→C/T and nt1139C→A), among which the first 2 were located in the S gene region but not in the “a” determinant , and the latter was located in the overlap region of S and X genes .There were 25 different mutation sites between 9 pairs of mothers and infants , but only 1 case had a differ-ent mutation site between the mother , newborn and infant .CONCLUSION: The HBV species in newborns and infants with immunoprophylaxis failure were transmitted from the mothers .The mutations in the HBV S gene with immunoprophy-laxis failure happened before and after active and passive vaccination , mainly before vaccination .The relationship between HBV S gene mutations and immunoprophylaxis failure should be further explored .

The purpose of this study is to find out anti-HIV-1 reverse transcriptase (RT)/protease (PR) activity and inhibition of virus replication in cell cultures of novel coumarin analogs and determine their structure-activity relationship. Coumarin derivatives have been demonstrated to inhibit the activity of HIV-1 RT/PR in cell free system. It also shows inhibition effects to HIV-1 replication in cell culture. Based on the Chinese traditional pharmacological characteristics and protein three dimension computer aided design, analogs of tetracyclic dipyranocoumarin were synthesized from natural leading compounds. We studied the relationship of antiviral effects and chemical structures via HIV-1 PR/RT enzyme models and cell culture model system. Seven compounds were designed and tested. Several compounds showed anti-HIV-1 activity in varying degrees, especially V0201 showed much higher anti-HIV-1 activity with 3.56 and 0.78 micromol x L(-1) of IC50 against HIV-1 PR/RT and 0.036 micromol x L(-1) against HIV-1 replication in PBMC cultures. V0201 with a novel structure may be a new leading compound. These new compounds are valuable for development of new anti-HIV drugs in the future.

Objective To investigate the alterations of dopamine,norepinephrine,cortisol,C-reactive protein (CRP),heart rate (HR),respiratory rate (RR) and mean artery pressure (MAP) before and after the laser photoeoagulation for retinopathy of prematurity (ROP) with topical anesthesia and to provide the guideline for improving its routine management and interventions.Methods Thirty children with ROP who received ROP laser photocoagulation in Guang zhou Women and Children's Medical Center from May to Dec.2012 were selected.The blood of the 30 cases of infants were collected at 4 time points:before laser therapy,the end of laser therapy,1 hour and 24 hours after laser therapy.The concentrations of dopamine,norepinephrine,cortisol and CRP in plasma were measured at each time point with radio immunoassay,and the values of HR,RR and MAP of infants were recorded as well.Results The levels of dopamine,norepinephrine and cortisol at the end and 1 hour after therapy were higher than those in the quiet state before therapy,and the differences were statistically significant (t =6.39,2.55 ; t =7.74,2.91 ; t =8.87,2.15 ; all P ＜ 0.05) ; the levels of CRP at the end of therapy,1 hour and 24 hours after therapy had no statistical difference in comparison with those in quiet state before therapy (t =0.06,0.89,1.16; all P ＞ 0.05) ; the levels of HR and RR at the end of therapy,1 hour and 24 hours after therapy had statistical difference in comparison with those in the quiet state before therapy (t =4.33,3.84,3.38 ; t =6.81,4.42,2.96 ; all P ＜ 0.05).The level of MAP at the end of therapy had statisti cal difference in comparison with that in the quiet state before therapy (t =6.10,P ＜ 0.001).Conclusions Infantswho experieneed ROP laser photocoagulation had stress response.Clinicians should pay more attention to monitoring HR and RR of preterm infants receiving retinal laser photocoagulation under topical anesthesia and take active intrvventions in order to relieve the stress response.

Objective:To investigate the possible role of NKT cells in unexplained recurrent spontaneous abortion by measuring the NKT cell numbers,maturity and cytokine secretion of the placenta of mice with unexplained recurrent spontaneous abortion.Methods:Normal pregnancy model in hybrid by feeding CBA / J and BABL/C in a cage,and the model of unexplained recurrent spontaneous abortion was established by feeding CBA / J and DBA2/J in a cage.The number of NKT and CD3~+T cells was determined by flow-cytometry;Th1/Th2-relative cytokines were assayed by ELISA and T-bet expression was determinded by fluorescence quantitative PCR.Results:There was not significant change of CD3~+ T cells when compared between normal pregnancy and unexplained recurrent spontaneous abortion group (P＞0.05).In the course of normal pregnancy,the IFN-γ secreted by placenta lymphocytes decreased gradually,accompanied by the decline of NKT cell number and the proportion of mature cells;whereas in the course of unexplained recurrent spontaneous abortion,it was on the opposite.There was significant difference of T-bet mRNA expression between the two groups.T-bet mRNA expression was related to the proportion of mature NKT cells or placenta IFN-γ secretion by lymphocytes.Conclusion:Unexplained recurrent spontaneous abortion may be related to NKT cells disorders,NKT cells are of low-mature proportion and inadequate secretion of IFN-γ during early pregnancy,whereas are shown high-mature proportion and excessive secretion of IFN-γ during latter pregnancy;the anomaly of T-bet mRNA expression may be one of the factors leading to NKT cells disorder.

Objective: To examine the mediating effects of mindfulness level on resilience and symptoms of anxiety and depression among healthcare workers, so as to provide the reference for developing effective psychological intervention. Methods: The clinical doctors, nurses and public health professionals were selected using the stratified random cluster sampling method from hospitals, disease prevention and control centers, and health departments in five cities in Shandong Province, including Qingdao, Jinan, Rizhao, Jining and Liaocheng in January 2023. Basic information, mindfulness level, resilience and symptoms of anxiety and depression among healthcare workers were collected using general demographic questionnaires, the 5-item Mindful Attention Awareness Scale, 10-item Connor-Davidson Resilience Scale, Generalized Anxiety Disorder Scale and Patient Health Questionnaire, respectively. The Process program was used to analyze the mediating effects of mindfulness level on resilience and symptoms of anxiety and depression. Results: A total of 1 836 healthcare workers were investigated, including 472 males (25.71%) and 1 364 females (74.29%), and the median age was 39 (interquartile range, 12) years. There were 629 clinical doctors (34.26%), 963 nurses (52.45%) and 244 public health professionals (13.29%). The median scores of mindfulness level and resilience were 22 (interquartile range, 7) and 20 (interquartile range, 4) points, respectively. The detection rates of anxiety and depression symptoms were 49.78% and 72.28%, respectively. The mediation analysis showed that mindfulness level exerted a partial mediating effect between resilience and anxiety symptoms (β=-0.510, P<0.001), with a direct effect value of -0.130 and a mediating effect value of -0.046, and the mediating effect accounted for 26.14% of the total effect; mindfulness level also exerted a partial mediating effect between resilience and depression symptoms (β=-0.575, P<0.001), with a direct effect value of -0.120 and a mediating effect value of -0.052, and the mediating effect accounted for 30.23% of the total effect. Conclusion Mindfulness level plays a mediating effect between resilience and symptoms of anxiety and depression among healthcare workers.

Objective To understand the epidemiological prevalence of drinking-tea type fluorosis in Haidong Region,Qinghai Province,and provide scientific data for its prevention and control.Methods According to the investigation plan of drinking-tea type fluorosis in China,cross sectional survey was adopted to select 6 counties in Haidong Prefecture from May to July in 2016.Five townships were selected according to the eastern,western,north and south directions,1 administrative village was randomly selected in each township (town) as the survey site.Water and brick tea samples were collected to test fluoride ion concentration;dental fluorosis in children aged 8 to 12 years and adult skeletal fluorosis were examined.Fluorine ion selective electrode was used to determine fluoridated fluoride (WS/T 106-1999),fluorine in urine (WS/T 30-1996) and fluorine content in brick tea (GB 19965-2005).Dental fluorosis was examined by Deans method.The diagnosis of skeletal fluorosis was referred to the "Diagnostic Criteria for Endemic skeletal Fluorosis" (WS 192-2008).Results Fifty-seven drinking-water and 56 brick-tea samples were determined,the means of fluoride in drinking water and brick-tea were 0.25 mg/L and 724.71 mg/kg [which was significantly higher than the national standard (300 mg / kg)],respectively.Totally 1 207 urinary samples of children and 1 428 urinary samples of adults were determined,the geometric means of urinary fluoride of children and adults were 0.57 and 0.62 mg/L,respectively;2 677 children and 1 968 adults were examined,the rate of dental fluorosis among children was 15.09％ (404/2 677),its index was 0.26,the prevalence rate of clinic skeletal fluorosis among adults was 2.44％ (48/1 968).Conclusion The fluoride content of brick tea in 6 counties of Haidong Prefecture of Qinghai is higher than that of the national standard.Local residents are still exposed to high fluoride brick tea,and health education and publicity should continue to be strengthened.

Objective To understand the pathway of iodine intaking among Tibetan, and provide basic data for prevention and control of iodine deficiency disorders (IDD). Methods Through the method of random sampling, the boarding and day student aged 8 - 10 and women of childbearing age were conducted dietary survey to understand the condition of food intaking via the 24 h review method in 2015. Samples of urine, drinking water, dried beef, milk, Qula and fried noodles were collected and tested iodine level. Results Due to taking iodized salt three times a day with meals, the median of urinary iodine among 492 investigated boarding students was 179.2 μg/L;differently, the median of urinary iodine among 298 day students in this investigation was 79.6 μg/L who taking iodized salt only at lunch at school;and in the study, the median of urinary iodine among 158 women of childbearing age who took iodine-free salt daily was 33.7 μg/L. The iodine contents in 51 drinking water samples, 66 dried beef samples, 48 milk samples, 20 Qula samples and 37 fried noodle samples were quantified respectively, and the average iodine contents of each food were 0.8 μg/L in drinking water, 59.1 μg/kg in dried beef, 61.5 μg/kg in milk, 226.4 μg/kg in Qula and 17.0 μg/kg in fried noodles. The acceptable daily intake (ADI) of iodine of the boarding and day students aged from 8 to 10 and women of child bearing age were 234.0, 126.4 and 76.7 μg/d, respectively, among which the ADI of iodine with iodized salt were 208.0, 78.0 and 0.0 μg/d. Conclusion Consuming iodized salt is a main method to get iodine among Tibetans in Nangqian County, so that it is significant to carried out this measure for a long time for free to let them have iodized salt every day instead of iodine-free one.

An improved and practical synthesis of racemic 11-demethylcalanolide A [(±)-1] was developed. This improved process involved Pechmann reaction on phloroglucinol with ethyl butyrylacetate to give 5, 7,-dihydroxy-4-n-propylcoumarin(3). Poly phosphoric acid (PPA) catalyzed acylation of compound(3) with crotonic acid, then intramolecular cyclization was achieved simultaneously in one step to afford the key intermediate chromanone(4). A microwave assisted synthetic method preparing chromene(6) using chromenynation of chromanone(4) with 1, 1-diethoxy-methyl-2-butene was conducted. Luche reduction of chromene(6) using NaBH<,4> with CeCl3·7H2O preferably gave (±)-1. The overall yield of this four step synthesis of (±)-1 was around 32% increasing one fold more than that of the previous method. An in vitro investigation showed that (±)-1 exhibited inhibitory activities against both wild-type and drug-resistant HIV-1 in HIV-1 RT and cell culture assay, and significant synergistic effects in combination with AZT, T-20, and indinavir. Its LD50 of acute toxicity in mice by intragastric administration and by intraperitoneal injection were 735.65mg·kg-1 and 525.10mg·kg-1, respectively. The C<,max> and AUC<,0-∞> were 0.54μg·mL-1 and 1.08(μg·mL-1)·h, respectively. The dynamics study of the inhibition of mice sera on HIV-1 RT showed that mice treated with 100mg·kg-1 (±)-1 once intraperitoneally were similar to that of 5mg·kg-1 of known clinical effective anti-HIV-1 drug neverapine. The results suggested that further investigation of the anti-HIV candidate (±)-1 was warranted.