Malaria is one of the most common insect-borne infectious diseases in the world. Among the five known malaria parasites infecting human beings, Plasmodium falciparum has the highest morbidity and mortality, and is one of the most important public health problems in the epidemic areas. With the increasing drug resistance of malaria parasites, people′s demand for malaria vaccine is more urgent. Human challenge trials(HCTs) can obtain preliminary evidence of vaccine effectiveness and safety by vaccinating fewer subjects, which is faster than traditional clinical trials, being a feasible method to study pathogenesis, immune mechanism and evaluate the efficacy of vaccine candidates. As a kind of HCTs against malaria,controlled human malaria infection(CHMI) has been widely used in clinical trials of malaria vaccines. In this paper, the application of HCTs in malaria research, the materials and methods of establishing CHMI model of Plasmodium falciparum,and the application of CHMI in malaria vaccine development were reviewed in order to provide new ideas for accelerating the development and improvement of new malaria vaccines.

As a kind of mineral medicine containing mercury, the toxicity of Cinnabaris has always been controversial. In recent years, along with the increasing reports and studies on Cinnabaris, it has been found that although the toxicity of Cinnabaris has effects on multi-systems, the main effect is on nervous system. In order to clarify Cinnabaris neurotoxicity and reduce its damage for nervous lesion caused in clinical application, this article made a thorough analysis on symptom expression and mechanism of Cinnabaris neurotoxicity and put forward corresponding countermeasures.

Objective To study the relationship of implicit memory and amnesia effect of oral midazolarn premedication and toobserve its anterograde amnesia, the effect on short-term memory and the onset time and out come of retrograde amnesia. Methods60 patients with ASA I - Ⅱ status undergoing abdomen and limb operations were divided into 3 groups with 20 cases each. Group A:oral midazolam 7.5mg;Group B:oral 15mg;Group C:placebo. The patients received combined spinal-epidural anesthesia after oral midazolam. The parameterns of EEG, SEF 95 %, BISwere collected at the same time and the degree and remark of sedation were dome according to OAA/S. The amnesia and implicit memory were investigated with pictures and muddy identified hearing rate 6 hours after operation. Results (1)Twenty min following drug ad dministration the remarks of sedation of group A and B were significantly loWver than that before and that of group C, Which was not significently different between group A and B. ( 2)The amnesia rates tested six hrs after surgery were significantly higher at 30min in group A, 20min in group B than those before treatment and were kept at 70%-80% levels, which in group C was remained zero. (3)The muddy identified hearing rate was not different significantly, among the three groups. (4) The short-term memory was all 100%during the period of drug action. (5)BIS and SEF 95% Were lower 30min after the treatment and all kept at 80 Hz and 20 Hz, which were not different remarkably between group A and B. ConclnsionOral midazolam 7. 5mg has a good effect on anterograde amnesia 30min after treatment, which may not be improved with increament in dosage. It does not lead to retrograde amnesia. The long-term memory, but not short-term memory, was impaired by midazolam. It only affects the explicit memory. Oral premnedication with midazolam can not prevent the awareness during operation totally.

Objective To compare the effects of biphasic square waveform (BSW) with low or high energy on external defibrillation.Method Adult swine model of closed chest ventricular fibrillation induced by electricity was established.Eighteen swine,weighing (30?3.3) kg were randomly divided into three groups:50-50-50 J group (n=6),30-50-75 J group (n=6),120-150-200 J (n=6).After three minutes of ventricular fibrillation without treatment,the pigs in the three groups were defibrillated accordance to the above sequences. Results 30 J BSW didn't succed to external defibrillate.The first defibrillation successful rate of 50 J and 120 J BSW was 5/6.The total defibrillation successful rate of every group was 100%.All pigs quickly had spontaneous circulation after defibrillation and survived more than 24 hours.ST-T change of low-energy was less than that of high-energy.After resuscitation,myocardial function decreased,but there had not significant differences between groups.Conclusions In the study,30J BSW could not reach successful defibrillation,and 50 J and 120 J BSW had similar defibrillation efficacy.The ideal energy of BSW external defibrillation was 50 J.

Objective:To explore the cytogenetic characteristics of hypospadias in children by karyotype analysis.Methods:From June 2008 to May 2018, 45 children with hypospadias in Tianjin Children's Hospital had cytogenetic abnormalities. Their median age was 10 months(range 3 hours to 5 years old). Of the 45 cases, 20 were proximal hypospadias, 1 was middle hypospadias. All 24 cases had varying degrees of genitourinary malformations. Among them, 15 cases had unilateral or bilateral cryptorchidism, 5 cases had scrotal division, 3 cases had penile scrotal transposition, 3 cases had small penis, 3 cases had indirect inguinal hernia, 1 case had repeated urethra, 1 case had hydrocele and 1 case had concealed penis. To the other systemic malformations, there was 1 with cleft lip and palate and 1 with congenital heart disease. G-banding karyotype analysis of peripheral blood lymphocytes was performed in all 45 cases.Results:Among the 45 cases of hypospadias with abnormal karyotypes, with an abnormal rate of 14.0%, 28 cases (62.22%) had sex chromosome abnormalities, including (47, XXY), (46, XX/47, XXY), (45, X0/47, XYY), etc. Sexual inversion occurred in 8 cases (17.78%), all of which were 46, XX. There were 4 autosomal abnormalities (8.89%), including (46, XY, 9p+ ), (46, XY, 10p+ ) and (46, XY, 1q+ ). Chromosome polymorphism was found in 4 cases (8.89%), including [46, XY, inv(9)] and [46, XY, 16qh+ ], and the equilibrium translocation of 1 case (2.22%) was [45, XY, -21, -22, + t(21; 22)]. Among the 45 cases, 8 sex reversal children with (46, XX) chromosome karyotype were all proximal hypospadias.Conclusions:Children with hypospadias may be associated with chromosomal karyotype abnormalities, including sex chromosomal abnormalities, autosomal abnormalities, chromosome polymorphism and balanced translocation. Among them, sex chromosome abnormality was the most common and balanced translocation was the least.

Objective To assess patients' self-management behaviors and examine factors influencing self-management behaviors in patients undergoing maintenance hemodialysis.Methods This research was conducted as a descriptive survey by 125 patients from a hemodialysis clinic in Tianjin.The data were collected with self-management behaviors questionnaire of hemodialysis patients and self-efficacy scale for managing chronic disease.Results Regression analysis revealed sex,educational level and selfefficacy were independent predictors for self-management behaviors.Conclusions Hemodialysis patients' self-management behaviors need to be improved in the future.Healthcare professionals should recognize the factors hindering self-management behaviors from the patients' perspective while assisting them with appropriate skills in making behaviors changes possible.

Objective To investigate the current situation and influencing factors of professional competence of master of nursing (MN)students. Methods 317 MN students were engaged in the investigation using self-designed questionnaire. Results The total score of MN student's professional competence was 72.56 ± 10.51. The time for nursing service before MN study, time for nursing internship during MN study and frequency of instructor's guidance were the main influencing factors ofprofessional competence (P<0.01). Conclusion MN student's professional competence is relatively good. Nursing educators should develop more detailed clinical study plan for those lack of clinical experience, strengthen advanced nursing practice theory study, and provide more opportunities for professional practice, make good conditions for their clinical practice and pay attention to the practical effect of specialized nursing.At the same time,the instructors of MN students should give more guidance to ensure the cultivation quality.

In order to solve the difficucties of renaturation and immunogenicity of new bifunctional fusion protein GAD,inclusion bodies of GAD were modified by PEG-maleimide.Conformational changes of the modified GAD were compared by circular dichroism and tryptophan fluorescence spectroscopy.The biological activity was verified by oral glucose tolerance test and lipid scavenging.The results showed that PEG-maleimide completed the specific-point modification of GAD,and improved its refolding efficiency.The secondary and tertiary structures of mPEGylated GAD were consistent with that of GAD.PEG-GAD has significant hypoglycemic and lipid-lowering effects (P ＜0.001) with longer half life in vivo and lower immunogenicity (P ＜0.01).This study provides effective strategies for the development of strongly hydrophobic peptide drugs.

Objective Through the research on relationship between achievement motive and personality traits,to provide the basis theory of personality attributes for selecting outstanding medical professional scientifically and effectively,and give some advice for improving medical education mode.Method The 310 medical staffs in sample hospital were treated as the research object in October 2015,who were randomly investigated with the big five personality questionnaire and achievement motivation scale,among of which,valid questionnaires were 290 copies leading to 93.5％ effective rate.SPSS 17.0 software was used to make t test,Chi-square analysis and correlation analysis for the data of the recover valid questionnaires.Result ①Personality traits of friendliness and rigor of the medical staffs of different gender exist statistically significant difference (t=-7.39,P=0.00;t=-8.28,P=0.00) and there were significant differences in the openness and rigor of medical staffs of different gender (P＜0.05).②The achievement motivation level of male medical staffs was higher than that of female (P=0.00),and there was no significant difference in achievement motivation among medical staffs.③The personality trait of neuroticism was negatively correlated with the pursuit of success and achievement motivation (correlation coefficient was-1.24),while the achievement motivation was positively related to extraversion and openness and the pursuit of success (the correlation coefficients were 1.51 and 1.53).Conclusion There is a significant correlation between personality traits and achievement motivation.The more extroverted personality medical staffs have,the more easy-going they are,and the more the pursuit of success oriented achievement motivation they have;and the higher the neurotic tendency individuals have,the more they incline to avoid failure of achievement motivation.

OBJECTIVE: To provide references for the improvement of drug recall system in China.METHODS: The problems existing in the drug recall system in China were analyzed through a comparison of the drug recall system between China and Australia.RESULTS & CONCLUSIONS: China should draw useful experiences from Australia to improve its drug recall system by perfecting the legal system and tracking measures,determining stratified drugs and the responsibilities of government etc.