Objective:To explore the effects of low birth weight on temperament and behavior prob-lems of children aged 2~3 years. Methods:50 low birth weight (LBW) children and 380 normal birth weight (NBW) children were investigated and assessed by Achenbach's children behavior checklist and tod-dler temperament questionnaire. Results:①Temperament: Independent t-tests identified that NBW children were significantly more active than LBW children(t=2.192, p=0.029). No significantly difference of tempera-ment distributing was found between LBW children and NBW children (p=0.943). ②Behavior problems: In-dependent t-tests identified that NBW children had more sleep problems than 1LBW children(t=2.20,P=0.031). There was more behavior problems of social withdraw in LBW children than NBW children (? 2 =5.427,p=0.02). Conclusion:LBW Children were less active than NBW children and they had high incidences in behavior problems of social withdraw.

To cultivate high-quality medical talents,Shanghai Jiao Tong University School of Medicine established a multidisciplinary and comprehensive basic medical practical integration curriculum Medical Functional Experiment.Over several years' exploration and renovation,insisting on student-centered,this course has established a modular experiment teaching system with emphasis on foundation,combina-tion with clinical and focusing on innovation.Integration curriculum adopts four-stage teaching pattern which is suitable for medical students,and implements diversified teaching method and evaluation system.And meanwhile,the paper explores the ideas and approaches to further deepen the construction of teaching staff,expand experimental teaching techniques,strengthen the construction of curriculum materials,and strengthen the cultivation of teachers' innovative ability.

To study the changes of metabolites in rat urine after treatment of Aristolochia fangchi decoction by metabonomic method.

Objective To investigate the strategy of cardiopulmonary resuscitation (CPR) after lung protective mechanical ventilation in critical children and follow-up study of the survivals 90 d after discharge.Methods Four hundred and eighty-nine cases of respiratory cardiac arrest which occurred for various reasons from January 2011 to June 2016 were analyzed in Pediatric Intensive Care Unit (PICU) in Guiyang Children's Hospital,in which mechanical ventilation was performed after CPR in 251 cases,death,or giving up treatment within 24 h in 83 cases,children surviving ＞ 24 h in 168 cases,118 cases were assigned into small tidal volume ventilation group,and 50 cases into conventional tidal volume ventilation group,and according to the tidal volume to adjust positive end expiratory pressure ventilation (PEEP),and the oxygen partial pressure [pa (O2)] and the oxygen index (OI),the change of the indexes of blood gas analysis,lactic acid clearance,and oxygenation were also observed.To observe the complications of mechanical ventilation,the situation of withdrawing machine as well as the outcome of the children.Follow-up was conducted for 90 d,including continuous respiratory symptoms,lung imaging examination after discharge and lung function,nervous system examination.Results (1) After mechanical ventilation treatment of 48 hours,compared with the levels of fractional inspired oxygen (FiO2) (0.42 ± 0.15 vs.0.43 ± 0.22),pa (O2) (8.25 ± 0.22 vs.8.27 ± 0.68),OI (5.33 ± 2.01 vs.6.59 ± 1.99) and lactic acid clearance(61.05 ± 1.87 vs.60.93 ± 2.71) between the routine tidal volume ventilation group and the lower tidal volume ventilation group,showing that the difference had no statistical significance (t =1.645,1.165,2.302,2.037,all P ＞ 0.05).(2) In small tidal volume group,the incidence of ventilator associated lung injury was significantly lower than that in the conventional tidal volume group,and the difference was statistically significant (x2 =5.873,P ＜ 0.05).(3) Comparing 2 groups of different tidal volume ventilation,the mortality of critical ill children had no statistically significant difference (x2 =1.063,P ＞ 0.05).(4) One hundred and twenty-seven cases of children survived and were discharged,and compared with their discharge,the follow-up of 62 cases after discharge for 30 d,90 d showed that all the children's lung function improved,tidal volume,inspiratory and expiratory time ratio(I/E),volume ratio of peak(VP/VE),time ratio of peak(TP/TE) and breathing rate(RR) were also improved,and there was significant difference (F =43.225,6.108,68.821,78.237,20.361,all P ＜ 0.05).(5) Neurological examination and children's brain function classification rating scale showed that some children had nerve dysfunction.Conclusions Small tidal volume ventilation in reducing the occurrence of ventilator associated lung injury is superior to the conventional tidal volume ventilation.To improve case fatality rate of the children with cardiac arrest resuscitation and oxygenation is not better than the conventional tidal volume group.Dynamic monitoring is helpful to adjust breathing mechanics indexes and parameters and ventilator.Through the follow-up most of the discharged children recovered well,but a few had recurrent respiratory infection and neurological sequelae.

OBJECTIVECombined the blood biochemical markers, the renal histopathological changes and the metabonomics profile were investigated to study the toxicity differences between Aristolochia fangchi and Stephania tetrandra.

METHODTen rats were randomly selected from 70 male Wistar rats as blank control group. The remaining 60 rats were divided into three groups. The two treated groups were orally administrated by 8.1 g x kg(-1) of A. fangchi and S. tetrandra respectively and the control group by equal volume of distilled water for 4weeks. Before the administrated and every 2 weeks, urine and plasma were collected and their 1H-NMR spectra were acquired, and then subjected to data process and PCA. Blood biochemical analysis and histopathological examination were carried out.

RESULTOn the 2nd weekend, the BUN of the two treated groups, the AST of A. fangchi group were all markedly higher than that of the control group (P < 0.05). Compared with the A. fangchi group, the SCr higher in the S. tetrandra group (P < 0.05). The kidney pathological changes were apparently in the two treated groups and the pathological changes in the liver apparently in the S. tetrandra group. Along with the lasting of administration to the 4th week, the BUN, ALT and AST of the two treated groups, the SCr of A. fangchi group were all significantly higher than that of the control group (P < 0.01). The renal and liver injuries in the two treated groups were all become more seriously. Comparing the A. fangchi group, the BUN, SCr and AST were all higher in the S. tetrandra group (P < 0.05). Compared with control group, the urinary concentrations of citrate, 2-oxo-glutarate, taurine, hippurate, TMAO, creatine and the plasma concentrations of 3-D-hydroxybutyrate, acetone, NAC, OAC, creatinine were all changed.

CONCLUSIONThe A. fangchi and S. tetrandra all can induce the renal and liver lesion and its seriousness is correspondent to the lasting of administration. The liver and kidney toxicity of S. tetrandra are all more serious than the A. fangchi.

Animals ; Aristolochia ; chemistry ; Blood Chemical Analysis ; Drug-Related Side Effects and Adverse Reactions ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; metabolism ; Kidney ; chemistry ; drug effects ; metabolism ; pathology ; Liver ; chemistry ; drug effects ; metabolism ; pathology ; Male ; Metabolomics ; Random Allocation ; Rats ; Rats, Wistar ; Stephania tetrandra ; chemistry ; Urine ; chemistry

OBJECTIVE:To observe the efficacy and safety of Sanjiao fuzheng mixture combined with concurrent chemoradiotherapy of paclitaxel and nedaplatin in the treatment of local advanced non-small cell lung cancer (NSCLC). METHODS:A total of 68 patients with local advanced NSCLC selected from our hospital during Jan. 2015 to Jan. 2017 were divided into control group and observation group according to random number table,with 34 cases in each group. Control group was given Paclitaxel injection 135 mg/m2 intravenously,d1+Nedaplatin for injection 75 mg/m2 intravenously,d3,21 d as a treatment course,for 2 courses;routine fractionated intensity modulated radiation therapy,2 Gy each time,5 times a week,60-70 Gy in total;given 2 cycles of primary chemotherapy continuously after radiotherapy. Observation group was additionally given Sanjiao fuzheng mixture 250 mL/d,divided into 3 times,till the end of treatment,on the basis of control group. Clinical efficacies were observed in 2 groups. The levels of nutritional indexes (BMI,PAB,ALB,Hb) and tumor markers (SCC-Ag,CEA,TK1, CYFRA21-10) before and after treatment were observed. The occurrence of ADR were recorded. RESULTS:There was no statistical significance in the total effective rate between 2 groups (observation group 82.35％ vs. control group 73.53％)(P>0.05). After treatment,the levels of BMI,PAB,ALB and Hb in 2 groups were significantly lower than before treatment,but the observation group was significantly higher than the control group. The levels of SCC-Ag,CEA,TK1 and CYFRA21-1 in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statistical significance (P<0.05). The incidence of Ⅲ-Ⅳ degree aleucocytosis,Ⅰ-Ⅱ degree hemoglobin reduction and thrombocytopenia in observation group were significantly lower than control group, with statistical significance (P<0.05). CONCLUSIONS:The efficacy of Sanjiao fuzheng mixture combined with concurrent chemoradiotherapy of paclitaxel and nedaplatin is similar to that of concurrent chemoradiotherapy of paclitaxel and nedaplatin for localadvanced NSCLC,which can improve nutritional status significantly,and reduce the incidence of ADR.

AIM: To investigate the effect of gastrodin on the expression of brain-derived neurotrophic factor (BDNF) and interleukin-6 (IL-6) in the striatum of cerebral ischemia rats, and to explore the potential mechanism of gastrodin in treating cerebral ischemia. METHODS: The rats were randomly divided into four groups: normal, sham, model, and gastrodin groups, each consisting of 10 rats. After successful modeling using middle cerebral artery occlusion (MCAO), the gastrodin group received intraperitoneal injection of gastrodin injection at a dose of 10 mg/kg once a day for 14 consecutive days. Pathological changes in striatal neurons were observed using Nissl staining. Immunohistochemistry was utilized to detect positive expression of BDNF and IL-6 proteins in the striatum. Additionally, immunoblot analysis was performed to determine the expression levels of BDNF and IL-6 proteins in the striatum. RESULTS: Nissl staining revealed clear and intact structures of striatal neurons in the normal and sham groups, with tightly arranged cells. In the model group, the number of cells was significantly reduced compared to the sham group (P<0.01), and there was a noticeable cytosolic atrophy and loose cell arrangement. The gastrodin group showed a significant increase in the number of Nissl-positive neurons compared to the model group (P<0.01), and there was also a significant improvement in cell morphology. The results of immunohistochemistry and immunoblot were consistent, and there was no statistically significant difference in BDNF and IL-6 protein expression between the normal group and the sham group (P>0.05). Compared to the sham group, the model group showed a decrease in the protein expression level of BDNF in the striatum on the ischemic side (P<0.01) and an increase in the protein expression level of IL-6 (P<0.05, P<0.01). In contrast, the gastrodin group showed an increase in the protein expression level of BDNF in the striatum on the ischemic side (P<0.05, P<0.01) and a decrease in the protein expression level of IL-6 (P< 0.05, P<0.01) compared to the model group. CONCLUSION: Gastrodin has a significant protective effect on striatal injury caused by cerebral ischemia, and its mechanism may be related to the up-regulation of the anti-inflammatory factor BDNF and the down-regulation of the pro-inflammatory factor IL-6.

Objective: To investigate the genetic characteristics of drug resistance and homology of extended-spectrum β-lactamase (ESBLs)-producing Klebsiella pneumoniae (Kpn) in hospitalized children in the pediatric intensive care unit (PICU) in Guiyang area. Methods: The Kpn strains were collected from hospitalized children at 3 PICU from the Affiliated Hospital of Guizhou Medical University, Guizhou Provincial People′s Hospital and Guiyang Children′s Hospital from September 2014 to December 2016.Automatic bacteria identification instrument and Kirby-Bauer method were used to identify Kpn strains and confirm ESBLs phenotype respectively.The drug resistance genes were detected by using polymerase chain reaction (PCR), and their homology was analyzed by means of pulsed field gel electrophoresis (PFGE) and cluster analysis. Results: (1) A total of 207 non-repetitive Kpn strains were isolated, of which 128 strains produced ESBLs (61.8%). There was no significant difference in the ESBLs detection rates among the different hospitals, years and types of samples(χ²=0.40, 5.19, 4.68, all P>0.05). (2) Among those 128 ESBLs-producing Kpn strains, 123 strains (96.1%) were found to have drug-resistant genes, of which the detection rate of SHV type was the highest, accounting for 87.5%.These 3 drug resistance genotypes were distributed in 7 modes, of which 85.2% were carrying more than 2 genotypes.(3) PFGE genotypic assay showed that there were 109 genotypes and 5 dominant clones.The PICU at 3 hospitals were all prevalent with type A strain, accounting for 14.8%.In 2015, there was a short-term outbreak of type A strain in Guiyang Children′s Hospital.While, the resistance phenotypes of Kpn and the genotype of PFGE could both be consistent or different. Conclusions The ESBLs-producing Kpn at PICU in Guiyang area has the characteristics of multi-drug resistance, its drug-resistant genotypes have diversified, and there is a small-scale short-term outbreak epidemic, which poses a serious threat to clinical anti-infection treatment.It is necessary to strengthen clinical drug resistance monitoring and adopt effective infection control measures to prevent and control the spread of nosocomial infections.

Integrated experiment course is beneficial to optimizing the whole structure of medical courses and plays an important role in improving medical students' comprehensive quality and innovation capability. After several years of reform and exploration, Shanghai Jiao Tong University School of Medicine has developed the medical functional integrated experiment course with concept of "strengthen quality, reinforce foundation, encourage innovation and provide professional service", established a diversified evaluation system, and developed a corresponding assessment scale for reviewing students' comprehensive ability and the quality of experiment teaching. This paper investigated and prospected how to construct and optimize this evaluation system from the aspects of the relationship between evaluation method and course structure, and their effects, so as to provide strategic guidance for the further development of integrated experiment course.

To implement the fundamental task of the Ministry of Education on carrying out curriculum ideological and political education and promoting colleges and universities to implement the morality education, this study tried to carry out ideological and political education for medical students in "medical functional science experimental course", and organically integrated the ideological and political elements of "loving experimental animals and reverencing for life" into the teaching of this course. This paper explored the implementation process and effect evaluation of ideological and political courses from the aspects of teaching objects, design, objectives, in-class and off-class practical activities, and analyzed the current problems and future directions. In order to provide beneficial ideas for the ideological and political construction of college curriculum and help cultivate excellent and innovative medical talents with warmth and feelings.