Objective To investigate the status and demands of prenatal education among pregnant women,and to provide reference for better prenatal education. Methods A total of 750 pregnant women were recruited from 20 hospitals in Chengdu and were investigated with a serf-designed questionnaire. Results 74.42% of the pregnant women had participated the prenatal education,25.58% of them didn't take even one prenatal class. The most preferred knowledge was newborn care. They most preferred to take prenatal classes at weekends in small group. The women's educational level,family income, delivery experience and times of prenatal check-up were the key factors to affect the participation in the prenatal educa-tion. Conclusions It is suggested to innovate the contents and means of prenatal education in order to attract the pregnant women to participate prenatal education actively.

Objective To further investigate the effect of sinomenine (SIN) on TNF-α-induced VCAM-1 expression in human umbilical vein endothelial cells (HUVECs). Methods HUVECs were isolated from freshly collected umbilical cords. Positive control samples were stimulated with TNF-α, but free of SIN. Negative control samples were treated in the same way, but without TNF-α and SIN. Experimental samples were co-cultured with TNF-α and SIN at various concentrations (0.25, 0.5, and 1.0 mol/L), or TNF-α and dexamethasone (Dex) at concentration of 1.0×10-6 mol/L, or TNF-α with Dex (at concentration of 1.0×10-6mol/L) and SIN at different concentrations (0,25, 0.5, and 1.0 mmol/L) (co-treated groups). VCAM-1 expression was detected by flow cytometry (FCM). Results SIN inhibited expression of VCAM-1 in TNF-α-induced HUVECs, the best effect was shown in the 1.0 mmol/L SIN treated group. VCAM-1 decreased more markedly in the co-treated groups. Conclusion SIN inhibits TNF-α-induced VCAM-1 expression on HUVECs in vitro, and SIN maybe synergistic with Dex in inhibiting TNF-α-induced VCAM-1 expression on HUVECs in vitro.

Objective To observe and evaluate the clinical efficacy and safety of Xiaoerzhili syrup in attention deficit/hyperactivity disorder(ADHD) in children.Methods This study was performed by a multicenter self-controlled clinical observation trial.A total of 1 833 children with ADHD selected from 18 clinical centers from June 2013 to December 2015 were treated by Xiaoerzhili syrup for 6 months,and the clinical efficacy and safety were evaluated.Chinese Version of ADHD Rating Scale-Ⅳ-Parent(ADHDRS-Ⅳ-P) and Clinical Global Impression (CGI) were used to evaluate the clinical efficacy,and the registration form of side reaction and the questionnaire of drug safety grade were used to assess the safety.Results Compared with the scores before treatment,the total scores of ADHDRS-Ⅳ-P,attention deficit subscale scores and hyperactivity impulsivity subscale scores decreased with statistically significant differences after treatment with Xiaoerzhili syrup in the total ADHD group,male ADHD group,female ADHD group,mild ADHD group,moderate ADHD group and severe ADHD group(all P ＜0.01).The statistically significant differences in the total scores of ADHDRS-Ⅳ-P,attention deficit subscale score and hyperactivity impulsivity subscale scores were not found in different gender before and after treatment (all P ＞ 0.05).According to the results of CGI-Ⅰ,the proportion of "improved obviously" and above were 80.98％ (1 379 cases),79.95％ (1 089 cases) and 85.05％ (290 cases),in the total poptlation group,male group and female group,respectively.The side effects of drugs were found in six male cases.After treatment,safety problems were not found in the analysis of the safety evaluation.Conclusion Xiaoerzhili syrup treatment is effective in children with ADHD treatment,and security problems are not found.

Objective To investigate the expression of Rab11 in children with sepsis at different sta-ges and severe sepsis and its relationship with the occurrence and development of sepsis in children. Methods A prospective control study was performed. All cases were enrolled from Bao′an Maternal and Children Health Care Hospital, and they were divided into sepsis group(40 cases) who were diagnosed as sepsis, severe sepsis group(20 cases) with diagnosis of severe sepsis,and healthy control group(40 healthy chil-dren) . Venous blood samples were collected at admission,and the expression level of blood leukocyte Rab11 was determined by Western blot. In the sepsis group,the expression levels of Rab11 were evaluated at the initial,the extreme and the recovery stages of sepsis,and were compared with those in severe sepsis group and healthy control group, respectively. Spearman correlation analysis was used to evaluate the relationship between the expressions of Rab11 and the levels of some parameters in blood,including white blood cell,neu-trophils,lymphocytes,monocytes,eosinophilic granulocyte,C-reactive protein and procalcitonin in blood,at the extreme stage. Meanwhile,the levels of Rab11 at extreme stage of sepsis,caused by different diseases, such as severe pneumonia,bronchiectasis complicated pulmonary infection,biliary tract infection,urinary tract infection, necrotizing enterocolitis and severe enteric viruses infection, were compared with each other. Results At the initial and the extreme stages of sepsis, as well as in severe sepsis group,the levels of Rab11 were significantly lower than that in the healthy control group(0. 54 times,0. 23 times and 0. 07 times, P<0. 05,respectively). There were no significant differences in the expression levels of Rab11 at the recovery stages of sepsis compared with that in the healthy control group(P>0. 05). There was no relation-ship between the level of Rab11 and the number of white blood cell, neutrophils, lymphocytes, monocytes, eosinophilic granulocyte, while the level of Rab11 was negatively correlated with C-reactive protein ( r =-0. 58,P=0. 014) and procalcitonin(r= -0. 63,P=0. 003) at the extreme stage of sepsis. There was no significant difference in the expression level of Rab11,at the extreme stage of sepsis,among those patients with severe pneumonia,bronchiectasis and pulmonary infection,biliary tract infection,urinary tract infection, necrotizing enterocolitis and severe enterovirus infection(P>0. 05). Conclusion The level of Rab11 is differently expressed at different stages of sepsis,and could be used as a predictor of the severity of sepsis in children.

Objective:To understand the cognition and attitude of medical staff towards medical ethics review, analyze possible influencing factors, to put forward relevant suggestions for strengthening ethical management in the future.Methods:From November 2021 to May 2022, a self-designed questionnaire and general data questionnaire on the cognition and attitude of medical staff to ethical issues in clinical research were used to investigate 408 medical staff from two first-class ternary hospitals in Hunan Province, data was analyzed to explore the respondents′ cognition and attitude, as well as related influence factors.Results:The average cognitive score of medical staff was 65.41, and the average attitude score was 91.83. Many possible influence actors regarding the cognition were identified, including degree, technical title, professional field, number of clinical research projects engaged as investigators, number of clinical research projects conducted as principle investigators, whether the hospital has established an ethics committee, and research ethics training experiences. While the influence factors of attitude were experiences of conducting and engaging in clinical research, the construction of hospital ethics committee and research ethics trainings.Conclusions:Medical staffs have the willingness to explore more research ethics knowledge, while their cognition of research ethics should be improved. Root-cause analysis should be conducted to identify influencing factors for improvement. The research management department should strengthen the publicity and training of clinical research ethics of medical staff, to improve their clinical research ethics knowledge literacy, and ensure the well-functioning of clinical research ethics review.

BACKGROUNDTo evaluate and compare the effects and toxicity of the domestic product of recombinant mutant human tumor necrosis factor (rmhTNF) combined with chemotherapy and chemotherapy alone in the treatment of patients with non-small cell lung cancer (NSCLC).

METHODSTwo hundred patients with NSCLC in multicenter were randomly devided into trial group (150 cases) and control group (50 cases). Chemotherapy with CAP regimen was given to the patients. Meanwhile, rmhTNF injection of 4×10⁶U/m² was also given from the 1st to 7th days, the 11th to 17th days on the chemotherapy cycle in the trial group. The control patients received chemotherapy alone. Twenty-one days were as a cycle, 2 cycles were given to each patient. The chemotherapeutic effects and toxicity were observed and compared between the two groups after the therapy.

RESULTSof the 200 patients, 5 cases in the trial group and 3 cases in the control group were out of the trial because of economy. The other 192 cases (145 cases in the trial group and 47 cases in the control group) could be analyzed and evaluated the clinical effects and toxicity. The response rate of chemotherapy was 46.90% (68/145) in the trial group and 17.02% (8/47) in the control group respectively ( P =0.001). The KPS scores was 86.02±9.74 in the trial group, and 80.14±9.10 in the control group ( P =0.025). No significant difference of degree III+IV toxicity was observed between the two groups ( P > 0.05). The side effects related to rmhTNF included slight fever, cold-like symptoms, pain and red and swelling in the injection site. All of them were mild and didn't need any treatment and disappeared after the therapy. There were no severe abnormality of liver and kidney function and ECG in both groups.

CONCLUSIONSThe results demonstrate that the effects of domestic rmhTNF combined with chemotherapy are remarkably higher than that of chemotherapy alone in the treatment of NSCLC. rmhTNF can increase the sensitivity to chemotherapy and improve the quality of life of the patients with slight toxicity. Hence rmhTNF is worth expanding clinical use.