Objective To investigate the efficacy by inoculated with hepatitis B immunoglobulin(HBIG) and hepatitis B vaccine in dif-ferent doses and time points to prevent maternal-infant vertical transmission of hepatitis B virus(HBV).Methods Gravidas positive for HBV were selected and measured HBV DNA,according to difference HBV DNA degrees divided into A,B,C groups.Every group was randomly divided into 4 groups using a variety of combined immunity methods to compare its efficacies.Results There were no significant differences in the positive rate of HBV and HBsAb in A,B groups by statistics analysis.There were significant differences in the positive rate of HBV and HBsAb in group C by statistics analysis.Conclusion According to the different HBV DNA take different combined immunodeficiency approach to prevent maternal-infant vertical transmission.

OBJECTIVE:To probe into the condition of the occurrence of the adverse drug reactions(ADRs) induced by Chinese materia medica.METHODS:A total of 933 ADR cases induced by Chinese materia medica published in 100 different kinds of journals during 2000～2008 were studied retrospectively.RESULTS:A total of 156 kinds of Chinese materia medica were involved in these ADRs,which were administered by 5 routes,with intravenous administration showing the highest incidence at 78.46%. Among all the ADRs,the systemic reactions represented 57.77%.CONCLUSION:It is necessary to popularize the knowledge on safe medication of Chinese materia medica,standardize clinical rational use of Chinese materia medica and its preparations and tighten control and monitoring on the ADRs induced by Chinese materia medica.

This paper explored and analyzed difficulties in English teaching and put forward some ways to deal with this situation.The suggestions included changing the curriculum from general English to medical English,establishing the multiple assessment system and developing multilingual teaching modes.

Objective To analyze the feeling of nursing undergraduates after one semester of earlyclinical placement.Methods School of Nursing at Soochow University initiated Early Clinical PlacementI for the undergraduates recruited from poverty-stricken areas in 2013.Results Each student hadgained a profound understanding of nursing.Conclusions Early clinical placement is helpful for under-graduate to cultivate interest towards nursing and broaden thinking.

Objective To determine the dynamic change of serum procalcitonin (PCT) level after traumatic brain injury and the rclated clinical significance.Methods Serum levels of PCT and adrenocorticotropic hormone (ATCH) in 137 patients with traumatic brain injury and 20 normal volunteers were measured by electrochemiluminescence assay.Correlation between serum PCT level and severity of traumatic brain injury was evaluated.Results Percentage of serum PCT level at low inflammatory-risk threshold detected from day 1 to day 14 after admission was descended from 80.3％ to 63.5％.Meanwhile,the percentage of serum PCT level at high inflammatory-risk threshold was a rising-fall-rising trend,but the percentages of serum PCT level at median and definite inflammatory-risk thresholds showed sustained increase from 13.9％ to 27.0％ and 0.7％ to 3.7％ separately.Based on the Glasgow Coma Scale (GCS),the dynamic change of serum PCT level demonstrated a distinct bimodal pattern in severe injury group,a gradual falling after rising mode in middle injury group which was significantly and positively correlated with GCS (r =0.463,P ＜ 0.05),and a rising-falling-slight rising tendency in minorinjury group.In addition,the GCS in each group only closely related to the positive detections of serum PCT level detected at days 3 and 7 (x2 =10.32,16.31 respectively P ＜ 0.01).Serum ATCH level at day 1 was far higher than that at day 14 in severe injury group and was significantly higher in severe injurygroup compared with minor and middle injury groups (P ＜ 0.01 or 0.05).Conclusions Positive serum PCT may be predictive of the traumatic brain injury and injury degree within 3-7 days after the injury.The dynamic change of serum PCT is associated with the specialized mechanism of traumatic brain injury and neuronendocrine response,and it may be a useful parameter to assess posttraumatic stress response and prognosis.

Objective To compare the effects of propofol and ketamine on long-term memory and the expression of brain N-methylgroup-D-aspartate receptor 2B(NMDAR2B) and Gamma-aminobutyric acid receptor 1(GABAR1) in aged rats, and preliminary investigate the relation between the long-term memory and expression of neurotransmitter receptors in different cerebral areas. Methods The aged male rats were randomly divided into control group,propofol group and ketamine group. Morris water maze training was performed in all the rats of three groups for 5 days. On the 6th day, intraperitoneal injection of 50 mg?mL-1 propofol was administrated in propofol group,80 mg?mL-1 ketamine was intraperitoneally injected in ketamine group,and blank control group was given the same dose of saline.Seven days after the administration,space exploration experiment and navigation experiment test were performed to test the impact on the learning and memory ability of rats. After that, the expression levels of GABAR1 and NMDAR2B in temporal lobe and hippocampal CA1 region of the rat brain were detected by immunofluorescence and FISH technique. Results The results of Morris water maze showed there was no significant difference between propofol group (9.49±1.24) s and blank control group (8.82±2.22) s.There was statistically significant difference between ketamine group (12.04±2.67) s and blank control group (P<0.05),with longer latency time and less number of times of passing through target as compared with blank control group.By using immunohistochemistry and FISH technique,the expression of GABAR1 in temporal lobe and hippocampal CA1 region of the rat brain was not significantly different between propofol group and blank control group,but it was significantly up-regulated in ketamine group as compared with blank control group ( P<0.05) . The expression of NMDAR2B in temporal lobe and hippocampal CA1 region of the rat brain was not significantly different between propofol group and blank control group,but it was significantly down-regulated in ketamine group as compared with blank control group (P<0.05). Conclusion Propofol anesthesia alone had no effect on long-term learning and memory,but ketamine anesthesia can result in long-term learning and memory impairment. The mechanism may be related with down-regulation of the expression of NMDAR2B receptor and up-regulation of GABAR1 not only in CA1 region hippocampus,but also in temporal lobe.

Objective To investigate the risk factors for postoperative cognitive dysfunction (POCD) and nursing intervention in patients undergoing laparoscopic radical hysterectomy. Methods One hundred patients undergoing laparoscopic radical hysterectomy were included, surgical history, general anesthetics way, education, family factors(alone), body mass index, age, duration of anesthesia, dose of sufentanyl, hematocrit, the time for regaining orientation, dysphoria, postoperative pain degree were recorded. The occurrence of POCD was observed at 7 days (early period) and 3 months (later period) after surgery. Logistic regression analysis was used to examine the risk factors for POCD at early period and later period. Results The incidence of POCD at early period was 29.0%(29/100). Logistic regression analysis of surgical history, general anesthetics way, body mass index, age, hematocrit, the time for regaining orientation, postoperative pain degree in patients, general anesthetics way (OR=2.821, 95%CI 1.099-7.240) and postoperative pain degree(OR=2.292, 95%CI 1.129-4.654) were the significant risk factors for POCD at early period. The incidence of POCD at later period was 7.0%(7/100). Logistic regression analysis of education and family factors(alone) in patients, family factors(alone) was the significant risk factor for POCD at later period (OR=5.517, 95%CI 1.010-30.126). Conclusions General anesthetics way and postoperative pain degree are the significant predictors for POCD in patients undergoing laparoscopic radical hysterectomy during hospitalization, and family factors(alone) is the risk factor for POCD at 3 months after surgery, and active nursing intervention could reduce the occurrence of POCD.

The changes of immunoreactive neurotensin (ir-NT) contents in the brain areas, pituitary gland and plasma in the trautized rats were observed by radioimmunoassay. The results showed the significant changes of the ir-NT contents in the hypothalamus, pituitary gland, plasma, injured tissue, hippocampus, central gray and spinal cord in the posttraumatic rats at different intervals. A predominant characterization of the change of ir-NT levels in the brain areas, pituitary gland and plasma, was the dramatical decrease at various times except for the hypothalamus, central gray, and hippocampus with biphasic alterations. The ir-NT contents in the frontal cortex, pons and medulla also displayed changes to different extent under the acute craniocerebral trauma condition These results suggest that NT may play a role in the pathophysiology of traumatic injury.

Objective To observe the clinical effect of artificial ventilation combined continuous positive airway pressure(CPAP) with removal of tracheobronchial foreign bodies for children and to explore the possibility and security of the method. Methods 60 children with tracheobronchial foreign body, underwent total intravenous anesthesia ,were randomly divided into A group and B group. Each group had 30 cases. A group was given artificial ventilation with CPAP. The bronchofibroscope was connected to anesthesia machine with side hole after induction for 3 minutes,and high fresh gas flow(10 ～ 15L/min) was given to maintain continuous positive airway pressure. B group were given high frequency jet ventilation(HFJV) ,60 ～ 100 bpm. The mask ventilation was given in stand of bronchofibroscope when SpO2 ＜ 90% and until SpO2 improved. MAP, HR, ECG, SpO2, PaO2, PaCO2 were monitored and recorded at time points: T0 (entered operation room), T1 (beginning of bronchofibroscopy), T2 (5 min after bronchofibroscopy), T3 (10 min after bronchofibroscopy), T4 (end of operation). The side effects, the rate of fail to bronchofibroscopy and the rate of intubations after operation in two groups were observed and recorded. Results The HR of post-anesthesia in two groups significantly decreased than those at T0 (P ＜ 0.01), but no difference showed in HR between two groups(P ＞ 0.05). SpO2 and PaO2 of post-anesthesia in two groups significantly increased than those at T0 (P ＜0. 01) ,PaO2 at T1 ,T2 ,T3 in A group were significantly higher than those in B group(P ＜0.05). PaCO2 gradually increased after bronchofibroscopy in two groups ,and the values in A group was significantly lower than in B group(P ＜0.05 or 0. 01). There were no significant differences in the rates of fail to bronchofibroscopy and of intubations after operation between two groups, but the total number of B group was higher. Conclusion Artificial ventilation with CPAP for children with removal of tracheobronchial foreign bodies was safe and practical, and has a better controllability, a minor effect to respiratory function, deserve popularizing.

Objective To elucidate the role of P38 signaling pathway on heat-induced apoptosis in monocytic cell line Raw264.7.Methods Raw cells were transfected with constitutively active mutant MKK6b(E)and dominant negative mutant P38(AF),or the empty cloning vector pcDNA3 and apoptosis was detected by flow cytometric analysis.Results The ectopic expression of P38 mutant was confirmed by immunostaining with the antibody against the Flag-epitope tag.Expression of MKK6b(E)led to a marked increase in P38 kinase activity in transfected cells and induced a 4-fold increase in the number of apoptotic cells as compared to that in cultures of control transfected cells.Meanwhile the expression of MKK6b(E)increased the apoptotic rate of Raw cells induced by heat.In contrast,the dominant-negative mutant P38(AF)inhibited Raw cells apoptosis induced by heat.Conclusion The activation of the MKK6-P38 MAP kinase signaling pathway is required for heat-induced apoptosis in Raw264.7 cells.