Objective To observe the efficacy of different dosage of midazolam oral solution in re-lieving anxiety in children undergoing laparoscopic high ligation of the hernia sac with oblique inguinal her-nia.Methods A total of 120 children,93 males and 27 females,aged 2-6 years,78-120 cm in height and 11-25 kg in weight,ASA physical statusⅠ orⅡ,were selected to perform laparoscopic high ligation of inguinal oblique hernia sac under general anesthesia.According to random number table method,the chil-dren were divided into three groups:the oral midazolam 0.25 mg/kg group(group M1),0.5 mg/kg group(group M2),and 0.75 mg/kg group(group M3)30 minutes before anesthesia,40 children in each group.Modified Yale preoperative anxiety scale-short form(mYPAS-SF)was recorded at premedication,parental separation,and immediate induction of anesthesia.Induction compliance checklist(ICC)score,recovery time,extubation time,PACU residence time,pediatric anesthesia emergence delirium scale(PAED)and the modified face,legs,activity,cry and consolability scale(FLACC)30 minutes after operation were also recorded.Results Compared with before taking medication,mYPAS-SF scores in groups M2 and M3 at parental separation and immediate induction of anesthesia were significantly decreased(P＜0.05).Com-pared with group M1,mYPAS-SF scores at parental separation and immediate induction of anesthesia and ICC scores at immediate induction of anesthesia were significantly lower in groups M2 and M3(P＜0.05),the recovery time,extubation time and PACU resident time in groups M2 and M3 were significantly pro-longed,PAED score was decreased significantly within 30 minutes after operation(P＜0.05).Compared with group M2,the awakening time and extubation time in group M3 were significantly prolonged.(P＜0.05).Conclusion Oral midazolam 0.5 mg/kg or 0.75 mg/kg 30 minutes before anesthesia can effectively alleviate the preoperative anxiety of children,improve the degree of cooperation in anesthesia in-duction,and reduce the occurrence of postoperative agitation,the recovery time and extubation time pro-longed in children with oral midazolam 0.75 mg/kg.Therefore,an oral solution of midazolam 0.5 mg/kg was a more appropriate dose for preoperative antianxiety regimen in children.

To investigate the clinical and endoscopic characteristics and endoscopic treatment efficacy of cap polyposis, data of 14 patients (56 polyps) who were histologically diagnosed as having cap polyposis after endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR) in Beijing Friendship Hospital from June 2017 to February 2021 was retrospectively analyzed. Of the 14 patients, 8 were males and 6 were females. The age ranged from 14 to 74 years, including 7 cases of <60 years old and 7 cases of ≥60 years old. 7 patients (50.0%) had clinical manifestations. Four cases had multiple polyps and 10 cases (71.4%) had single polyps. There were 42 polyps (75.0%) located in the rectum, 13 (23.2%) in the sigmoid colon and 1 in the transverse colon. According to the classification of Yamada, 44 polyps (78.6%) were type Ⅰ, 3 polyps were type Ⅱ, 5 polyps were type Ⅲ and 4 polyps were type Ⅳ. Under endoscopy, there were 41 polyps (73.2%) with obvious white cap-like coverings on the surface and 23 polyps with obvious hyperemia and redness on the mucosa, 8 of which were both visible. Two cases were treated with ESD and 12 cases were treated with EMR, all of which were completely excised. No bleeding, perforation, infection or other complications occurred during and after operation. The clinical symptoms of 7 patients were relieved. During the follow-up period, 11 cases (78.6%) completed colonoscopy, and no polyp recurrence was found. In conclusion, there is no gender or age difference in patients of cap polyposis. It is usually single and located in the rectum and sigmoid colon with Yamada type Ⅰ. The surface of lesions is mostly covered with white cap. Patients may have no obvious clinical symptoms. Treatment of ESD and EMR is safe and effective for cap polyposis.

OBJECTIVE： To establish a method for simultaneous determination of gallic acid， cinnamic acid and catechin in 3 processed products of Rheum officinale. METHODS： RP-HPLC method was established. The determination was performed on Thermo ScientificTM Hypersil GOLD Dim column with mobile phase consisted of methanol-0.1％ phosphoric acid solution （gradient elution） at the flow rate of 1.0 mL/min. The detection wavelength was set at 278 nm， and the column temperature was 30 ℃. The sample size was 10 μL. RESULTS： The linear range of gallic acid， cinnamic acid and catechin were 0.126 2-1.262 0 μg（r＝0.999 9）， 0.036 2-0.362 0  μg（r＝0.999 9） and 0.177 9-1.779 4 μg（r＝0.999 8）， respectively. Quantitative limits were 25.4， 28.2， 62.5 ng， and detection limits were 6.2， 3.6， 11.8 ng， respectively. RSDs of precision， stability， repeatability and durability tests were all less than 3％. The recoveries ranged from 94.64％-102.71％（RSD＝2.74％， n＝9）， 95.35％-102.49％（RSD＝2.44％， n＝9）， 93.56％-103.66％（RSD＝3.27％， n＝9）. The determination results showed that the contents of gallic acid and cinnamic acid in prepared R. officinale were higher， and the order of both were prepared R. officinale＞steamed R. officinale＞raw R. officinale. The content of catechin in raw R. officinale was higher， and the order of it was raw R. officinale＞ steamed R. officinale＞prepared R. officinale. CONCLUSIONS： The method is sensitive， reliable and reproducible. It can be used to determine the contents of gallic acid， cinnamic acid and catechins in 3 processed products of R. officinale simultaneously.

The nursing students of Grade 2009 to Grade 2016 were selected.Their skills,midterm,usual and final performances as well as comprehensive scores of normal human morphology course were analyzed by one-way ANOVA in combination with different stages of curriculum integration in order to compare the teaching effect between traditional teaching mode + evaluation system and mixed teaching mode + formative evaluation in the course of normal human morphology.Statistical analysis by SPSS 17.0 showed that the average score of formation stage (traditional teaching mode) was 67.55 ± 12.72,the average score of integration stage (mixed teaching mode) was 72.79 ± 10.93 and the average score of development stage (formative evaluation +mixed teaching mode) was 83.94 ± 9.58.After making comparisons,the P values of ANOVA of the course of normal human body morphology in all stages were all less than 0.001,having statistical significance.The results showed that the overall development of the curriculum is becoming mature and the new teaching model can help students who usually do not like to review.

In clinical practice, the teachers should lead students to integrate the basic medical and clinical medical knowledge, and promote their comprehensive ability. Taking the department of gynaecology as an example, we learn from the analysis of specific practice that teachers need to pay attention to the reasonable conversion between doctors and teachers, strengthen their own basic medical knowledge reserves and teaching ability, strengthen the experience exchange with the teachers who teach basic course and give students clear interpretation of the relevant basic medical knowledge, pro-mote students to converse from basic medical skills to clinical skills, from theory to practical skills, and enable students to adapt to the role of interns as soon as possible.

were no significant differences in the detection rate of recto-sigmoid colon,mid colon,right colon and total detection of polyps among the 3 groups (P >0.05).Conclusion 4-L split-dose PEG is better than the oth-er 2 regimens in the colon cleansing quality,so it can better reach the intestinal cleaning standards before enteroscopy,which is a more suitable regimen for bowel preparation.

Objective To establish the molecular weight distribution of anti-HBV placenta transfer factor injection (PSTF) by electrophoresis, HPLC and MS.Methods Using the methods of SDS-PAGE, HPSEC, MALDI-TOF-MS to test the molecular of PSTF.Results The Molecular was 8000 Da by SDS-PAGE.There were 5026.67,6783.44,7496.42,8736.55 Da components in PSTF by HPSEC.The main component molecular was 2972 Da and the maximum molecular component was 8194 Da.Conclusion HPSEC is simple and rapid to determine the maximum component molecular of PSTF.

Objective To research the effect mechanism of ultrashortwave in the correlation of ultrashortwave and the tail replantation, provide the experiment basis of clinical practice of prevention and cure for the vascular crisis after micromodule anastomosis. Methods Eighty Sprague-Dawley(SD) rats of clean grade were 3-month-old,female,and were divided into four groups:control group (group 0),model group (group 1 ),contrast group (group 2),ultrashortwave (USW) group (group 3).The preparation of tail replantation model was cut off soft tissue except for caudal veins on both sides of the tail. The coccyx was not broken away from tail.At last,the audal artery under abdominal main centre ditch was anastomosed.In experiment process, the USW group was divided into high dosage group (group 3A) and low dosage group (group 3B). The caudal arterys were ligated and not anastomosed in the group 0. Caudal arterys in other groups were anastomosed.Rats in the group 0 and group 1 received no treatment,normal management after the operation. Rats in the group 2 were given abdominal cavity injection of papaverin liquid immediately,then once a day to 5 days after the tail replantation.Rats in the group 3 were immediately given USW therapy of twenty minutes on the anastomosis section,and then once a day for 5 days after the tail replantation.The USW dosage of group 3A was 3th grade and 50mA. The USW dosage of group 3B was 2th grade and 28mA.The survival rate of the rat tails was observed after the tail replantation for 10 day.Before being grouped,it was measured that the tail skin temperature diference between near and far side of anastomosis section.After the tail relpantation, the temperature diference was inspected daily for 10 postoperative days hence. Before rats were grouped and the eighth hour after the tail replantation, rats were collected blood plasma specimens and measured contents of nitric oxide with destination colorimetric mathods of nitric oxide.Results Carrying out comparison of survival rate of every group,the output weve:between tail cutting off group (group 0,0) and tail replantation group (group 1,2,3,43.94％) to compare P ＞ 0.05; between each group of the tail replantation groups (1,2,3A,3B group) to compare P＞ 0.05,group 3B ＜ 2 ＜ 1 ＜ 3A; between group 3B and group 1 to compare P ＞ 0.05; between group 2 and group 1 to compare P ＞ 0.05. Each group were compared with the change daily between postoperative and preceding operative the skin temperature diference,single-factor analysis of variance (One-Way ANOVA) analysis:Postoperative 1 day,group 3A ＜ 1,P ＜ 0.05.Postoperative 6 day:3A ＜ 3B ＜ 1 ＜ 2,P ＞ 0.05.Postoperative 7 day:group 3B ＜ 1 ＜ 3A ＜ 2,P ＜ 0.05.Each group were compared with the change of the content of nitric oxide between postoperative 8 hour and preceding operative,with rank-sum test:group 3B ＞ 3A ＞ 2 ＞ 1 ＞ 0,H =33.760,P ＜ 0.05,shows statistically significant.Conclusions USW therapy,especially USW low-dose therapy,can reduce vascular crisis and improve the survival rate of replanted rat tails,after the postoperative 1,6,7 days,reduce skin temperature,improve blood supply,improve nitric oxide at postoperative eighth hour,prevent vascular crisis.Rat tail replantation model in this experiment is feasible.

Objective To investigate the effects of liraglutide on glucose-lipid metabolism in ApoE-/-mice with RNAi-mediated adiponectin gene inhibition. Methods The dose-effective relationship of liraglutide was evaluated by intravenous glucose tolerance test (IVGTT), and the insulin sensitivity and glucose-lipid metabolism were assessed by the hyperinsulinemic-euglycemic clamp technique using 3-[3 H]-glucose as a tracer. Results In the IVGTT, blood glucose was significantly lower in the 1 mg/kg liraglutide group than that in other groups ( all P＜0. 01 ) at the points of 5, 15, and 30 min after glucose load. However, plasma insulin was significantly higher at the points of 5 and 15 min (all P＜0. 01 ). Fasting blood glucose (FBG), body weight, free fatty acids (FFA),total cholesterol, triglycerides, low-density lipoprotein-cholesterol ( LDL-C), and fasting plasma insulin in ApoE-/-mice with co-injection of liraglutide and adiponectin shRNA adenovirus ( HEA group ) were significantly lower than those in ApoE-/-mice with adiponectin shRNA adenovirus injection ( ADI group, P＜0. 05 or P＜0. 01 ). However,high-density lipoprotein-cholesterol (HDL-C) was significantly higher than the latter (P＜0. 05 ). During the steady-state of clamp, plasma insulin in ADI group was significantly higher than that in HEA group (P＜0. 01 ). Although FFA, total cholesterol, and triglycerides were suppressed in all groups, they were still higher in ADI group than those in HEA group (P＜0. 05). Glucose infusion rate (GIR) in HEA group were significantly higher than that in ADI group ( P ＜ 0. 01 ). At the end of clamp, glucose disappearance rate ( GRd ) was significantly lower, and hepatic glucose production significantly higher in ADI group than those in HEA group (P＜0.01 ). Conclusion Administration of liraglutide may ameliorate insulin resistance via increasing plasma adiponectin level in ApoE-/-mice with RNAi-mediated adiponectin gene inhibition.

Objective To explore the risk factors of and the influence of different hepatitis B virus (HBV) DNA load on paternal vertical transmission of HBV.Methods Totally,161 HBsAg negative women,whose husband was HBsAg positive,attended the antenatal clinics of the Provincial Maternity and Child Health Hospital of Fujian from September 2007 to December 2008 and their newborns were selected,and the epidemiologic information,the duration of being a HBV carrier,the first class HBV family history of the fathers,HBV markers,HBV DNA load,HBsAb of the gravidas,the outcomes of the newborns were all collected.Cord blood was sampled after delivery for HBV DNA quantification and those with HBV DNA load ≥1.0×103 copy/ml were chosen as the case group and those ＜ 1.0×103 copy/ml as control.Results (1) Among the 161 newborns,36 HBV DNA positive cord blood samples were detected,giving a rate of 22.4% (36/161) for paternal vertical transmission of HBV.The HBV DNA positive rate in cord blood was 32.0% (23/72) in HBeAg-positive fathers and 14.6% (13/89) in HBeAg-negative fathers.(2) Univariate analysis showed that HBeAg-positive,HBV DNA positive,first class family history of HBV and the duration of being a HBV carrier of the fathers were risk factors of paternal HBV vertical transmission[X2= 6.892,29.916,29.499 and 23.821,OR = 2.7,5.2,8.3 and 1.4 (P＜0.01)].(3) Multivariate analysis found that paternal serum HBV DNA positive and the first class family history of HBV of the father side were risk factors of paternal vertical transmission of HBV (OR = 11.1,95% CI;4.6-27.1;OR = 17.1,95% CI:3.5-82.6).(4) According to the different serum HBV DNA load of the HBsAg-positive father,7 groups were divided.A dose dependent effect was found that the HBV DNA positive rate of the cord blood increased with the rising of HBV DNA load.No HBV DNA positive cord blood was detected when paternal HBV DNA load was＜1.0×104 copy/ml,while 100% of the cord blood were positive when paternal HBV DNA load≥1.0×108 copy/ml.(5) The average birth weight of the newborns in the two groups was the same (3.3±0.4) kg.And the delivery mode,gestational age at delivery,height and Apgar score of the newborns at 1 minute,neonatal pathological jaundice and other complications had no significant difference between the two groups (P ＞ 0.05).No relationship was found between the neonatal outcomes and the paternal HBV vertical transmission (P＞0.05).Conclusions HBV DNA load in the serum of HBsAg-positive father,and the paternal first class family history of HBV are risk factors of paternal HBV vertical transmission.When the serum HBV DNA load in HBsAg-positive father is≥1.0×107 copy/ml,the possibility of paternal vertical transmission of HBV would increase.