[Objective]To excavate the medical affairs in the letters of ZHAO Mengfu,an artist in the Song and Yuan Dynasties.[Methods]Based on the method of historical literature research and text analysis,this paper sorts the letters according to the chronological order by referring to the existing documents,summarizes the contents of traditional Chinese medicine and analyzes the corresponding causes,prescriptions and curative effects of ZHAO Mengfu's different diseases,as well as the social medical treatment at that time.Through the interpersonal and personal exchanges between ZHAO Mengfu and his relatives and friends recorded in the letters,this paper explores the literates and rulers'views on medicine in the Song and Yuan dynasties.[Results]ZHAO Mengfu had many illnesses during his life,and he had excellent medical quality.He could not only diagnose and prescribe prescriptions by himself according to the symptoms of the disease,but also give medication suggestions to his relatives and friends.In addition,he exchanged prescriptions with his relatives and friends,and gave each other healthy medicine and food.It proved that the people of Song and Yuan Dynasties would prevent and treat diseases through food therapy,and it showed the social custom of the Confucian scholarian-bureaucrats in practicing medicine and the political attitude of the rulers to pay attention to medicine.[Conclusion]ZHAO Mengfu's letters,as real historical materials,provide new insights into the study of traditional Chinese medicine culture.

【Objective】 To investigate the mechanism of pristane inducing autophagy in macrophages. 【Methods】 Pristane was used to stimulate NR8383， a rat macrophage cell line. The changes in signaling pathways of AMPK， mTOR， and endoplasmic reticulum （ER） stress pathways including eIF2α and IRE1α in the cell model， as well as the expression of transcriptional factor TFEB and its translocation to the nucleus， were detected by using Western blotting. ER stress pathways were intervened by using an inducer DTT or an inhibitor 4-PBA to determin its effect on mTOR expression and autophay. 【Results】 In pristane-stimulated NR8383 cell model， ER stress pathway eIF2α was activated at 0.5 h after stimulation， and then mTOR expression was decreased at 1 and 3 h after stimulation. There was no change for AMPK and IRE1α pathways. With 4-PBA treatment， pristane-reduced mTOR expression and increased LC3-II were reversed， while with DTT treatment， mTOR expression decreased and LC3-II expression increased even more. Pristane induced the expression and activation of TFEB in NR8383 cells. 【Conclusion】 Pristane induces ER stress and leads to autophagy enhancement in rat macrophages.

Objective To investigate the effect of supine regulating on maternal fetal occiput posterior position during the delivery after epidural analgesia. Methods Totally600 cases of parturient with intravaginal posterior occipital position with 3cm voluntary labor analgesia were selected,who were born in Dalian maternity hospital from October 2015 to October 2016.The(Visual Analogue Scale/Score) VAS pain score at 15min after epidural labor analgesia was as effective as less than 3 points.They were randomly divided into the control group and the observation group by random number table method,with 300 cases in each group.The control group monitored parturient respiration, pulse, blood pressure, heart rate and fetal heart rate according to routine treatment.The control group monitored parturient respiration, pulse, blood pressure, heart rate and fetal heart rate according to routine treatment.In the observation group,except for routine treatment according to the labor process,after the opening of 5cm,the pregnant women were instructed to take the lateral prone position,so that the maternal side and the fetal side of the spinal column should be the same side. To observe the difference between the two groups in the rate of spontaneous vaginal delivery, delivery rate, cesarean section rate, fetal cardioversion rate, time of birth process and neonatal Apgar score. Results Totally 283 cases delivery through vagina and 17 cases of cesarean section in observation group,while 257 cases of vaginal delivery and 43 cases of cesarean section in the control group.The successful rate of fetal position transfer in the observation group was 74.6%(211/283) which was significantly higher than 45.9% (118/257) of the control group (Χ2=62.782, P<0.01), natural labor rate was also 87.3% (262/300) which increased significantly according to 64.7% (194/300) (Χ2=42.251, P<0.01),the rate of midwifery (7.0%, 21/300) and cesarean section (5.7%, 17/300) were significantly lower than 21.0% (63/300)and 14.3% (43/300) of the control group (Χ2=24.419, 12.519,P<0.01),the second stage of labor was(1.60±0.56)h which was significantly shortened than(2.19±0.53)h also(t=-12.589,P<0.01).In the observation group, the ratio of the posterior occipital position to the occipital transverse position after the opening of 8-10 cm and the complete dilation of the cervical were 7.4%(21/283)and 13.1%(37/283),which were also significantly increased than 3.4%(9/264),6.8%(18/264) of the control group (Χ2=4.240, 5.911, P<0.05). Conclusions Supine adjustment after the cervix dilatation larger than 5cm is more conducive to fetal rotation and to avoid the adverse complications, reduce the rate of vaginal delivery and cesarean section rate,improve the rate of natural childbirth,shorten delivery time,improve the quality of delivery.

Objective On the basis of theory research, tostrengthen the motivation of benevolence effectively and take the initiative to practice the behavior of benevolence among nursing baccalaureate students, combining with the law of behavior transformation, the author designed and applied "nursing benevolence behavior cultivation program based on field theory". Methods The questionnaire of nursing undergraduates' benevolence behavior based on field theory , interview, observation, interview and reflective journal were designed by our team. Results Of the five dimensionality evaluation indexes, there was no significant difference in the scores between the five dimensions except the field theory (P > 0.05). The"cognitive field theory","belief field theory","self field theory"and"group field theory"were (24.74 ± 2.36), (40.34 ± 4.32), (44.84 ± 4.17), (81.30 ± 8.15) points before cultivation, (25.74 ± 3.37), (42.46 ± 4.19), (46.26 ± 3.97), (82.64 ± 9.60) points during cultivation, (26.65 ± 3.93), (44.47 ± 4.46), (47.78 ± 5.20), (85.78 ± 7.20) points after cultivation, and there were significant differences (F=5.597-16.928, P<0.01). Conclusions The nursing benevolence behavior cultivation scheme based on the field theory is beneficial to the nursing baccalaureate students' benevolence behavior development.

In the context of "big health, big medicine and big medicine", the relationship of medical and humanities have drawn the attention of the medical world again. For the present, how to develop humanistic care and nursing care behavior is the key point of this study. Nursing care behavior acts as an integral part of nursing work, need spiritual implantation, deepen understanding, continuous training and pragmatic practice. Therefore, the designation of "Benevolence and Faith" in the process of nursing should integrate the "Field Theory" of psychology, which focus on the benevolence and faith cultivation during the practice of nursing care behavior. It is necessary to identify the similar cultivation meaning of "benevolence" and "field" behind different manifestations. Consequently, the logical starting point of nursing care behavior could be identified.

Objective To detect the changes of G protein-coupled inwardly rectifying potassium channels (GIRK)expression in allergic asthma model and identify the regulatory factors.Methods The E3 rat asthma models were induced by challenge with ovalbumin 14 days after immunization with ovalbumin and aluminium adjuvant.The asthma models were evaluated based on changes in lung pathomorphology and total IgE levels.The levels of GIRK1-4 mRNA and protein were detected using real time-PCR and Western blot.The anatomic sites where GIRK was expressed dominantly in the lung were identified using immunohistological staining.To identify the effects of IL-4 on the expressions of GIRK channels,GIRK 1 -4 mRNA and protein in IL-4 stimulated bronchial epithelial cell line A549 were detected by RT-PCR and Western blot.Results The levels of GIRK1-4 mRNA and protein decreased significantly in the lung in asthmatic E3 rats.The results of immunohistological staining showed that GIRK channels were dominantly expressed in airway epithelia in the lung.The levels of GIRK 1-4 mRNA and protein were down-regulated in time-and dose-dependent manners in IL-4 treated A549.Conclusion IL-4 down-regulates the expression levels of GIRK subunits in bronchial epithelia during allergic asthma.

[ABSTRACT]AIM:Toexplorethedevelopmentofhepaticsinusoidalcapillarizationintheearlystageofliverfi-brosis induced by carbon tetrachloride (CCl4) in rats.METHODS:Clean SD rats were randomly divided into normal con-trol group (group N, n=6) and liver fibrotic model group (group M, n=32).The rats in group N were intraperitoneal in-jected with saline and the rats in group M were intraperitoneal injected with CCl 4(2 mL/kg, twice a week for 4 weeks).At the end of the 3rd day and the 1st, 2nd and 4th weeks, all rats were killed and then the samples were collected .The patho-logical changes in the livers were observed by HE staining and Masson straining .The development of hepatic sinusoidal capillarization was observed by transmission electron microscopy (TEM) and immunohistochemical staining .The cell sur-face expression of vascular endothelium-associated marker CD31, collagen type Ⅳ(Col IV) and laminin (LN) was deter-mined.RESULTS:HE and Masson staining showed the formation of liver fibrosis after treatment with CCl 4 for 4 weeks. TEM showed that the fenestrate diameter of liver sinusoidal endothelial cells (LSECs) grew down, the fenestrate numbers of LSECs were decreased along with the development of liver fibrosis , and the consecutive basement membrane was formed at the end of the experiment .The expression of CD31 was significantly increased along with the development of defenestration , and the expression of Col IV and LN was significantly increased after the treatment with CCl 4 for 2 weeks and 4 weeks , re-spectively .CONCLUSION:The typical hepatic sinusoidal capillarization was detected in the early stage of liver fibrosis , and the deposition of LN in the liver sinusoidal walls was the mainly factor of formation of the consecutive basement mem -brane .

Objective To observe the effect of proanthocyanidin on the expression of nuclear factor kappa B (NF-кB) and interleukin-6 (IL-6) in rats with spinal cord injury (SCI). Methods 36 healthy adult Sprague-Dawley rats were randomly divided into proanthocyanidin treatment group (group A, n=12), methylprednisolone (MP) treatment group (group B, n=12) and model control group (group C, n=12). Allen's method was used to establish the model of acute spinal cord injury in T9. On the 1st, 3rd and 7th days after operation, 4 rats in each group were assessed with Basso-Beattie-Bresnahan (BBB) scale and Slanting Board Test (SBT), and the expression of NF-кB and IL-6 of the spinal cord were detected with immunohistochemistry. Results The scores of BBB and SBT were better in groups A and B than in the group C 3 and 7 days after SCI (P<0.05). Compared with group C, the expression of NF-кB in group A decreased all the time after SCI (P<0.01), and 3 and 7 days after SCI in group B (P<0.01); while the expression of IL-6 decreased all the time after SCI in groups A and B (P<0.05). Conclusion Proanthocyanidin may inhibit the expression of NF-кB and IL-6 in spinal cord after SCI in order to reduce inflammation and improve the hindlimb motor function in rats after SCI.

Objective To investigate whether cesarean section on pregnant women with chronic hepatitis B virus (HBV) infection may reduce mother-to-infant transmission risk of HBV.Methods Preserved serum samples of pregnant women at 15-20 weeks of gestation which were collected from July 2002 to August 2004 in 14 counties of Jiangsu Province were analyzed retrospectively.These samples were tested for HBV serologic markers with enzyme immunoassay,and 419 cases of positive hepatitis B surface antigen (HBsAg) were found.HBV DNA level of these HBsAg-positive women were further quantitatively measured with real-time polymerase chain reaction assay.Children of these 419 HBsAg-positive mothers were followed up during October 2009 to March 2010 and 298 of them were contactable (71.1％),among which 281 were enrolled in final analysis as they had complete information and had been vaccinated with three regular doses of HBV vaccine during infantile period.The 281 children were tested for serum HBV markers.The HBV infection rate in these children at age 5-7 was compared between those born by cesarean setion (CS group,n =136) and by vaginal delivery (VD group,n=145).T-test,x2 test or Fisher's exact test was used to analyze relevant parameters.Results(1) Maternal HBeAg-positive rates [25.7％ (35/136) vs 34.5％ (50/145)],HBV DNA levels in HBeAg-positive women [(2.30 × 106) IU/ml vs (2.09× 106) IU/ml],the percentages of HBIG injection after birth [38.2％ (52/136) vs 35.9％ (52/145)],breastfeeding ratios [82.4％ (112/136) vs 75.9％ (110/145)],and children' s ages at the follow-up [(5.9 ± 0.8) vs (6.0±0.6)] were comparable between CS group and VD group (all P＞0.05).(2) Among these 281 children,272 (96.8％) were HBsAg-negative,9 (3.2％) were HBsAg-positive and 163 (58.0％) were anti-HBs-positive.The prevalence of HBsAg-positive [(2.9％ (4/136) vs 3.4％ (5/145)],HBsAg negative and anti HBc positive [0.0％ (0/136) vs 1.4％ (2/145)] and anti-HBs positive [57.4％(78/136) vs 58.6％(85/145)] in CS group were similar to those in VD group.Conclusions Cesarean section does not reduce the risk of mother-to-infant transmission of HBV.In clinical practice,elective cesarean section should not be suggested in order to prevent HBV vertical infection.

Objective To assess the protective effect of vaccination in routine application on hepatitis B virus (HBV) exposed infants and to clarify whether hepatitis B immunoglobulin (HBIG) administration of pregnant women may reduce the risk of maternal-fetal transmission of HBV. Methods Serum samples of 6398 pregnant women at gestation of 15-20 weeks from 6 urban and 8 rural areas across Jiangsu province were previously tested for serologic markers of HBV by ELISA from July 2002 to August 2004. In this study, infants born to 419 HBV carrier mothers were taken as the study group, while infants born to 453 non-carrier mothers were taken as the control group by stratified random sampling. They were followed-up and screened for HBV markers during October 2009 to March 2010. Information including HBIG administration during pregnancy, HBV vaccination and HBIG administration of the infants were collected. χ2 test or Fisher′s exact method were used to compare the rates and the comparison of the means was by t test. Results The follow-up rates of the study group and control group were 71.12% (298/419) and 72.41% (328/453), respectively. Of the 298 infants born to HBV carrier mothers, 11 (3.7%) were positive for HBsAg, while none of the 328 infants born to non-carrier mothers was HBsAg positive (χ2=12.32, P<0.01). All of the 11 children were born to mothers with both HBsAg and HBeAg positive, and nine of the 11 children were not injected HBIG or not immunized with hepatitis B vaccine within 24 hours after birth, with only one received regular vaccination and detailed information was unknown in one case. The positive rates of anti-HBs in the study group and the control group were 69.46% and 69.21% respectively (χ2=0.01, P=0.95). HBsAg positive rate of the children born to pregnant women treated with HBIG during late pregnancy (n=92) was 2.17% (n=2), whereas that in the children born to women not treated with HBIG (n=197) was 4.57% (χ2=0.98, P=0.51). Conclusions The protective effect of immunoprophylaxis in routine application against perinatal HBV infection in Jiangsu province is good. Efforts are required to emphasize the importance of HBIG administration in infants born to HBV carrier mothers, especially in HBeAg positive mothers within 24 hours after delivery. Treatment of HBsAg positive pregnant women with HBIG in third trimester would not decrease the risk of maternal-fetal transmission of HBV.