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Objective@#To investigate the role of HBsAg status and content in neonatal venous blood to predict HBV mother-to-children transmission.@*Methods@#The study candidates from a prospective study about HBV mother-to-children transmission blocking who were hepatitis B surface antigen (HBsAg) positivity, hepatitis B e antigen (HBeAg) positivity, and HBV DNA levels >105 IU/ml.All of their infants were enrolled.200 IU of hepatitis B immunoglobulin (HBIG)was injected within 6 hours after birth, and 200 IU HBIG was voluntarily selected 1 month after birth.All infants according to 0-1-6 month standard procedure were given 10 or 20 μg of hepatitis B vaccine. Pregnancy women before birth, and infants at the time of birth, 1-month and 7-month after birth, venous blood was tested for HBV virus and serological markers to assess the association with success of mother-to-children transmission blocking.@*Results@#530 pregnant women and 530 neonates were enrolled. 60.75% at birth and 86.02% at birth for one month children were HBsAg-negative. The successful transmission in HBsAg-negative neonates was 100.00%. According to the receiver operating characteristic curve, the AUC of HBsAg content≥0.35 IU/ml at birth predicted to block failure was 0.979. The sensitivity was 85.60%, and the specificity was 100.00%. The AUC of HBsAg content≥0.18 IU/ ml at one month after birth predicted to block failure was 0.988, the sensitivity was 89.40%, and the specificity was 100.00%.@*Conclusions@#The HBsAg level in venous blood at birth and 1 month after birth can predict the failure of HBV mother-to-children transmission, and the neonates with HBsAg positivity in venous blood are a high-risk group that may block failure.
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Objective To explore and compare the clinical effects of pregnant women with liver cirrhosis after hepatitis in cesarean section between general anesthesia and single spinal anesthesia.Methods Clinical data of pregnant women of 35,including compensated cirrhosis 26 cases,decompensated cirrhosis 9 cases,aged 24-45 years,weighing 55-98 kg,falling into ASA Ⅱ or Ⅲ,were divided into group A (general anesthesia group,n=15) and B (single spinal group,n=20).In patients of group A,propofol were infused at 1.5 mg/kg till the time for fetal delivery,after intubation,followed by infusion of remifentanil at a rate of 0.2 μg·kg-1·min-1 TCL combined with propofol until the end of operation.In group B,the puncture was performed at L3-4 interspace,following by intrathecal injection of ropivacaine 10~15 mg and within 10 seconds.With liver cirrhosis after hepatitis were collected and analyzed,retrospectively.Preoperative general status,blood loss and time of operation,Apgar score of neonates compared and analyzed in groups A and B.And the changes of hepatic function and coagulation function of the body under different anesthesia methods were also studied.The influential factors of postoperative elevation of hepatic function were analyzed by non-conditional logistic regression models.Results Blood loss and time of operation,Apgar score of neonates and postoperative hospital stay had no significant differences between the two groups.Postoperative albumin of group A was higher than that of preoperative,with a statistical significance (P<0.05).Alanine aminotransferase,aspartate aminotransferase of postoperative of group B were increased,with a statistical significance (P<0.01).Logistic analysis showed that the type of anesthesia was the possible influencing factor of postoperative elevation of total bilirubin (OR=12.04,95%CI 1.14-127.45).Conclusion The negative effect of single spinal anesthesia on hepatic function more than that of general anesthesia in pregnant women with liver cirrhosis in cesarean section.
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Objective To measure the collagen content in the granulation tissue of skin wound surface in rats with depression in order to explore the possible mechanism about depression to wound healing.Methods Totally 126 Sprague-Dawley rats were randomly and equally allocated to 3 groups: simple wound group,depression plus wound group,wound plus depression group.Unpredictable stimuli,including fasting,electrocution,water deprivation,swimming in cold water and others,were performed for 18 d to establish depression model of rats.A full-thickness dermal wound(2.2 cm in diameter) was made on the back of rats to build wound model.Rats from depression plus wound group received 18 days' stimuli and then wound cutting.For those of wound plus depression,stimuli were carried out from the next day of wounding.The basal tissue in the center of the wound was taken out from 6 rats of every group in 3,5,7,10,14,18 and 21 d after wounding.Hydroxyproline reagent kit was used to detect the content of hydroxyproline in collected tissue.Wound collagen depositions in every time point were stained by nitroxanthic acid sirius red and then observed by polarization microscopy.Results Hydroxyproline content and collagen deposition in wound granulation tissue of depression plus wound group rats were lower than those in the other 2 groups.From 18 d after wounding,rats of depression plus wound group had a tendency to the same level as wound plus depression group.Conclusion Depression plus wound significantly decreases hydroxyproline synthesis,reduces collagen deposition in wound,and then delays the wound healing.
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Objective To develop a portable automatic tourniquet.Methods Using microcomputer and pressure sensor,the pressure and hemostatic time of current pressurized tourniquet were controlled.Results Portable automatic tourniquet was composed of gasbag pressurized bandage,electric micro-pump,pressure sensor,preamplifier,impact damper,A/D converter,single-chip micro-computer controller,data memory,keyboard and its interface circuit,display and its interface circuit,photoelectronic control circuit,etc.Conclusion Portable automatic tourniquet is small,light,safe and convenient.Besides,rapid hemostasia and automatically controlled & stable pressure enable it to be used both in the war and at peace time.[Chinese Medical Equipment Journal,2008,29(2):21-23]