Neonatal jaundice is one of the common diseases in preterm neonates. But there are still some problems to be determined,for example,the clinical diagnosis criteria for neonatal jaundice,the prediction,diagnosis and therapies for hyperbilirubinemia,and diagnosis for bilirubin encephalopathy in early-stage and prevention from bilirubin encephalopathy sequelae.

Bronchopulmonary dysplasia(BPD) is one of the main causes which threatend the health of preterm infants. As neonatal intensive care improved, the "new" BPD have replaced the" old" BPD. The development of BPD involved many factors, and several preventative and therapeutic strategies have been used in BPD.

Objective　To investigate clinical features of neonatal ventilator associated pneumonia.Methods　Retrospective analysis of clinical features was performed in twenty-two newborns with ventilator associated pneumonia.Results　Ventilator associated pneumonia were found in 22 ou t of 36 neonates with mechanical ventilation.Conclusion　The incidence of VAP is significantly increased if the time of mechanical ventilation in longer than 96 hours.

Objective　To study the characteristics of serious central nervous system(CNS) involvement in childhood systemic lupus erythematosus.Methods　We made a comparison on the level of ANA、dsDNA and positive rate of Sm、C3 between primary and secondary CNS involvement and analysed the clinical manifestations between two groups.Results　The level of ANA、dsDNA and ositive rate of Sm、C3 were not related with SLE encephalopathy;EEG was useful to the diagnosis of SLE.Conclusion　The differiential diagnosis between primary and secondary CNSD in volvement of SLE must be analysed according to clinical manifestations and other laboratory findings.

This article summarizes the mechanisms, and the effects of clinical application of more common mode of blood purification in rescuing the acute poisoning in children. The timing of blood purification and the considerations are reviewed as well. It also proposes that acquaintancing the indications and contraindications of blood purification, proper selection of treatment modalities and mastering the operation can reduce the adverse reaction and improve the survival rate in children with acute poisoning.

The adenovirus pneumonia is one of the severe pneumonia in infants and young children.Adenovirus serotype 3 and 7 can cause severe clinical presentation,a wide range of clinical syndrome,difficult treatment,high mortality and serious pulmonary sequelae.The epidemiology,pathogenesis,clinical manifestation,treatment and prognosis of severe adenovirus pneumonia in children are reviewed in the paper.

Adenovirus,respiratory syncytial virus,influenza virus type A and B,cytomegalovirus and EB virus are the mainly etiology of severe pneumonia in children.New type of virus,such as influenza-H1N1 virus,avian influenza virus(H5N1 or H7N9) can also be epidemic in pediatric population.Ribavirin is effective drugs in the treatment of respiratory syncytial virus and adenovirus pneumonia.Acyclovir or ganciclovir is used for EB virus or immune deficiency and irnmunosuppressive patients with CMV pneumonia.Current opinin strongly recommend treatment with oral oseltamivir as soon as possible in influenza and seasonal influenza.Oseltamivir reduces the severity,duration of the symptoms of influenza,and reduces the frequency of secondary illnesses and exacerbation of underlying conditions.Zanamivir and peramivir may be effective in patients infected with influenza virus,including oseltamivir-resistant virus.Some Chinese medicine such as maxingshigan-yinqiaosan can obtain similar effect of oseltamivir in treatment of influenza virus infection.

Objective To investigate the clinical and laboratory characters of infantile organic acidemia(OA) accompanied with acute metabolic crisis.Methods We analyzed retrospectively datum of infants with OA diagnosed in our unit from April 2006 to October 2014.Results Fity-three cases(37 male and 16 female,aged under 1 year old) were enrolled in this study,in which,28 cases were methylmalonic acidemia,11 cases were propionic acidemia,3 cases were biotinidase deficiency,3 cases were glutaric acidemia type Ⅱ,2 cases were glutaric acidemia type Ⅰ,2 cases were isovaleric acidemia,1 case was variety of coenzyme A carboxylase deficiency,1 case was glycerol kinase deficiency,1 case was 3-methylcrotonyl-CoA carboxylase deficiency and 1 case was holocarboxylase synthetase defect.Tweny-five of the 53 cases(47.2％)developed metabolic crisis within 7 days after onset,main manifestations included feeding difficulties,frequent seizures dyspnea,et al.The most common abnormal laboratory findings manifested severe hypoglycemia,intractable metabolic acidosis,hyperammonemia,et al.Twenty cases had family history.All patients were given symptomatic relief and supportive treatment,including colleting hypoglycemia,reducing hyperammonemia,keeping water,electrolyte and acid base balance,maintaining function of vital organs,suppling metabolic cofactor and special fomula,et al.After treatment,32 cases (60.4％) improved markedly while death occurred in 15 cases(28.3％).Conclusion OA confirmed under 1 year old is especially vulnerable to acute metabolic crisis,which characterized by sudden onset,rapid progress and is difficult to treat.Feeding difficulties,frequent seizures and dyspnea were the very common presentations.Early diagnosis and timely treatment are critical for improving the prognosis.Clinicians should be aware of it,and an early metabolic disorders screening should be intervened in patients with hypoglycemia of unknown etiology or refractory metabolic acidosis.

Pneumonia is the primary cause of death in children under five-years old.About 2 million children younger than 5 years die of pneumonia each year worldwide,accounting for 19％ of the total number of deaths.According to the survey in 2008,7％ to 13％ of the children with pneumonia were severe pneumonia.Currently,the early diagnosis and treatment of severe pneumonia is often difficult.In order to improve the early diagnosis an prognosis cognition level of severe pneumonia,here is to make a review on the recent literatures on the biomarkers like brain natriuretic peptide,D-Dimer,C-reactive protein,lactate,zinc,procalcitoin,prealbumin,platelet count,endothelin-1 and high mobility group box 1 in children with severe pneumonia.

Objective To explore the experience of emergency operation for patent ductus arteriosus (PDA) in neonates and to assess the therapeutic effect.Methods The clinical data of 31 PDA neonates(15 male,16 female) treated in our department from July 2012 to February 2015 were reviewed retrospectively.Of these cases,28 were preterm infants and 3 were full term infants.Mean gestational age was 30+4 weeks ranging from 26+2 to 39 +3 weeks.Mean birth weight and weight at operation was(1 159.0 ± 729.2) g and (1 522.0 ± 644.5) g,respectively.We operated with left transaxillary straight incision in 6 cases and posterolateral minimal incision in 25 cases,and the pleural cavity was entered via the 4th intercostal space.All the neonates were divided into ＜ 1 500 g group(n =24) and ＞ 1 500 g group(n =7) by weight,the clinical prognosis were analysized.Results All 31 operations were finished successfully.No deaths occurred as a result of surgery.Average time of operation was (62.7 ± 29.9) min.Mean time of mchanical ventilation after the operation among survivors was (5.5 ± 4.7) d.The time of mechanical ventilation between ＜ 1 500 g group and ＞ 1 500 g group were (7.2 ± 2.3) d and (4.9 ± 2.4) d respectively,and there was significant difference between two groups(P ＜ 0.001).The time of hospital stay were (45.3 ± 11.0) d and (20.4 ± 14.5) d respectively between two groups (P ＞ 0.05).Twenty-eight cases recovered and released from the hospital successfully.Two cases quited the treatment themselves and 1 succumbed to death because of heart failure,hyperkalemia and arrhythmia.ConclusionEmergency surgical closure is a safe and effective method for the treatment of neonatal large PDA,especially with congestive heart failure,a variety of complications,long time ventilator dependence,medical treatment failure,which should be ligatured timely as it can have severe influence on the cardiopulmonary function.After ligation the abnormal shunt will disappear and the cardiopulmonary function will be better.It is helpful to extubate ventilators and improve the survival rates.