Objective To explore the pathogenesis of acute respiratory distress syndrome (ARDS) in fullterm newborns, and to assess the effect of pulmonary surfactant. Methods All full-term newboms were divided into two groups,with 50 cases in group A and 12 cases in group B. Compared to the treatment of group A,pulmonary surfactant was added to group B. The indicators of pH, PaO2, PaCO2, SaO2, HCO3- were compared between the two groups.Results The cure rate was 92% in group B , which was significant higher than that of 80% in group A( t = 3. 5,P < 0. 05 ). There were 42 cases of neonatal asphyxia (68%), 36 cases of asphyxia combined aspiration pneumonia (58% ) ,19 cases of cesarean section(31% ) ,6 cases of milk aspiration pneumonia (10% ) and 3 cases of infectious pneumonia (5 % ). The AUC was 0. 80,0. 76,0. 35,0. 83 and 0.74, respectively.Neonatal asphyxia, asphyxia combined aspiration pneumonia,milk aspiration pneumonia and infectious pneumonia were associated with ARDS in full-term newborns. PaO2 in group A and B was (78. 80 ± 8. 2 ) mm Hg and (87. 20 ± 8. 30) mm Hg, respectively (t = 4. 56, P < 0. 05 ). SaO2 in group A was (89. 50 ± 5.40) % ,which was significantly lower than that of (99. 63 ± 3. 30 ) % in group B (t = 5. 78, P < 0. 05). Conclusions There are various causes of ARDS in full-term newborns.Intensive clinical observation and continuous monitoring of blood oxygen saturation will be helpful to improve the efficiency of treatment Pulmonary surfactants can improve the efficiency in the treatment of ARDS in the full-term newboms.

Objective:To investigate the prevalence and influencing factors of mild visual impairment in type 2 diabetic patients aged ≥50 years living in Funing County, Jiangsu Province.Methods:A population-based cross-sectional study was adopted.Cluster sampling was conducted among diabetic patients aged ≥50 years registered in the Chronic Disease Information Center of Funing County Center for Disease Prevention and Control from March 7th to April 20th, 2019.General information of selected patients was collected.Visual and ocular examinations on site were performed by ophthalmologists and technicians.The International Council of Ophthalmology standard for mild visual impairment, 0.3≤best corrected visual acuity<0.8 was adopted.The influencing factors of mild visual impairment were analyzed by logistic regression.This study protocol was approved by the Ethics Committee of Affiliated Hospital of Nantong University (No.2014-071).Results:Among the included 2 067 patients, 1 909 cases completed the investigation, with a response rate of 92.4%.There were 1 146 patients with mild visual impairment in at least one eye, and the prevalence of mild visual impairment was 60.00%.Among the eyes examined, 1 832 eyes were with mild visual impairment, accounting for 47.98%.Cataract (896/1 632), refractive error (515/1 632) and diabetic retinopathy (166/1 632) were the main causes of mild visual impairment in diabetic patients, accounting for 54.90%, 31.61% and 10.19%, respectively.Aging, female gender, low educational attainment, oral hypoglycemic drugs or subcutaneous insulin injection were risk factors for mild visual impairment in both eyes.Higher educational attainment, more sunshine exposure and exercise were protective factors for mild visual impairment in both eyes.Conclusions:The prevalence of mild visual impairment is relatively high in type 2 diabetic patients.Cataract surgery, correction of refractive error may help to improve mild visual impairment.Strengthening blood glucose control, more physical exercise and outdoor activities may slow the progression of mild visual impairment and prevent it from moderate and severe visual impairment.

Objective To investigate the relationship between neutrophil-to-albumin ratio(NAR)and severity and prognosis of patients with spontaneous intracerebral hemorrhage(sICH).Methods A total of 330 patients with sICH who met the enrollment criteria were included.They were divided into good prognosis group(mRS≤3,n =139)and poor prognosis group(mRS>3,n =191)according to the modified Rankin scale at 30days after onset.The clinical data of the two groups were analyzed by Univariate analysis,and the risk factors affecting the poor prognosis of sICH patients wereidentified by multivariate Logistic regression analysis.Spearman correlation analy-sis was used to explore the correlations between NAR and National Institute of Health stroke scale and intracerebral hemorrhage scale.The receiver operating characteristic(ROC)curve was further used to evaluate the predictive value of NAR in the early clinical prognosis of sICH patients.Results The NAR of patients with poor prognosis was significantly higher than that of patients with good prognosis[0.16(0.13,0.18)vs 0.22(0.19,0.28),P<0.001].Multivariate Logistic regression analysis showed that NAR was an independent risk factor for poor prognosis in patients with sICH after adjusting for confounding factors(OR =1.480,95%CI:1.320-1.521,P<0.001).NAR was moderately positively correlated with NIHSS(r =0.489,P<0.001)and ICH score(r =0.450,P<0.001).The area under the ROC curve of NAR was0.818(95%CI:0.771-0.865),indicating good prediction efficiency.Conclusion Elevated NAR on admission was associated with the severity of sICH,and NAR represents an independent factor associated with poor outcome in sICH patients.