AIM:To analyze the effect of non-exchange transfusion therapy, including simple phototherapy or phototherapy combined with albumin therapy, on severe jaundice in full-term neonates.METHODS: The full-term neo-nates (n=110) with serum total bilirubin (TBIL) level over 342 μmol/L recewed simple phototherapy or phototherapy combined with albumin therapy.The changes of serum bilirubin levels and neurological signs of these neonates were ob-served.RESULTS:Serum TBIL and indirect bilirubin ( IBIL) levels in the 2 groups of hospitalized cases significantly re-duced after the first day of treatment and at discharged (P<0.01).The reduced degrees of TBIL and IBIL levels in the neonates given phototherapy combined with albumin therapy were higher than those in the neonates given simple photothera-py.All these neonates did not have bilirubin encephalopathy on admission or at discharged.CONCLUSION:Both simple phototherapy and phototherapy combined with albumin therapy treat severe jaundice effectively and prevent acute bilirubin encephalopathy in full-term neonates.

Objective To explore the value of improved family management model to reduce the occurrence of death and rehospitalization rate of children with bronchopulmonary dysplasia (BPD) after discharge.Methods The children with BPD who were admitted in Neonatal Intensive Care Unit of Zhongshan Hospital Affiliated to Sun Yat-Sen University from January 2006 to December 2013 were enrolled.Thirty-one cases with BPD used with improved family management mode after discharge from January 2010 to December 2013 were as experimental group.Twenty-seven cases with BPD used with traditional family management mode after discharge from January 2006 to December 2009 were as control group.The occurrence of death and rehospitalization were observed because of apnea,choking,respiratory failure,pneumonia and asthma within 3 months after discharge and compared the difference between two groups with chi-square test.The lung functions of all cases were checked in 40 week of the corrected gestational age and 3 month of the corrected age and compare the difference between the experimental group and control group with t test.Results The occurrence of death in the experimental group was 3.22％ (1/31 cases),and that of the control group was 22.22％ (6/27 cases),there was significantly statistical difference in the occurrence of death between two groups (x2 =4.907,P ＜0.05).The occurrence of rehospitalization in the experimental group was 25.80％ (8/31 cases),and that of the control group was 77.78％ (21/27 eases),there was significantly statistical difference in the occurrence of rehospitalization because of apnea,choking,respiratory failure,pneumonia and asthma between two groups (x2 =15.591,P ＜ 0.05).The difference of the lung functions between two groups in 40 week of the corrected gestational age was not statistically significant.The respiratory rate in the experimental group (30 survivors) were lower than those in the control group (21 survivors) in 3 month of the corrected gestational age (t =9.225,P ＜ 0.05),and time to peak tidal expiratory flow,volume to peak tidal expiratory flow,25 ％ tidal expiratory flow,50％ tidal expiratory flow,75 ％ tidal expiratory flow levels in the experimental group were higher than those in the control group in 3 month of the corrected gestational age,the difference of lung functions between 2 groups were statistically significant (t =3.992,3.301,4.645,3.152,2.916,all P ＜ 0.05),the lung functions in experimental group were significantly better than that in control group in 3 month of the corrected age.Conclusions The improved family management mode can reduce the occurrence of death and rehospitalization for the children with BPD after discharge and is conducive to the improvenent of pulmonary function.

ObjectiveTo detect the mechanism of the growth inhibition and apoptosis of human acute leukemia cell line U937 cells induced by honokiol.MethedsThe proliferation inhibition was detected by MTT method.Cell apoptosis was tested by Hoechst 33342 staining and flow cytometry with Annexin V/PI staining.RT-PCR was used to detect the mRNA expression of the apoptosis gene Bcl-2,Bax,Caspase 3,Caspase 8 and Caspase 9.ResultsThe inhibition effect of honokiol(5 μg/ml,48 h) on U937 cells proliferation could he observed,and the inhibition rate of 10 μg/ml honokiol on cell proliferation reached above 50％ (48 h).U937 cells proliferation could be completely inhibited for 120 h. U937 cells apoptosis rate reached 26.8％ (P ＜0.01)after being treated with 10 μg/ml honokiol.After being treated with 10 μg/ml honokiol for 48 h,the Bcl-2 gene expression in U937 cells was reduced (control group:0.33 ± 0.02,experimental group:0.14 ±0.01,P ＜ 0.01 ),and the Bax gene expression was elevated ( control group:0.1 ± 0.01,experimental group:0.87 ± 0.08,P ＜ 0.01 ).The gene expressions of Caspase 3 ( control group:0.48 ± 0.01,experimental group:0.87±0.06,P ＜0.01),Caspase 8(control group:0.23±0.02,experimental group:0.41 ±0.07,P ＜ 0.01 ) and Caspase 9 ( control group:0.44 ± 0.05,experimental group:0.76 ± 0.06,P ＜ 0.01 ) were all increased.The activity of Caspase-3 was 0.325 ±0.089,which was significantly higher than that of the control group ( P ＜0.01 ).ConclusionHonokiol can significantly inhibit the proliferation and induce cell apoptosis of human acute leukemia cell line U937 cells.The mechanism is related to the up-regulation of Bax and down-regulation of Bcl-2,and the endogenous and exogenous pathways are both inolved in the apoptosis process.

Objective To study transforming growth factor ?_1 (TGF-?_1) expression in the lung of neonatal premature rats exposed to hyperoxia at different time. Methods 99 neonatal premature rats were assigned to hyperoxic group and air group randomly They were sacrificed at the postnatal 3 rd ,7 th and 14 th day,then their lungs were achieved for H.E staining and immunohistochemistry to measure the expression of TGF-?_1. The difference of TGF ?_1 expression were tested by rank-sum test. Results TGF-?_1 expression in hyperoxic group was always wider than that of air group at the corresponding period,and its expression in alveolar and bronchi epithelial cells as well as mesenchymal was stronger than that of control group(u respectively is: 49.0、14.0、63.0 at the 3 rd day;34.0、2.0、45.0 at 7 th day;and 32.0、13.5、33.0 at 14 th day (all P

Objective To evaluate the effects of laparoscopic filling with pedicled greater retina for hepatic cysts. Methods Clinical data were reviewed on 36 patients with hepatic cysts undergoing laparoscopic filling with pedicled greater retina from January 2010 to May 2014.The diameters of cysts ranged from 10 to 26 cm, with a diameter smaller than 20 cm in 29 patients and bigger than 20 cm in 7 patients.Laparoscopic fenestration of hepatic cysts was performed to destroy cyst cells with iodine and absolute alcohol. Pedicled greater retina was used for filling the cavity of cysts. Results The procedures were completed smoothly.The operative time was 45-115 min, with an average of (80.4 ±13.1) min.No abdominal cavity infection happened.Primary healing of abdominal incision was achieved in all the patients.The postoperative hospital stay was 5-10 d, with an average of (6.4 ±1.2) d.All the 36 patients were followed up for 6-12 months with a mean of (9.3 ±1.5) months.None of the patients showed recurrence under liver B-ultrasonography or CT scanning. Conclusion Laparoscopic filling with pedicled greater retina for hepatic cysts has advantages of minimal invasion, quick postoperative recovery, short hospital stay, and good results.

Objective To explore the risk factors of initial surgery and postoperative complications of Crohn's disease (CD).Methods The retrospective case-control study was conducted.The clinical data of 227 patients with CD who were admitted to the Cangzhou Central Hospital from April 2011 to July 2015 were collected.Treatment principles included reducing the clinical symptoms,promoting healing of intestinal mucosa under endoscopy,delaying CD progression and preventing intestinal exhaustion and related complications.The medication was performed in the early period.The resection of partial intestines was applied to patients if there was poor effect of medication or combined with intestinal obstruction,intestinal fistula,digestive tract perforation,abdominal abscess and complex anal fistula.Observation indicators:(1) treatment situation,(2) follow-up situation,(3) related factors analysis affecting initial surgery of patients with CD,(4) related factors analysis affecting postoperative complications of patients after initial surgery for CD.Follow-up using regular telephone interview and outpatient examination was performed up to May 2016.Follow-up included the wound infection,abdominal abscess,intestinal obstruction,anastomotic fistula and pulmonary infection.Measurement data with normal distribution were represented as-x ± s and comparison between groups was analyzed using the t test.Count data were represented as the proportion and analyzed by the chi-square test.The univariate analysis was done using the chi-square test and Kruskal-Wallis test,and multivariate analysis was done using the Logistic regression model.Results (1) Treatment situation:of 227 patients,68 underwent initial surgery and 159 didn't undergo surgery.The duration from diagnosis to initial surgery in 68 patients was (4.7 ± 2.5) months.Of 68 patients with surgery,28 received the emergency surgery and 40 received the selective surgery.Operation time and volume of intraoperative blood loss were (175 ±44) minutes and (285 ± 110) mL,respectively.The side-to-side anastomosis was conducted in 47 patients and non-side-to-side anastomosis in 21 patients.Other 159 patients without surgery received the medication of mesalazine,hydrocortisone,methotrexate and infliximab.(2) Follow-up situation:68 patients with initial surgery were followed up for 5-61 months,and 22 had postoperative complications.Of 9 patients with anastomotic fistula,6 had enterocutaneous fistula (5 patients with enterocutaneous fistula were improved by selective surgery,and the other patient was progress to acute diffuse peritonitis and then was improved by peritoneal lavage,adequate drainage and nutritional support therapy after emergency surgery).Three patients with anastomotic abscess were improved by adequate drainage.Six patients with secondary intestinal obstruction were improved by conservative treatment.Three patients with abdominal abscess were improved after antiinflammatory treatment and adequate drainage.Two patients with wound infection were improved by regular dressing change.Two patients with pulmonary infection were improved by anti-inflammatory and phlegm conservative treatment.(3) The related factors analysis affecting initial surgery of patients with CD.The results of univariate analysis showed that age of diagnosis,smoking history and behavior of disease were the related factors affecting initial surgery of patients with CD (Z =-2.120,x2 =5.082,50.512,P＜ 0.05).The results of multivariate analysis showed that A3 of age of diagnosis,B2 and B3 of pattern of disease were the independent risk factors affecting initial surgery of patients with CD [OR =15.624,10.535,28.509,95％ confidence interval (CI):4.856-29.375,3.609-17.637,8.526-79.228,P ＜ 0.05].(4) The related factors analysis affecting postoperative complications of patients after initial surgery for CD.The results of univariate analysis showed that preoperative levels of albumin (Alb) and hemoglobin (Hb),emergency surgery,operation time and anastomotic method were the related factors affecting postoperative complications of patients after initial surgery for CD (x2 =10.757,7.639,6.773,4.309,16.346,P ＜ 0.05).The results of multivariate analysis showed that preoperative Alb≤28 g/L,Hb≤ 100 g/L,emergency surgery and non-side-to-side anastomosis were the independent risk factors affecting postoperative complications of patients after initial surgery for CD (OR =9.592,8.849,6.538,12.645,95％CI:2.209-25.235,2.034-24.773,1.846-15.893,3.935-38.873,P ＜ 0.05).Conclusions The age of diagnosis ＞ 40 years,B2 and B3 of CD are high risk group of initial surgery.The poor preoperative nutritional status,emergency surgery and non-side-to-side anastomosis are independent risk factors affecting postoperative complications of patients after initial surgery for CD.

The paper introduced the hospital's attempt to build a scientific and practical set of performance evaluation system based on KPI.The system determines the quantitative indicators for the efficiency and performance of each department,and effectively helps accomplish common objectives of the hospital and its departments,playing a key role in the sustaimble development of the hospital.

Objective To explore the association between variation in genes related to lipid metabolism and the susceptibility of nonalcoholic fatty liver disease (NAFLD). Methods Obese children with fatty liver aged 6~18 years old were included. All of them got ultrasonic testing, routine examination and biochemical detection. In addition, the DNA of peripheral blood was extracted and the 36 target genes related to lipid metabolism were detected by next generation sequencing. Results In 368 obese children who met the inclusion criteria, 183 children (49.7%) were detected to have NAFL . 100 children with NAFLD and 100 children without NAFLD were randomly selected from obese children. The levels of body mass, waistline, alanine aminotransferase (ALT), triacylglycerol (TG), cholesterol, low density lipoprotein (LDL) and apolipoprotein B (ApoB) in NAFLD children were all higher than those in non-NAFLD children, and there were significant differences (P all<0.05). However, the levels of aspartate aminotransferase (AST), alkaline phosphatase (ALP), apolipoprotein A1 (ApoA1), fasting blood glucose, insulin, high density lipoprotein (HDL), free fatty acid (FFA) and insulin resistance index (HOMA-IR) were not significantly different between the two groups (P all>0.05). The levels of bilirubine in the two groups were within normal range. Logistic regression analysis showed that the genes of MTTP rs2306986 (OR=2.70, 95%CI: 1.38~5.27) and MTTP rs3792683 (OR=7.34, 95%CI: 2.04~26.50) that encode microsomal triglyceride transfer protein (MTTP or MTP), and the mutation of rs738409 (OR=2.11, 95%CI:1.31~4.48) in gene PNPLA3 that encode patatin-like phospholipase domain-containing protein 3 are the independent risk factors for the occurrence of the disease. Conclusion Genovariation of MTTP rs2306986, MTTP rs3792683, and PNPLA3 rs738409 may increase susceptibility to NAFLD in children.

Objective To study the effects of Vitamin D (VitD) supplementation on growth and immune function in neonatal mice.Methods A total of 120 mice were divided into four groups (30 mice in each group) according to dose of VitD.The high-dose group,medium-dose group and low-dose group was given 3.44,1.72,0.86 IU VitD drops,respectively.The control group was not treated with VitD drops.Rat body weight,level of peripheral blood 25-(OH)D3 were observed.The cellular immune function (determined by using delayed hypersensitivity reaction experiment),humoral immune function (assessed by antibody producing cells counts and HC50 determination) and mononuclear-macrophage phagocytic function (assessed by mouse peritoneal macrophage phagocytosis of chicken red blood cells test and carbon clearance test) were detected.The flow cytometry assay was carried out to differentiate T lymphocyte subsets.Results With the increase of dose of VitD,levels of peripheral blood 25-(OH)D3 and calcium ion were gradually increased,there were statistically significant differences when compared with the control group(P＜0.05);the body weight and body length were gradually increased,while no statistically significant difference was found among the groups treated with VitD(P＞0.05).Compared to the control group,the toes swelling,phagocytic percentage,number of antibody producing cells,serum soluble HC50 in the high-dose group and medium-dose group were increased significantly,while carbon clearance test phagocytic index were decreased significantly (P＜0.05).With the increase of dose of VitD,the number of CD4+,CD8+ T lymphocytes and the CD4+/CD8+ ratio were gradually increased.Conclusion VitD could promote the growth and development of offspring mice,and enhance the immune function of the body.