Neonatal pain is a common phenomenon. For a long time neonatal pain had not been focus on properly and managed appropriately. American Academy of Pediatrics Committee on Fetus and Newborn and Section on Anesthesiology and Pain Medicine published policy statement to emphasize the necessity of neonatal pain assessment,and summarize the neonatal operability pain assessment method,drug and non-drug control measures,also update prevention and management of procedural pain in the neonate in 2016. Until today the guideline for neonatal pain management has not yet been released in China. As the reference for clinicians in domestic,the content of policy statement will be reorganized and introduced.

ObjectiveToinvestigateRUNX3genepromoter methylationincolorectal carcinogenesis and its prognostic significance. MethodsThe protein expression of RUNX3 was detected by immunohistochemistry and the methylation status of the RUNX3 was determined by methylation-specific PCR (MSP) in colorectal normal mucosa and cancer tissue from 65 patients,and adenoma from 28 patients.5-year overall survival rate was analysed according to RUNX3 methylation status from cancer patients.Kruskal-Wallis rank sum test,x2 or Fisher's exact test,Log-rank test and multivariable Cox regression analysis were used for statistical analysis.ResultsThe protein expression of RUNX3 gene in adenoma and cancer was 85％ (24/28) and 52％ (34/65),significantly lower than that in normal mucosa 94％ (61/65)( x2 =4.328,P =0.037 ; x2 =16.675,P =0.000),the difference between adenoma and cancer tissue was no statistic significance (x2 =3.266,P =0.071 ).No case showed RUNX3 methylation in normal mucosa,methylation rates in adenoma and cancer tissue were 21％ (6/28) and 35％ (23/65),significantly higher than in normal mucosa (P =0.000 ),but there was no statistic significance between adenoma and cancer tissue (x2 =1.766,P =0.183).The protein expression rate with RUNX3 methylation was 67％ (4/6) in adenoma,unmethylation 91％ (20/22) (P =0.191 ).The protein expression rate with RUNX3 methylation was 26％ (6/23) in cancer,unmethylation was 88％ (28/32).The presence of RUNX3 methylation was related to loss of protein ( x2 =9.810,P =0.002 ).5-year total survival rate with methylation in cancer was significantly lower with unmethylation ( x2 =5.87,P =0.016 ).Multivariate analysis showed RUNX3 methylayion wasanindependentprognosticfactoramongthefactorsanalyzed(P=0.033 ).ConclusionsRUNX3 methylation is important genetic event in colorectal carcinogenesis,possibly related to protein downregulation,and an independent prognostic factor for colorectal carcinoma.

Blood transfusion therapy is one of the commonly used intervention in newborn infants.Red blood cell transfusion is the only treatment for most cases of neonatal anemia,but the indications of application and implementation strategy are not yet perfect,and the benefits,adverse outcomes and potential risk of transfusion remains to be evaluated.There are many uncertain problems in transfusion management.This paper mainly introduces the evidence-based recommendations of neonatal blood transfusion released by Italian Society of Transfusion Medicine and Immunohaematology and Italian Society of Neonatology Working Group for reference of domestic clinicians.

As a widely accepted and convenient method,the Apgar score has been applied to assess the status of the newborn infants and the response to resuscitation since 1952.But the Apgar score has also been used inappropriately in infants to predict specific neurologic outcomes in many cases.The Apgar Score produced by American Academy of Pediatrics(AAP) in collaboration with American College of Obstetricians and Gynecologists(ACOG),updated policy statements of the Apgar score in October 2015.The Apgar score has limitations,and it is not appropriate to use it alone to establish the diagnosis of asphyxia;the method does not predict individual neonatal mortality or neurologic outcome.AAP/ACOG encourages the use of an expanded Apgar score reporting form that accounts for concurrent resuscitation interventions.

Measles is an acute viral disease, almost all deaths cases of measles in children occur in developing countries each year.Despite the availability of a safe and effective vaccine, measles is still one of the main causes of death of children in global area.2015 report of Committee on Infectious Diseases of American provided evidence of clinical diagnosis, treatment and prevention of measles.

Neonatal hypoxic-ischemic encephalopathy as a standard term has been used for over 30 years,but now increasingly being questioned.Most experts recommend using neonatal encephalopathy instead of hypoxic-ischemic encephalopathy.The American College of Obstetricians and Gynecologists and The American Academy of Pediatrics published separately the report of Task Force on Neonatal Encephalopathy Neonatal Encephalopathy and Neurologic Outcome,Second Edition in 2014.Definition,diagnosis and treatment of neonatal encephalopathy and other content have been updated in the report.It is recommended that a comprehensive multidimensional assessment be performed of neonatal encephalopathy.This article will introduce the controversy about neonatal encephalopathy or hypoxic-ischemic encephalopathy and contents of the report of Task Force on Neonatal Encephalopathy.

Bronchiolitis is a common lower respiratory tract viral infection in infants.Incidence of bronchiolitis is greatly increasing in recent years,and seriously affecting the health of children.In order to better manage bronchiolitis,American Academy of Pediatrics (AAP) convened a new subcommittee to review and revise the 2006 bronchiolitis guideline.This evidence-based guideline amended to provide new evidence of diagnosis,treatment and prevention bronchiolitis for the clinician.

Objective To analyze the clinical features of patients with traumatic brain injury in the Ya' an earthquake and discuss the treatment experiences.Methods Medical records of 69 patients admitted from April 2013 to May 2013 because of traumatic brain injury in the Ya' an earthquake were collected.Retrospective review was performed for age,gender,causes of injury,time from injury to hospitalization,types of injury,associated injury,treatment methods and outcomes.Results There were 47 males and 22 females.Forty-two patients (61％) were injured from falling objects.Fifty-eight patients (84％) were sent to the West China Hospital within 72 hours postinjury.Twenty-two cases (32％) sustained associated injuries.Twenty-nine patients (42％) were critically injured.Twenty-four patients underwent operation at the local hospital and twelve patients had operation at our hospital.Outcome measure using GOS one month after treatment showed 55 favorable recovery,5 moderate disability,4 severe disability,and 5 coma.Conclusions Main cause of injury is hit by falling objects during the Ya' an earthquake.Majority of the patients obtained effective treatment in the time window.GCS in combination with patients' general condition used in casualty triage and critical patients charged by neurosurgeons and treated with the cooperation of multiple disciplinary teams are helpful to successful treatment.

Objective To assess the effectiveness and safety of Azithromycin for preventing bronchopulmonary dysplasia(BPD) in preterm infants in order to provide reference for the clinical treatment of BPD.Methods The electronic retrieval were conducted to review randomized controlled trials (RCTs) from The Cochrane Library,PubMed,EM-Base,China Biological Medicine Database (CBM),Chinese Journals full-text Database (CNKI),Chinese Technological Journals Database(VIP) and Wan Fang Digital Journal Full-text Database by free texts and medical subject headings.The retrieval time was from inception to Dec.2012.Randomized or quasi-randomized studies were conducted by comparing Azithromycin therapy and no treatment or placebo management to prevent BPD among the preterm or low birth weight infants were included.The reference lists of relevant trials and conference proceedings were searched.Risk biases of the trials were assessed.Statistical analysis was performed by using Revman 5.1 offered by Cochrane.Results A total of 2 trials including 328 preterm infants were included.No significant difference was observed between the Azithromycin group and the control group in the incidence of BPD(RR =0.81,95％ CI 0.55-1.19).The risk ratio of death and post-natal steroid used in the Azithromycin group were lower,but there was no difference.The risk ratio of length of stay was not significantly different.The rate of BPD in preterm infants who had a positive respiratory culture of Ureaplasma between the preventative Azithromycin group and the placebo group showed that the incidence of BPD was significantly less in the Azithromycin group.Conclusions The available data are insufficient to make a recommendation regarding treatment with prophylactic Azithromycin to prevent BPD in preterm infants.More RCTs with large-scale and high-quality are required to provide more reliable evidence.

A stimulate method for determination of polybrominated diphenyl ethers ( PBDEs) and derivatives (OH-PBDEs and MeO-PBDEs), tetrabromobisphenol A (TBBPA), hexabromocyclododecane (HBCD) in egg samples was developed by gel permeation chromatography ( GPC) and dispersive solid phase extraction ( DSPE) combined with liquid chromatography tandem mass spectrometric ( HPLC-MS/MS) and gas chroma-tography-negative chemical ionization mass spectrometry ( GC-NCI/MS ) . The analytes were extracted with mixture of hexane and dichloromethane (1∶1, V/V) by accelerated solvent extraction (ASE), and purified by 100 mg C18 dispersive solid phase extraction ( SPE) sorbents followed with gel permeation chromatography (GPC) , and then analyzed by liquid chromatography tandem mass spectrometric (HPLC-MS/MS) and gas chromatography-negative chemical ionization mass spectrometry (GC-NCI/MS), respectively. The quantita-tion was carried out external standard method. The recoveries of objects were 64. 5%-97. 2% and 65. 6%-109 . 2% ( except BDE85 was 54 . 8%, OH-BDE-137 was 47 . 4%) spiked at 1 . 0 μg/kg or 5 . 0 μg/kg in egg white and egg yolk, respectively. The relative standard deviations (RSDs) were less than 20. 2%. The limits of quantitation (LOQ) for the object were 0. 01-0. 2 μg/kg.