Objective To explore the correlated factors of bilirubin neurotoxicity. Methods From July 2007 to October 2007, 53 hospitalized patients with jaundice in neonatal ward of Peking University Third Hospital were enrolled in the study. The relationship between serum free bilirubin and parameters of brainstem auditory evoked potential(BAEP) was analyzed to screen the sensitive index of bilirubin neurotoxicity. Multivariate analysis was conducted between the sensitive parameter and various factors. Results Partial correlation analysis showed that the wave Ⅴ latency was positively correlated to serum free bilirubin(r=0. 228, P= 0. 020) after the corrected gestational age was controlled. There were no correlation between other latencies or interwave intervals and serum free bilirubin. Linear regression showed the equation was wave Ⅴ latency= 9.721-0. 082 × corrected gestational age+0. 064 × bilirubin/albumin+ 0. 504 × acidemia(F= 7. 534, P＜0.01). Conclusions Wave Ⅴ latency is the sensitive indicator of bilirubin neurotoxicity, which is correlated with the value of bilirubin/albumin and acidemia.

Objective To investigate the regulation of metabolize characteristic of some antibiotics in ACST in human bile, and provide the theoretic basis for physician selecting antibiotic rationally when biliary tract has been infected. Methods Samples of ACST in human bile were obtained by ERCP + ENBD, contents of Cefradine, Cefoperazone, Ceftriaxone, Ciprofloxacin and Lomefloxacin in human bile were simultaneously measured by HPLC method. Results After antibiotics were given through iv 0. 25 ～ 1. 5 hour, an increase was observed in contents of all antibiotics in bile, and the changes of Ceftriaxone and Ciprofloxa-cin were the most significant ( P <0.01). Ceftriaxone and Ciprofloxacin had a higher Cmax than other antibiotics, and Cefoperazone had a longer tl/2. Conclusion As maintaining a little time to tmax , a higher Cmax and a longer tl/2 in the bile by iv, Cefradine and Ciprofloxacin are recommended in the patient with ACST.

OBJECTIVE To ascertain the causes of unreported hospital infection in our hospital and apply countermeasures. METHODS To adopt investigation way to review and analyze 34 694 hospital files in our hospital from Aug 2002 to Jul 2004. RESULTS From them 1164 cases had experienced hospital infection,264 were unreported,the monthly unreported rate decreased from 52.50% to 0;the yearly unreported rate decreased from 36.17% to 10.67%. CONCLUSIONS The unreported reason is because the relevant staff lack infection knowledge,the control and supporting system isn′t so efficient.So the key to reduce the missing report rate is to enhance the awareness of the hospital infection control among the staff in hospital,to strengthen communication and cooperation,and to implement the administrative regulation.

Objective To study the expressions of Hsp70,P27,Bcl-2 in mucoepidermoid carcinoma of salivary glands and clinical significances.Methods Forty cases of mucoepidermoid carcinoma of salivary glands were chosen and the expressions of Hsp70,P27,Bcl-2 were detected by the method of immunohistochemistry,10 cases of polymorphic adenoma were chosen as control group.Results Both Hsp70 and P27 were stained with aliomycin in nucleus and cytoplasm,the positive rates of them were 75% and 27.5%,respectively,there were significant differences compared with control group(P0.05).The expressions of Hsp70 and P27 had significant differences in different clinical stages,different histological grades and lymph node metastasis(P0.05).Conclusion The expressions of Hsp70 and P27 can be used to estimate prognosis of patients with mucoepidermoid carcinoma.Hsp70 and Bcl-2 can inhibit apoptosis by different ways.

Objective To evaluate the clinical effects of early endoscopic therapy for elderly patients with acute severe biliary pancreatitis.Methods Ninety-two elderly patients with acute severe biliary pancreatitis were randomly divided into 2 groups:ERCP group ( n =43) and non-ERCP group ( n =49).Serum TNF-a,IL-6,IL-8,the recovery time of blood amylase,the duration of abdominal pain,hospitalization,mortality and complications were compared.Results ERCP group showed a greater decrease in serum TNF-α,IL-6 and IL-8 levels than the control group ( 45.16 ± 13.48 ) μg/L v.s.( 176.89 ± 47.35 ) μg/L,(31.76 ± 13.85)μg/L v.s.(68.48 ±24.87) μg/L,(113.39 ±63.78) μg/L v.s.(309.86 ± 117.13)μg/L) (P ＜0.05 ).The duration of abdominal pain,the recovery time of blood amylase and hospitalization in ERCP group were significantly shorter compared to the non-ERCP group [ ( 10.2 ± 1.7 ) d v.s.( 13.2 ±2.4)d,(3.3 ±1.0)dv.s.(5.5 ±1.2)d,(15 ±1.6)dv.s.(20±3.0)d] (P＜0.05),and complication rate of the ERCP group was lower,too (5％ v.s.22％,P ＜ 0.05).Conclusion Early ERCP is safe and highly effective for the elderly patients with acute severe biliary pancreatitis.

Objective To investigate whether the genetic variant rs10830963 of melatonin receptor 1B(MTNR1B)gene is associated with increased risk for gestational diabetes mellitus (GDM).Methods Eighty-seven GDM subjects(GDM group)and 91 normal pregnant women (control group)were randomly recruited form Women and Children's Hospital of Quzhou,Zhejiang Province,China.The allele and genotype frequencies of the rsi0830963 in MTNR1B gene were determined in all participants with PCR amplification and DNA sequencing.The allele and genotype frequencies of rs10830963 were compared to determine their differences between GDM subjects and normal controls.In addition,multiple linear regression was conducted to investigate the association patterns of the risk allele with fasting glucose and HbAlc levels.Results Both GG genotype and G allele frequencies of the rs10830963 loci in the GDM group were significantly higher than those in the controls,and women with G allele and GG genotype were associated with increased GDM risk(OR=1.53,95％ CI:1.005-2.324,P=0.047 and OR=2.16,95％ CI:1.052-4.434,P=0.034 respectively).After adjusting for age,body mass index before pregnancy,and family history of diabetes mellitus,women carrying GG genotype still had a higher GDM risk(OR =2.07,95％ CI:1.048-4.372,P =0.022).Multiple linear regression showed that the rs10830963 G allele was positively correlated with higher levels of fasting glucose(0.068 mmol/L,P=0.015)and HbAlc(0.073％,P=0.028).Conclusions Genetic variant rs10830963 in MTNR1B gene may contribute to the susceptibility to GDM in Chinese population and the rs10830963 G allele is a risk factor for the GDM susceptibility.

Objective To investigate the influence of nursing intervention on perioperative psychological status and treatment compliance of patients undergoing breast augmentation. Methods 82 patients were investigated with self-rating anxiety scale (SAS), self-rating depression scale (SDS), self-designed mental activity questionnaire on patients with breast augmentation. And they were divided into the intervention group(42 patients) and the control group(40 patients) randomly. The control group was given routine treatment and nursing. The intervention group received systematic nursing intervention such as psychological needs,confidentiality, the relevant specialist knowledge and explanation and prevention o complications besides routine treatment and nursing care. The perioperative psychological status and treatment efficacy were compared between the two groups. Results The worrying degree about operation - related problems was lower in the intervention group compared with that of the control group, but SAS and SDS score showed no significant difference one day before operation between the two groups. SAS and SDS score of the intervention group were improved before discharge compared with those before operation and were also better than those of the control group. Conclusions Patients undergoing breast augmentation surgery subject to a variety of perioperative psychological barriers, systematic nursing intervention can significantly improve the psychological state and treatment compliance, make them to acquire the unification of perfect body shape and psychology with best physical and mental status during perioperative stage.

OBJECTIVE To overcome shortcomings in use of bed sheet,and to improve it for examining bed.METHODS Based on the working principle of the reel toilet paper and industrial drive belt,a reel device for(disposable) whole bed sheet was designed,and used on the bed examining more than 300 times.(RESULTS) The new designed reel aevice with disposable whole bed sheet was operated easy and safely,with decreased cost and(contamination) in use.It could alleviate infection opportunity in favor of control againt hospital infection and(environmental) protection.(CONCLUSIONS) The device can mount on any size of examining bed and widely accept for use.

OBJECTIVE To analyze 28 cases in an outbreak of neonatal enterovirus nosocomial infection during summer of 2006.METHODS Demographic characteristics,clinical manifestations,laboratory data and outcome were analyzed to reveal the clinical severity.RESULTS The outbreak lasted more than one month and the nosocomial infection rate increased to 6.4%.There were 22 cases(78.6%) first presented with fever.Half of the patients were detected enterovirus from blood or cerebrospinal fluid by PCR.All of the 28 cases were diagnosed enterovirus infection based on the contact history,clinical signs and laboratory results.Among them,ten cases had viral meningitis.All patients discharged home after hospitalization with no sequelae.CONCLUSIONS Although this group of neonatal enterovirus infection developed viral meningitis,they had relatively mild illness with benign clinical course.Extreme vigilance is required in interrupting the spread of nosocomial enterovirus infections in neonatal units.This includes respect of strict hygiene measures and meticulous hand-washing.

Objective:To explore whether the inequality of economic development in different provinces in China leads to differences in pediatric nurses ′ health education literacy and to analyze related factors affecting pediatric nurses ′ health education literacy. Methods:Self-designed and tested online questionnaire of competencies in health education (scoring scale 10-50) were distributed to pediatric nurses in China in October 2018. We examined the influencing factors of competencies in health education and its relationship with the province-level data on gross domestic product (GDP) per capita.Results:A total of 15 443 pediatric nurses from 31 provinces were eligible for the analysis. At the regional of GDP per capital over than 20 000 US dollars, 15 000 to 20 000 US dollars, 10 000 to 14 900 US dollars and less than 10 000 US dollars, the health education literacy scores were 40.76±4.52, 40.66±4.08, 40.50± 4.02 and 39.69±4.32 respectively. Significant difference was found between the competencies in health education of pediatric nurses and provinces with different GDP per capita ( F value was 9.21, P<0.001). Regression and hierarchical analysis models based on GDP per capita showed that: nurses with senior professional titles, bachelor degrees or above, aged over 40, and those working in emergency rooms have higher competencies in health education ( OR value was 0.296-4.766, P<0.05) . Lower competencies in health education were demonstrated on nurses who have been working less than 5 years ( OR value was 0.319, P<0.05). Conclusions:Economic development is one of the main factors that affect the competencies in health education of pediatric nurses in China. Pediatric nurses who were young, had limited working experience, with low office titles, with low education background, and who working at non-emergency rooms require more training.