Objective To study the efficacy and safety of pulmonary surfactant used in hyaline membrane disease(HMD)of newborn treatment.Methods 67 cases of HMD children were treated.And pulmonary surfactant was used by intratracheal instillation.Clinical manifestation,blood gas analysis,X-ray chest film and complication before and after treatment were observed and recorded.Results 65 cases of children were recovered and discharged(97.01％),while 2 cases were dead.The PO2 increased significantly after the surfactant was given(P＜0.05),while the PCO2 decreased significantly(P＜0.05),and situation of skin cyanosis was relieved.X-ray chest films in 24 hours showed that 62 cases were improved(92.54％),while 4 cases were not obvious(5.97％),and there was hemorrhage image in the last 1 caes(1.49％).There were 5 cases of complication,involving 3 cases of pneumonia,1 case of intracranial hemorrhage and 1 case of pulmonary hemorrhage.Conclusion Clinical symptoms could be impurved rapidly,pulmonary oxygenation could be ameliorated,the need of mechanical ventilation could be lower and the rate of incidence of complication and death could be reduced effectively by using pulmonary surfactant early.

Objective　To study the causes of failure to IOL implantation during cataract surgery.Methods　We reviewed 540 eyes in which 23 eyes were failed to implant IOL during cataract surgery.Results　Detachment of suspended zonular ligament, rupture of posterior capsule and vitreous prolapse are the main factors influencing IOL implantation during cataract surgery.Conclusion　Improvement of surgical technique and reduction of complications are the key points for the IOL implantation successfully during cataract surgery.

Objective To explore preventive effect of evidence-based nursing intervention program in patients at high risk of pressure ulcer in intensive care unit.Methods A total of 227 patients with risk evaluation score of Braden leas than 12 were randomly divided into the observation group (125 cases) and the control group (102 cases).The control group was only given regular nursing interventions.Patients in the observation group received evidence-based nursing interventions : including turning over per 2 hours, turning prostration to 30 degree left to fight inclined position, raising patient's head lower than 30 degree and putting a soft pillow under his/her heels; the patients whose risk evaluation score of Braden was less than 7, with cervical fracture or turning ever was limited by her/his situation needed to use air bed; comfeel transparent paste was used on the surface probably suffered from skin ulcer;, giving PN or EN according to patients' nutritional condition; keepping the skin around anus dryness.The incidence of pressure ulcer be-tween the two groups was compared.Results The incidence rate of pressure ulcer was siguificantly lower in the observation group than that in the control group.The occurring time significantly delayed and the sit-uation significantly better.Conclusions The evidence- based nursing inventions can lower the incidence rate of unavoidable pressure ulcer,reflect the scientific and artistic characteristics of nursing care, also effi-cient allocate limited nursing resources and reduce the incidence of pressure ulcer.

Objective To develop a rapid, sensitive and specific assay based on multiplex real-time PCR for detecting and identifying Escherichia coli O157: H7. Methods The lipopolysaccharide gene (rJbE) and H7 flagellar antigen gene(fliC) of Escherichia coli O157:H7 was chosen as targets, and then the primers and TaqMan-MGB probe were designed. The 5'end of probes was labeled with FAM and HEX fluo-resceins respectively; the 3'end of probes was labeled with MGB. The PCR reaction was optimized systemati-cally. Then the specificity, sensitivity and reproducibility of multiplex real-time PCR were estimated. Final-ly, multiplex real-time PCR was applied to detected clinical specimens. Results Escherichia coil O157:H7 were detected by multiplex real-time PCR accurately and quickly, which could distinguish Escherichia coli O157:H7 from O157: non-H7. Meanwhile, none of other bacteria could be identified. The sensitivity was 10 CFU/ml in pure culture. The coefficient of variation of intra-assay and inter-assay was less than 5%. When this assay was applied directly to identify 66 clinical specimens, the results showed that t5 were positive to Escherichia coil O157:H7 and 2 were positive to Escherichia coil O157: non-H7, in which 16 was the same to the results obtained from the conventional assays. The coincidence was 98.49%. Conclusion It is showed that multiplex real-time PCR is a reliable, accurate and feasible assay for detecting and identifying Escherich-ia coli Oi57: H7, The assay reported here provided a tool for analysis and diagnosis in the field of detecting clinical pathogens, epidemiologic survey and food safety monitoring.

Objective To observe the effect of Integrated Traditional Chinese and Western Medicine on persistent vegetative state (PVS) in children. Methods 7 children with PVS were treated with Integrated Traditional Chinese and Western Medicine, and were analyzed retrospectively. Results 3 childer were effectual, 3 improved, 1 ineffective. The PVS improved significantly after the treatment. The ones with course less than 3 months, the neuroimage show atrophy, appeared more effective. Conclusion The integrative therapy is effective on PVS in the children. The prognosis may associate with the course of the disease and the pathology of the brain.

OBJECTIVETo explore the effect of scalp acupuncture for children with cerebral palsy whose video-electroencephalogram(VEEG) showed epileptiform discharges.

METHODSA total of 184 children with cerebral palsy whose VEEG showed epileptiform discharges or those combined with epilepsy were randomly assigned into a combination group (99 cases) and a rehabilitation group (85 cases). All the cases were treated with the original antiepileptic drugs. The conventional physical training and massage were applied in the rehabilitation group for 3 courses with 20 d at the interval, once a day, 5 times a week and 15 times as one course. Based on the treatment as the rehabilitation group, scalp acupuncture was used in the combination group for 3 courses with 15 d at the interval, once the other day and 10 times as one course. Shenting (GV 24), Benshen (GB 13), Sishencong (EX-HN 1) were selected as the main acupoints, combined with motor zone, foot motor-sensory area, balance zone,and temple-three-needle etc. Clinical onset and VEEG results were observed before and after treatment.

RESULTSAfter treatment in the combination group, 27 cases improved; 47 cases had no effect; 25 cases aggravated. While in the rehabilitation group, 11 cases improved; 46 cases had no effect; 28 cases aggravated. There was no statistically significance between the two groups (>0.05). As for the cases with epilepsy onset in the combination group, 8 cases improved; 4 cases had no effect; 4 cases aggravated. In the rehabilitation group, 4 cases had no effect; 7 cases aggravated. The result in the combination group was better than that in the rehabilitation group (<0.05). As for the cases with epileptiform discharges in the combination group, 19 cases improved; 43 cases had no effect; 21 cases aggravated. In the rehabilitation group, 11 cases improved; 42 cases had no effect; 21 cases aggravated. There was no significance between the two groups (>0.05).

CONCLUSIONSScalp acupuncture therapy does not increase the risk of onset or epileptiform discharges in the children with cerebral palsy combined with epilepsy or epileptiform discharges. Scalp acupuncture combined with rehabilitation is better than simple rehabilitation for thosewith cerebral palsy and epilepsy onset.