Persistent pulmonary hvpertension of newborn(PPHN) is a life-threatening condition which occurs at a rate of 2/1 000-6/1 000.The etiology of PPHN is still unknown and its treatment remains a major challenge for neonatologist.Impaired pulmonary artery relaxation,reduced blood vessel density and pulmonary vascular remodeling are the main pathological changes in PPHN.The general managements include mechanical ventilation,sedation,surfactant and hemodynamic support.Inhaled nitric oxide is the main vasorelaxant used in the treatment of PPHN.Several other vasorelaxants have been studied such as phosphodiesterase inhibitors,prostacyclin,endothelin-1 inhibitors.Even with the introduction of several new therapeutic modalities there has been no significant change in survival rate.

Objective:To analyze the probability of breast cancer with skin involvement and discuss the extent of removal of skin.Methods:Skin of the tumor surface was examined by series section in 40 cases of breast cancer.Results:Of the 40 patients,except 1 Paget disease,none of the rest was confirmed with skin involvement.The rate of skin involvement was 2.5%.Conclusion:If there are no abnormal clinical manifestation in skin,the extent of removal of skin shall not be enlarged and subcutaneous mastectomy with skin preservation can be accepted for early stage breast cancer.

AIM: To establish a method for determining isofraxidin and formononetin in Aidi Freezing Dried Powder for Injection(Radix et Rhizoma Ginseng,Radix Astragali,Radix et Rhizoma seu Caulis Acanthopanacis senticosi,etc.) by HPLC. METHODS: Chromatographic assay was performed on Hypersil C_(18) column(200 mm?4.6 mm,5 ?m).The mobile phase consisted of acetonitrile(A) and water(B).Gradient program was adopted as follows:0-15 min:16% A,15-45 min:40% A.The flow rate was 1.0 mL/min and the detection wavelength was 344 nm and 254 nm. RESULTS: Isofraxidin had a good linearity(r=(0.999 7)) in the range of 36.80-184.0 ?g/mL.The average recovery was 97.2%,and RSD=2.1%(n=9).Formononetin had a good linearity(r=0.999 7) in the range of 36.40-182.0 ?g/mL.The average recovery was 98.8%,and RSD=2.1%(n=9). CONCLUSION: The above method is simple,sensitive and accurate.It can be used for quality control of Aidi Freezing Dried Powder for Injection.

Objective To investigate the clinical and imaging features of the reversible posterior leukoencephalopathy syndrome(RPLS).Methods The clinical and imagig data of 9 patients with RPLS were analyzed retrospectively.Results Among the patients,4(44%)were secondary to pregnancy-induced hypertension syndrome,1(11%)was second to short bowel syndrome,1(11% )was second to acute lymphoblastic leukemia,1( 11% )was second to IgA nephropathy,and 2(22%)were second to hypertensive encephalopathy.Their mean age of symptom onset was 23.4 ± 9.9 years.Their main clinical manifestations were headaches,seizures,blurred vision,and consciousness disturbance.Magnetic resonance imaging(MRI)showed symmetrical lesions of bilateral white matter in posterior brain.T1 weighted imaging and diffusion-weighted imaging showed low or isointense signal.T2 weighted imaging,fluid attenuated inversion recovery(FLAIR),and apparent diffusion coefficient(ADC)map showed high-intensity signal.The symptoms of the patients disappeared after the treatment.MRI reexamination showed that the lesions disappeared completely or almost completely.Conclusions The causes of RPLS were different.The imaging mainly showed the signal of vasogenic brain edema on the posterior white matter of the brain.After timely treatment,the symptorms and imaging features were improved rapidly.The patients with young-onset RPLS are their important clinical feature.[Key wonds]Posterior leukoencephalopathy syndrome;Magnetic resonance imaaging;Hypertension;Age factors were improved rapidly.The patients with young-onset RPLS are their important clinical feature.

ObjectiveTo investigate the distribution of human immunodeficiency virus-1 (HIV-1)subtypes and the relationship with transmission routes in Shenzhen city. MethodsThe epidemiological survey was conducted in 429 subjects with HIV-1 infection.Vein blood was collected and prepared with anticoagulation.Thereafter,the viral nucleic acid was extracted and subsequently amplified for HIV-1 env,gag genes by reverse transcription nested polymerase chain reaction. The viral sequences were analyzed using Mega software and compared with those in HIV database. The HIV-1 subtypes were confirmed and evolutionary tree was established. The gene discrete rate of different subtypes was calculated.ResultsFour hundred qualified samples were identified as CRF01_AE (n=207),CRF07_BC (n=115),CRF08 _BC (n=14),CRF02_AG (n=1),B (n=49) and C(n=14),respectively.CRF01_AE was the predominant subtype that was detected in the subjects with different transmission routes,such as homosexual contact,heterosexual contact,intravenous drug use and hospital-acquired infection. Among these,sexual contact was the most common route.There were nine cases infected with subtype B HIV-1 in 10 case who were blood borne. The gene discrete rate was more significant in subtype B HIV-1 compared to the other subtypes.According to the evolutionary tree analysis,the viruses under the same subtype formed the relatively independent clusters by different transmission routes. But some overlaps were observed as well. Conclusions Tbere are many HIV-1subtypes in HIV-1 infected subjects in Shenzhen, while the recombinant viruses present as the predominant form.Transmission routes are various with sexual contact as the most common route.Every subset distributes unevenly and forms its own characteristic.Overlap can be observed among the gene distribution of different HIV-1 subtypes.

Objective To explore the curative effect of the pressure sore treated by iodophors associating with oxygen and peptide. Method 36 cases with pressure sore in stage Ⅲ and stage Ⅵ were randomly divided into the observation group and the control group. After ebriding was carried out in both groups, the control group was trea-ted with the rout change dressing and the other group was treated by iodophors associating with oxygen and peptide es-pecially. Result The cicatrization time of the observation group was remarkablely shorter than the control group. Conclusion Treating the pressure sore by iodopbors associating with oxygen and peptide has the advantage of less passion, shorter course of treatment, better curative effect, economy and mote convenience which is worth for the pro-moting of clinical usage.

Mother-to-child transmission (MTCT)is an important way of hepatitis B virus (HBV)transmission.Blocking the HBV MTCT has a great significance for the prevention and treatment of hepatitis B.This article reviews the current blocking strategies implemented in the antepar-tum,peripartum,and postpartum stages,and summarizes the controversies existing in the blocking strategies in different stages.The significance of HBV occult infection and germ cell transmission in the HBV MTCT is analyzed.The results indicate that the current strategies for the prevention of hepatitis B MTCT need further improvement.Attentions should be focused on HBV occult infection and germ cell transmission.

Objective To evaluate the safety and effects of feeding very low birth weight infants and extremely low birth weight infants with human donors' milk in China.Methods One hundred and ninety-nine very low birth weight infants and extremely low birth weight infants (VLBWI/ELBWI) admitted to NICU in Nanjing Maternity and Child Health Care Hospital were analyzed retrospectively (from August 1,2013 to July 31,2014) one year before and one year after the establishment of human donors' milk bank.Only 1 infant's parents(1/199 cases) refused to use donor milk,and 198 infants were fed with donors' milk since their own mothers' milk was unavailable.One hundred and forty-eight infants admitted to NICU from August 1,2012 to July 31,2013 were chosen as the control group,who were fed with formula milk since their own mothers' milk was unavailable.The mortality,incidence of necrotizing enterocolitis (NEC) and sepsis,time to full enteral feeding and hospital stay between 2 groups were analyzed.Results One year before the establishment of breast milk bank,there were 148 cases of very low or extremely low birth weight infants receiving mixed feeding,and 16 cases of them had neonatal necrotizing enterocolitis,the incidence rate was 10.81％.Since the establishment of human milk bank,187 women donated breast milk in the first year and 260 555 mL of human milk were collected and delivered.Only 1 infant (1/199 cases) refused to use donor milk,and 198 infants were fed with donors' milk since their own mothers' milk was unavailable.Nine babies with VLBWI/ELBWI were diagnosed as NEC in donor milk feeding group,and 16 cases were diagnosed as NEC in formula-feeding group.The incidence rate of NEC was lower in the donor-milk-feeding group (4.52％ vs 10.81％,x2 =5.02,P ＜ 0.05).Donor-milk-feeding group reached full enteral feeding[(16.4 ± 5.3) d vs (18.2 ± 6.2) d,t =2.84,P ＜ 0.05] and had shorter period of hospital stay[(35.1 ± 9.5) d vs (37.3 ± 10.4) d,t =2.05,P ＜ 0.05] compared with formula feeding group.The mortality and incidence of sepsis had no difference between 2 groups (all P ＞ 0.05).Conclusions Donors' breast milk is associated with a lower risk of NEC,sooner full enteral feeding and shorter hospital stay.Further research is needed to confirm these findings and measure the growth and long term neurodevelopment effects of donors' breast milk.

Objective:To pursue a scientific approach for medical equipment purchase, set up a standard purchase model, and try to transform the extensive and empirical way in purchase management into a scientific way.Methods: Analyze and test the data using linear regression method on yearly revenue, equipment value, yearly volume of work and yearly maintenance and repairs fee for 25 kinds of equipment in one hospital.Results: Assuming other parameters do not change, for each additional 10,000 yuan in equipment value, the revenue of the hospital increases by 14,858 yuan; for each additional 10,000 times in the volume of work, the revenue increases by 2,214,407 yuan; for each additional 10,000 yuan in maintenance, the revenue decreases by 132,683 yuan.Conclusion: Based on the scientific approach on equipment purchase management, we should improve the efficiency of medical equipment usage, scientifically mange the maintenance and repairs of equipment, in order to provide more accurate information and data for equipment purchase in hospital and make the purchase management more scientific, objective and rational.