Objective To study the clinical factors of sclerema neonatorum complicated with pneumorrhagia and propose therapy and control measures in order to.improve clinical treatment.Methods27 cases of sclerema neonatorum complicated with pneumorrhagia treated in Chaozhou Central Hospital from January 2005 to December 2007 were investigated retrospectively.Results In all 96 cases of sclerema neonatorum,27 Were complicated with pneumorrhagia.mortality of which was 67%.9 cases of pneumorrhagia without mechanical ventilation died totally.Early tracheal intubation discovered 9 cases of pneumorrhagia,mortality was 56%.5 cases died within the 6 oronasal emissing blood,taking up 83%in mortality.There were significant differences between them(P＜0.05).Conclusion The incidence of pneumorrhagia in sclerema neonatorum was closely related to fetal month,age,scleredema degrees,acidosis,birth weight ect.The more severe scleredema,the lower birth weight and the fewer fetal month were,the higher incidence rate was.

Objective To investigate the access to online health information in community residents.Methods The online health information behaviors in residents of 10 communities in Baiyun District, Guangzhou, China, were in-vestigated with questionnaires and analyzed by SPSS 19 .0 .Results Of the community residents included in this in-vestigation, 25%were positive in access to online health information on general gate website and commercial health information service website, 74.34%showed their concern for food safety information, 52.30%focused their con-cern on disease symptom information, and 66.79%were unable to differentiate true information from false informa-tion.Conclusion The community residents have a low positivity and lack of awareness in access to online health in-formation.It is thus pressingly necessary to build the government-dominated online health information platform, and improve the commercial network model and the ability of community residents to differentiate true information from false information.

Teaching information retrieval course in two phases for students of 8-year clinical medicine was de-scribed in aspects of its contents, organization, teaching material construction and examination methods.Its results were analyzed according to the written examination score, report on a special topic, group report and feedback of students.Measures were put forward for further improving the classroom teaching results, namely effective linking of teaching contents, careful section of retrieval topics, selection and training of teachers.

ObjectiveTo analyze the clinical manifestation of hemolytic disease of the newborn (HDN) due to anti-M and Rhesus system.MethodsClinical information was collected and analyzed for three cases with HDN due to anti-M and 64 with Rhesus hemolytic disease, who were admitted to Department of Neonatology, Beijing Children's Hospital Affiliated to Capital Medical University from February 2011 to January 2015, as well as another 28 cases of HDN due to anti-M with complete information retrieved from literature in Wanfang and China National Knowledge lnfrastructure (CNKI) Database from 1992 to 2014.Chi-square test was performed for statistical analysis.ResultsTwo out of the 64 Rh hemolytic babies gave up therapy due to kernicterus and another two out of the 31 MN hemolytic babies, obtained from literature, died 24 h after birth because of anemia or edema, while the rest survived. Although more babies were the first child of the family in HDN due to anti-M than those of Rh hemolytic disease [26%(8/31) vs 9%(6/64),χ2=4.487, P=0.034], but lower incidence of jaundice [81%(25/31) vs 98%(63/64),χ2=9.686,P=0.002], less proportion of presentation of jaundice within 24 h after birth [29% (9/31) vs 64%(41/64),χ2=10.279,P=0.001] and lower positive rate of direct antiglobulin test [39%(12/31) vs 100%(64/64), Fisher exact test,P=0.000] were shown in HDN due to anti-M. No significant difference was found in the incidences of hyperbilirubinemia [58%(18/31) vs 66%(42/64),χ2=0.513], severe hyperbilirubinemia [23%(7/31) vs 36%(23/64),χ2=1.724], anemia [81%(25/31) vs 89%(57/64),χ2=1.253] and severe anemia [29%(9/31) vs 34%(22/64),χ2=0.271] between HDN due to anti-M and Rh hemolytic babies (allP>0.05).ConclusionsHDN due to anti-M and Rhesus hemolytic disease can cause severe pathological jaundice and/or anemia in newborns. Indirect antiglobulin test should be offered when direct antiglobulin test is negative which is helpful in the diagnosis of HDN due to anti-M.

Surgery combined with postoperative stereotactic radiosurgery (SRS) can improve the overall survival and becomes one of main treatments for resectable brain metastases. Compared with postoperative SRS, preoperative SRS (Pre-SRS) has theoretical advantages of reducing the dissemination of active tumor cells into the treatment cavity during surgery, reducing radiation dose, reducing radiation to surrounding normal brain tissue, and ensuring successful implementation of perioperative treatment, etc. Recent clinical studies have confirmed that Pre-SRS can reduce local recurrence rate and the incidence of radiation necrosis (RN) and leptomeningeal metastasis (LMM). Moreover, the indications, dose fractionation, and combined therapy remain to be confirmed by more prospective studies. In this article, research progress in Pre-SRS for resectable brain metastases was reviewed.

Objective To investigate the relationship between the level of serum triglyceride and early pain after posterior lumbar interbody fusion.Methods A total of 79 patients who were admitted into our hospital from March 2016 to December 2016 were selected into the study,and these patients were divided into two groups according to the degree of pain which means 32 cases in the minor pain group and 47 cases in the intermediate pain group.The difference of serum triglyceride level 3 days after operation were compared between the two groups.Pearson correlation analysis was performed to test the correlation between the level of serum triglyceride and early post-surgical pain.Logistic regression analysis was performed to test the risk factors for early post-surgical pain.Results The data indicated the level of pain was significant higher in the intermediate pain group than that of the minor pain group.Level of serum triglyceride had a significantly positive correlation with the level of post-surgical pain and it was the risk factor of pain after posterior lumbar interbody fusion.Conclusion The level of serum triglyceride is the risk factor of early post-surgical pain of lumbar single level interbody infusion,and it should be adjusted in the perioperative treatment.

Objective The study aimed to identify risk factors of lumbar disc herniation in patients after decompression,and provide theoretical basis for postoperaive rehabilitation.Methods A told of 169 patients with lumbar spinal stenosis underwent bilateral partial laminectomy were included in the study,24 patients in herniation group,and 145 patients without develop postoperative acute sciatica as a control group.The radiographic variables were measured.The threshold of risk factors was evaluated by multiple logistics analysis and receiver operating characteristic curve(ROC) analysis.Results The results revealed that preoperative retrolisthesis during extension was the independent risk factor for lumbar disc herniation(1.24,95％CI[1.07～1.43];P<0.01).The area under the curve(AUC) was 0.801,and the cutoff value was 6.89％.Conclusion The preoperative retrolisthesis was the risk factor of lumbar disc herniation.

Objective:To explore the clinical effect of percutaneous vertebroplasty (PVP) at stage I in treatment of acute multi-segment osteoporotic vertebral compression fracture (OVCF) in the elderly with over 3 vertebrae operated.Methods:A retrospective case-control study was conducted to analyze the clinical data of 105 aged patients with acute multi-segment OVCF admitted to Honghui Hospital, Xi'an Jiaotong University from October 2015 to February 2019. There were 27 males and 78 females, aged 65-92 years [(73.0±14.5)years]. All patients received stage I multi-segmental PVP and standard anti-osteoporosis treatment. There were more than 3 operative vertebral segments in 30 patients (observation group) and less than or equal to 3 operative vertebral segments in 75 patients (control group). The operation time, intraoperative fluoroscopy frequency, cement injection volume, cement leakage rate and incidence of recurrent vertebral fractures were compared between the two groups. The visual analogue scale (VAS), Oswestry disability index (ODI) and activity of daily living (ADL) score were compared before operation, 1 day, 1 month after operation and at the last follow-up.Results:All patients were followed up for 11-13 months [(12.5±1.8)months]. The observation group showed operation time of (71.2±12.2)minutes, intraoperative fluoroscopy frequency of (38.8±6.4)times and cement injection volume of (20.2±4.6)ml, more than those in control group [(52.3±10.6)minutes, (25.4±5.3)times, (12.3±4.3)ml] ( P<0.05). There was no significant difference in cement leakage rate and incidence of recurrent vertebral fractures between the two groups ( P>0.05). No complications such as infection, nerve damage or cement implantation syndrome occurred. Before operation, 1 day after operation, 1 month after operation and at the last follow-up, the VAS in observation group [(7.6±0.7)points, (3.0±0.8)points, (2.3±0.7)points, (2.2±0.6)points] showed no significant difference from those in control group [(7.4±0.5)points, (2.9±0.4)points, (2.1±0.5)points, (2.0±0.5)points], the ODI in observation group [(74.6±3.3)%, (36.8±4.6)%, (29.7±4.0)%, (24.0±3.6)%] did not differ from those in control group [(73.8±1.0)%, (35.1±0.9)%, (28.4±2.2)%, (22.8±0.9)%], the ADL score in observation group [(34.5±5.0)points, (54.5±3.8)points, (73.7±3.9)points] were similar with those in control group [(36.2±3.4)points, (56.8±4.7)points, (75.3±5.3)points, (81.3±4.5)points] (all P>0.05). The postoperative VAS, ODI and ADL score in both groups were significantly improved in comparison with preoperation ( P<0.05). Conclusion:For acute multi-segment OVCF in the elderly with over 3 or not more than 3 the vertebrae operated, PVP at stage I has the same advantages in early pain relief and improvement of motor function and quality of life.

Objective:To compare the clinical efficacy of percutaneous vertebroplasty (PVP) and non-surgical treatment of patients with type I fracture according to the acute symptomatic osteoporotic thoracolumbar fracture (ASOTLF) classification.Methods:A retrospective case-control study was used to analyze the clinical data of 115 patients with ASOTLF admitted to Honghui Hospital of Xi'an Jiaotong University from January 2015 to December 2018. There were 48 males and 67 females, aged 65-92 years [(75.3±8.5)years]. According to clinical symptoms and imaging characteristics, all patients were identified with type I fracture according to the ASOTLF classification. Injury segments were at T 6 to T 10 in 10 patients, at T 11 in 15, at T 12 in 26, at L 1 in 34, ay L 2 in 18, at L 3 in 7, and at L 4 in 5. A total of 73 patients received PVP combined with anti-osteoporosis treatment (surgery group), and 42 patients received non-surgery combined anti-osteoporosis treatment (non-surgery group). Before treatment, at 1 day, 1 month, 3 months, 6 months after treatment, and at the last follow-up, the visual analogue scale (VAS) was used to assess the pain, the Roland Morris Disability (RMD) score to assess the spinal function, and the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) score to evaluate the quality of life. The bone mineral density was compared between groups before treatment and at 1 year after treatment. The complications were observed as well. Results:All patients were followed up for 12-18 months [(13.2±4.6)months]. At 1 day, 1 month, and 3 months after treatment, the VAS in surgery group [(3.9±0.6)points, (3.3±0.6)points, (2.9±0.3)points] was significantly lower than that in non-surgery group [(6.0±0.7)points, (5.0±0.8)points, (4.2±1.0)points, respectively] (all P<0.05); the RMD score in surgery group [(15.2±0.7)points, (12.6±0.7)points, (10.6±0.7)points] was significantly lower than that in non-surgery group [(16.4±0.8)points, (14.6±0.8)points, (12.7±0.6)points, respectively] (all P<0.05). At 1 day and 1 month after treatment, the QUALEFFO score in surgery group [(46.0±1.1)points, (41.4±0.8)points] was lower than that in non-surgery group [(50.3±0.8)points, (44.7±1.2)points] (all P<0.05). There was no statistically significant difference between the two groups at other time points of the above indicators ( P>0.05). At 1 year after treatment, the bone mineral density in surgery group was (-3.0±0.9)SD, and was (-2.8±1.1)SD in non-surgery group ( P>0.05). There was no significant difference in the incidence of complications between surgery group [37%(27/73)] and non-surgery group [33%(14/42)] ( P>0.05). Conclusion:For patients with ASOTLF type I fracture, PVP and non-surgical treatment has similar effects in anti-osteoporosis and occurrence of complications, but the PVP is superior to non-surgical treatment in early pain relief, spinal function improvement and quality of life.

Objective: To summarize the clinical features of 7 rare cases of hemolytic disease of newborn (HDN), and to improve the understanding of rare HDN. Methods: Data of clinical information, laboratory findings, treatments and outcomes were collected and analyzed for four cases with HDN due to anti-M, two cases due to anti-Kidd, and one case due to anti-Duffy. All of them were admitted to the Department of Neonatology, Beijing Children's Hospital Affiliated to Capital Medial University from July 2007 to June 2017. Results: Among the four MN hemolytic babies, two were males and two were females. Jaundice was found in three cases. Two cases had hyperbilirubinemia, one of them had severe hyperbilirubinemia. All the four cases developed anemia, including severe anemia in three cases. Two cases of Kidd hemolytic disease and 1 case of Duffy hemolytic disease had jaundice and anemia, but did not reach the level of severe hyperbilirubinemia and severe anemia. MN hemolytic disease babies got negative results in direct antiglobulin test, whereas the Kidd and Duffy hemolytic disease babies had positive findings in direct antiglobulin test. None of the babies had blood transfusion, and they were discharged from the hospital. Conclusions Without maternal and fetal blood group incompatibility (ABO or Rh blood-group system), for early onset of jaundice, severe jaundice or anemia, antiglobulin test to mother and child earlier should be administered, and MN, Kidd, Duffy and other rare hemolytic disease of the newborn should be pay attention to.