Neonatal jaundice or hyperbilirubinemia is a common occurrence in newborns.Most cases of neonatal jaundice have a benign course.Hyperbilirubinemia can be best understood as a balance between the production and elimination of bilirubin,with a multitude of factors and conditions affecting each of these processes.When an imbalance results because of an increase in circulating bilirubin ( or the bilirubin load)to significantly high levels( severe hyperbilirubinemia),it may cause permanent neurologic sequelae( kernicterus),which is preventable if the hyperbilirubinemia is identified early and treated appropriately.Phototherapy for jaundice is a common treatment in neonatal medicine and is used to prevent the neurotoxic effects of bilirubin.Phototherapy for hyperbilirubinemia should be based primarily on total serum bilirubin levels of the infant's age in hours and other factors that affect the risk of bilirubin encephalopathy.

[Summary] Glucagon-like peptide-1 ( GLP-1 ) as a new treatment of type 2 diabetes, not only has hypoglycemic effect, but also plays an important role in the regulation of lipid metabolism. GLP-1 plays a unique role in regulating lipid metabolism via lipid absorption and transport, fat formation and decomposition, hepatic lipid metabolism, and cholesterol transport.

Objective To determine the range of total serum bilirubin(TSB) of healthy term newborns during the first post natal week in Huainan region of Anhui province and provide the theoretical basis for the neonatal jaundice intervention in this region.Methods The bilirubin analyzer for capillary blood was used to measure TSB level of 1257 healthy term newborns during the first post natal week,P25,P50,P75 and P95 were recorded at every time point,the peak serum bilirubin(PSB) and the time it appeared was observed.50 blood samples were randomly selected and the TSB level was measured by the routine laboratory method,at the same time,the serum bilirubin level was measured by bilirubin analyzer for capillary blood.Then,the linear correlation coefficient of capillary blood bilirubin level and TSB level was calculated and statistically analyzed,and at last got the linear regression model.The newborns'skin xanthochromia coverage scales and TSB levels were recorded in order to get the corresponding TSB level in terms of xanthochromia coverage.Results In this study,the serum bilirubin P25,P50,P75 and P95 of 1 257healthy term newborns were 58.64μmol/L,72.51μmol/L L,102.44μmol/L,120.35 μmol/L,respectively in the first day,2nd day 105.41μmol/L,119.72μmol/L,150.18μmol/L,185.30μmol/L,3rd day 128.85μmol/L,157.951μmol/L,191.22μmol/L,227.61μmol/L,4th day 160.24μmol/L,191.40μmol/L,216.65μmol/L,277.49μmol/L,5th day 164.26μmol/L,179.51 μmol/L,209.88μmol/L,263.74μmol/L,6th day 131.87mol/L,172.73μmol/L,195.57μmol./L,231.26μmol/L,and the 7th day 118.94μmol/L,157.57μmol/L,204.83μmol/L,223.84μmol/L,with PSB 294.46μmoL/L appeared at the fourth day.The correlafionship was existed between the capillary blood bilirubin measurement and the routine laboratory method (r =0.948,t =21.067).The TSB level was (1 12.3 ± 6.2) μmol/Lwhen the xanthochromiawas on thehead,(165.1 ± 2 6.7) μmol/Lon the chest,(214.0 ±30.8) μmol/L on the belly,(268.5 ± 28.2) μmol/L on the knee or elbow,and ＞ 271.7μ mol/L on the palm or sole of the foot.Conclusion The TSB variation rang is 120.35 ～ 223.84μmol/L within 7 days after their birth in Huainan region of Anhui province,capillary blood bilirubin is reliable in measuring serum bilirubin level of newborns ; visual assessment of xanthochromia coverage is also an easy and feasible way of estimating serum bilirubin level initially.

Objective To explore which operation and the accuracy of the detection method is better by exploring the correlation among three bilirubin detection methods.Methods 50 hospitalized neonates within 7 days after birth with visual jaundice were randomly selected.The total serum bilirubin level was measured by the routine laboratory method.At the same time,the serum bilirubin level was measured by bilirubin analyzer for capillary blood and transcutaneous bilirubin(TcB) measurement,then calculated the linear correlation coefficient of TcB level and TSB level,capillary blood bilirubin level and TSB level respectively to analyze their statistical significance,and get the linear regression model at last.Results Close correlation is existed between the capillary blood bilirubin measurement and the routine laboratory method,also the transcutaneous bilirubin measurement and the routine laboratory method.Moreover,the former is better than the later.Conclusion Capillary blood bilirubin is reliable in measuring serum bilirubin level of newborns.

Objective To learn about the mastery level of midwives and obstetric nurses about fetal monitoring knowledge.Methods 77 midwives and obstetric nurses attending a fetal monitoring education programme in Huaxi Second Hospital of Sichuan University were investigated by using a self-made questionnaire.Results Some respondents lacked of systematic training in fetal monitoring knowledge,and they could not accurately answer the purpose or contents of fetal monitoring,as well as the basic elements and related knowledge about fetal electronic monitoring.Most of the respondents focused on fetal monitoring in clinical practice,but neglected the corresponding frontier progresses.Conclusions The training and education on fetal monitoring knowledge should be strengthened to improve obstetric quality because of the unsatisfactory survey results in midwives and obstetric nurses.

Scenario-based teaching method can be applied in clinical skills training of obstetrics and gynecology,which increases practice opportunities of interns by imitating the real clinical work.For professional examination teaching,teachers and simulation models as simulated patients help interns improve inspection skills and provide error feedback timely; for emergency and severe diseases teaching,real cases combined simulation models,medical equipment,and multi-professional collaboration develop the clinical problem-solving competence of interns; for doctor-patient communication teaching,the communication skills of interns can be improved by scenario database which has been constructed by teachers; and for clinical skills test,the clinical practice quality of interns can be reflected accurately by integrating various clinical skill tests.Scenario-based teaching requires a large amount of scenario materials,as well as highly qualified teachers who can control the teaching process effectively.

Objective To study the chemical composition and the sources of indoor PM10 in some residential houses in Beijing. Methods PM10 samples were collected using cascade impactors in smoker's and non-smoker's homes in winter. The mass concentrations and enrichment characteristics of nineteen elements, such as Al, Si, and S in airborne particles were analyzed by proton induced X-ray emission (PIXE) and enrichment factor. Results The concentrations of 19 elements were higher in smoker's homes than those in non-smoker's homes in winter, especially K and S concentrations were 2-4 times of those in non-smoker's homes. Al, Si, S, K, Ca and Fe made greater contribution to concentrations of elements in PM10, of which K and S accounted for 72% of total elements in smoker's homes while Al, Si and Ca amounted to 57% of total elements in non-smoker's homes. Conclusion Al, Si, Ca, Ti and Fe come from natural sources while S, Zn, Pb, Cr, Cu, As, Cl and P originated from anthropogenic sources such as smoking, coal combustion and oil combustion.

Objective To study the optimal timing of tracheotomy in patients with acute cervical spinal cord injury who need ventilation for a long time . Methods A retrospective research on seventy-nine patients with acute cervical spinal cord injury who underwent tracheostomy in our hospital from January 2011 to December 2015 was conducted .The 79 patients were divided into two groups.The patients with a duration from intubation to tracheostomy less than or equal to 10 days were enrolled in group A , and the duration more than 10 days, group B.The duration of ventilation , the length of ICU stay , and the incidence rate of lung infection were compared between the two groups . Results The duration of ventilation in the group A (192 ±58) h was less than that in the group B (348 ±53) h (t=-12.490, P=0.000).The length of ICU stay in the group A (9.8 ±2.7) d was less than that in the group B (15.9 ±2.2) d (t=-11.058, P=0.000).The incidence of pneumonia in the group A (16.2%, 6/37) was lower than that in the group B (38.1%, 16/42,χ2 =4.686, P=0.030).Mechanical ventilation was successfully withdrawn in 34 and 38 cases of group A and B, without significant difference (χ2 =0.000, P=1.000). Conclusion Early tracheostomy in patients with acute cervical spinal cord injury who need ventilation for a long time could shorten the duration of ventilation and the length of ICU stay , and decrease the incidence of pneumonia .

Objective To investigate the relevant factors of early stage hyponatremia in patients with complete cervical spinal cord injury (CSCI). Methods A retrospective study was conducted in consecutive 49 individuals with complete CSCI from January 2010 to December 2015.The diagnostic criteria for hyponatremia was two consecutive tests (interval <24 h) of serum sodium <135 mmol/L.Twenty-six patients with hyponatremia were classified as hyponatremia group , and the other 23 patients without hyponatremia were classified as control group .Ten factors were included in the univariate analysis: age, gender, the highest level of CSCI , the degree of CSCI , the blood albumin when transferred to ICU , the serum sodium when transferred to ICU , the use of glucocorticoid , the incidence of neurogenic shock , the average daily urine output , and the average daily liquid balance .The variables with significance (P<0.05) in the univariate analysis then entered stepwise logistic regression analysis .The optimal critical point of the continuous variables with statistical significance in the univariate analysis was determined by drawing the receiver operator characteristic curve . Results There were differences in two variables between the two groups ( P<0.05 ) .The incidence of neurogenic shock before the occurrence of hyponatremia was 57.7% ( 15/26 ) in the patients with hyponatremia and 26.1% ( 6/23 ) in the patients without hyponatremia(χ2 =6.516,P=0.011).The average daily urine output was (2225 ±389) ml in the patients with hyponatremia and (1936 ±289) ml in the patients without hyponatremia (t=2.924,P=0.005).The stepwise logistic regression analysis indicated that these two factors may be the independent relevant factors (OR =13.708 and 0.996, P =0.004 and 0.002, respectively).The receiver operator characteristic curve demonstrated the average daily urine output more than 2331 ml was the optimal critical point . Conclusion The neurogenic shock and the average daily urine volume more than 2331 ml are the independent relevant factors of early stage hyponatremia in patients with complete CSCI .

0.05);the cost-effectiveness ratio(C/E)were9.48and9.16respectively.The cost for every one unit increment of effectiveness for gatifloxacin group was11.43yuan more than that of the levofloxacin group.CONCLUSION:Taking everything into consideration,levofloxacin was better than gatifloxacin in the treatment of urinary system infection.