The management of extremely low birth weigh infants is challenging,including how to communicate with family members,cooperation between pediatric and obstetrics,overall NICU management level,targeted and personalized management mode,and etc.In this article,clinical management experience for extremely low birth weigh infants was summarized,such as management at birth,stabilization of body temperature after birth,prevention and treatment of intracranial hemorrhage,infection,and blood transfusion management,as well post-discharge management.

With the development of the prenatal medicine, the survival rate of the premature has im-proved obviously. However,doctors should focus on the ethics problem whether treat the extreme survival and critical diseased premature is necessary. During the process,the attitude of parents and the medical care personnel impact the premature survival rate. Therefore, the role excellent communication skills and the hospital ethics committee to improve the premature rate and avoid the medical conflict should not be ignored.

Streptomycetes are Gram-positive bacteria of Actinomycetales. These organisms can produce many economically important secondary metabolites. With the development of molecular biology, gene sequencing technology and synthetic biology, people gained a better understanding of the Streptomyces family. The means to transform genome on the molecular level is also increasing. By simplifying the Streptomyces genome rationally and efficiently, it will improve the yield and quality of the metabolites as well as reduce the consumption of the substrates. Markerless knockout is an important way to carry out genetic modification. Here we describe novel genome modification techniques developed for Streptomyces in recent years with focus on the markerless knockout technologies.
Chromosomes, Bacterial ; genetics ; Gene Knockout Techniques ; methods ; Genes, Bacterial ; genetics ; Streptomyces ; genetics

ObjectiveTo study the changes and clinical significance of serum heart-type fatty acid-binding protein (H-FABP) and soluble ST2 protein (sST2) in children with chronic heart failure (CHF).MethodsThirty-nine children with CHF and 30 healthy children were recruited. Serum levels of H-FABP and sST2 were determined by ELISA, The left ventricular ejection fraction (LVEF) and fractional shortening of the left ventricle (LVFS) were measured by two-dimensional echocardiog-raphy.ResultsIn 39 children with CHF, 15 males and 24 females, aged 2 months to 14 years, included 27 cases of endocardial ifbroelastosis (EFE) and 12 cases of dilated cardiomyopathy (DCM). According to the cardiac functional grading standard, the children with CHF were divided into 10 cases with cardiac function II, 15 cases with cardiac function III, and 14 cases with cardiac function IV. The mean levels of H-FABP, sST2 and NT-Pro-BNP in children with CHF at stage of heart failure and heart failure remission were statistically higher than those in the healthy children (allP<0.01). The serum H-FABP and sST2 levels had signiifcant differences among groups grouped according to cardiac functional grading standard (allP<0.05). The serum H-FABP and sST2 levels had no signiifcant difference between the EFE and DCM groups (allP>0.05). The Spearman correlation analysis showed that, in children with CHF at stage of heart failure, the serum H-FABP level was positively correlated with NT-Pro-BNP, sST2 and cardiac function (r=0.402、0.621、0.644,P<0.05). Serum sST2 level was positively correlated with NT-Pro-BNP and cardiac function (r = 0.501、0.678,P<0.05), and was negatively correlated with LVEF and LVFS (r=?0.340、?0.329, P<0.05).ConclusionsH-FABP and sST2 are involved in the development of heart failure. H-FABP and sST2 can be used as reference indices for clinical diagnosis and assessment of CHF.

Periventricular leukomalacia ( PVL) is the most distinctive and characteristic brain injury in premature infants, which may result in nervous system sequelae, and affect motor development and quality of life of the infants. PVL lacks specific symptoms and the diagnosis of PVL depends on imagine. Transcranial ultrasound could make initial diagnosis and prognostic evaluation for PVL. Combined with MRI, it can assess the degree of the white matter damage and predict the possible adverse consequences, which could provide evi-dence for early treatment. The changes of brain imaging and their impact on the prognosis of PVL in preterm newborn was reviewed in this article.

Objective To investigate the effect of informational support on disease uncertainty in liver cancer patients undergoing interventional therapy. Methods Sixty patients of liver cancer patients undergoing interventional therapy were randomly divided into the intervention group and the control group with 30 in each.The control group was treated with general treatment and care. The patients in the intervention group were given general treatment and care with a series of informational support interventions. Patients in the two groups were measured by uncertainty in illness scale (MUIS) at the day of admission,before operations and discharged from hospital. The measurement results were statistically analyzed. Results There was significant decrease about disease uncertainty scores both on the day before operation and the day before discharge in the intervention group compared to the day of admission. The decreasing score of uncertainty in illness in the intervention group was significantly greater than the control group on the day before operation and the day before discharge. Conclusions A series of informational support interventions could significantly reduce the diseases uncertainty in liver cancer patients undergoing interventional therapy.

Objective In order to evaluate the efficacy of Diammonium Glycyrrhizinate in the treatment of chronic hepatitis B. Methods The randomized clinical trials(RCTs) that compared the efficacy of Diammonium Glycyrrhizinate and other kind of treatment in chronic hepatitis-B were chosen from CBM disks from 1995 to 2004 and CNKI from 1995 to 2004.A meta-analysis was employed to evaluate the results of these therapies. Results Twenty-four RCTs including 3201 cases were analyzed.Compared with control group,the total RR of efficiency rate of Diammonium Glycyrrhizinate group were 1.378(95%CI 1.243～1.529),showing significant difference(P

OBJECTIVE:To investigate the characteristics and influential factors of adverse drug reactions(ADRs)of docetax-el in our hospital,and to provide suggestions for clinical rational drug use and individualized administration. METHODS:Medical records of patients receiving anti-tumor chemotherapy were extracted from hospital information system(HIS)of our hospital during Apr. 2014 and Oct. 2015,and Docetaxel related ADR reports were collected and comprehensively analyzed by retrospective classi-fied statistics. RESULTS:Among 417 cases,105 cases of docetaxel related ADR were reported. There were 69 patients aged 50-69 with highest ADR frequency. The ADR incidence of female patients was higher than that of male patients (29.29% vs. 19.66%). The incidence of docetaxel related ADR and arrest of bone marrow increased as the increase of drug dosage;the incidence of breast cancer ADR was the highest (46.03%),followed by lung cancer (37.25%) and gastric cancer (25.00%). The incidence of docetaxel+platinum chemotherapy plan ADR was the highest (35.10%). Main organs/system involved in ADR was hematological system (55.65%). CONCLUSIONS:The individual difference of docetaxal related ADR are great and affected by several factors. Individual physical condition of patients should be taken into consideration as early as possible,which can reduce the incidence of ADR and promote clinical rational drug use.

Objective: To establish a rapid detection method for Salmonella based on the combination of enzymatic recombinase amplification (ERA) and lateral flow chromatography (LF), so as to provide technical support for the on-site detection of Salmonella. Methods: Specific ERA primers and probes were designed based on the highly conserved flagella gene fimY in Salmonella. The primers were screened using capillary electrophoresis, and the probes were designed according to the amplification range of the screened primers. The amplification temperature and time were optimized to establish the amplification method, and the product was detected using LF strips. A standard strain of Salmonella was used to verify the sensitivity, 10 other gut bacteria were used to to verify the specificity and sensitivity, and the nucleic acid of the actual Salmonella strains was amplified to verify the detectability. Results: After screening for Salmonella-specific primers using capillary electrophoresis, the minimum detection concentration was 5 copies/μL under the amplification temperature of 37 ℃ and reaction time of 20 minutes. This method had a positive amplification result for Salmonella nucleic acid, and the amplification results of 10 other gut bacteria were all negative, with good specificity. Conclusion This method provides a possibility for on-site point of care testing of Salmonella infection.

Objective To explore the influence of intubation-surfactant-extubation (InSurE)therapy combined with bilevel positive airway pressure (BiPAP)in the use time of mechanical ventilation,and to clarify the value of BiPAP in the treatment of respiratory distress syndrome in the preterm infants.Methods Toral 95 preterm infants with respiratory distress syndrome were treated with InSurE therapy during January 2011 to October 2014. Among them,the preterm infants before January 2013 were selected as control group who were treated with InSurE and nasal continuous positive airway pressure (nCPAP).After January 2013, 60 preterm infants were treated with BiPAP,as BiPAP group.The rates of InSurE failure,the need for mechanical ventilation (MV)on the 7th day after InSurE failure, total non-invasive ventilation time, total mechanical ventilation time, atmospheric oxygen therapy time and incidence of clinical complications were compared between two groups.Results ① There were no significant differences in the clinical data of the preterm infants between two groups, such as gender and age.② Although there was no significant difference in the failure rate of InSurE,but the rate of repeated mechanical ventilation during 1 week in BiPAP group was lower than that in control group (P <0.01).③ The Rank sum test result showed that the total time of non invasive ventilation in BiPAP group was longer than that in control group (P <0.01).The total time of invasive mechanical ventilation and oxygen therapy in BiPAP group was lower than that in control group (P < 0.05).④ The incidence of retinopathy of prematurity (ROP)and bronchopulmonary dysplasia (BPD)in BiPAP group was lower than that in control group.Conclusion BiPAP can significantly reduce the use of invasive mechanical ventilation after the failure of InSurE,thereby decreases the oxygen toxicity and barotrauma hazards.