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.

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.

[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 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.

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 investigate the curative effect of cephalosporins in the treatment of neonatal infectious pneumonia and the effect on intestinal microflora.MethodsA total of 124 cases of neonatal pneumonia in our hospital were divided into the cephalosporin group (40cases), the piperacillin group (38 cases) and the combined treatment group (46 cases), and 40 healthy neonates were selected as healthy group.The clinical efficacy was compared.The intestinal bacterial genus of the four groups was examined on the 5th day after treatment, including Enterobacter, Bacteroides, Enterococcus, Bifidobacterium and Lactobacillus.ResultsThe cure rates of the cephalosporin group, the piperacillin group and the combined group were 82.5%, 81.57% and 89.13%, respectively.The healing time of the above three groups was (5.3±0.2) d, (5.5±0.3) d and (5.2±0.3) d, respectively.Enterobacteriaceae, Bacteroides, Enterococcus and Lactobacillus were significantly more in the above three groups than the healthy group, and Bifidobacterium was fewer than healthy group (P<0.05).There was no significant difference between the cephalosporin group and piperacillin group.ConclusionThe curative effect of cephalosporins is similar to other antibiotics in the treatment of neonatal infectious pneumonia.The former can effectively relieve alteration of intestinal flora, combined with other drugs.Irrational use of antibiotics woll increase alteration of intestinal flora.

Amyotrophic lateral sclerosis is a progressive neurodegenerative disease that targets motor neurons without efficient treatment. Stem cell receives the enormous attention because it from specific tissues can differentiate into motor neuron. Stem cells from specific tissues could be used for amyotrophic lateral sclerosis, such as embryonic stem cells, neural stem cells, bone marrow mesenchymal stem cells, umbilical cord blood-derived stem cells and induced pluripotent stem cells. The mechanism of stem-cell therapy includes cell-replacement, delivery neurotrophic factors and immunomodulation. Animal researches and some clinical trails have confirmed that stem cells have great potential to treat neurodegenerative diseases. Till now, people are still unknown some aspects of stem cells, and many problems still need to be resolved.

Objective To study the causes of early death of patients with acute severe cervical spinal cord injury.Methods A retrospective analysis was done on 78 cases of acute severe cervical spinal cord injury,who were treated in our hospital between January 2003 and December 2007.The patients were divided into death group and survival group(survived more than 30 days after the injury).The clinical data including age,level of spinal cord injury,time of injury and admission,surgical treatment,duration between injury and surgery,neurogenic shock,central hyperthermia,hyponatremia,serum level of albumin,percentage of lymphocytes in serum,tracheotomy,and pulmonary infection,were recorded and analyzed. Results The proportion of high-level spinal cord injures(C1-C4) in death group(8/9) was significantly higher than that in the survival group(49/69,?2=18.086,P=0.000).Whereas the duration between injury and surgery in the death group was significantly shorter than that in the survival group(1-12 d,median 2 d vs 1-39 d,median 3 d;Z=-2.664,P=0.008).In the death group,4 of the 9 patients had neurogenic shock,and 4 developed hyponatremia,which were significantly more than those in the survival group(6/69,?2=12.392,P=0.000;19/69,?2=4.526,P=0.033).The percentage of peripheral lymphocyte on admission was(11.84?5.80)% in the death group,which was significantly lower than that of the survival group(19.17?16.64)%(t=-4.006,P=0.000).In the death group,7 patients received tracheotomy,and 8 patients showed pulmonary infection,the proportions were significantly higher than those in the survival group(10/69,?2=29.749,P=0.000;and 15/69,?2=17.266,P=0.000).Conclusions Several factors,including high-level injury(C1-C4),neurogenic shock,pulmonary shock,and tracheotomy,may cause the death of patients with acute severe cervical spinal cord injury in an early stage.

Objective:To Study the equity of Chinese health systems performance and provide evidence for strengthening health system.Methods:Based on WHO health systems performance evaluation framework,the provincial data of expanded pilots under the national health service investigation and relative concentration index (RCI) were used to study the inequality of Chinese health systems performance from regions,income and education,etc.Results:The RCI values were lower than 0.1 on health status and satisfaction dimensions.The RCI of financial risks protection was higher than 0.2,which was at a respective higher level.Conclusion:The health performance of people with lower education and wealth were fragility and these people usually with health shocks.Therefore,the national and regional government should pay more attention on vulnerable group and provide more healthcare management and security support.

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.