Objective To study the relationship between exon gene polymorphism of pulmonary surfactant pro-tein B(SP -B)and the susceptibility and severity,prognosis of respiratory distress syndrome (RDS).Methods To detect the gene sequence of SP -B exon by adopting the gene sequencing technology,and samples were 80 prematures of very low birth weight in Southern Han Chinese,who were divided into 2 groups,the RDS and the non RDS,and the difference of genotype in SP -B exon in 2 groups was compared.Results There was no significant difference between 2 pretem groups in the aspects of the gestational age,sex,birth weight and delivery mode etc(all P >0.05).Fifty -nine prematures of very low birth weight had exons heterogenesis,and there were 2 types of mutations,V1 :Exon2:c.[5A >C]+[5A >C]or c.[5A >C]+[=];V2:Exon5:c.[428C >T]+[428C >T]or c.[428C >T]+[=].There were 20 cases of type V1 ,1 8 cases of type V2,3 cases of type V1 +V2 in 45 cases of RDS,and there were 1 2 cases of type V1 ,9 cases of type V2,no case of type V1 +V2 in the non RDS group.Comparing the incidence of V1 and V2 in 2 groups,there were all significant differences(χ2 =3.73,5.02;all P <0.05),and the OR values of 2 polymorphisms to RDS were 3.33 and 4.00,but there was no significant difference in mutation cases and non mutation cases in RDS group when comparing severity and prognostic(χ2 =0.07,P >0.05).Conclusion Gene polymorphism of SP -B exon are risk factors for premature of very low birth weight in southern Han Chinese in RDS.

Objective To test the attachment quality of autism children between 2～6 years with attach-ment Q-Sort,and to understand the difference from normal children. Methods Use the AQS to test the parents of 167 normal children and 55 autism children,which can evaluate the children' attachment types. Results The rate of security attachment in normal children was 68.3% ,and the rate of unsure attachment was 31.7%. The rate of security attachment in autism children was 29.1% ,and the rate of unsure attachment was 70.9% ;and the rates of security attachment in normal and autism children were different significantly(X2=26.16, P<0.01). Attachment quality was not associated with sex both in normal and autism children and neither age was. Conclusions Most of the normal children have the security attachment,and the autism children have the unsure attachment. Neither age nor sex is associated with attachment quality both normal children and autism children.

ObjectiveTo explore the control factor of pulmonary microvascular endothelial cells in pulmonary hemorrhage with the RhoA-Rock pathway inhibitors.MethodsHuman pulmonary rnicrovascular endothelial cells were conventionally cultured,and were divided into four groups:control group,inhibitor group,hypoxia group and hypoxia group with inhibitor.As different fluorescein lsothiocyanate-phalloidin and filamentous actin (F-actin) in cytoplasm combined,it issued red fluorescence.We observed the dynamic changes of F-actin by laser scanning confocal microscope in hypoxia human pulmonary microvascular endothelial cells and recorded the value of fluorescence.ResultsThe mean fluorescence intensity of F-actin of hypoxia group in 1 h,12h and 24 h was (64.3 ±5.5)％,(60.3±4.2)％,and (47.8 ±4.6)％ as compared with the control group;the ratio of hypoxia group with inhibitor was (66.2 ±3.2)％,(67.1 ±6.2)％,and (72.5 ± 6.1 ) ％ as compared with the control group.The mean fluorescence intensity of F-actin decreased obviously after 1 h hypoxia treated to cells,decreasing to (64.3 ± 5.5 ) ％ of the control group (P ＜0.05 ) ;to 24 h,decreasing to (47.8 ±4.6) ％ of the control group(P ＜0.05).The mean fluorescence intensity of F-actin decreased to (66.2 ± 3.2) ％ of the control group after 1 h hypoxia treated in inhibitor group,which was more than 1 h in the hypoxic group.F-actin decreased obviously to (72.5 ± 6.1 ) ％ of the control group after 24 h hypoxia treated in inhibitor group.There was significant difference comparing with the hypoxia group after 24 h hypoxia(P ＜0.05).The mean fluorescence intensity of F-actin of inhibitor group without anoxic was invariant comparing with the control group(P ＞0.05).Cortex-like structure disappeared and the stress fibers arranged disorderly after hypoxia.Actin depolymedzated and broke gradually with the extension of hypoxia time.If to be hypoxic after pretreated with RhoA-Rock pathway inhibitor,cortex-like structure by the composition of pednuclear F-actin reappeared,distribution and arrangement of stress fibers in the cytoplasm tended to rule.ConclusionThe RhoA-Rock pathway mediates the damage on F-actin of pulmonary microvascular endothelial cells after hypoxia.Interfering with the RhoA-Rock pathway inhibitors can provide a new direction for the treatment of neonatal pulmonary hemorrhage.

OBJECTIVE:To investigate the efficacy and mechanism of ademetionine for treating hyper-unconjugated bilirubinemia in neonate rats.METHODS:The model of hyper-unconjugated bilirubinemia was established in 95 neonate SD rats by subcutaneously injection of phenylhydrazine hydrochloride,then the rats were randomly assigned to model control group(treated with normal saline),therapeutic control group(phenobarbital/nikethamide)and the therapeutic group(s-adenosyl-1-methionine)q.d for 7 days all by intraperitoneal injection.Blood samples were taken at different time for the analysis of the hepatic BUGT activity and serum bilirubin.RESULTS:In therapeutic control group compared with the model control group,the serum unconjugated bilirubin was lower,and the hepatic BUGT activity of therapeutic was higher(P

Objective To estimate the effection of orbital blowout fracture when Medpor was implanted to restore it. Methods The plastic operations on 15 patients with orbital blowout fracture were reviewed and studied. Results On discharge from the hospital, function and outline form was improved greatly in all cases. Conclusion Early diagnosis, early treatment and early movement training after surgery were emphasized. Medpor is one of the preferred material on reparing orbital blowout fracture.

Objective Compare the difference on vision,vision field between treating on central retinal artery with compound anisodine retrobulbar injection associate with emporat artery side injection and emporal artery side injection simply.Estimate the curative effect of the two ways on the disease.Methods Observe the patients'vision,vison field and cross-check,analyze the results who have central retinal artery and there are 20 who treated by compound anisodine retrobulbar injection associate with emporal artery side injection together with 20 who treated by emporal artery side injection purely.Results The therapeutics that is compound anisodine retrobulbar injection associate with emporal artery side injection is excellence to 10,effective to 6 and ineffective to 4;the therapeutics that is arter3,side injection purely is excellence to 5,effective to 5 and ineffective to 10.The two therapeuticses has significant difference on improving vision and ameliorating vision field.Conclusion It's quite effective to treat central retinal artery occlusion by compound anisodine retrobulbar injection associate with emporal artery side injection.

Objective To explore effect of different postures for PICC intubation through basilic vein in very low birth weight infants. Methods Eighty infants from Oct. 2013 to Sep. 2014 with PICC via basilic vein were set as the control group in which traditional method of preventing catheter displacement was applied, another 80 cases from Oct. 2014 to Sep. 2015 were divided to the observation group. And improved method was applied in the experiment group besides the traditional method. The ectopic occurrence rates of the two groups were compared. Result The ectopic rate of PICC catheters in the observation group was significantly lower than that of the control group (P<0.05). Conclusion When the catheter tip reaches the shoulder of the very low birth weight infants, the method of raising their upper limbs slightly to the head can reduce the ectopic incidence of catheters and thereby improve the success rate of PICC intubation.

Objective To explore the effect of Vitamin K1(Vit K1), fresh frozen plasma (plasma) andcryoprecipitate on prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen original(Fbg), thrombin time (TT) of newborns with different gestational ages. Methods The serum of 1,134 newbornsfrom The Third Affiliated Hospital of Guangzhou Medical University was collected from February 2009 to September2012. All newborns had been divided into four groups (according to the gestational age of 28-31+6 weeks, 32-33+6weeks, 34-36+6 weeks and gestational age≥37 weeks).The effect of various interventions (Vit K1, Vit K1+plasmaand Vit K1+cryoprecipitate) on PT, APTT, Fbg, and TT had been recorded. Results (1)The PT and APTT ofeach group with the interventions of Vit k1 were significantly improved (P < 0.05). (2)The PT, APTT, Fbg and TTof each group with the interventions of Vit k1 combined with plasma were significantly improved (P < 0.05). (3)ThePT, APTT and Fbg of each group with the interventions of Vit k1 combined with cryoprecipitate were significantlyimproved (P < 0.05). (4)With Vit k1 combined with plasma, PT and APTT were mostly improved and Fbg wasimproved mostly with Vit k1 combined with cryoprecipitate. Conclusion Vitamin K1, fresh frozen plasma andcryoprecipitate can effectively improvedin the coagulation index of newborns with different gestational ages.

Objective To analyze the correlative factors of neonatal deaths in neonatology department to improve the treatment level and reduce the death rate of the hospitalized newborn patients.Method The medical records and death review data of the infants who died in the neonatology department of the Hospital from 2009 to 2015 were retrospectively reviewed.They were assigned to three groups according to the therapeutic measures before their death,including comfort care group,do not resuscitate (DNR) group and active treatment group.Gestational age,birth weight,postnatal age at death and the direct cause of death were compared between groups by x2 test.Result A total of 337 infants were enrolled in this study.There were 112 cases (33.2％) in the comfort care group,73 cases (21.7％) in the DNR group and 152 cases (45.1％) in the active treatment group.Compared to the proportion of the different group during 2009-2012,the proportion of the comfort care group during 2013-2015 significantly increased(38.9％ vs.27.2％,P =0.023),and the proportion of the active treatment group significantly decreased (38.3％ vs.52.5％,P =0.009),while the proportion of the DNR group showed no significant difference (22.9％ vs.20.4％,P =0.580).The proportion of the comfort care group was significantly higher in the group of neonates who died in early neonatal period than that in the late neonatal period and post-neonatal period (42.9％ vs.9.3％,P ＜0.001),while the proportion of the active treatment group and DNR group decreased(17.9％ vs.30.9％,P =0.009;39.2％ vs.59.8％,P =0.001).The proportion the comfort care group increased with the decrcasing gestational age and birth weight (P =0.001 and 0.002).Of the 34 term infants,the top two principle causes of death were severe asphyxia (4.1.1％,14.cases) and congenital defects (32.4％,11 cases).Of the 303 preterm infants,the top three direct causes of death were neonatal respiratory distress syndrome (31.4％,95 cases),neonatal pulmonary hemorrhage (22.4％,68 cases) and congenital defects (6.3％,19 cases).Conclusion The proportion of comfort care and DNR was higher than the proportion of active treatment before the newborns' death and it was relative to gestational age and birth weight.Preterm infants were the predominant population of the infant deaths in the neonatology department.Neonatal respiratory distress syndrome was the principle cause of death in preterm infants,and severe asphyxia was the main cause of death in term infants.

The article explored the cause of recovery failure by adopting advanced simu-lation system(ECS) in the teaching of ‘recoveing of neonatal asphyxia’and put forward some improvement methods and counter measures.Marking full use of the advantages of ECS,designing the training course with specifit roles and objectives,paying attention to the guidance of organiza-tion and exchange as well as the training of cooperative team are the key to improve the skills of neonatal asphyxia recovery in obstetrical pediatric and the teaching quality.