Based on multiple painless needle insertion skills in clinic combined with own experience, the authors propose the opinion that different painless needle insertion methods need to be used according to the positions where acupoints are. The appropriate needle insertion mean must be selected in accord with the anatomical characteristic of acupoint position, namely, tapping insertion is applied in scalp part, skin-pinching up needle insertion is used in forehead and superficial nerve trunk, fingernail-pressure needle insertion in ocular region and positions where large blood vessels distribute, flying acupuncture insertion in face and finger tip, vibrating needle in occipitonuchal region, quivering insertion in abdomen, quick pricking by single hand in the four limbs and back, and chop acupuncture in palm and pelma. The insertion methods are systematically discussed in terms of preparation, acupoint position, manipulation and attention, etc, so that to provide the reference for painless needle insertion.
Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Humans ; Meridians ; Needles

Patent ductus arteriosus (PDA)is a common disease among premature neonates and the management of which has always been a challenge to the neonatologists. Early treatment has been advocated as the first-line approach, and drug induced closure is yet the most effective, inexpensive, and convenient method. During the last two decades,indomethacin was often given as conservative treatment, and its closure rate in PDA was approximately 46% ～ 89%. However,indomethacin may increase the number of undesirable or harmful effects including renal damage, intraventricular hemorrhage, necrotizing enterocolitis, and enterobrosis,etc. Recently,ibuprofen is rapidly emerging as a new promising drug for treatment of PDA in preterm infants with closure rate of 73.0% ～95.5%. It is used as standard therapy to close PDA,and it has less influence on the hemodynamics of kidneys, brain and gastrointestinal tract. The surgery is needed in patients with drug treatment failure and cardio-pulmonary function damage.

Objective To observe the serum estradiol level in newborns at different gestational age and the infants with retinopathy of prematurity (ROP), and explore the relationship between these changes and ROP. Methods A total of 178 newborns hospitalized in the Children's Hospital of Fudan University were enrolled in the study. They were divided into three groups based on the gestational age, ＜ 32 weeks group, 32-37 weeks group and term group. The three groups were further divided into non-oxygen and oxygen subgroups. Infants with birth weight less than 2000 g were evaluated for ROP and those diagnosed as ROP were under ROP group (n=6). Serum estradiol levels were measured every week from birth to discharge with radioimmunoassay. Results Serum estradiol levels of newborns quickly declined after birth. In the non-oxygen subgroups, serum estradiol levels in 32 ～ 37 weeks group were remarkably higher than those of term group in the first week [(3506±1376) pmol/L vs (1717±179) pmol/L,P＜0. 05] and the third week [(1431±92) pmol/L vs (996±102) pmol/L, P＜0. 05]; Serum estradiol levels in ＜32 weeks group was only remarkably higher than those of term group in the first week [(3173± 1369) pmol/L vs (1717± 179) pmol/L,P＜0. 05]; Serum estradiol level in the ＜32 week group was (560±355) pmol/L, lower than that in the 32-37 weeks group [( 1124 ± 128) pmol/L] (P＜0. 05). There was no difference of serum estradiol levels in the oxygen and non-oxygen subgroups of the same group. There was no significant difference of serum estradiol levels between the ROP group and ＜32 weeks group. Serum estradiol levels in ROP group was lower than that of premature group without ROP at 29 and 32-36 weeks of corrected gestational age, but no statistical difference was shown. Conclusions Very low serum estradiol level in premature infants may be related to the development of ROP, but further clinical studies are required.

Objective To estabolish an optimal animal model of oxygen-induced retinopathy(OIR) suitable for examining pathogenesis and therapeutic intervention for retinopathy of prematurity(ROP). Methods Fifty-four 7-day-old C57BL/6J mice were devided into two groups. Twenty-seven mice in hyperoxic group were exposed to 75% oxygen for 5 days and then to room air for another 5 days. Twenty-seven mice in normoxic control were exposed to room air for 10 days. The proliferative neovascular response was estimated by observing the vascular pattern in adenosine diphosphate-ase(ADPase) stained retina flat-mounts and quantitated by counting the number of new vascular cell nuclei extending into the internal limiting membrane in cross-sections. Results Angiography in ADP ase stained retina flat-mounts delineated the entire vascular pattern. Hyperoxia-induced neovascularization occurred at the junction between the vascularized and avascular retina in the mid-periphery in all mice exposed to hyperoxia. After 5 days of exposure to hyperoxia at postnatal day 12(P12),the larger central radial vessels became tortuous and constricted and central perfusion became decreased obviously. After return to room air for 2 days at P14,neovascularization was seen. This response was maximal at P17. There was a mean of 44 neovascular nuclei per cross-section extending into the vitreous in hyperoxia compared to less than 2 nuclei in the normoxia control ( P

Objective To explore the effect of comprehensive rehabilitation on patients with knee ankylosis and contracture of popliteal fossa after severe burn. Methods 35 patients with severe burn on lower limb (containing the around skin of popliteal fossa) accepted exercise therapy, hydrotherapy, occupation therapy (including pressure therapy), electrotherapy, etc. They were assessed with Functional Independence Measure (FIM), range of motion and muscle strength of knee before and after treatment. Results The scores of FIM, range of motion and muscle strength of knee improved after treatment (P<0.01). Conclusion Comprehensive rehabilitation can improve activities of daily living and function of knee after severe burn.

Objective To predict the risk of neonatal hyperbilirubinemia by transcutaneous bilirubin (TcB) nomograms and clinical risk factors.Methods Healthy term and late-preterm newborns (≥ 35 gestational weeks,and birth weight ≥ 2 000 g) born in Guizhou Maternal and Child Care Hospital between January 1,2013 and December 31,2013,were included.TcB levels were continuously recorded within 168 hours after birth.The value of hour-specific TcB nomogram combined with receiver operating characteristic (ROC)curves and Logistic regression model for predicting risk of hyperbilirubinemia was evaluated.Pearson's Chisquare test was also used for statistical analysis.Results A total of 5 250 cases were enrolled.TcB increased rapidly in the first 40 hours after birth,slowly increased between 40 to 96 hours,and reached a high level after 96 hours.Among them,the 95th percentile TcB stablized at 96 hours after birth.The 40th,75th and 95th percentile TcB peak levels were 173,217 and 248 μmol/L.Among the 5 250 neonates,there were 277 cases (5.3％) in the high-risk zone within 72 hours.The positive predictive value (PPV) was 22.02％;1 087 cases (20.7％) and 1 854 cases (35.3％) were in the medium-high risk and medium-low risk zones along with the PPV of 10.58％and 3.72％,respectively.There were 2 032 cases (38.7％) in the low-risk zone with the PPV of 1.38％.Multivariate analysis showed that the TcB high-risk zone after 72 hours was associated with gestational age,delivery mode,feeding mode and TcB level of risk zones within 72 hours.Compared to those born at ≥ 40 gestational weeks,those born at ≥ 37-＜40 gestational weeks were more likely in the TcB high-risk zone after 72 hours (OR=1.80,95％CI:1.29-2.51).The likelihood was reduced by 42％ among neonates born with cesarean section compared to those delivered vaginally in term of the TcB high-risk zone after 72 hours.Infants who received mixed feeding were less likely to be in the TcB high-risk zone after 72 hours when compared to breastfed infants (OR=0.51,95％CI:0.29-0.88).With the reduction of the high-risk zone level within 72 hours,the likelihood in the TcB high-risk zone after 72 hours was also decreased.ROC curve showed that the area under the curve (AUC) for predicting hyperbilirubinemia was 0.75 and its 95％CI was 0.72-0.78,with a sensitivity of 90.00％ and specificity of 40.00％.The AUC of a combination of predictive results obtained by the Logistic regression model with significant variables in univariate analysis and high-risk zone after 72 hours was 0.66,and its 95％CI was 0.62-0.69.AUC estimated by Logistic regression model according to the TcB levels of risk zones within 72 hours combining with clinical risk factors was 0.79,and its 95％CI was 0.76-0.82 (P＜0.01).Conclusions Hour-specific TcB nomograms of newborns in our hospital have been obtained,which facilitates the prediction and early intervention of neonatal hyperbilirubinemia.

Traditional Chinese medicine ( TCM ) is an important part of traditional Chinese culture . As the car-rier of TCM culture , TCM hospital should continuously strengthen its culture construction . This is conducive to develop TCM advantages , to consolidate the development direction of TCM , to embody basic features of TCM hospital , to improve the core competitive power , to meet needs of the masses of TCM services . Therefore , fur-ther promoting the cultural construction of TCM hospital is worth thinking and practicing deeply . This article discussed the connotation and function of hospital culture , elaborated measures and effects by demonstrating the process of hospital cultural construction , and put forward ideas for the reform and innovation of hospital cultur-al construction .

Objective:To investigate the effects of Bailing capsules on the expression of TGF-β1 in the peritoneal dialysis solution for peritoneal dialysis patients. Methods: Totally 40 patients treated with peritoneal dialysis ( PD) were randomly divided into two groups (20 cases in the control group and 20 cases in the experimental group). All the patients were treated with PD by 1. 5% perito-neal dialysis effluent (6 000 ml everyday), and the patients in the experimental group were additionally treated with Bailing capsules (5 capsules each time, three times a day after meals) for 6 months. The adequacy of PD (including Kt/V and Ccr) of the two groups was examined after the one-month treatment. The renal function and the level of TGF-β1 in the effluent in 1, 3 and 6 month were com-pared between the two groups. Results:The adequacy of PD ( Kt/V and Ccr ) had no significant difference between the two groups (P<0. 05). The level of serum creatine was decreased significantly in both groups after the one-month treatment (P<0. 05), and no significant change was shown in 3 and 6 month (P>0. 05). In the control group, the expression of TGF-β1 in the effluent in 1, 3 and 6 month was increased gradually with significant difference (P<0. 05). In the experimental group, the expression of TGF-β1 in the effluent had no significant difference in 1, 3 and 6 month (P>0. 05), which was lower than that in the control group (P<0. 05). Conclusion:Bailing capsules can decrease the expression of TGF -β1 in the effluent for the patients treated with PD and inhibit the peritoneal fibrosis.

Objective To construct eukaryotic expression plasmid pIRESneo3-pigment epithelium-derived factor (PEDF) and detect its transient expression in SP2/0 cells. Methods Specific primers were designed based on the mature peptide sequence of human PEDF cDNA in the GenBank. Human PEDF gene was cloned into the eukaryotic expression vector pIRESneo3. The PEDF DNA was transfected into SP2/0 with LipofectamineTM 2000. The recombinant human PEDF protein expressed in SP2/0 cell culture supernatant was identified by Western blot and enzyme-linked immunosorbent assay. The biological activity of the recombinant human PEDF was measured by 3-(4,5-dimethylthiazol-z-y1)-2,5-diphenytetrazolium bromide(MTT) method. Results PCR amplification, restriction enzyme digestion and DNA sequencing confirmed that the mature peptide sequence of human PEDF cDNA was successfully cloned into the eukaryotic expression vector pIRESneo3. And the plasmid was transfected into SP2/0 cells, which could secret PEDF. Western blot analysis showed that there was only one obvious band at the position of relative molecular weight of 50 000, and it is equivalent to the expected value. Enzyme-linked immunosorbent assay suggested that the content of PEDF began to rise after transfection, and peaked at 36 h [(0.92±0.04) μg/ml]. The proliferation of human umbilical vein endothelial cell line was significantly inhibited by supernatant after transfection of 36 h (P<0.05). Conclusions The eukaryotic expression plasmid pIRESneo3-PEDF had been successfully constructed and active human PEDF was transiently secreted, which made a foundation for further study of stable expression and purification of PEDF. This protein could be a potential medication for preventing and managing retinopathy of prematurity.

ObjectivesTo present the current condition of non-invasive ventilation in newborns in the last ifve years in China, to describe the probable research trends of this ifeld, and to provide the possible research directions in future.Methods Using co-word analysis, the keywords “neonate” and “non-invasive ventilation” were searched in the CNKI database. The search results included 457 articles. Then the relation matrix was built by Excel 2010. Finally the visualized network was drawn by Ucinet 6.3.ResultsNasal continuous positive airway pressure (nCPAP) is primarily for the treatment of neonatal respiratory distress syndrome (NRDS) in China. Meanwhile, nasal intermittent positive pressure ventilation (nIPPV) and bilevel positive airway pressure (BiPAP) are gradually applied in clinic. The application scope of non-invasive ventilation is expanding. Besides the neonatologists, nurses are also paying close attention to non-invasive ventilation.ConclusionsThe visualized network, successfully built by Netdraw, relfects the hot topics and current condition in this ifeld.