Objective To investigate current status of learned resourcefulness in pregnant women,and to identify its influencing factors.Methods With convenient sampling,a self-made General Data Questionnaire and the Chinese version of Self-Control Schedule (C-SCS) was used to survey 360 pregnant women in the antenatal clinic in one three-class hospital in Guangzhou.Results The mean score of learned resourcefulness in pregnant women was (115.00±14.42) and its influencing factors included education degree,gravidity,pregnancy school training and planed pregnancy.Conclusions Learned resourcefulness in pregnant women loads upper level.Medical staff should take targeted interventions to strengthen it and facilitate the mental well-being of pregnant women.

Objective To investigate the present incidence and the risk factors of retinopathy of prematurity (ROP).Methods The clinical data of 1 356 premature infants who were born in our hospital from Dec 2008 to Feb 2011 with birth weight of 2 500 g or less and gestational age of 37 weeks or less were analyzed retrospectively,and divided into ROP group(n =208) and without ROP group(n =1 148).They were screened for ROP from 4 ～ 6 weeks of chronological age or 32 weeks of postmenstrual age.Results In 1 356 cases,there were 208 cases with ROP,the incident rate was 15.34％,of which 36 cases were severe diseases (2.65％).Compared with the infants without ROP,the development of ROP was correlated with birth weight [(1 528 ±243) g vs (1 960 ± 187) g],gestational age [(30.92 ±0.72) weeks vs (32.87 ± 1.28) weeks],oxygen uptake time ＞ 8 d (123 cases vs 865 cases),pulmonary surfactants (18 cases vs 216 cases),septicemia (42 cases vs 154 cases),in utero distress (63 cases vs 511 cases) and anemia (64 cases vs 237 cases) (P ＜ 0.05).Logistic regression analysis suggested that birth weight,gestational age,oxygen uptake time ＞8 d,septicemia and pulmonary surfactants were significant risk factors associated with the development of ROP(P ＜ 0.05).Meanwhile,there were significant differences in the incidence of infants with ROP at different birth weight and different gestational age (P ＜ 0.05).Conclusion The birth weight and gestational age are lower,the incidence of ROP is higher and the disease is more serious.The probability of ROP,particularly severe ROP,is highest in the most immature infants while it is lower in the least immature ones.

Objective To explore clinical value of optimizing the contrast medium injection protocol for dual-source CT high-pitch spiral acquisition in children with complex congenital heart disease.Methods Sixty patients with complex congenital heart disease were prospectively recruited and randomly divided into group A and group B by the random number table method.Patients in group A received a conventional contrast medium injection protocol,i.e.a diluted contrast material with fast and slow rate respectively,and then a flush with normal saline.The volume of contrast medium was 2.0 ml/kg.Patients in group B received an optimized injection protocol,i.e.a four-phase diluted contrast material with contrast/ saline ratio of 8:2,6:4,4:6,2:8 respectively.The volume of contrast medium was 1.0-1.5 ml/kg.Attenuation and noise were measured in superior vena cava,right atrium,right ventricle,the main pulmonary artery,left atrium,left ventricle,ascending and the descending aorta in the two groups and compared by t test.The image uniformity was assessed by t test.Subjective image quality and artifacts of superior vena cava were analyzed by the Mann-Whitney U test.Diagnostic accuracy was evaluated by x2 test.All the patients undergone the surgical treatment and demonstrated 121 abnormalities (22 species) of internal and external heart structure,i.e.56 in group A and 65 in group B.Results There was no significant difference in diagnostic accuracy between group A and group B (A:96.9％,52/56,vs.B:96.4％,62/65;x2=0.28,P=0.59).While,significant difference was found in the amount of consumed iodine between the two groups [A:(15.7±6.5) ml vs.B:(10.4±2.4) ml;t=4.14,P＜0.01].Furthermore,the image uniformity in group B was statistically higher than that in group A[A:(36.5± 18.0)HU vs.B:(272.0± 124.5)HU;t=10.30,P＜0.01].As for subjective image quality,no significant difference were observed (A:3.3±0.5 vs.B:3.5±0.5;Z=396.00,P=0.39);while significant difference was found in artifacts of superior vena cava (A:3.2±0.9 vs.B:3.7 ± 0.7;Z=300.50,P=0.02).Conclusion The optimized contrast medium injection protocol for children with complex congenital heart disease could eliminate the image artifacts of superior vena cava and improve the image quality.

Objective To realize the clinical characteristics of fungemia in premature infants.Methods Clinical characteristics of fungemia in premature infants in the intensive care unit of a children''s hospital between January 2011 and December 2015 were analyzed retrospectively, general condition of premature infants, laboratory-related indicators, and antimicrobial susceptibility testing results were compared.Results From January 2011 to December 2015, 42 premature infants with confirmed fungemia were treated in this hospital, 22 (52.38％) of whom were with fungemia caused by Candida albicans(C.albicans), 13 (30.95％) by Candida parapsilosis (C.parapsilosis), 3 by Candida krusei (C.krusei), and 4 by other fungi.Patients were grouped according to the main pathogens causing infection: C.parapsilosis group and C.albicans group.Maternal genitourinary tract infection rate and incidence of fungal meningitis in C.albicans group were both higher than C.parapsilosis group(27.27％ vs 7.69％, 27.27％ vs 0.00％ respectively), peripherally inserted central catheter (PICC) rate in C.albicans group was lower than that in C.parapsilosis group(22.73％ vs 69.23％), platelet count in C.parapsilosis group was lower than C.albicans group, differences were all statistically significant (all P<0.05).Conclusion The major fungi causing fungemia in premature infants were C.parapsilosis and C.albicans, maternal reproductive system infection during pregnancy can easily lead to candidemia, premature infants with candidemia are more vulnerable to developing fungal meningitis;PICC is more likely to lead to C.parapsilosis fungemia, and platelet decline is more obvious.

In order to adapt to the training target of medical laboratory technology professionals under the condition of five to four educational system,we reformed the experimental teaching of medical laboratory technology.The experiment teaching was divided three phases (traditional classroom teaching + simulated clinical laboratory training + clinical laboratory teaching).Classroom teaching focused on the cultivation of students' basic skills test;simulation laboratory training focused on strengthening the students' operating skills and basic post ability and professional quality;hospital laboratory teaching focused on strengthening the students' ability of medical laboratory management,test comprehensive analysis and scientific research.The reform practice of two sessions of the students showed that the students' examination skills and comprehensive quality improved significantly,which could better adapt to the social demand for technical personnel.

Objective To study apoptosis and antigen presentation changes of monocytes in HBV-related acute-on-chronic liver failure (ACLF) patients under immune dysfunction state.Methods Peripheral blood samples of 26 HBV-related ACLF patients (ACLF group),20 active chronic hepatitis B patients (CHB group) and 18 healthy individuals (control group) were collected.The changes of apoptosis and proliferation (Ki67) in monocytes and the expression of surface markers including human leukocyte antigen (HLA)-DR and B7 molecules (CD86) of monocytes were analyzed by flow cytometry. Results The percentage of Annexin V expressed monocytes of ACLF group (64％) was significantly higher than that of CHB group (28％) and control group (20％),and the difference was statistically significant (x2 value was 11.75 and 27.23 ; both P＜0.01),which indicated that monocytes apoptosis increased.The Ki67 expression in monocytes of ACLF group was lower than that of CHB group and control group,and the difference was statistically significant (x2 value was 4.71 and 4.83; both P＜ 0.05),which indicated that activated monocytes reduced. The mean fluorescence intensity (MFI) of HLA-DR and CD86 of monocytes in ACLF group was 22.85 and 11.63,which was significantly lower than that of CHB group and control group,indicating the antigen presentation ability of monocytes injured. The percentage of Annexin Ⅴ positive monocytes in survivals (62 ％ ) was significantly higher than that of dead patients (46 ％ ) in ACLF group.Conclusion In HBV-related ACLF patients under immune dysfunction state,the apoptosis of peripheral blood monocytes increased,and the quantity of activated cells reduced,resulting in the decline of the antigen presentation ability of monocytes.

Objective To study the transport risk and factors that influence deaths of very low birth weight (VLBW) and extremely low birth weight (ELBW) infants.Method All infants transferred to our neonatal intensive care unit (NICU) by our hospital transport team or local hospital transport team from January 2014 to December 2015 were included in our study.Their clinical data were retrospectively studied.The risks of transport between hospitals were analyzed.The risk factors of deaths within and after 7 days of admission were further analyzed by multivariate Logistic regression analysis.The receiver operation characteristic (ROC) curve was used to assess the sensitivity and specificity of mortality index for neonatal transportation (MINT),transport related mortality score (TREMS),transport risk index of physiologic stability (TRIPS) for predicting mortality of preterm infants.Result (1) A total of 527 cases of ELBW/VLBW infants were included in our study.There were no deaths during transport.There were 10.2％ (54/527) died within and 8.9％ (42/473) died after 7 days of hospitalization.(2) Multivariate Logistic regression analysis showed that scleredema of newborn,secondary transport,gastrointestinal malformations,metabolic acidosis,high TREMS score,and high MINT score were risk factors of mortality within 7 days of admission for ELBW/VLBW infants;necrotizing enterocolitis,intraventricular hemorrhage ≥ three degree,high MINT score and low admission weight were risk factors of mortality after 7 days of admission.(3) The area under the ROC curve for MINT,TREMS,and TRIPS score were 0.672,0.655 and 0.665,respectively.The cut-off values for MINT score (cut-off 8,sensitivity 0.444,specificity 0.829),for TREMS score (cut-off 2,sensitivity 0.500,specificity 0.757,for TRIPS score (cut-off 20,sensitivity 0.444,specificity O.829) were selected to predict mortality within 7 days of admission.Conclusion (1) Secondary transport is the transport-related risk factor of mortality within 7 days of admission for ELBW/VLBW infants.(2) High MINT score is the risk factor of mortality within and after 7 days of admission.(3) If MINT ≥ 8,TREMS ≥2,or TRIPS ≥20,it might significantly increase the risk of mortality of ELBW/ VLBW infants within 7 days of admission after transport.

Objective To study the occurrence of bronchopulmonary dysplasia (BPD) in extremely low birth weight (ELBW) infants and to determine the risk factors of severe BPD.Method From January 2007 to January 2017,ELBW infants admitted to neonatal intensive care unit (NICU) in Hunan Children's Hospital were retrospectively analyzed.They were assigned into severe and mild/moderate groups based on the severity of BPD.The general condition,maternal status,prenatal and delivery room treatment,transportation,clinical courses,therapy and outcome in NICU of the two groups were compared,and the risk factors of severe BPD were analyzed.Result A total of 367 cases were hospitalized during the 10 years.281 ELBW infants with complete medical records survived longer than 28 days were enrolled in this study.Among them,233 had BPD.Among BPD infants,116 cases were in the severe BPD group,47 cases (40.5％) died.117 cases were in the mild/moderate BPD group and 1 case (0.9％) died.The difference between the two groups was statistically significant (P ＜ 0.05).Multivariate Logistic regression analysis showed that the risk factors of severe BPD were duration of mechanical ventilation ≥ 7 days (OR =7.518,95 ％ CI 3.197 ～ 17.676),ventilator-associated pneumonia (OR =3.047,95 ％ CI 1.436 ～ 6.464),1 min Apgar score ≤7 (OR =2.341,95 ％ CI 1.142 ～ 4.796) and patent ductus arteriosus (OR =2.223,95 ％ CI 1.079 ～4.582).Conclusion The incidence and mortality of BPD,especially severe BPD,are high in ELBW infants.Avoiding asphyxia,shortening the time of mechanical ventilation,preventing infection and closing ductus arteriosus are important measures to reduce the severity of BPD.

OBJECTIVE:To synthesize 4-hydroxyphenylacetic acid(PHPAA)molecular imprinted polymers(MIPs),and to provide reference for separation and enrichment of PHPAA in urine of cancer patients. METHODS:With PHPAA as template molecule and azobisisobutyronitrile as evocating agent,MIPs was synthesized by precipitation polymerization using 4-vinyl pyridine(4-V),acrylamide(AM),1-vinyl imidazole(1-V)and o-diaminobenzene as functional monomers,ethylene glycol dimethacrylate(EGDMA)and trimethylolpropane trimethacrylate(TRIM)as crosslinking agent. Using scanning electron microscope,infrared spectrum,static adsorption test and molecular recognition performance test used adopted to characterize the structure and performance of MIPs. RESULTS:MIPs1(4-V,EGDMA)microspheres adhered seriously,and MIPs2(AM, EGDMA)microspheres are aggregated. MIPs3(1-V,TRIM),MIPs4(o-diaminobenzene,TRIM)microspheresare were dispersed and had good sphericity. Characteristic absorption peak of PHPAA was not found in infrared spectrum of MIPs. The adsorption capacity of each MIPs was higher than that of blank imprinted polymer without the template molecule,and increased as the increase of template molecular concentration. The adsorption capacity of MIPs3 was significantly higher than that of other MIPs,and its static distribution coefficient(0.14)of PHPAA was higher than that of other structural analogues [PHPA(0.06),TA(0.01)],selective separation factors of PHPAA to PHPA,PHPAA to TA were 2.3,11.5,respectively. CONCLUSIONS:MIPs synthesized with 1-V as functional monomer and TRIM as crosslinking agent has the ability of specific adsorption and selective recognition. It can used as solid phase extractant to separate and enrich low content of PHPAA in the urine of tumor patients.

Objective: To investigate the impact of improved AHA cardiovascular health behavior score (CHS) on short-time systemic blood pressure variability (SBPV) in elder population.
Methods: A total of 2464 participants ≥ 60 years from 3 hospitals of Kailuan area were taken for cohort study. The participants had no cardiovascular disease, not taking anti-psychotic drug, Parkinson treatment drug, anti-depression drug and analgesic drug within 2 weeks. All participants received 24-hour ambulatory blood pressure monitoring (ABPM) and the 24-hour, day-time, night-time SBPV were deifned by the standard deviation of 24-hour, day-time, night-time systolic blood pressure. The influence of CHS on SBPV was studied by multi-linear regression analysis. Improved cardiovascular health behavior and factors implied as changing the vegetable intake amount to salt amount by American Humane Association, 2010; boundary of BMI based on《Guidelines for prevention of overweight and obesity in Chinese adults》; status of exercise was deifed as the ideal status: ≥80 min/week, general status: < 80 min/week and bad status: no exercise.
Results: Finally, 1812 participants were recruited for survey and they were divided into 3 groups according to improved CHS: Group①, CHS (0-4) points,n=56, Group②, CHS (5-9) pointsn=1600 and Group③, CHS (10-14) points,n=156. The 24-hour SBPV in Groups①,②and③were 16.02 mmHg, 14.91 mmHg and 13.18 mmHg; day-time SBPV were 15.42 mmHg, 14.50 mmHg and 13.22 mmHg; night-time SBPV were 12.68 mmHg, 11.44 mmHg and 10.16 mmHg, allP<0.05. Multi-linear regression analysis indicated that with adjusted confounding factors, with 1 point of CHS elevation, the 24 hour-, day-time, night-time SBPV would reduce for 0.20 mmHg, 0.19 mmHg and 0.37 mmHg respectively, allP<0.05.
Conclusion: CHS was negatively related to short-time SBPV in elder population.