Objective To study the relation of the variations of serum neuron-specific enolase (NSE) level and brain damage in asphyxia neonatorum.Methods The serum NSE level were detected in 75 asphyxia neonatorum(asphyxia group) and 20 normal neonatorum(control group) by the method of ELISA after parturition 1,3 and 7 d.The relation of serum NSE level and brain damage was analyzed.Results After parturition 1,3 and 7 d,the serum NSE level in mild asphyxia group and severe asphyxia group was higher than that in control group [(29.85 ±8.53),(59.26 ± 15.75) μg/L vs.(15.59 ±6.25) μg/L; (23.69 ± 6.54),(47.28 ±12.46) μg/L vs.(15.38 ±5.84) μg/L; (18.95 ±5.37),(62.57 ±19.62) μg/L vs.(13.92 ±5.37) μg/L],and the serum NSE level in sever asphyxia group was higher than that in mild asphyxia group,there had significantly difference (P＜ 0.05).After parturition 1,3 and 7 d,the serum NSE level in brain damage neonatorum (25 cases) was increased and in CT normal neonatorum (50 cases) was decreased,the serum NSE level in brain damage neonatorum was higher than that in CT normal neonatorum [(37.48 ± 12.09) μg/L vs.(30.95 ± 11.86) μg/L,(51.84 ± 14.21) μg/L vs.(21.73 ±6.15) μg/L,(68.25 ± 18.69) μ g/L vs.(15.62 ± 5.94) μ g/L],there had significantly difference (P ＜ 0.05).Conclusion The variations of serum NSE level can be the important indicator to monitor brain damage in asphyxia neonatorum.

Objective To investigate the changes of the levels of immunoglobulin(Ig)G,IgM,factor B,complement C3 and C4,T lymphocyte subsets in children with bronchial asthma during acute attacks and their correlation with the severity of the disease.Methods The clinical data of 133 children with bronchial asthma admitted to the Department of Pediatrics,Zhuji Maternal and Child Health Hospital from January 2020 to July 2022 were analyzed.According to whether the children were in acute exacerbation stage,they were divided into acute stage group(85 cases)and stable stage group(48 cases);The data about the levels of IgG,IgM,factor B,complement C3 and C4,T lymphocyte subsets(CD3+,CD4+,CD4+/CD8+)on admission were collected from the two groups of children;The acute phase and stable phase were analyzed.The changes of the above indicators,compared the changes of the above indicators in children with different acute attack;Spearman linear equation was used to analyze the correlation between Ig,complement,and T lymphocyte subsets levels and the severity of the disease.Results The level of IgG,factor B,IgM,C3 and C4 were lower than those in stable stage group,with statistical significance(P<0.05).The levels of CD3+,CD4+ and CD4+/CD8+ in acute stage group were lower than those in stable stage group,and the difference was statistically significant(P<0.05).With the improvement of the severity grade of acute asthma attack,the levels of factor B,C3,C4,CD3+,CD4+ and CD4+/CD8+ decreased gradually,and the differences among different grades were statistically significant(P<0.05).There was no significant difference in IgG level among different severity grades(P>0.05).Spearman linear correlation analysis showed that the levels of factor B,IgM,C3,C4,CD3+,CD4+ and CD4+/CD8+ were negatively correlated with the severity of the disease(P<0.05).Conclusion There is obvious immune dysfunction in children with acute attack of bronchial asthma.Monitoring the levels of Ig,complement and T lymphocyte subsets is helpful to evaluate the severity of the disease.

Objective:Objective To explore the special role of nutrition specialists in the one-day-care clinic of gestational diabetes mellitus (GDM), and provide a basis for strengthening the standardized construction of one-day-care clinic.Methods:It was a retrospective observation study that the pregnant women who participated in the one-day-care clinic of GDM in our hospital without nutrition specialists in November and December 2017 were divided into control group (177 cases), and who participated in the one-day-care clinic of GDM in our hospital with nutrition specialists in January and February 2018 were divided into observation group (307 cases). The differences of pregnancy outcomes between the two groups were compared after the propensity score matching.Results:176 pairs of patients were successfully matched with a 1:1 propensity score. The incidence of macrosomia in pregnant women with GDM in the observation group (2.8%) was significantly lower than that in the control group (8.5%) ( P=0.036). There were no significant differences in the weight gain during pregnancy, the gestational week of delivery and the incidences of insulin use, hypertension during pregnancy, preeclampsia, cesarean section, premature infants, premature rupture of membranes, umbilical cord around the neck, and fetal distress between the two groups ( P>0.05). Conclusion:Nutrition specialists are indispensable in the multidisciplinary cooperation of one-day-care clinic of GDM, and they play a key role in considerably lowering the prevalence of macrosomia in GDM pregnant women.

OBJECTIVE:To establish the method for rapid judgement of blending endpoint of Jingqi shuangshen capsules and content determination of astragaloside Ⅳ. METHODS:AOTF-NIR combined with principal component analysis and Moving Block Standard Deviation method was used to identify the blending endpoint. First derivative combined with savitzky-golay filter method were used to spectrum pretreatment. The partial least square method was used to establish quantitative analysis model of the content of astragaloside Ⅳin mixed endpoint sample. The content of astragaloside Ⅳ in mixed endpoint sample was determined by HPLC-ELSD to validate the model. RESULTS:Methodology validation of content determination of astragaloside Ⅳ in mixed material sample and mixed endpoint sample was in line with the requirements. NIR monitoring results showed that the product reached the blending endpoint after 30 min. The results of NIR monitoring were generally consistent with the results of HPLC-ELSD. The principal component dimension of the quantitative model was 9;determination coefficients was 0.954 9;Root Mean Square of Calibration of the model was 0.039 2;Root Mean Square Error of Prediction of the model was 0.042 6. Predicted average value of astragaloside Ⅳ by NIR was 11.74 mg/g,and measured average value of astragaloside Ⅳ by HPLC-ELSD was 11.38 mg/g;average deviation was 3.16%. CONCLUSIONS:AOTF-NIR can rapidly judge the blending endpoint sample of Jingqi shuangshen capsules,rapidly determine the content of astragalosideⅣin mixed endpoint material,improve the quality control level of blending process and shorten blending cycle.

Objective: To promote best discharge practice in sedated patients′ following endoscopic procedures in an endoscopy center in Shanghai, China. Methods: A clinical audit was undertaken using the Joanna Briggs Institute Practical Application of Clinical Evidence System tool. Eight audit criteria that were representative of best practice recommendations for discharge following endoscopic sedation procedures were used. A baseline audit was conducted followed by the implementation of multiple strategies, determined by the key stakeholders. The project was finalized with a follow-up audit to determine change in practice. Results: Improvements in practice were observed for all eight criteria. The most significant improvements were in the following: completion of an organizational policy, the minimum discharge criteria, patient has met minimum discharge criteria before being discharged (all from 0% to 100% compliance), and giving verbal and written instructions (from 12% to 100% compliance). Criteria 4 (the authority to discharge), 6 (staff training and education) and 7 (being accompanied by family) achieved the least improvement in compliance rates, as baseline measures already showed a high degree of compliance. The compliance rate for criterion 8 (medical file) attained 88%. Conclusion This protocol utilized a clinical audit process leading to improvements in practice behavior related to patient discharge following endoscopic sedation procedures. A continuous cycle of audit and re-audit will be required in the future to maintain high quality standards.