Neonatal illness severity score is a scoring system for assessing severity of illness,predicting mortality and guiding clinical work in neonatal intensive care units.It plays an important role in the progressive development of neonatology.This article introduces and compares several illness severity scores commonly used in the world.Compared with score for neonatal acute physiology ( SNAP),score for neonatal acute physiology perinatal extension(SNAPPE) and our country's neonatal illness severity score,cinical risk index for Babies ( CRIB ),score for neonatal acute physiology version Ⅱ ( SNAP-Ⅱ),simplified version of the score for neonatal acute physiology (SNAPPE-Ⅱ) and clinical risk index for babies-revised (CRIB-Ⅱ) simplify the variables,weight the items scientifically,cost less time and predict the motality risk reliably.In conclusion,CRIB,SNAP-Ⅱ,SNAPPE-Ⅱ and CRIB-Ⅱ have better practicability and need to be promoted.

Objective:To find out the clinic characteristics of congenital syphilis(CS),to reduce the possibility of misdiagnosis.Methods:Fifty-five(aged at hedyanhour to three years)cases were analyzed the clinic manifestation retrospectively during 1999 to 2008.Results:There were 33 male and 22 female.of 55 cases,only 5 were diagnosed as CS at the beginning of entry hospital and the rest were misdiagnosed.The main complain showed 27 cases with mucocutaneous lesion(papula,papulopustule,bleb,desquamation),26 with jaundice,32 with hepatomegaly,14 with splenomegaly,12 with tachypnea,6 with osteomyolitis,20 with nose problem(rhinocleisis, epistaxis,rhinorrhea),7 with congenital deformity,5 with hemorrhage,4 with abdominal distension,1 with abdominal pain,2 with vomiting,2 with edema,1 with tic,1 with bad cry.Conclusion:In most newborns and infants,the onset of CP is heralded by nonspecific signs which involved multi-system.The rate of misdiagnosed for CP could be beyond 90%.

Described in this paper are the characteristics of medical big data such as multi-dimensionalities, non-integrities, time sequencing, redundancies, their sources such as health service,medical insurance,health adminis-trations, producers of drugs and medical equipments, Internet, life science, their applications in R & D of drugs, diagnosis and treatment of diseases,medical insurance,intelligent decision-making,individual health management, and challenges they are faced such as data integration,data storage,data sharing, shortage of trained professionals, and privacy protection.

Objective To explore the main risk factors related to birth defects to provide the scientific basis for making the best prevention policy and implementing the effective interventions .Methods Totally 21 domestic research articles on the risk fac‐tors of birth defects were comprehensively analyzed by the meta analysis method ,including accumulated 6 112 patients and 15 741 control cases .The articles were screened preliminarily according to inclusion and exclusion standard ,and then the fixed and random effects model were selected according to the homogeneity test .The merged results were performed the chi‐square test .Results The main merged results OR values of single‐factor‐analysis were as follows:the family history of birth defects 36 .22 ,early pregnant in‐fectious disease 5 .62 ,early pregnancy exposure to chemicals 4 .19 ,paternal smoking 3 .89 ,contact sedatives during pregnancy 3 .19 , pregnancy complication 2 .94 ,high protein food during pregnancy 0 .37 ;the main merged results OR values of multiple‐factor‐analy‐sis were as follows :early pregnancy infectious disease 7 .65 ,poor prenatal mental state 5 .44 ,early pregnancy fever 4 .70 ,early preg‐nancy exposure to toxic chemical 3 .90 ,history of abortion 3 .59 ,supplement of multivitamin during pregnancy 0 .45 .Conclusion The main risk factors of birth defects in our country are family history of birth defects ,early pregnancy infectious disease ,early pregnancy exposure to chemicals ,paternal smoking and pregnancy complication;the protective factors are eating more high protein food during pregnancy ,supplement of multivitamin during pregnancy and taking folic acid during pregnancy .

Objective To study the management of enterostomy in children.Methods The clinical data of 425 cases of enterostomy in children were analyzed retrospectively.Results The primary diseases of 425 cases underwent enterostomy included:intestinal perforation(119 cases),intestinal necrosis(36 cases),necrotizing enterocolitis(45 cases),congenital megacolon(61 cases),congenital anal atresia with rectourethral fistula(86 cases),and congenital anal atresia with rectovaginal fistula(78 cases).Among the 425 cases,159 cases underwent small bowel enterostomy and 266 cases had colostomy;single-stoma enterostomy was done in 225 cases,and double-stoma enterostomy in 197 cases.Follow-up was acquired in 389 patients,and all the stomas were closed successfully.The closure time of small bovvel enterostomy was 1-3 month(ayerage 1.87 months)later,and of colostomy was 3-12 month(averag 4.95 months)later.Conclusions When an enterostomy is to be adopted in pediatric surgery,a suitable time and enterostomal location should be chosen according to the state of illness.The timing of enterostomy closure is also very important.

Objective:To evaluate whether Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection has posi-tive effects on the prevention and treatment of radiation-induced lung injury. The basic function and mechanism of Salviae Miltiorrhi-zae Liguspyragine Hydrochloride and Glucose Injection were also investigated. Methods:A total of 70 adult male rats weighing about 200 g were selected and divided into seven groups. These groups were as follows:1) normal control group (N):rats were injected with 1 ml of normal saline per day;2) single medicine treatment group (D):rats were administered with 1 ml of Salviae Miltiorrhizae Ligus-pyragine Hydrochloride and Glucose Injection per day;3) single irradiation group (Z):rats were exposed to 20 Gy single whole-chest ir-radiation and injected with 1 ml of normal saline per day;4) irradiation with 10 Gy and medicine treatment group (Z10):rats were ex-posed to 10 Gy single whole-chest irradiation and administered with 1 ml of Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection per day; 5) irradiation with 15 Gy and medicine treatment group (Z15): rats were exposed to 15 Gy single whole-chest irradiation and administered with 1 ml of Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection per day;6) irradiation with 20 Gy and medicine treatment group (Z20a):rats were exposed to 20 Gy single whole-chest irradiation for four weeks, and administered with 1 ml of Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection per day;and 7) irradia-tion with 20 Gy and medicine treatment group (Z20b):rats were exposed to 20 Gy single whole-chest irradiation and administered with 1 ml of Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection per day. Two rats were selected and sacrificed at the end of two, four, six, eight, and ten weeks of irradiation. Samples of blood and lung tissues in rats were obtained. Results:In the group with single irradiation, the tumor necrosis factor-α (TNF-α) and transforming growth factor-β (TGF-β) levels in plasma of rats were higher than those in the other groups. In the group with irradiation and medicine treatment, the TNF-αand TGF-βlevels in plasma were higher than those in the normal control group and single medicine treatment group. In the group with single irradiation for four weeks,some petechial hemorrhages on the surface of the lung were visible to the naked eye. In the groups with medicine treatment, the petechi-al hemorrhages on the surface of the lung visibly reduced. According to the pathological mechanism of lung tissues, the groups with Sal-viae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection exhibited less inflammation than the single irradiation group. Ir-radiation at 20 Gy for four weeks followed by a daily abdominal injection was slightly better than single irradiation, but the effects were not obvious. Conclusion: Salviae Miltiorrhizae Liguspyragine Hydrochloride and Glucose Injection could prevent the occurrence of lung injury by reducing the TNF-αand TGF-βlevels in plasma. After the occurrence of radiation-induced pneumonitis, the application of medicine could not decrease the symptoms.

Objective: To study the effects of ureolysis on the proliferation and acid-resistance of Actinomyces naeslundii.Methods:The growth of Actinomyces naeslundii cultured in different nitrogen sources were measured, and the acid-resistant ability of Actinomyces naeslundii cultured in acid condition with different urea concentration was compared.Results:In contrast with other nitrogen sources,Actinomyces naeslundii could be cultured by urea and higher final A value of the bacteria was obtained;at the range of pH=4.0-7.0, ureolysis could increase the survival of Actinomyces naeslundii from acid killing to some extend, but at pH=3.0, ureolysis could not protect Actinomyces naeslundii anymore.Conclusion:Ureolysis may stimulate the growth of A. naeslundii and increase the acid-resistant ability of Actinomyces naeslundii.

Objective To evaluate the clinical value of the chemiluminescence immunoassay particles (CMIA)in the diagnosis of syphilis.Methods The serum specimens from 150 cases of syphilis in our hospital were selected as the observation group and con-temporaneous 150 serum samples from non-syphilis healthy people were selected as the control group.The toluidine red unheated serum test (TRUST),treponema pallidum particle agglutination test (TPPA)and CMIA were adopted to conduct the detection. The sensitivity,accuracy and specificity of the three kinds of method were calculated and their differences were compared and ana-lyzed.Results The sensitivity of TRUST and TPPA and CMIA was 65.3%,97.7% and 99.3% respectively,the specificity was 74.7%,97.3% and 100.0% respectively,the accuracy was 70.0%,97.0% and 99.7% respectively,the difference among three kinds of methods had statistical significance (P <0.05).The sensitivity,specificity and accuracy of TRUST were lower than those of CMIA and TPPA (P <0.017),there was no statistically significant difference between CMIA and TPPA (P >0.017).Conclu-sion CMIA is equivalent to TPPA in the sensitivity,specificity and accuracy,is superior to TRUST,and has the advantages of sim-ple operation,objective results and good repeatability.

Objective To analyze the risk factors of congenital heart disease(CHD) in China by using the meta‐analysis method to provide reference for etiology study and prevention of CHD .Methods The Chinese literature database such as CBM , VIP ,CNKI ,Wan Fang were retrieved from 2005 to 2015 for collecting the related literatures ,then the collected literatures were screened ,performed the information extraction ,quality evaluation and merged analysis by using the Stata12 .0 software .Results In this study ,37 articles were included ,including 20 provinces (municipalities and autonomous regions) ,8 588 cases in the case group and 12 479 cases in the control group;a total of 21 risk factors(5 pre‐pregnant factors and 16 gestational factors) were included . Conclusion All 21 risk factors include 4 pre‐pregnancy factors ,15 gestational factors and 2 factors which not be verified .The top 3 risk factors and their OR values with 95% CI were gestational diabetes 5 .80(2 .72-12 .37) ,contacting the occupational risk factors 5 .14(3 .30-8 .00) ,advanced age before pregnancy 4 .96(1 .45-16 .97) .Not considering to be as the risk factors and their OR value with 95% CI are high body mass index before pregnancy 1 .32(0 .99 -1 .75) ,living near street during pregnancy 1 .36(0 .50-3 .71 ) .

Objective To optimize the antibacterial drug regimen in ICU common staphylococcal infection.Methods The pharmacokinetic and pharmacodynamic parameters of antibacterial drugs were collected in combination with the hospital ICU anti-microbial drug resistance monitoring reports from the national antimicrobial resistance investigation net (Mohnarin)of the Ministry of Health and the performance standards for antimicrobial susceptibility testing (2013)issued by the clinical and laboratory stand-ards institute (CLSI),the minimum inhibitory concentration (MIC)of staphylococci was set by using the discrete uniform distribu-tion method and 16 kinds of administration regimens with 6 antimicrobial agents were worked out.The best initially antimicrobial regimen was optimized by using the pharmacokinetic and pharmacodynamic models and Monte Carlo simulations of cumulative frac-tion of response (CFR)from 5 000 patients.Results The alternative initially drug regimens to the infectious bacteria were:linezolid 0.40 g twice daily and vancomycin 0.75 g twice daily for staphylococcus aureus;amikacin 0.60 g once daily and linezolid 0.40 g twice daily,and vancomycin 0.75 g twice daily for hemolytic staphylococci and staphylococcus epidermidis;linezolid 0.40 g twice daily and vancomycin 0.75 g twice daily for methicillin-resistant Staphylococcus aureus;ampicillin/sulbactam 1.50 g 4 times daily, cefuroxime 0.75 g 4 times daily,amikacin 0.60 g once daily,moxifloxacin 0.40 g once daily for methicillin-sensitive staphylococcus aureus.Conclusion In the Staphylococcus aureus infection occurred in ICU,if which being methicillin-sensitive could be deter-mined,ampicillin/sulbactam,cefuroxime,amikacin and moxifloxacin could be selected for treatment,and linezolid or vancomycin could be selected for treating possible methicillin-resistant Staphylococcus aureus infection or undetermined whether being methicil-lin-resistant Staphylococcus aureus infection.