Objective To evaluate the curative effect of compound nutrient assisted phototherapy on neonatal jaundice.Methods Neonatologists at seven hospitals participated in the study.A total of three hundred and twenty full-term newborns with high indirect bilirubin admitted to hospital from September 2017 to January 2018 were selected.One hundred and sixty-six cases in the observation group,and one hundred and fifty-four cases in the control group,all enrolled neonates were given single-sided,conventional intensity phototherapy.Observation group took compound nutrient at the same time.The average gestational age,age,birth weight of two groups before treatment were not significantly different.Serum total biilirubin,indirect bidirubin,liver function (ALT,AST) and phototherapy time were monitored before treatment and 3 days after treatment.Results The serum total bilirubin in the observation group was significantly lower than that of the control group after 3 days of treatment[(196.7 ± 57.2) μmol/L vs (216.5 ± 54.6) μmol/L],(t=3.17,P＜0.01).The indirect bilirubin in the observation group was significantly lower than that of the control group after 3 days of treatment [(176.3 ± 54.3) μmol/L vs (197.2 ± 52.9) μmol/L],(t=3.50,P＜0.01).The time of phototherapy of the children in the observation group was significantly shorter than that of the control group[(19.8 ± 14.4)d vs (22.9 ± 13.3) d],(t =2.00,P ＜ 0.01).Rash,fever,bronze disease,spilled milk,vomiting,abdominal distention,diarrhea,constipation,liver damage etc.were no significant difference the observation group and the control group(P ＞ 0.05).Conclusion Compound nutrients had good efficacy and safety in adjuvant phototherapy for neonatal high indirect bidirubin.

Objective To study the incidence of acute renal injury ( AKI), related clinical risk factors and recent prognosis in critically ill neonates. Methods The study was a retrospective analysis from January 2016 to December 2016 in the neonatal care department of General Hospital of Shenyang Military Region and the First Hospital Affiliated to China Medical University. We collected the perinatal data,clinical data,biochemical indexes and short-term prognosis. Logistic regression analysis was used to identify the risk factors. Results The incidence of AKI in critically ill neonates was 13. 11%(32/244),and the probability of poor prognosis was 62. 50%(20/32). Gestational age,birth weight,1 min and 5 min Apgar score,con-sciousness,mechanical ventilation,blood pH,blood glucose,blood urea nitrogen,white blood cell and red cell distribution width were the related factors for AKI in critically ill neonates. Logistic regression analysis showed that consciousness(OR=4. 542,95%CI 1. 176-17. 539,P=0. 028),mechanical ventilation(OR=0.267,95%CI 0.101-0.705,P = 0.008),5 min Apgar score(OR = 0.750,95% CI 0.605-0.930,P =0. 009),blood urea nitrogen value(OR=1. 074,95%CI 1. 006-1. 146,P=0. 030)were identified as the inde-pendent risk factors of AKI. ConclusionThe incidence of AKI is high in critically ill neonates. Consciousness,mechanical ventilation,5 min Apgar score,blood urea nitrogen value are identified as independent risk factors for AKI.

Early newborns,especially premature and very low birth weight infants (VLBWI)are vulnerable to low environmental temperature and/or other factors at birth,they may be insufficient to maintain core body and can cause hypothermia which leads to a variety of disease,affecting their life quality.As the birth rate of premature newborns and VLBWI are increasing in China these years,newborns temperature management have become significant for decreasing newborn's mortality.The main causes for hypothermia are low environmental temperature,insufficient calorie intake,premature newborns,low birth weight and other diseases.Studies shown that the prevention strategies of neonatal hypothermia include:(1) thermal neutral zone;(2) incutators and radiant warmers;(3) plastic hoods and plastic blankets;(4) kangaroo care;(5) breast feeding.

Neonatal visceral injury have high clinical incidence and it is hard to make clinical diagnosis early by routine inspection. In recent years,researches have shown that neonatal multiple organs damage can be diagnosed early by analyzing some special components in urine. Besides,urine analysis is a noninvasive examina-tion method and it is suitable for clinical promotion. This paper enumerates the application of neonatal urine ex-amination in the early diagnosis of kidney damage,bronchial pulmonary displasia,patent ductus arteriosus,hy-poxic ischemic encephalopathy and metabolic disease.

Objective To analyze the effect of “pillars” in vertebral bodies and balloon expansion of convex forming in treatment of elderly thoracolumbar compression fractures. Methods A total of 150 cases with thoracolumbar vertebral compression fractures in elderly patients from January 2012 to June 2013 were divided into two groups based on ran-domly, the experimental group were given "pillar" block while the control group received balloon expansion of convex forming method, the effect of two groups were observed. Results Compared the operation time and blood loss of surgery patients between the experimental group and the control group, there were statistically significant differences (P<0.05). 24 h pain visual class of experimental group was better than the score of control group, the difference was statistically significant (P<0.05). Conclusion"Pillar" block in vertebral bodies and balloon expansion after convex forming method have little influence in elderly patients with thoracolumbar compression fractures, and each has advantages, should make choices according to the specific condition of patients.

Objectives To investigate the incidence of brain injuri in premature infants in ten hospitals of seven large cities in China sponsored by the Subspecialty Group of Neonatology of Pediatric Society, China Medical Association. Methods All premature infants with gestational age less than 37 weeks in ten hospitals were given routine cranial ultrasound within three days of birth, and then repeated every 3-7 days till the discharge from the hospital during January 2005 to August 2006. Results Incidence of intraventricular hemorrhage (IVH) and severe IVH were 10.8% (406/3 768) and 2.4% (92/3 768) with 22.6% (92/406) for grade 1, 54.7% (222/406) for grade 2, 17.2% (70/406) for grade 3 and 5.4% (22/406) for grade 4 in nine hospitals; incidence of periventricular leukomalacia (PVL) and cystic PVL were 2.3% (112/4 933) and 0.3% (16/4 933) with 85.7% (96/112) for grade 1, 12.5% (14/112) for grade 2, and 1.8% (2/112) for grade 3 including all ten hospitals, respectively. Risk factors associated with increased severity of IVH were vaginal delivery (OR = 1.874, 95% CI = 1.172 - 2.997, P < 0.01), perinatal asphyxia (OR = 1.598, 95% CI = 1.077 - 2.372, P < 0.05), mechanical ventilation (OR = 3.988, 95% CI= 2.448 -6.948, P< 0.01), and amniotic fluid contamination (OR = 2.192, 95% CI = 1.054 - 4.544, P< 0.05). Risk factors that might result in the development of cystic PVL were vaginal delivery (OR = 1.400, 95% CI = 1.186 - 1.652, P < 0.001) and mechanical ventilation (OR = 3.000, 95% CI = 1.015 - 8.864, P < 0.05). Conclusions These data reflect basically the prevalence of brain injuriy in premature infants in major cities of China. However, more than 60% of population lives in the rural area, further multicenter investigation including the rural area is expected to be undertaken in future.

Objective To study the temporal changes of alveolar epithelial type Ⅱ cells and surfactant pro-tein A in young rats with acute lung injury induced by lipopolysaecharide. Method Totally 110 SD young rats (male:53, female : 57) were randomly divided into ALI and normal control groups (six subgroups in each group).LPS(4 mg/kg) was given intraperitoneally in ALI group. The same amount of normal saline was given in the con-trol groups. Eight rats in each subgroup were sacrificed at 6, 12, 24, 36, 48 and 72 hours after the injection.Lung samples were taken for transmission electron microscope examination. RT-PCR was epmloyed for the mea-surement of SP-A mRNA. Western blot was used for the detection of SP-A in the lung tissue. ANOVA and homo-geneity of variance test were performed by SPSS 12.0. Results The microvilli disappeared at 24 hours after the injection of LPS. The number of lamellar body (LBs) was provisionality increased at 24 hours and 48 hours. The ring-like an'angement of LBs around nucleus and the giant LB with vacuole-like deformity were found as the main characteristics of AEC- Ⅱ in ALI at 48 hours. The number of LBs reduced and broken and residual LB remained at 72 hours. SP-A elevated greatly from 24 to 48 hours (P < 0.01), reached peak at 36 hours (6.94 ± 0.80, P <0.01),reached the lowest level(3.87 ±0.50, P <0.01)at 72 hours. Conclusions The pathological changes of AEC-Ⅱ and SP-A in lung tissue wiht ALI are time-dependent. The typical alterations of AEC- Ⅱ occurs at 48 hours accompanied by the compensatory increase of SP-A. AEC- Ⅱ is seriously injuried with the typical changes of LBs and the diminishing of SP-A in lung tissue.

Objective Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are common and life-threatening disease in children with mortality as high as 40%-70%. Alveolar type Ⅱ cells (ATII cells),characterized by the presence of lamellar bodies (LBs),synthesize and secret surfactant proteins (SPs),which contribute significantly to surfactant homeostasis and pulmonary immunity.The functions of ATⅡ cells including pulmonary surfactant production are autocratically dominated by the structural integrity of ATII cells.Our study is focused on the ultrastructural alterations of AT Ⅱ cells in rats with lipopolysaccharide(LPS)-induced ALI.Methods Rat ALI models were established by intraperitoneal injection of LPS (4 mg/kg).0.9 % NS with same amount was given in the normal control group.The rats were randomly chosen and sacrificed at 24, 48 and 72 hrs after LPS injection (8 rats at each time point).Lung samples (1 mm3 of the size) were obtained from the lower parts of left lungs and fixed with 2.5% glutaraldehyde for the transmission electron microscope examination.Results The microvilli around ATII cells disappeared and the number of LBs increased at 24 hrs after LPS administration.LBs rearranged like a ring around the nuclei.It was commonly seen that two nuclei were present in one AT Ⅱ cell.Vacuole-like deformity prominently occurred in cytoplasm at 48 hrs.Giant LBs presented at the same time.The shapes of nuclei were irregular and some of the borders were unclear at 48 and 72 hrs.The remnant of ruptured LBs scattered in cytoplasm at 72 hrs.The number of LBs reduced obviously.Karyolysis occurred in some of the nuclei.Conclusions The ALI-related alterations of ATII cells characterized by the changes of LBs,nuclei,and nucleoli were time-dependent. ATII cell injury was serious at 48 and 72 hrs.This may lead to the insufficiency of pulmonary surfactant synthesis and unstability of pulmonary homeostasis,which contributed to to the pathogenesis of acute lung injury.

AIM: To study the changes of neurokinin A (NKA) and NKA mRNA in lung tissues of asthmatic guinea pigs exposed to chronic cigarette smoke and investigate the mechanism. METHODS: The model of asthma in guinea pigs was made by exposure to aerosolized ovalbumin and animals were randomly assigned into: ① inhale cigarette smoke (ICS) 2 weeks before provoked; ② ICS 2 weeks after provoked; ③ 2 weeks after provoked (no-ICS); ④ asthma (no-ICS before provoked); ⑤ normal control. The contents of NKA in lung tissues were detected by ELISA and NKA mRNA expression was detected by reverse transcription-polymerase chain reaction. RESULTS: ① The levels of NKA and NKA mRNA expression in lung tissues of asthma group were significantly higher than those in normal control group (P

Objective To study the changes of TNF-??NO in lung of immature rabbits with meconium aspiration and the relationship with right ventricular pressure. Methods (1)We established mild and severe immature rabbits model of meconium aspiration by endotracheal intubation imbuing meconium 0.6 ml/kg and 4 ml/kg. (2)We measured the right ventricular pressure by right ventricular puncture. (3)level of TNF-? in lung was measured by radioimmunoassay and that of NO was detected by Cr deoxidation. Results Meconium caused pulmonary inflammatory response which was reflected in the increase of cell counts in BALF, peaking at 24 h after instillation [WBC counts (6.06? 0.15 ) ?10 8/L,PMN counts (0.484?0.009)?10 8/L] and recovered by 72 h[(1.93?0.08)?10 8/L,(0 082?0 007)?10 8]. (2)The level of TNF-? in lung of mild group (1.41?0 15) ng/ml increased significantly comparing with control group (0 48?0.07) ng/ml, level of NO (31.9?2.4) ng/ml decreased significantly. Peaked at 16~24 h and recovered to normal by 72 h. the changes of severe group [TNF-?(1.85?0.17) ng/ml, NO(26.4?2.4) ng/ml] were significantly different from those in mild group. (3) At mild group,the right ventricular pressure began to increase at 16 h ( 19.28 ? 0.10 ) mm Hg, peaked at 24 h (26.78?0.14) mm Hg and returned to normal level by 72 h ( 14.18 ? 0.04) mm Hg. The pressure of severe group ( 32.70 ? 0.14 ) mm Hg was significantly higher than that of control and mild group. Conclusions (1)After immature rabbits aspirating meconium, there were remarkable pulmonary inflammatory responses. (2)The level of TNF-? in lung increased, and was correlated with right ventricular pressure,which revealed that MAS with PPHN could be associated with inflammatory response. (3)The level of NO decreased after meconium aspiration, and was lower at severe group. The level of NO was negatively correlated with right ventricular pressure, which indicated that the severe meconium aspiration was companied with severe damage of endotheliocyte which promoted and exacerbated PPHN.