The development of organ transplantation has brought new hope to many patients with organ failure and their families， but it has also raised numerous ethical issues. How to balance the rights and interests between organ donors and recipients， as well as ensure the fairness and transparency of the transplantation process has become an urgent problem to be solved. Based on the latest Regulations on Organ Donation and Transplantation and the Working Rules of the Ethics Committee for Human Organ Transplantation， the current difficulties and challenges in organ transplantation ethics were deeply analyzed. Taking the ethical review practice of Shenzhen Third People’s Hospital as an example， this paper explored issues such as full informed consent of both donors and recipients， risk assessment of marginal donors， and the review of relationships between donors and recipients. It also explored and constructed a set of complete ethical review models for organ transplantation through refined management. This model improved the efficiency and quality of ethical review as well as enriched the related knowledge system. It is expected that the implementation of this model can provide a reference for promoting effective ethical review nationwide， advancing the improvement and development of ethical review work in organ transplantation. Meanwhile， more medical ethics experts and practitioners are called upon to focus on and engage in the research and practice of ethical review in organ transplantation， jointly promoting progress in this field.

Objective:To evaluate the teaching effect of multi-disciplinary integrated training program on the open comprehensive training room to improve the post competency of medical imaging students.Methods:A total of 122 residential students of five-year medical imaging from Batch 2014 of The First Affiliated Hospital of Chengdu Medical College were divided into experimental group and control group. The experimental group carried out the multi-disciplinary open comprehensive training program, and the control group carried out open-ended exercises. The comprehensive discipline theory examination, assessment of clinical thinking and comprehensive skill appraisal, and satisfaction questionnaire results were compared between the two groups. SPSS 23.0 was used for t test. Results:①Comprehensive discipline theory examination scores were higher in experimental group than the control group [(80.33±3.70) vs. (74.56±5.09)], with statistical differences ( P<0.05). ②Experimental group scored higher in clinical thinking and comprehensive skills than the control group did, and the difference was statistically significant [(87.58±3.15) vs. (74.52±3.66), P<0.05]. ③The questionnaire investigation showed that the experimental group students did better in improving autonomous learning ability, expression ability, the team cooperation ability, the ability to find and fix problems and the degree of self-esteem than control group, with statistically significant differences ( P<0.05). Conclusion:The multi-disciplinary open comprehensive training program has a good effect on optimizing the open-ended exercises. Students' knowledge of multi-disciplinary comprehensive theoretical knowledge and imaging skills have been improved, and the ability of teamwork, problem-solving ability, self-learning ability and innovation ability required by the core competence of the profession have been developed and improved, which meets the modern medical treatment of education "to create an educational platform of medical education collaboration and multi-disciplinary integration, and to cultivate students' innovative and autonomous learning."

Objective To raise awareness of the late-onset meningitis caused by group B streptococcus (GBS) which was homogenous to the maternal colonization.Methods The clinical data of late-onset GBS meningitis in neonates twins whose pathogens were homogenous to their maternal colonization were collected from Department of Neonatology,Guangzhou Women and Children's Medical Center.The general conditions,clinical symptoms,laboratory tests and drug treatment of the twins and their mother were retrospectively analyzed,and the GBS homology during inpatient care was tested.And the progress of the twins' condition was investigated by telephone follow-up.Results The mother had two pregnancies without prenatal GBS screening or intrapartum antimicrobial intervention for GBS,everything was normal during pregnancy and delivery.Twins were born through cesarean section.The elder sister was discharged with Linezolid taken orally after 167 days in hospital without convulsions,shaking or other discomfort.The elder sister was followed up for every 2 weeks,and in the last time of follow-up,cerebrospinal fluid white blood cell counts were 45 × 106/L,protein level was 1.52 g/L and Linezolid was withdrawn.The younger brother was discharged after 58 days in hospital with follow-up for every 2 weeks,and in the last time of follow-up,cerebrospinal fluid white blood cell counts were 30 × 106/L,protein level was 0.66 g/L.During the hospitalization and follow-up without convulsions and irritation,and the cranial magnetic resonance imaging of the twin brother was normal.Test results showed that the GBS bacteria strain for twins and their mother were all serotype Ⅲ.The possibility of the GBS homology was more than 90％.Conclusions The toxicity of serotype Ⅲ GBS strain was strong.More proactive precautions should be considered to apply for the mother whose first birth already had GBS infection.Early identification and intervention of infection risk factors would help optimize the anti-infection treatment program and reduce nerve system damage and other adverse outcomes caused by invasive GBS infection.

Objective To investigate the clinical characteristics,antibiotic susceptibilities and serotypes of Group B Streptococcus(GBS)isolated from neonatal meningitis to provide references for the prevention and treatment of neonatal GBS meningitis. Methods From June 2013 to June 2016,we surveyed the GBS strains iso-lated from purulent meningitis of < 90 days infants from Guangzhou Women and Children′s Medical Center. The GBS isolates were identified and the minimum inhibitory concentration of the antibiotics was determined by Vitek 2 Compact automatic bacterial identification system.GBS serotyping was performed using Strep-B-Latex?rapid latex agglutination test kit. Results A total of 46 cases of neonatal GBS meningitis,15 cases of early-onset infection and 31 cases of late-onset infection were diagnosed. 78.3% of GBS meningitis with varying degrees of complica-tions.Among 41 survivors with 3~24 months follow-up,50% of the early-onset and 44.8% of the late-onset GBS meningitis with varying degrees of neurological sequelae.Four capsular types were identified among the 46 isolates, serotype-Ⅲwas the most prevalent(73.9%),followed by Ib(19.6%),V(4.3%)and Ia(2.2%).All the isolates were susceptible to penicillins,cephalosporins,linezolid and vancomycin. Conclusion The highly pathogenic serotype-Ⅲ was the predominant serotype among neonatal GBS meningitis in Guangzhou,Therefore,it is neces-sary to strengthen the epidemiological surveillance of GBS invasive infection and the effective implementation of pre-ventive measures.

Group B streptococcus ( GBS) is the most common cause of neonatal invasive infections in western countries , leading to severe pneumonia , sepsis and meningitis with high mortality and morbidity . Neonatal GBS infections are mainly transmitted from mother to baby .Since the end of 1990 s, prevention strategies of antenatal GBS screening and intrapartum antibiotic prophylaxis ( IAP) have been implemented by European and American area , decreasing the incidence of neonatal GBS disease significantly .The harm of GBS to neonates has been recognized and valued in recent years in China , but the authorized prevention measures are still lacking.Efficacy of IAP-based prevention depends on the accuracy of GBS screening results during pregnancy .Here, the GBS prevention guideline or consensus recommended by European and American CDC, including the screening strategies , detection methods, sample collection, storage and transportation were interpreted .

Objective To investigate the variation characteristics of peripheral platelet parameters in children with dengue fever and to assess their use and value in diagnosis,prognosis and treatment for dengue fever.Methods Platelet parameters of 69 pediatric patients with dengue fever in acute febrile phase and remission period and 103 healthy controls were compared.The difference of platelet parameters between the liver function injury group and the normal liver function group,the coagulation dysfunction group and the coagulation function normal group,the severe group and the mild group with dengue fever was compared,the causes of thrombocytopenia in children with dengue was investigated so as to better understand the situation of bone marrow producing platelets.Results P-LCR,PDW,MPV were significantly higher in patients in acute febrile phase of dengue fever,compared with the healthy subjects(P＜0.01),while PCT,PLT were significantly lower in patients in acute febrile phase of dengue fever,compared with the healthy subjects(P＜0.01).MPV was significantly lower in patients with abnormal hepatic function when compared with patients with normal hepatic function(P＜0.05),while other platelet parameters did not show significant differences(P＞0.05).PLT and PCT were significantly lower in the severe patients than those in the mild patients(P＜0.05),while other platelet parameters did not show significant differences(P＞0.05).Peripheral platelet parameters did not show significant differences between patients with or without abnormal coagulation function (P＞0.05).Conclusion Peripheral platelet parameters may play a role in the diagnosis,treatment and prognosis of dengue fever in children.

Objective To investigate the dynamics of white blood cell count (WBC),prealbumin(PA),high sensitive C-reactive protein (hs-CRP),and vascular endothelial growth factor (VEGF) in hand-foot-and-mouth disease (HFMD) complicated with or without encephalitis and in vitro inhibitory effects of artesunate on VEGF secretion of mononuclear cells from HFMD patients.Methods Peripheral blood mononuclear cells from healthy control group,HFMD group and HFMD combined with encephalitis group were isolated by Ficoll density gradient centrifugation and treated with different concentrations of artesunate (25,50,100 mg/L).The expression of VEGF in the supernatant was examined by ELISA double antibody sandwich method.The levels of WBC,PA and hs-CRP in the three groups were also detected.Multiple samples were compared by one-way analysis of variance.Multiple comparison was performed by Dunnett T3 test.Correlation of two variables was analyzed by Spearman correlation test.Results There were significant differences in the levels of WBC,hs-CRP,PA and VEGF between the HFMD combined with or without encephalitis group and health control group (F=172.69,366.02,166.32 and 5 941.89,respectively,all P＜0.01).There were significant differences in the levels of VEGF secreted by mononuclear cells treated with three different concentrations of artesunate between the HFMD combined with or without encephalitis groups and health control group (F =194.265 and 4 750.69,respectively,both P＜0.01).Correlation analysis showed that the VEGF level secretion by mononuclear cells from HFMD patients with or without encephalitis were both negatively correlated with different concentrations of artesunate (r=-0.903 and-0.969,both P＜0.01).Conclusions Compared with HFMD without encephalitis,the secretion of VEGF by mononuclear cells,WBC and hs-CRP levels in HFMD complicated with encephalitis group all increase and PA decrease significantly.Artesunate can inhibit the secretion of VEGF by mononuclear cells of patients with hand-foot-and-mouth disease in a dosedependent manner in vitro.

Objective To compare the effect of phloroglucinol with lidocaine in treatment of cervical edema at the active stage.Methods 262 normal primiparae with cervical edema were randomly divided into three groups. Group A(89 cases)was intravenously given phloroglucinol,group B(83 cases)was injected lidocaine into the cervix, group C(90 cases)was wet compress lidocaine on the cervix.The cervical change,progression of labor and maternal and fetal outcomes were compared among the three groups.Results The disappearance ratio of cervical edema after 1h of group A,group B,group C were 79.8%,59.0%,57.8% respectively,there were statistically significant differ-ences between group A with group B and group C(χ2 =4.31,5.04,all P <0.05),there was no statistically significant difference between group B and group C(χ2 =0.14,P >0.05).The mean time period from drug administration to full dilation of the cervix of group A,group B,group C were (3.2 ±0.5)h,(4.1 ±0.6)h,(4.3 ±0.3)h,there were statistically significant differences between group A with group B and group C(t =0.91,1.06,all P <0.05),there was no statistically significant difference between group B and group C(t =0.15,P >0.05).The disappearance ratio of cervical edema after 2h (group A:94.3%,group B:95.2%,group C:93.3%),vaginal delivery rate(group A:94.3%,group B:91.6%,group C:94.4%),asphyxia neonatorum(group A:1 case,group B:0 case,group C:1 case),and postpartum hemorrhage[group A:(187 ±90)mL,group B:(202 ±100)mL,group C:(199 ±94)mL]had no statistically significant differences among the three groups(χ2 =0.14,0.29,0.10,F =0.633,all P >0.05 ). Conclusion Phloroglucinol and lidocaine all can treatment of cervical edema,the phloroglucinol is the best,two uses of lidocaine have same effect,there are no adverse effect on mother and newborn.

Objective To investigate the reference ranges of peripheral white blood cells (WBC) and five classification parame‐ters among 13 442 apparently healthy children to provide reference for clinical diagnosis .Methods A total of 13 442 apparently healthy children aged from 1 month old to 5 years undergoing the health physical examination in the healthcare department of the Guangzhou Municipal Women and Children Medical Center were chosen according to the healthy children screening standard and the exclusion standard of hematological diseases ,infection diseases and drug administration history .The WBC analysis and its parame‐ters detection were performed by using the Sysmex XS‐800i automatic blood cell analyzer .Results WBC and its five classification parameters were not accorded with the normally distribution .By the Mann‐whitney test ,no statistically significant differences in WBC ,BASO# and NEU # were detected between different genders of children (P> 0 .05) ,while the differences in LYM # , MONO# and EOS# had statistical significance(P<0 .001) ,in which the LYM # level in females was significantly higher than that in males ,while the MONO# and EOS# levels in females were lower than those in males ;By the Kruskal‐Wallis test ,WBC and five classification parameters had statistically significant differences among different age groups (P<0 .001) .The parameters of WBC ,LYM # ,MONO# and EOS# were decreased with age increase ,while NEU # was constantly increased with age increase and BASO# was decreased with age increase before 4 years old .Conclusion All factors such as gender ,age should be The inde‐pendent reference rangesl of WBC parameters among children aged from 1 month old to 7 years old should be formulated on the ba‐sis of fully considering the factors such as gender ,age .

Objective To explore the clinical significance of platelet count increasing in patients with ovarian malignant tumor . Methods 80 cases of ovarian malignant tumor patients ,80 patients with ovarian benign tumor and 80 cases of healthy women were enrolled in the study as group A ,B ,C respectively .The group A was divided into FIGOⅠ group(n=30) ,and FIGOⅡ and above group(n=50) .Platelet count was detected by using fully automatic blood cell analyzer and the serum CA125 concentrations were also measured for all the groups .Results The platelet count and CA125 concentrations in group A were higher than group B and group C(P< 0 .05) .The positive rate of platelet increasing and serum CA125 were also higher than group B and group C(P<0 .05) .There were significant differences between FIGOⅠ group and FIGOⅡ and above group in platelet count and CA125 concen‐trations .Conclusion Ovarian malignant tumor complicated with increased platelet count is common in patients of advanced stage . The increased platelet count could indicate the malignant degree of ovarian malignant tumor .