Smartphones have made great strides in neonatology.With the advantages of portability, low cost, ease of operation, and powerful application processing, smartphones, when combined with appropriate medical applications, enable rapid and accurate monitoring of neonatal diseases and are important for the early prevention and treatment of various neonatal conditions.In this review, we discussed the application of various smartphone-based assistive technologies in the neonatal field.

Objective To investigate the efficacy of neuroendoscopy combined with urokinase in the treatment of spontaneous intraventricular hemorrhage.Methods From August 2014 to August 2017,91 spontaneous thalamic hemorrhage ruptured into ventricles patients in Affiliated Hospital of the Yangzhou University were enrolled,who were underwent surgical treatment in this retrospective study.The patients were divided into the study group(n =41) and control group(n =50) based on different methods of treatment.The patients in the study group were given with remove visible intraventricular hematoma by neuroendoscopy,followed by External Ventricular Drainage (EVD) combined with urokinase fibrinolysis.The patients in control group were given with EVD combined with urokinase fibrinolysis.The time of postoperative drainage,ICU stay,duration of onset of fever,the number of intracranial infections,and the proportion of Glasgow outcome scale (GOS) (1 to 5) at 6 months postsurgery were compared between two groups.Measurement data were expressed as (Mean ± SD),and t test was used for measurement data.The count data were analyzed by x2 test or nonparametric rank sum test.Results The time of postoperative drainage,the number of intracranial infections,ICU stay in study group were (6.19 ± 1.1) d,5 cases,(2.8 ± 1.6) d,the indexes in control group were (7.06 ± 1.3) d,15 cases,(5.2 ± 2.0) d.The time of postoperative drainage,ICU stay,the number of intracranial infections were superior to those of the control group,and the difference was statistically significant.The proportion of GOS (1 to 5) at 6 months after surgery was 5 cases (12.2％),5 cases (12.2％),10 cases (24.4％),14 cases (34.1％),7 cases (17.1％) in study group,the indexes in control group were 10 cases(20.0％),13 cases (26.0％),11 cases(22.0％),10 cases(20.0％),6 cases(12.0％).The 6-month postoperative GOS of the study group were superior to those of the control group,and the difference was statistically significant (P ＜ 0.05).Conclusion Neruendoscopy combined with urokinase in the treatment of spontaneous intraventricular hemorrhage can reduce the time of postoperative drainage and the incidence of intracranial infection,shorten the time of ICU stay and improve the functional prognosis of the patients.

Objective: To assess the effectiveness of seasonal influenza vaccine among children aged 6 to 72 months. Methods: The test-negative case control study was conducted based on available surveillance data which was from China Influenza Surveillance Information system (CSIS). From October 2016 to April 2017 and from October 2017 to April 2018,1 161 cases aged 6-72 months with influenza-like illness in Yongkang and Yiwu city, were selected as the study subjects, and the cases with influenza test-positive were selected as the case group (403 cases). Test-negative subjects were selected as control group (758 cases). The etiology and immunization data of the subjects were obtained from CSIS and Immune Information and Management System (IIMS) respectively. Vaccine effectiveness was estimated using multivariate logistic regression model,and the mixed effects of non-randomized control in TNCC study were equalized by using the propensity score (PS) method in the statistical analysis. Results: The age of the subjects was (2.44±1.60) years,and there were 681 boys (58.66%). The age of case group was (2.62±1.58) years, and there were 246 boys (61.04%). The case group was including of 237 cases (58.81%) of influenza A (H3N2), 92 cases (22.83%) of influenza A (H1N1) pmd09, 62 cases (15.38%) of influenza B(Victoria) lineage, 11 cases (2.73%) of influenza B (Yamagata) lineage and one case (0.25%) co-infection of influenza [A(H₃N₂)+B (Victoria)]. The mean age of the control group was (2.35±1.61) years,and there were 435 boys (57.39%). Overall vaccine effectiveness (VE) against all type influenza for two seasons combined was 58% (95%CI: 31%-74%). An analysis by age groups showed 68% (95%CI:41%-82%) of the VE estimate among children aged 36-72 months while it was 28%(95%CI:-80%-71%)of the VE estimate among children aged 6-35 months. The VE estimate value was 54% (95%CI:16%-75%) against all type influenza and 65% (95%CI:24%-83%) against influenza A (H₃N₂) during the 2016-2017 season. During the 2017-2018 season, the VE estimate value was 69% (95%CI:18%-88%) against all type influenza. Conclusion Influenza vaccine is effective in preventing influenza virus infection during the flu season,especially the effect among children aged 36-72 months is higher compared to that among children aged 6-35 months.

Objective: To investigate the clinical significance of cellular immune function, inflammatory factors and myocardial enzyme detection in evaluation of prognosis of septic shock, so as to provide a reference for clinical diagnosis and treatment of septic shock. Methods: From June 2015 to June 2018, 73 patients with septic shock treated in the First People's Hospital of Yongkang were selected as the research subjects.According to the 28d prognosis after the patients entered the ICU, the patients were divided into the death group and the survival group.Another 67 cases of health examination from June 2015 to June 2018 were selected as control group.The changes of T lymphocyte subsets includingCD3, CD4 and CD8 were measured by BD FACSCanto I I flow cytometry, the content of procalcitonin(PCT) was determined by immunoluminescence assay, the content of C-reactive protein(CRP) was determined by immunoturbidimetry, and the content of creatine kinase MB(CK-MB), cardiac troponin I(cTnI) and lactate dehydrogenase(LDH) was determined by enzymatic kinetics. Results: The APACHE Ⅱ score and MODS score of the survival group and the death group were higher than those of the control group [(2.20±0.61)points and (4.86±1.29)points]. The APACHE Ⅱ score and MODS score of death group [(16.45±4.28)points and (27.63±4.97)points] were higher than those of survival group [(9.84±2.45)points and (19.84±3.28)points](all P<0.05). The CD₃⁺, CD₄⁺ and CD₄⁺/CD₈⁺ in the survival group and the death group were significantly lower than those in the control group[(71.32±6.96)%, (42.63±4.26)%, (1.67±0.31)%](all P<0.05). The contents of PCT and CRP in the survival group and the death group were higher than those in the control group [(0.19±0.03)ng/mL and (2.19±0.76)mg/L], and the contents of PCT [(15.93±3.26)ng/mL] and CRP [(184.32±29.80)mg/L] in the death group were higher than those in the survival group [(6.87±1.94)ng/mL and (69.49±17.42)mg/L] (all P<0.05). The CK-MB content in the survival group and the death group of septic shock was lower than that in the control group [(1.97±0.21)μg/L], and the cTnI and LDH contents were higher than that in the control group [(0.03±0.01)μg/L and (168.93±16.52)U/L], the content of CK-MB [(0.68±0.10)μg/L] in the death group was lower than that in the survival group [(1.27±0.13)μg/L], while the contents of cTnI [(0.39±0.06)μg/L] and LDH [(384.52±39.89)U/L] in the death group were lower than those in the survival group [(0.17±0.04)μg/L and (257.18±25.47)U/L] (P<0.05). Conclusion The immune function of the patients with septic shock is obviously reduced, there are obvious inflammatory reactions and abnormal myocardial enzymes, and the detection of cellular immune function, inflammatory factors and myocardial enzymes can be used as an effective index to judge the shock of septic shock.

Objective To evaluate the clinical effect of chronic subdual hematoma between surgical procedure twist drill craniostomy with injecting urokinase into hematoma space and only with twist drill craniostomy.Methods Two hundred and twenty-five patients with chronic subdual hematoma patients who were admitted in the Affiliated Hospital of Yangzhou University from January 2011 to April 2017 were retrospectively analyzed.They were divided into two groups according to the different surgical methods,group A for twist drill craniostomy with injecting urokinase into hematoma space (n =116),group B only for twist drill craniostomy (n =109).Then the postoperative drainage volume and residual hematoma was analyzed by repeated measures,while radiographic grading system and recurrence rates after operation were compared between groups with statistical analysis which was done by ANOVA analysis or non-parametric rank sum test.Results The drainage volume 48 hours after surgery was(52.41 ± 7.86) ml in group A,(28.42 ± 4.46) ml in group B as well.The residual volumes which were calculated at 1 month,3 months after surgery was (23.35 ±4.18) ml and (15.31 ±6.15) ml in group A,comparing the volumes of (46.07 ± 5.96) ml and (25.60 ± 5.03) ml in group B.The radiographic grading system was evaluated by grade 1-4.There were 75(64.7％) cases in grade 1,32(27.6％) cases in grade 2,8(6.9％) cases in grade 3,1 (0.9％) cases in grade 4 of group A,as well as 42(38.5％) cases in grade 1,55(50.5％) cases in grade 2,11 (10.1％) cases in grade 3,1 (0.9％) cases in grade 4 of group B.The rate of recurrence for chronic subdural hematoma was 6.0％ in group A,while it was 15.6％ in group B.These data all had significant statistical difference between the two groups (P ＜ 0.05).Conclusion Twist drill craniostomy might be a safe,effective and mini-massive method for treating chronic subdual hematoma,while injecting urokinase into the hematoma space could significantly reduce the rate of recurrence and decrease the volume of hematoma.

OBJECTIVE: To compare the clinical effects and complications of two hybrid decompression techniques in treating multilevel (>=3) cervical spondylotic myelopathy(MCSM). METHODS: The clinical data of 124 patients with multilevel (>=3) cervical spondylotic myelopathy treated by surgery and follow-up from January 2008 to December 2016 were retrospectively analyzed. According to the different operative methods, the patients were divided into group A and group B. Anterior cervical discectomy and fusion (ACDF) combined with anterior cervical corpectomy and fusion with preserved posterior vertebral wall (PWCF) were performed in group A; ACDF combined with anterior cervical corpectomy and fusion(ACCF) were performed in group B. There were 44 males and 16 females in group A with an average age of (60.43±7.52) years old, 46 males and 18 females in group B with an average age of (61.61±6.39) years old. No significant differences were found in gender, age between two groups. The operative time, intraoperative blood loss, hospital stay, rate of complications, postoperative Japanese Orthopaedic Association (JOA) score and improvement of cervical curvature were compared between two groups. RESULTS: All the operations were successful. The follow-up time was 13 to 28(23.0±12.1) months in group A and 12 to 30(24.0±11.5) months in group B. The operative time, intraoperative blood loss, hospital stay in group B were higher than those in group A(<0.05). A total of 37 patients occurred complications, including 14 cases in group A and 23 cases in group B. The incidence of complications was 23.33%(14/60) in group A and 35.94%(23/64) in group B. The incidence of complications in group B was significantly higher than that in group A(<0.05). Postoperative JOA scores were significantly improved (<0.01), there was no significant difference between two groups (>0.05). The physiological curvature of cervical vertebra was improved significantly after operation, and there was no significant difference between two groups(>0.05). CONCLUSIONS Both surgical methods can obtain satisfactory clinical efficacy for multilevel(>=3) cervical spondylotic myelopathy, but compare with group B (ACDF combined with ACCF), group A (ACDF combined with PWCF) has shorter operation time, less trauma, less bleeding, and lower incidence of complications. ACDF combined with PWCF can be preferentially selected for the patients who corresponding to the indications.
Aged ; Cervical Vertebrae ; Diskectomy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spinal Cord Diseases ; Spinal Fusion ; Spondylosis ; Treatment Outcome

Objective To explore the effect of 5-aminosalicylic acid (5-ASA)combined with antrum mucosal protein-18 (AMP-18)on the expression of myeloperoxidase (MPO),nuclear factor-kB(NF-kB)and epidermal growth factor (EGF)in trinitrobenzene sulphonic acid (TNBS)in-duced colitis rats.Methods 40 male sprague-dawley (SD)rats were randomly divided into group A,B,C and D.After the production of colitis,10 rats in each group were given the following topical treatments respectively:group A,normal saline;group B,5-ASA at the dose of 100 mg/kg;group C,AMP-18 at the dose of 10 mg/kg;group D,5-ASA and AMP-18.Animals were sacrificed at the 4th and 8th day after topical treatment.The macroscopic and histological changes of the colon were e-valuated and scored.MPO activity of the mucosa was detected by biochemical methods.Expressions of serum EGF and tissue NF-kB were detected by ELISA and immunohistochemistry respectively.Re-sults Compared with group A,macroscopic and histological scores and MPO activity in group B,C and D significantly decreased (P <0.05 ).Expressions of serum EGF were significantly higher in group B,C and D than in group A (P <0.01),while the expressions of tissue NF-kB significantly decreased (P <0 .0 5 ).The combination ofAMP -1 8 with 5 -ASA showed a better effect than single use of AMP -1 8 or 5 -ASA .Conclusion Topical treatment with 5 -ASA and AMP -1 8 shows a positive effect in treating TNBS-induced colitis rats,and combined treatment is better than single treatment.The mechanism is related to decreasing of content of colonic MPO,down-regulation of NF-kB and up-expression of EGF.

Objective To explore the effect of 5-aminosalicylic acid (5-ASA)combined with antrum mucosal protein-18 (AMP-18)on the expression of myeloperoxidase (MPO),nuclear factor-kB(NF-kB)and epidermal growth factor (EGF)in trinitrobenzene sulphonic acid (TNBS)in-duced colitis rats.Methods 40 male sprague-dawley (SD)rats were randomly divided into group A,B,C and D.After the production of colitis,10 rats in each group were given the following topical treatments respectively:group A,normal saline;group B,5-ASA at the dose of 100 mg/kg;group C,AMP-18 at the dose of 10 mg/kg;group D,5-ASA and AMP-18.Animals were sacrificed at the 4th and 8th day after topical treatment.The macroscopic and histological changes of the colon were e-valuated and scored.MPO activity of the mucosa was detected by biochemical methods.Expressions of serum EGF and tissue NF-kB were detected by ELISA and immunohistochemistry respectively.Re-sults Compared with group A,macroscopic and histological scores and MPO activity in group B,C and D significantly decreased (P <0.05 ).Expressions of serum EGF were significantly higher in group B,C and D than in group A (P <0.01),while the expressions of tissue NF-kB significantly decreased (P <0 .0 5 ).The combination ofAMP -1 8 with 5 -ASA showed a better effect than single use of AMP -1 8 or 5 -ASA .Conclusion Topical treatment with 5 -ASA and AMP -1 8 shows a positive effect in treating TNBS-induced colitis rats,and combined treatment is better than single treatment.The mechanism is related to decreasing of content of colonic MPO,down-regulation of NF-kB and up-expression of EGF.