To study the influential factors of C-reactive protein (CRP) in neonates.

A total of 220 neonates whose serum CRP exceeded 8 mg/mL were recruited in the department of Neonate Intensive Care Unit (NICU) of BaYi Children's Hospital of General Military Hospital of Beijing from January 2009 to December 2010. They were selected to study group According to the diagnostic criteria for neonatal disease of Practical Neonatology and in accordance with the diagnosis and examination results on admission, they were divided into following sub-groups: sepsis sub-group (n=19), premature low birth weight sub-group (n=50), neonatal pneumonia sub-group (n=151), hypoglycemia sub-group (n=14), hemolytic disease sub-group (n=20), respiratory distress syndrome of newborn (NRDS) sub-group (n=8), pathological jaundice sub-group (n=81), intracranial hemorrhage sub-group (n=13), hypoxic ischemic encephalopathy (HIE) sub-group (n=29), asphyxia sub-group (n=20), amniotic fluid pollution sub-group (n=62) and premature rupture of membranes sub-group (n=44). At the same time, a total of 2129 inpatient neonates without corresponding diseases were chosen as corresponding control group (n=201, 170, 69, 206, 200, 212, 139, 207, 191, 200, 158, 176), respectively. Procedures were performed according to the Helsinki Declaration and approved by institutional Review Board (Institutional Review Board of General Military Hospital of Beijing PLA). The blood sampling of neonates were collected according to patient condition after approval was obtained from their families during hospitalization period. There were no statistically significant difference about gender, age, feeding and delivery methods between two groups (P>0.05). The average rank of serum CRP took two-sample rank test (Mann Whitney U test), correlation analysis took Pearson correlation of multiple linear regression analysis.

The preliminary screening results by Mann Whitney U test showed mean rank: Serum CRP of neonates septicemia (Yes: 138.32, No: 107.86; U=1381.0, P=0.046), NRDS (Yes: 66.44, No: 112.16; U=495.5, P=0.046), results of Pearson correlation showed possible correlation among serum CRP and hemoglobin (Hb), hematocrit (Hct), total bilirubin (TBIL), direct bilirubin (DBIL), glucose (Glu) (r=-0.149, -0.143, -0.164, 0.246, 0.316, P<0.05). Stepwise regression analysis was used further, dependent variable: Serum CRP, covariates: Neonatal septicemia, NRDS, Hb, Hct, TBIL, DBIL, Glu, only DBIL and Glu entered regression equation, standardized partial regression coefficient were 0.477, 0.311, respectively. The 95% confidence intervals were 0.608-2.265 and 0.588-9.445 (P=0.001, 0.028), respectively, so DBIL and Glu were positively correlated with serum CRP, the model had statistical significance (F=9.298, P=0.001), goodness of fit was slightly poorer (R²=0.341).

Serum CRP are positively correlated with DBIL and Glu, furthermore, DBIL has more positive effects on serum CRP than Glu. Some others important influential factors on serum CRP need to be detected.

To explore the relationship between adiponectin (APN) and lipoproteins in the late pregnancy women with preeclampsia (PE).

From October 2008 to October 2010, a total of 40 cases of pregnancy women with PE were admitted in the Second Affiliated Hospital of Qingdao Medical University as PE group. According to severity grading of PE [severe preeclampsia (SPE) and mild preeclampsia(MPE)], they were divided into SPE group(n=22) and MPE group(n=18). Meanwhile another 40 healthy pregnancy women gestational ages as control group. The levels of serum APN, total triglyceride(TG), cholesterin(TC), low density lipoprotein(LDL)and high density lipoprotein (HDL) in 80 pregnant women at 34~38 weeks were measured with radioimmunoassay(RIA). There had no significant differences between PE group and control group, MPE group and SPE group among ages, gestational ages, parities(all first born), pregnant weight in late pregnancy, special past medical history and other pregnancy complications (P>0.05). This was a prospective observational study with institutional ethics approval and written subjects consent.

①The levels of serum APN and HDL were significantly lower in PE group than those in control group(P<0.01). The TG level was significantly higher in PE group than that in control group(P<0.01). ②The levels of APN and TG were negative correlated in PE group(r=-0.90, P<0.01). The levels of APN and HDL were positive correlated in PE group(r=0.93, P<0.01).

Lower APN and disturbance of lipid metabolism in late pregnancy might be associated with the pathogenesis of PE.

To evaluate the value of liquid-based cytological test (LCT) as a screening method to detect cervical carcinoma.

The clinical data of 61 610 cases were collected from March 2004 to March 2011. The LCT results and colposcopic biopsy of 61 610 cases and 128 554 conventional Papnicoulau smears (CP) were compared and retrospectively analyzed. Follow-up diagnoses of colposcopic biopsy were available for those previously detected cytological abnormalities.

① Among 61 610 LCT results, 1772 (2.88%) cases were cytological interpreted as atypical squamous cell of undetermined significance (ASCUS) or above, and among them, 1017 cases who received colposcopic biopsy showed 38 (0.06%, 38/61 610) were squamous cell carcinoma (SCC) or cervical adenocarcinoma (GLCA), 251 (0.41%, 284/61 610) were high grade squamous intraepithelial lesions (HSIL) [cervical intraepithelial neoplasia (CIN) Ⅱ, Ⅲ were 169 cases and 82 cases, respectively], 409 (0.66%, 399/61 610) were low grade squamous intraepithelial lesions (LSIL) (216 were condyloma and 193 were CIN I), atypical glandular cell (AGC) were 5 cases, adenocarcinomain situ (AIS) were 2 cases, and chronic inflammation were 312 cases. In the results of 128 554 specimen by CP, 272 cases (0.21%) were cytological interpreted as Pap Ⅲ or above. Among these 272 cases, 253 who received biopsy showed that 65 cases were cytological interpreted as SCC or GLCA, 97 were HSIL including 57 for CINⅡ and 40 for CINⅢ, 82 were LSIL including 45 for CINⅠ and 37 for condyloma, 9 were chronic inflammation. There was no significant difference between CP and LCT in detecting cervical carcinoma. ② The consistent rate of LCT and histological diagnosis was the follow: HSIL(82.77%, 173/209)>SCC(73.53%, 25/34)>LSIL(63.46%, 264/416).

Compared with CP, LCT has more sensitivity and reliability in screening for cervical carcinoma and SIL, especially in detecting HSIL. But we must pay more attention to the misdiagnosis or under-diagnosis of cervical carcinoma because of scant cellular, cell overlying, inflammation, etc. in the preparations.

To explore the diagnostic value of molybdenum (Mo) target X-ray radiography and color Doppler ultrasonography in breast carcinoma in situ.

From October 2003 to September 2009, the clinical data of 21 cases with breast carcinoma in situ were selected into this study. The data of molybdenum target X-ray radiography and color Doppler ultrasonography were retrospectively analyzed by Breast Imaging Reporting and Data System (BI-RADS) and BI-RADS ultrasonography (BI-RADS-US). Informed consent was obtained from all participates.

The color Doppler ultrasound results of 21 cases which were analyzed by BI-RADS-US classification showed, grade 5 were 2 cases (9.52%), grade 4 were 15 cases (71.42%, including grade 4A were 5 cases, 4B were 4 cases, 4C were 6 cases), grade 3 were 4 cases (19.04%). The molybdenum target X-ray radiography of 21 cases which were analyzed by BI-RADS classification showed, grade 5 were 3 cases (14.29%), grade 4 were 13 cases (61.90%, including grade 4A were 3 cases, 4B were 7 cases, 4C were 3 cases), grade 3 were 3 cases (19.04%), grade 2 were 2 cases (9.52%). The consistency rate of two methods (≥grade 4)was 71.42% (15/21). The Cohen Kappa (κ value) was 0.73 (>0.6).

The BI-RADS classification of molybdenum target X-ray radiography combined with BI-RADS-US classification of color Doppler ultrasonography, and other clinical tests in diagnosis of breast carcinoma in situ is of important value.

To investigate distribution and antibacterial resistance of pathogens causing neonatal septicemia in Xichang City, Liangshan Yi Autonomous Prefecture, Sichuan Province.

A total of 254 blood samples of newborn with positive results of blood cultures from May 2005 to October 2010 were identified and their drug-susceptibility tests were done. The study protocal was approved by the Ethical Review Board of Investigation in human being of First People's Hospital in Liangshan.

Among 254 strains, 237 strains (93.3%) were Gram-positive (G⁺ ) strains and 17 strains (6.7%) were Gram-negative (G^-) strains. Among the G⁺ strains, coagulase negative Staphylococcus (CNS) accounted for 82.3%(195/237) and took the overall isolating rate of 76.8%(195/254). Escherichia Coli took the major part in the G^- strains, which accounted for 5.5%(14/254) of the overall isolating rate. The top four pathogens detected from this study were Staphylococcus Epidermidis, Staphylococcus Haemolyticus, Staphylococcus Hominis and Escherichia Coli. Drug sensitivity results showed that G⁺ strains including Staphylococcus Epidermidis, Staphylococcus Haemolyticus and Staphylococcus Hominis had the highest resistance rate to penicillin, then, erythromycin, ampicillin, cephazoline, amoxicillin/clavulanic acid and Sulfamathoxazole and trimethoprim(SMZ-TMP), while all of them were sensitive to vancomycin and rifampin. Escherichia coli had relatively high resistance rate to ampicillin and cefotaxime, then cephazoline, gentamicin and chloromycin, but very sensitive to imipenem.

G⁺ strains are the mojor pathogens causing neonatal septicemia in Xichang city, Liangsha Yi Autonomous Prefecture, Sichuan Province. Among G⁺ strains, CNS takes the first place, among G strains Escherichia coli is at the first. The phenomenon of antibacterial resistance is quite common and severe.

To explore the influence of ultra-early intervention on intellectual and physical development of premature infants.

From August 2005 to July 2008, a total of 120 survived premature infants, born at 30-36 weeks of gestational age, were recruited into neonatal intensive care unit (NICU). All of them had no congenital deformity and hereditary metabolic disease. They were divided into intervention group (n=60) and control group (n=60) according to whether their parents allow their infants to be involved in the ultra-early intervention model or not. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Dazhou Central Hospital. Informed consent was obtained from the parents of each participating neonate. There had no significance difference between two groups among birth weight, gestational age at delivery, gender, delivery mode, Apgar score, complications, maternal age, rates of breast feeding and culture degree of parents (P>0.05). Premature infants in both groups received conventional treatment, and intervention group received ultra-early intervention including rehabilitation training focused on sensory stimulation after their vital signs became stable. Intervention of exercise, activities and motion were performed in rehabilitation training. After the premature infants discharged from NICU, both groups received early education which were performed by the parents according to early education schedule of this study. Besides that, intervention of exercise, activities and motion were performed in intervention group only. Intellectual and physical developmental conditions in two groups were followed up and evaluated regularly by Gesell Developmental Schedules.

Hospital stay at NICU in intervention group (8 d) was much shorter than that in control group (15 d) with significant difference (P<0.05). There had significant difference of mean value of development quotient(DQ) between two groups when the premature infants were at 6-month-old and 12-month-old (P<0.05).

Ultra-early intervention can not only promote the maturation of digestive function and respiratory function of premature infants and shorten the hospital stay at NICU, but also significantly promote the intellectual and physical development of premature infants.

Congenital diaphragmatic hernia(CDH) is a common and critical care in neonatal surgery, and the severity of pulmonary hypoplasia(PH) and pulmonary hypertension that CDH combined with was the main factor which determines the prognosis. The clinical effects of integrated treatment with CDH was an important indicator of neonatal standards. This article focuses on the research in the pathogenesis of pulmonary hypertension and clinical progress in diagnosis and treatment with CDH.