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The neonatal critical illness scoring system is widely used to assess the severity of neonatal disease, serious complications, neonatal mortality risk, long-term prognosis, and guide transport.At present, the scores widely used at home and abroad include clinical risk index for babies(CRIB), clinical risk index for babies Ⅱ(CRIB-Ⅱ), score for neonatal acute physiology(SNAP), score for neonatal acute physiology Ⅱ(SNAP-Ⅱ), score for neonatal acute physiology, perinatal extension, version Ⅱ(SNAPPE-Ⅱ), and neonatal critical illness score(NCIS), etc.Although there are many neonatal critical illness scoring systems, there is no recognized and ideal score, the most suitable score for assessing the severity of neonatal disease.This paper reviews the application and research progress of the three scoring systems SNAP-Ⅱ, SNAPPE-Ⅱ and NCIS.
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The cerebral hemodynamic disorders are most likely to occur in preterm infants, especially in extremely preterm infants with gestational age <28 weeks, due to the immaturity of cerebral vascular development and poor autoregulation of cerebral blood flow. Also the neurons, oligodendrocytes and their precursors in preterm infants are abnormally sensitive to hypoxia and ischemia with low tolerance and high vulnerability, which lead to a higher incidence of brain damage and neurological sequelae in preterm infants than that in full-term infants. Because brain injury in the premature often lacks the obvious nervous system symptom and the sign clinically, it is easy to be misdiagnosed and hence suitable treatment opportunity is missed. Cranial ultrasonography, MRI and EEG are the special examinations for early diagnosis of brain injury in preterm infants. In the diagnosis of early intracranial hemorrhage, cranial ultrasonography is superior to both MRI and EEG, but MRI especially DWI has the highest diagnostic value in the evaluation of leukoencephalomalacia, and EEG plays a supporting role in diagnosis of brain injury in each period. The three techniques have their own advantages and disadvantages. In clinical practice, if three techniques can be rationally used for the diagnosis of brain damage in preterm infants, it would be helpful to detect the disease in time and treat appropriately as soon as possible, and thus reduce the neurological sequelae and disability in preterm infants, and improve the long-term prognosis.
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Object Through performing the service satisfaction survey,to learn their interest claim and discover the service defects ,so as to provide advice and countermeasures.Method Using field survey methods and statistics analysis to study.Result The satisfaction of relatives of pediatric patients at the level of "relatively good" and "good" is about 60% both in medical treatment environment and equipment ,over 70% in medical treatment effect,doctor capacity,nursing capacity and overall assessment,but only 5.1% in medical expenses.Conclusion Relatives of pediatric patients have high satisfaction in treatment capability of medical staff,medical treatment effect as well as overall assessment ,normal satisfaction in medical environment and equipment,but lowest satisfaction in medical expenses,and the satisfaction in tertiary hospital is not high.Relatives in some districts demand much in some aspects,such as improving hospital environment,attaching importance to ward hygiene ,improving service attitude,and providing single ward ect.
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Objective Discussion of the role/effect of an incentive mechanism in encouraging proactive reporting of adverse events in hospital.Methods Applying an incentive mechanism to encourage medical staff to report on adverse events found in their hospitals.Incentives in question include financial rewards.alleviation or cancellation of some penalties for medical defects.These measures were followed by a comparison between the number and types of proactive reporting on adverse events with those prior to such measures.in addition to typical case studies.Results Comparison of the figures during Jan.August,2007 and those during the sanqe period in 2008 after the incentive mechanism was in place found significant changes.For example,cases of proactive reporting rose from 34 to 176.Most significant changes were found in even types including medical malpractice.For medical disposal events,the number of events rose from 5 in 2007 to 10 in 2008;events in medical technical inspections from 0 to 24 cases;and that of patients identification from 2 to 14.These figures were followed by typical case analysis and improvements.Conclusion Such all incentive mechanism has significantly increased the number of proactive reporting on adverse events in hospitals,changing the types of such reporting to stand out malpractice related events,and enhancing the reporting to improve quality of care in hospitals.
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[Objective] To investigate the influence of serum containing Danggui Buxue Decoction (DBD) on chemotaxis of oxidized low-density lipoproteins ( OxLDLs) for monocytes ( MC). [ Methods ] Six New Zealand rabbits were randomized to DBD group, Radix Angelicae Sinensis (RAS) group and Radix Astragali seu Hedysari (RASH) group. The rabbits were treated by gastric infusion of the above drugs respectively, bid for three days. On the third day, the serum containing drugs was obtained by heart blood sampling one hour after administration. Free chemotaxis group (normal control group) and OxLDLs group ( model group) were established for control. The number and figure of OxLDLs - chemotactic MC were observed by micropore filter method with chemotactic chamber. [Results] OxLDLs -chemotactic MC number in DBD group were lower than those in model group (P
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Objective To establish the predictive value of perinatal factors associated with periventricular intraventricular haemorrhage (PIVH). Methods All very low birth weight infants underwent real time ultrasonography of the brain. The haemorrhages were graded to make use of stepwise logistic regression analyses to search predictive factors of PIVH and severe intraventricular haemorrhage. Results The incidence of PIVH of 412 very low birth weight infants was 25.0% (103/412), the mortality rate of PIVH was 39.8% (41/103). The incidence of PIVH by year was declining from 32.0% in 1994 to 17.6% in 2000 through the formulation of rational interventions. Infants who were of lower gestational age and lower birth weight had a higher incidence of PIVH and more severe intraventricular haemorrhage. Correlated factors were subjected to multivariate analysis. The predictive factors were perinatal asphyxia (OR 2.46,95% CI 1.48,4.42), gestation of less than 29 weeks (OR 2.37,95% CI 1.35,3.68),severe respiratory distress syndrome (OR 2.16,95% CI 1.34, 4.19),vaginal delivery (OR 2.14, 95% CI 1.15, 4.12). Conclusion Some intervention like prevention of low birth weight infant may reduce the incidence of periventricular intraventricular haemorrhage.
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Object To establish the fingerprint of isoflavones and ferulic acid of Danggui Buxue decoction.Methods HPLC with Hypersil ODS column was adopted,the methanol-0.2 % acetic acid glacial(gradient elution) as mobile phase with a flow rate of 1mL/min and detecting wavelength at 254 nm.Results There were 10 main peaks in Danggui Buxie decoction,9 of them came from Radix astragali and 3 came from Radix angelicae sinensis.Conclusion This fingerprint can be used as a reference for the stability of the isoflavones and ferulic acid in Danggui Buxue decoction.
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AIM: To study the main components of the position of n-Butanol extract of Danggui Buxie Decoction(Radix Astragali,Radix Angelicae Sinensis). METHODS: The main components were determined by HPLC.HPLC with Nucleodur C18 Gravity column was used,the Acetonitrile-water(gradient elution) was used as a mobile phase and detecting wavelength at 210 nm. RESULTS: There were 14 common peaks in the peak position of n-Butanol extract of Danggui Buxue Decoction,Radix astragli had 14 peaks and Radix angelicae sinensis 3 peaks. CONCLUSION: The main components of the peak position among n-Butanol extract of Radix astragali and its extract and Danggui Buxie Decoction have correlation.
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AIM: To study the main components of volatile oil of Danggui Buxue Decoction (Radix Astragali, Radix Angelicae Sinensis) . METHODS:The main components of volatile oil were determined by GC-MS. The injector temperature was 250 ℃. The interface temperature was 230 ℃. The column flow was 1.3 mL?min -1. The column pressure was 100 kPa. The temperature rate was 3 ℃?min -1. RESULTS: The main components of volatile oil of Danggui Buxue Decoction were composed of trans-ligustilide, butylidene phthalide, n-butylphthalide, and cis-ligustilide. CONCLUSION: The main components of volatile oil of Danggui Buxue Decoction come mainly from volatile oil of Radix Angelicae sinensis.