The new revision of Declaration of Helsinki in 2013 has adjusted the structure, added or deleted some provisions on the content and modification, and modificated on the details of some words.Revision of the new version has improved the architecture, perfected the content of the declaration, strengthened the protection of the subjects, increased demand for researchers, and cleared the duty of country, research institutions and bidders.The enlighten-ment to our country are:constantly revised involving human clinical trials of the relevant laws and regulations , to pro-tect rights and interests of the subjects;National obligations for protection of the subjects, clinical trials explore the establishment of national compensation system;Ethics committee responsibilities and clearly positioning, exploring to establish an independent ethical review body.

【Objective】 To study KAP mode intervention on parental knowledge attitude and behavior of the mother in child rearing process in order to promote the growth and development of infants.【Methods】 401 babies born in International Peace Maternity and Child Hospital,were randomly divided into intervention and control groups,to carry out four parents' school curriculum to the class parents,compared the differences between two groups' parental knowledge and feeding behavior before and after of intervention.then offer them the growth and development monitoring;evaluation guidance individually.【Results】 One-year-old the study group had much progress than control on parental knowledge.They care of the feeding behavior,good dining environment,properly dining speed,and encourage children to feed themselves.The picky eaters were much less than control.Body length and weight on 3-month,5-month,the two groups had significant differences(P<0.05) that showed the study group was higher than the control.The length of girls in two groups in 5month-old had significant differences(t=2.65,P<0.01) study group was higher.Infant neurodevelopment assessment in terms of adaptability of language also the same difference.the study group score was higher.【Conclusion】 The knowledge of KAP mode intervention can improve parents' child-rearing knowledge attitudes and behavior to infant's growth and development.it has a positive role in promoting.

Objective Neonatal sepsis is the most serious problem in neonatal intensive care unit,which results in significant mortality.The causative pathogens,drug sensitivity,hematological data,clinical course and mortality rate of neonatal sepsis were evaluated.Methods Neonates admitted to the neonatal intensive care unit(NICU)of International Peace Maternity and Children's Hospital between January 1999 and December 2008 were included in this study.They were divided into two groups according to the time of their positive culture test after birth,early-onset sepsis group(within the first 7 days of life)and late-onset sepsis groups(after 7 days).Results A total of 67 episodes of sepsis were identified in 66 neonates.The incidence of sepsis was 1.36% among all NICU patients admitted at the same period.Most neonates with early-onset sepsis were term infants,while very low birth weight(VLBW)and preterm infants accounted for the majority of cases of late-onset sepsis(P 0.05).In early-onset sepsis,the most common pathogens responsible included Escherichia coli(E.coli)(33.3%)and group B streptococci(GBS)(31.0%).The most common causative microorganisms in late-onset sepsis were Klebsiella pneumoniae(32.0%)and E.coli(28.0%).The sepsis-related mortality rates were higher in early-onset sepsis(21.4%)than in late-onset sepsis(4.2%).Conclusions E.coli and GBS were found to be the leading pathogens in early-onset sepsis.The most common causative microorganisms of late-onset sepsis were Klebsiella pneumoniae and E.coli.GBS screening among pregnant women and intrapartum antibiotic prophylaxis performed to those GBS positive mothers were suggested to prevent their babies from early neonatal sepsis.

目的通过检测窒息新生儿血清中神经特异性烯醇化酶(neuron-specificenolase,NSE)和S-100蛋白含量的变化,建立对窒息患儿的早期预后评估技术指标。并探讨NSE和S-100蛋白浓度之间的相关关系。方法采用酶联免疫吸附试验双抗体夹心法检测,对156例窒息患儿与对照组20例健康新生儿第3天血清NSE和S-100蛋白含量进行检测,并追踪随访,于1岁时进行Gesell测试。结果窒息新生儿血清NSE和S-100蛋白含量显著高于对照组(P<0.05);HIE组和无HIE组的血清NSE和S-100蛋白浓度比较有显著差异(P<0.05);预后良好的窒息新生儿其血清NSE和S-100浓度较预后不良者低(P<0.05);NSE和S-100蛋白相关系数为0.756,经检验具有统计学意义(P<0.05)。结论窒息新生儿血清NSE和S-100蛋白浓度可联合作为窒息后脑损伤的生化学评估指标。

Objective To study the risk factors and clinical features of sepsis caused by Klebsiella pneumoniae in neonatal intensive care unit(NICU)and improve the diagnosis and management of this disease.Methods There were 16 cases of Klebsiella pneumoniae sepsis in the Hospital's NICU from January 2005 to May 2008 included in this study,their clinical data and drug sensitivity results were retrospectively analyzed and compared with 32 cases of non-sepsis and 33 cases of sepsis caused by other organisms.Results It was found that the risk factors of Klebsiella pneumoniae sepsis were preterm low birth weight,peripherally inserted central catheter(PICC)placement and prior usage of third generation cephalosporins.It was also found that all the cases of Klebsiella pneumoniae sepsis were nosocomial infection and occurred in premature infants,81.2% of infants were very low birth weights(VLBW);the outcome was poor if it was complicated with infection caused by other organisms.The cultures showed that 93% of the Klebsiella pneumoniae strains were extended spectrum betalactamase producing(ESBLs),it also showed that 100% of Klebsiella pneumoniae was sensitive to imipenem but resistant to penicillin and cephalosporins.Conclusion Klebsiella pneumoniae is the most common bacteria causing nosocomial infection in NICU and it is highly resistant to many antibiotics.The risk factors of Klebsiella pneumoniae sepsis are preterm low birth weight,PICC placement and prior usage of third-generation cephalosporins.Carbapenems are the first line antibiotics to treat such infection.