Objective To demonstrate the association between fluid intake and sodium intake during the first 10 days of life and the risk of chronic lung disease (CLD) in very low birth weight (VLBW) infants.Methods A retrospective analysis of data from VLBW infants enrolled in the Neonatal Department of our hospital; 130 infants with birth weight between 790 and 1 470 g were randomized, among which 12 infants was diagnosised CLD. The daily fluid intake and sodium intake during the first 10 days of life were compared between the infants without CLD and those who developed CLD. Demographic and clinical neonatal variables were also compared. Results 118 infants survived without CLD and 12 infants developed CLD. Analysis showed that the daily fluid intakes were higher (day 2～10) and weight loss less (day 6～9) in the group of infants who developed CLD. In addition, the daily sodium intakes were also higher (day 2～6) in infants who developed CLD. Conclusion In the VLBW infants treated during the post surfactant era, higher fluid or sodi-um intake during the first 10 days of life were associated with an increased risk of CLD. The finding suggests that careful attention to fluid balance might be an important means to reduce the incidence of CLD.

Objective To investigate the clinical effect and safety of paracetamol in premature infants with patent ductus arteriosus(PDA). Method A protrospective comparsion study was performed onthe data of premature infants with PDA. Seventy-two premature infants with echocardiographically comfirmed PDA were randomized into the oral paracetamol group(n1=18) and the ibuprofen group(n2=54), and the rate of ductal closure, side effects and complications were compared between the two groups. Results The ductus was 66.7% (12 infants) in the paracetamol group, which was similar to 70.4% (38 cases) in the ibuprofen group, with no significant difference(χ2=0.087,P=0.768).Except for the incidence of hyperbilirubinemia in the paracetamol group was higher than that in the ibuprofen group (P<0.05), no statistical differences were found in the other index (P>0.05), including oliguria,NEC,renal impairment,the incidence of IVH3-4 and gastrointestinal bleeding. Conclusions The clinical effect of paracetamol in premature infants with PDA is similar to that of ibuprofen , withlower incidence of hyperbilirubinemia, and paracetamol is worthy of amplication in clinical practice.

Objective To evaluate the application effect of evidence-based care model in hemostasis by compression in patients after renal biopsy.Methods 80 patients undergoing renal biopey from December 2006 to December 2009 in our hospital were chosen as the research object.They were randomly divided into the control group and the observation group with 40 patients in each group.The control group was given routine nursing,and the observation group was treated with evidence-based care model for nusing.The re-bleeding rates,satisfaction degree and the SAS,SDS score,mastering degree of related knowledge,treatment compliance for the two groups before and after nursing were compared.Results The ineidence rate of bleeding in the observation group was higher than the control group,satisfaction degree was higher,and the SAS,SDS score,related knowledge,treatment compliance were all better than the control group,there were significant differences.Conclusions The effect of evidence-based care model in hemostasis by compression after renal biopsy is better.It can significantly reduce the incidence of adverse circumstances and improve the negative emotional state of patients.

Objective To analyze the incidence of retinopathy of prematurity(ROP)among extreme-ly preterm infants,and to evaluate the treatment methods and effects among those with severe ROP.Methods A retrospective analysis was performed to analyze incidence of ROP in 96 cases of extremely preterm infants who were born at a gestational age of 〈28 weeks and survived beyond a postmenstrual age of at least 1 year from Apr 2006 to Oct 2013,and to analyze the treatment outcomes of photocoagulation and ranibizum-ab intravitreal injection among the infants with severe ROP.Results Fifty-six of 96 cases(58.33%)grew into ROP finally and 21 cases(21.88%)grew into severe ROP,2 cases(2.08%)grew into aggressive poste-rior ROP.Fifteen cases with severe ROP were treated with laser photocoagulation.Four cases with severe ROP were received ranibizumab intravitreal injection prior to photocoagulation.Two cases with severe ROP were only treated with ranibizumab intravitreal injection.The eyesight of 96 patients (100%)in this study were all preserved.Conclusion ROP screening should focus on extremely preterm infants because of higher incidence of ROP and severe ROP among them.The infants with severe ROP should be treated with laser photocoagulation in time.The infants in critical condition or with aggressive posterior ROP can be treated with ranibizumab injection.

Objective To analyze the clinical characteristics of severe retinopathy of prematurity (ROP) in extremely low birth weight infants (ELBWI),and to evaluate the management model of ROP screening of ELBWI and the clinical effects and treatment timing of photocoagulation with intravitreous injection of vascular endothelial growth factor inhibitor (Avastin).Methods Forty-five cases of ELBWI (birth weight ＜ 1000 g) survived finally in our neonatal intensive care unit from July 1,2004 to June 30,2011 were reviewed.ROP screening was regularly performed in 4 ～ 6 weeks postpartum with binocular indirect funduscope by ophthalmologists.Newborns with severe ROP were treated with laser photocoagulation in the fundus.Some newborns that developed aggressive posterior ROP(APROP) were treated with combined intravitreous injection of Avastin and photocoagulation.Results Thirteen of 45 cases (28.89％) had not developed to ROP finally.Six cases (13.33％) developed to stage 1 ～ 2 ROP and then spontaneous recovery during the follow-up period.Twenty-six newborns (57.78％) developed to severe aggressive posterior ROP (APROP) and need to be treated with photocoagulation.All 3 APROP infants (6.67％) were received intravitreous Avastin injection prior to photocoagulation.The visual acuity of all 45 patients (100％) in this study was preserved.Conclusion ELBWI have a higher morbidity of severe ROP.Timely screening and intervention are effective to prevent disease progression.Intravitreous Avastin injection prior to photocoagulation may be necessary to preserve the visual acuity of infants with APROP.Respiratory management is the key for post-operation care.