The new neonatal resuscitation guidelines was published in 2011 in China,which said no more neonatal asphyxia resuscitation guidelines as used,and showed a correct statement as the same as international that,also contained a deep essence meaning which would bring about some new thought and new behavior on neonatal resuscitation.There are three aspects should be realized:( 1 ) the diagnosis of neonatal asphyxia is extremely strict abroad now,which demonstrates that asphyxia is a after-resuscitation event instead of before-resuscitation one,and only failure of resuscitation will cause a asphyxia.Therefore,it is no suitable to say asphyxia resuscitation ; ( 2 ) in neonatal resuscitation algorithm,it never mentions asphyxia or not from birth to resuscitation finished; ( 3 ) under thinking shackle of the mistake concept asphyxia resuscitation,resuscitation behavior usually becomes more passive and inactive,and though the guidelines are the same,the resuscitation results are different between our country and abroad.So,changing conception,and resuscitation first,will be beneficial to decreasing neonatal asphyxia mortality to international level at which we might have arrived originally.

The article introduced and stressed laryngeal mask airway(LMA)'s invention and development,structure and classification,history and current situation of the applications of LMA in neonatal resuscitation,placement methods,recommendation of international guidelines for neonatal resuscitation on LMA,advantage and disadvantage when LMA versus bag-mask and endotracheal intubation ventilation for neonatal resuscitation,LMA extensions of research in neonate,and significance and prospects of its application in China.

The development of cardiovascular system in very premature infants is immature.Hypotension and patent ductus arteriosus are common problems in the few days of life.The enormous difference that these infants receive cardiovascular support may affect the morbidity and mortality.Volume expansion,inotropes,cyclooxygenase inhibitor and glucocorticoid is commonly used drugs,but when and how to treat for these extremely low birth weight infants with cardiovascular problems has been plagued by clinical doctors.

Application of sustained lung inflation (SLI)during neonatal resuscitation can increase alveolar opening,promote lung fluid absorption and maintain the appropriate functional residual capacity (FRC) which can complete the transition from fetal phase of respiratory system to neonatal period.In recent years,SLI has also been confirmed by a large number of animal experiments and clinical studies,and it is expected to be practically applied in the resuscitation of newborns.However,more randomized controlled trials with a large number of samples is required for exploring suitable populations,methods of operation,and recent or long-term effects on newborns.Now,the application and research of SLI in neonatal resuscitation are described.

Invasive fungal infection is an important cause of mortality and morbidity in preterm infants.Extremely preterm and extremely low birth weight infants are at highest risk because of the intensive and invasive nature of the care that these infants receive.How to prevent and treat the invasive fungal infection in preterm infants has become a new hot spot in the neonatologists.This review focused the progress on treatment and prevention of invasive fungal infections in preterm infants.

Objective:To determine the changes of intramucosal pH(pHi) after severe craniocerebral injuries and the correlation to bleeding from stress ulceration. Methods:Nineteen cases of severe head trauma patients were enrolled, their pHi were determined at different time point with tonometry. The pH of gastric juice and plasma gastrin concentrations were monitored for 7 days. Results:Five cases(bleeding group) developed stress ulcer bleeding. On admission, the pHi were not significantly different in the non bleeding group, but the differences between two groups at 12 hours, 24 hours, the 3rd day, the 5th day, the 7th day after admission were significant, pHi in the bleeding group was statistically lower than non bleeding group. The pH values of gastric juice and the plasma gastrin concentrations were not different significantly between two groups during each therapeutic periods. Conclusion:Bleeding group had significantly lower pHi than non bleeding group during the therapeutic periods. pHi was predictive for bleeding from stress ulceration after severe craniocerebral injury.

OBJECTIVE:To explore the effects of alendronate sodium on bone mineral density (BMD) and bone marker in prostate cancer elderly patients after medical castration therapy. METHODS:In perspective study,84 elderly patients undergoing medical castration therapy were selected and divided into treatment group(45 cases)and control group(39 cases)according to ran-dom number table. Control group received medical castration therapy+Calcium carbonate D3 tablets,1 tablet,po,qn;treatment group was additionally given Alendronate sodium tablets 70 mg,po,once a week,1 week after routine treatment,on the basis of control group. Treatment course of 2 groups lasted for 12 months. The levels of 25-OH-D,testosterone,BMD and bone marker were observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:3 cases of treatment group and 1 case of control group dropped out of the study. Before treatment,there was no statistical significance in above indexes between 2 groups (P>0.05). After treatment,25-OH-D levels of 2 groups were increased slightly,but there was no statistical significance(P>0.05);tes-tosterone level of 2 groups were decreased significantly compared to before treatment,with statistical significance (P<0.05). 12 months after treatment,BMD of lumbar vertebra,collum femoris and hip were increased significantly in treatment group,while those were decreased significantly in control group;there was statistical significance in above indexes between 2 groups(P<0.05). The levels of N-terminal midfragment of osteocalcin,procollagen Ⅰ N-terminal propeptide and β-crosslaps were decreased signifi-cantly in treatment group,while those were increased significantly in control group;there was statistical significance in above in-dexes between 2 groups (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Alendronate sodium can prevent bone loss and reduce the rate of bone turnover in elderly patients with prostate cancer receiving medical castration therapy.

ObjectiveTo study the feasibility, efficacy and safety of laryngeal mask airway (LMA) Supreme (SLMA) in neonatal resuscitation.MethodsSixty neonates, who were born at South Medical University Affiliated Maternal & Child Health Hospital of Shenzhen from June 1, 2012 to June 1, 2013 and requiring positive pressure ventilation after 30 s primary resuscitation post born, with birth weight above 2 000 g or gestational age above 34 weeks, were randomly assigned into two groups: SLMA group (n=30) and LMA Classic (CLMA) group (n=30). The outcome indicators included the curative effect, insertion time and possible adverse reactions of the two kinds of LMA, and the serum bio-markers, heart rate and percutaneous pulse oxygen saturation (SpO2) of all neonates. Independent samplet test, non-parametric test andChi-square test were applied for statistical analysis.ResultsThe insertion time was shorter in SLMA group than in CLMA group [(4.9±1.0) vs (7.6±1.3) s,t=8.98,P<0.05]. And more displacement occurred in CLMA group than in SLMA group [13.3% (4/30) vs 0% (0/30), Fisher exact test,P<0.05]. The successful rate of resuscitation in SLMA group was higher [100.0% (30/30) vs 90.0% (27/30), Fisher's exact test,P<0.05], and both the onset time and the total ventilation time were shorter than those in CLMA group [(12.4±3.7) vs (15.6±3.8) s,t=3.31,P<0.05; (37.3±17.0) vs (48.2±20.1) s,t=2.29,P<0.05]. The heart rate at 1 min after delivery was higher in SLMA group than in CLMA group [(93.5±20.9) vs (74.2±17.8) bpm,t=-3.86,P<0.05], and the same results were shown for SpO2 at 1, 2 and 3 min after birth [(47.1±8.4)% vs (38.7±12.1)%, t=-3.13; (68.1±9.5)% vs (52.8±10.8)%,t=-5.82; (78.3±10.0)% vs (72.1±9.7)%,t=-2.46; allP<0.05]. In the CLMA group, vomit or regurgitation occurred in three neonates, abdominal distension in two cases, aerogastria in seven cases. However, none of the above was reported in the SLMA group. No laryngeal injury was found in any of the subjects.ConclusionSLMA is more potential than CLMA in neonatal resuscitation because of its simplicity, better airtight, less adverse effect, superior efficacy and less requirement for tracheal intubation.

Objective To investigate the expression and clinical significance of ER, PR and C-erbB-2 in breast cancer. Methods 82 cases of primary breast cancer were examined for ER, PR and C-erbB-2 by immunohistochemical S-P methods. Results The expressions of ER, PR and C-erbB-2 were 54.9 %, 40.2 %, 47.6 % respectively. There was a negative correlation between ER and C-erbB-2(P

Objective To evaluate the effect of hand hygiene (HH)promotion on awareness,correctness and compliance rates of HH among health care workers(HCWs).Methods HH promotion was started to carry out on May 8,2014,on-site questions,theoretical examination,and direct observation were adopted to survey the percent-age of HH awareness,correctness of six-step hand-washing method,and compliance to HH among HCWs before and at the phase five of promotion implementation,results before and after implementing promotion were compared. Results After implementing HH promotion,percentage of HH awareness,correctness of six-step hand-washing method,and compliance to HH among HCWs increased from 42.50%,35.45%,and 24.00% to 87.12%, 68.60%,and 43.20% respectively,differences were all significant (all P <0.05 ).Conclusion HH promotion has strengthened HCWs’HH awareness,standardized HH method,and enhanced compliance to HH.