Meconium-stained amniotic fluid is one of the main risk factors for neonatal meconium aspiration syndrome, and can even cause death, which is a dangerous emergency to handle during neonatal resuscitation. Routine intubation and endotracheal suction are not recommended for non-vigorous newborns born through meconium-stained amniotic fluid in the latest international neonatal resuscitation guideline. But it is controversial due to lacking high-level evidence. We review the recent evidence for the rationale for endotracheal suction in non-vigorous neonates born through meconium-stained amniotic fluid.

Objective To explore the application of experienced teaching method in the teaching of Fundamentals of Nursing.Methods The feasibility and validity of experienced teaching method was evaluated by expounding the utilization and result of role-play method and practice experienced method.Results The experienced teaching method received good result and proved appropriate in the teaching of Fundamentals of Nursing.Conclusion The experienced teaching method overcame the disadvantages of mere traditional teaching method and aimed at the improvement of quality and ability of students.It contributed to developing the critical thinking ability and other abilities of students.

Objective To investigate and improve clinical treatment and care methods of convulsions in postoperative children with congenital heart disease.Methods One postoperative child suffered from convulsions with congenital heart disease in our hospital PICU in August 2013 was reviewed,and then related clinical monitoring treatment methods were summarized.Results The patient suffered three times of convulsions and after drug treatment and careful nursing,the symptoms were under control without critical condition.Then the patient was safely and stably transited into the general ward and discharged.Conclusions There are three essential points for nursing convulsions in postoperative child with congenital heart disease:strengthen monitoring after heart surgery,handle symptom of seizures in time; rapidly make sure the reasons of convulsions and make effective preventions.

Neonatal cerebral infarction is an area of damaged cerebral tissue resulting either from disruption to blood flow in a major cerebral artery from thrombosis or embolism or from thrombosis in a major cerebral vein.The pathogenesis is unknown at present,many studies have shown that genetic,mother hypertension,gestational diabetes,smoking,neonatal congenital heart disease,infections,meningitis are the risk factors of neonatal cerebral infarction.

OBJECTIVE: To establish a HPLC method for the determination of the content of Demethylbellidifolin in different parts of Swertia davidi Franch. METHODS: The analysis was carried out on Hypersil C18 column (150mm?4.6mm,5 ?m) at room temperature with mobile phase consisted of CH3OH-0.5%H3PO4(56∶44) at a flow-rate of 1.0mL?min-1.The detection wavelength was set at 254 nm. RESULTS: The linear range of Demethylbellidifolin was 0.52～2.60?g (r=0.999 4) and the average recovery was 99.77%(RSD=0.95%).CONCLUSION: The method is simple, rapid, reproducible, and suitable for the determination of the content of Demethylbellidifolin in Swertia davidi Franch..

Objective:To analyze the mortality of extremely preterm infants(EPIs) born at 22 +0-25 +6 weeks of gestation in Tianjin Central Hospital of Obstetrics and Gynecology and then compare it with data from other countries to provide evidence for better healthcare for this population. Methods:Clinical data of EPIs born at 22 +0-25 +6 gestational weeks in our center from January 2011 to December 2017 were retrospectively collected. The enrolled patients were grouped based on their gestational age, birth weight, and admission time in order to analyze the mortality in different groups. According to the inclusion and exclusion criteria, five sets of data regarding the mortality of EPIs born at 22 +0-25 +6 gestational weeks during the same period were retrieved from a multicenter survey involving 15 centers in China, the National Institute of Child Health and Human Development Neonatal Research Network (NICHD-NRN) in the United States, Canadian Neonatal Network TM, Australian and New Zealand Neonatal Network (ANZNN) and Korean Neonatal Network (KNN). The mortality rate among data from different sources was compared using Chi-square test on the condition that the definition of death was the same. Besides, the causes of neonatal death were analyzed. Results:A total of 64 EPIs were enrolled in our center. The total mortality rate was 42.2% (27/64), and were 1/1, 8/10, 50.0%(10/20) and 24.2%(8/33) in EPIs of gestational age of 22 +0-22 +6, 23 +0-23 +6, 24 +0-24 +6 and 25 +0-25 +6 weeks, 5/6, 50.0%(16/32), 25.0%(6/24) and 0/2 in those with birth weight of ≤600 g, >600-≤800 g, >800-≤1 000 g and >1 000 g, respectively. In the 27 death cases in our center, the causes of death were as follows: neonatal respiratory distress syndrome (16 cases, 59.3%), sepsis (two cases, 7.4%), necrotizing enterocolitis (three cases, 11.1%), severe intraventricular hemorrhage (three cases, 11.1%) and others (three cases, 11.1%). The mortality rate was 57.1%(12/21) before 2016(2011-2015), 45.0%(9/20) in 2016 and 26.1%(6/23) in 2017. The total mortality of EPIs in our center was higher than that in Canada [42.2% vs 26.6%(165/621), χ2=7.015, P=0.008], as well as in Australia and New Zealand [42.2% vs 28.2%(140/497), χ2=5.330, P=0.021], while there was no statistically significant difference when compared with that in South Korea [42.2% vs 42.1%(218/518), χ2<0.001, P=0.988]. Conclusions:The mortality of EPIs born at 22 +0-25 +6 gestational weeks is higher in our center when compared with that in some developed countries such as Canada and Australia. Therefore, we should pay more efforts to reduce the mortality of EPIs through quality improvement.

Objective To explore whether apply selective perineal skin preparation or not is feasible for patients with coronary heart disease (CHD) before percutaneous coronary intervention (PCI).Methods Divided patients with CHD before PCI into the experimental group (801 cases) and the control group(798 cases) according to the hospital number.Selective perineal skin preparation was used in the experimental group,while the right forearm skin preparation was used in all the patients in the control group.The rate of skin preparation and the care hours in the two groups were compared.Results The care hours of skin preparation in the experimental group was (5.58±0.30) h,which was significant shorter than that in the control group,(66.50±1.50) h,t=-1127.03,P＜0.05.Conclusions Before PCI,for patients with CHD,applying selective perineal skin preparation is feasible.It can not only reduce care labor,decrease nursing costs,but also relieve nurse-patient psychological pressure,cut back patients' expenses;and without percutaneous entrance infection.

Objective To investigate the effects of three external nasogastric tube fixations on unplanned nasogastric tube removal after radical esophagectomy for esophageal cancer.Methods Two hundred and thirty four esophageal cancer patients who underwent radical esophagectomy with nasogastric intubation were assigned into conventional group I(n=74),conventional group II (n=79)and experiment group(n=81)using random number table.For external fixation of the nasogastric tube,the traditional group I used“3M”silk tape,the traditional group II used a white flat strap with two knots and the experiment group used anI-shaped nasal fixation tape combined with a flapping cheek fixation tape.The three groups were compared in terms of displacement of the indwelling nasogastric tube and slippage of the tube.Results The displacement rate of nasogastric tube and the rate of slippage in the experiment group were both significantly lower than those in both conventional groups I and II(all P<0.05).Conclusion TheI-shaped nasal fixation tape combined with a flapping cheek fixation tape in fixing the nasogastric tube can effectively reduce the incidence of unplanned removal of nasogastric tube and meanwhile the patients may feel comfort and satisfactory.

Objective To explore the therapeutic effect and security of caffeine citrate in preventing primary apnea of preterm infants by observing the clinical effect, adverse reaction and prognosis of caffeine citrate preventing the primary apnea. Methods A total of 132 preterm infants admitted to neonatal department of Tianjin Central Hospital of Obstetrics and Gynecology were selected during January 2015 to July 2016. They were randomly divided into two groups, one was the caffeine group, and the other was the control group. The infants of caffenine group were intravenous injected caffeine citrate 24 hours after birth, with the first dose 20 mg/kg, and the maintain dose 5 mg/kg every 24 hours, until the corrected gestational age was 34 weeks. The infants of control group were not given methylxanthine drugs. Data were compared between two groups including the incidence of apena after 48 hours of giving drugs, the period of using nasal continuous positive airway pressure (n-CPAP) or ventilator, the incidence of feeding intolerance, tachycardia, patent ductus arteriosus (PDA), intracranial hemorrhage (HIE), necrotizing enterocolitis (NEC),and bronchopulmonary dysplasia (BPD), weight growth rate and the length of hospitalization. Results There were significantly lower incidence of apnea after 48 hours, the period of using nasal continuous positive airway pressure or ventilator, incidence of patent ductus arteriosus and intracranial hemorrhage and the duration of hospitalization in caffeine group than those in control group (P < 0.05). There were no statistically significant differences in the incidence of feeding intolerence, bradycardia, NEC, BPD and the weight growth rate between the two groups (P>0.05). Conclusion The preterm infants given caffeine could reduce the incidence of the primary apnea, improve the prognosis of the preterm infants, and no significant adverse reaction.

OBJECTIVE:To establish an RP-HPLC analysis of Carthamin in mice and to study its pharmacokinetics.METHODS:The serum concentration of Carthamin was determined by RP-HPLC.The blood concentration-time curve was established and the main pharmacokinetic parameters were computed.RESULTS:The linear range of Carthamin was 0.558～55.8 ?g?L-1(r=0.999 2),with the lowest limit of detection at 0.005 ?g?L-1Carthamin in vivo assumed two-compartment model and rapid absorption.CONCLUSION:The proposed method is simple,sensitive and reproducible,and it met the standard for pharmacokinetic study.