Bronchopulmonary dysplasia( BPD) is one of the common complications in premature in-fants,especially those with very and extremely low birth weight. Among all the related factors of BPD,the role of patent ductus arteriosus( PDA) and especially its management with the different approaches and tim-ing of interventions have received widespread attention. Research progresses of the relationship between patent ductus arteriosus management and the development of BPD were summarized . On the basis of that,the sug-gestions focusing on lowering the incidence of BPD in very /extremely low birth weight infants are recom-mended.

Objective:To investigate the prevalence and prognosis of non-alcoholic fatty liver disease (NAFLD) complicated with coronary vulnerable plaque (VP).Method:Consecutive patients were included who had undergone coronary artery CT angiography (CCTA) from January 1, 2011 to January 30, 2015 at the First People′s Hospital of Neijiang. NAFLD was diagnosed according to the liver imaging findings (liver/spleen CT ratio≤1.0) and clinical data. Baseline data, diagnosis, vulnerable plaque were recorded and followed up. The end points included all-cause death rate, cardiac death rate, non-fatal myocardial infarction rate, and elective coronary revascularization rate.Result:A total of 1 069 patients were eventually recruited in this study, including 316 (29.6%) cases diagnosed as NAFLD. In patients with NAFLD, 130 (41.1%) cases had vulnerable plaque, which was significantly higher than 217 of 753 non-NAFLD patients (28.8%) ( P<0.01). The percentages of spotty calcification, low attenuation plaque, positive remodeling and napkin ring sign in NAFLD cohort were 36.5%, 14.2%, 17.6% and 6.8% respectively, while those corresponding in non-NAFLD cohort were 18.4%, 6.3%, 5.8% and 3.2% respectively. The proportion of each vulnerable feature in NAFLD cohort was significantly higher than that in the non-NAFLD cohort, with P values of 0.016, 0.028, 0.019 and 0.042, respectively. The cardiac mortality rate in NAFLD group was significantly higher than and that of non-NAFLD group (7.0% vs. 3.6%, P=0.044). Multivariate Cox analysis suggested that NAFLD was not an independent risk factor for cardiac death. NAFLD subgroup ( n=316) was divided into VP positive group (NAFLD+VP+, n=130) and VP negative group (NAFLD+VP-, n=186). The mean follow-up time was 4.6±1.3 years. All-cause mortality rate, cardiac death rate, elective coronary artery reconstruction rate, non-fatal myocardial infarction rate in NAFLD+VP+group were 20.8%, 12.3%, 25.4%, 13.8% respectively, which were significantly higher than those corresponding rates in NAFLD+VP-group (5.9%, 3.2%, 8.6%, 6.5%) ( P<0.01, 0.002,<0.01, and 0.032 respectively). Conclusion:The incidences of cardiac mortality, elective coronary revascularization, and non-fatal myocardial infarction are significantly higher in patients with NAFLD than those without. NAFLD combined with vulnerable plaque of coronary arteries predicts worse prognosis.

Objective To investigate whether the therapy of combining budesonide with pulmonary surfactant,compared with only surfactant,has an effect on the incidence of bronchopulmonary dysplasia,mortality and other complications in preterm infants.Methods The preterm infants in accordance with the inclusion criteria,who were born during from 12/2016 and 2/2018,were randomly divided into the combination treatment group (treated with the combination of budesonide and pulmonary surfactant) and control group (treated with only surfactant).Ninety eight preterm infants were enrolled this trial,48 of whom are in budesonide group and 50 are in control group.The basic data were not have statistic significant between two groups except for birth weight (P ＞ 0.05).The incidence of bronchopulmonary dysplasia,the mortality and other complication of premature were compared.Results There was a statistic significance in the incidence of bronchopulmonary dysplasia between the budesonide group and control group (42％ vs 66％,P＜0.05);The severity of bronchopulmonary dysplasia and case fatality rate between two groups have no satistical difference.The complications of preterm infants in two groups also have no statistical difference apart from the incidence of PDA (15％ vs 38％,P ＜ 0.05).Conclusion Budesonide combined with pulmonary surfactant can reduce the incidence of bronchopulmonary dysplasia and does not increase mortality and the rate of other complications in preterm infants.

Objective: To evaluate the consistency of ultrasonic cardiac output monitor (USCOM) and electric impedance (ICON) in cardiac function monitoring in preterm infants compared with echocardiography (ECHO). Methods: All enrolled children were monitored with ECHO, USCOM and ICON on the 2nd and 7th day after birth.Heart rate (HR) and cardiac index (CI) were recorded. Results: On the second day after birth, the CI measured by ECHO was (3.26±0.68) L/(min·m²), the CI measured by USCOM was (3.21±0.66) L/(min·m²), and the CI measured by ICON was (3.67 ±0.69) L/(min·m²), with an average percent error of 27.9% and 42.3%, respectively.On the 7th day after birth, the CI measured by ECHO was (3.53±0.57) L/(min·m²), the CI measured by USCOM was (3.47±0.59) L/(min·m²), and the CI measured by ICON was (3.73±0.67)L/(min·m²), with an average percent error of 25.8% and 28.3%, respectively. Conclusion Comparing USCOM with ECHO in cardiac output monitoring of preterm infants, the consistency is good at each time point after birth.Compared with ECHO, ICON has poor consistency in early postnatal cardiac index monitoring, but dynamic monitoring has a certain reference value after one week of birth.