Objective We aimed to evaluatd the effect of oral nursing with oral washing on patients with peroral endotracheal intubation and discuss the appropriate oral nursing method for patients with patients with peroral endotracheal intubation. Methods We chose 150 patients with indwelling peroral endotracheal intubation after neurosurgery and divided them into the control group (73 cases) and the test group (77 cases). The test group received oral nursing with oral washing while the control group with routine oral nursing method. We compared the incidence of halitosis, the moist degree of oral cavity and the amount of the tooth fungus spot between the two groups. Results The incidence of halitosis and the amount of the tooth fungus spot in the test group were lower than those of the control group; The moist degree of oral cavity in the test group was higher than that of the control group, P<0.01. Conclusions Oral washing could effectively control halitosis, keep oral cavity moist and prevent the formation of tooth fungus spot.

Objective To study the relationships of plasma myelin basic protein (MBP) and S100B level with periventricular hemorrhage-intraventricular hemorrhage (PVH-IVH) and periventricular leucumalacia (PVL) in preterm infants.Methods There were 385 cases of preterm infants whose gestational age was less than 34 weeks and were admitted in NICUs of Guangzhou Women and Children's Medical Center of Guangzhou Medical University,Guangzhou Huadu District Maternal and Child Health Hospital and Dongguan Hospital Affiliated to Jinan University from Jan.2010 to Jun.2013,enrolled in the study.The plasma levels of S100B and MBP protein were detected within 24 hours and on the 3rd,7th,14th day after birth.Cranial ultrasound (US) was preformed 2-3 d,1 week,2 weeks,3 weeks and 4 weeks after birth.They also received Cranial MRI examination before discharge or when the correct gestational age reached 40 weeks.According to the exclusion standard 73 cases were excluded.The included 312 cases were divided into 3 groups (no brain damage group,PVH-IVH group and PVL group) according to the result of cranial US and MRI.The differences of the plasma levels of S100B and MBP protein among each groups were compared,and the relationship of the plasma levels of S100B and MBP protein in no brain damage group with gestational age were analyzed.Results The results of cranial ultrasound and/or MRI showed:204 cases had no brain damage (put in no brain damage group),69 cases had PVH-IVH (put in PVH-IVH group),and 27 cases had PVL,12 cases had PVL and PVH-IVH (both put in PVL group).The plasma level of S100B:within 24h and 3 d after birth,the serum levels of S100B in PVH-IVH group were significantly higher than those in no brain damage group (P ＜ 0.05) ; and the plasma levels of S100B in PVL group were significantly higher than those in no brain damage group and PVH-IVH group (all P ＜ 0.05).On 7 d and 14 d after birth,there were no significant differences between PVH-IVH group and no brain damage group (P ＞ 0.05) ;and the plasma levels of S100B of PVL group were still significantly higher than those in no brain damage group and PVH-IVH group (all P ＜0.05).The plasma levels of MBP:within 24 h,3 d,7 d and 14 d after birth,there were no significant differences between PVH-IVH group and no brain damage group (all P ＞ 0.05) ; and the plasma levels of MBP in PVL group were significantly higher than those in no brain damage group and PVH-IVH group (all P ＜ 0.05).Correlation analysis of gestational age and S100B and MBP:the plasma level of S100B in no brain damage group had negative correlation with gestational age (r =-0.483,P =0.006).The plasma level of MBP had no correlation with gestational age (r =-0.295,P =0.105).Conclusions The plasma levels of S100B and MBP increased significantly in preterm infants with brain damage within 24 h after birth,and the plasma levels of S100B and MBP of PVL infants were much higher than PVH-IVH infants.The increased plasma levels of S100B and MBP of PVL infants lasted longer than PVH-IVH infants.The increase of plasma levels of S100B and MBP in preterm infants would have certain clinical significance for judging whether early brain damage and PVL would happen.

Objective:To study the genetic profile of neonatal hyperbilirubinemia with unknown etiology in Guangdong Province and the clinical significance of jaundice-related genetic screening.Methods:From July to September, 2021, neonates with hyperbilirubinemia of unknown etiology born in different hospitals in Guangdong Province were studied. 24 neonatal jaundice-related exons were sequenced using targeted capture and high-throughput sequencing technology. The pathogenic variants were analyzed.Results:A total of 331 cases, 139 (42.0%) cases showed positive screening results with five diseases, including 65 (19.6%) cases of Gilbert syndrome, 48 (14.5%) cases of glucose-6-phosphate dehydrogenase (G6PD) deficiency,18 (5.4%) cases of sodium taurocholate cotransporting polypeptide deficiency, 4 (1.2%) cases of Citrin deficiency and 4 (1.2%) cases of Dubin-Johnson syndrome. 149 (45.0%) cases carried one or more genetic variants and 43 (13.0%) cases showed no clinically significant variants. The 8 high-frequency mutation loci (carrier rate >1%) are UGT1A1 gene c.211G>A and c.1091C>T, G6PD gene c.1466G>T and c.1478G>A, SLC10A1 gene c.800C>T, SLC25A13 gene c.852_855del TATG, HBB gene c.126_129delCTTT and c.316-197C>T.Conclusions:Genetic factors are important for neonatal hyperbilirubinemia with unknown etiology in Guangdong. The common pathogenic genes are UGT1A1, G6PD, SLC10A1, and SLC25A13 and the population carries high-frequency mutation loci. Therefore, genetic screening in neonates with hyperbilirubinemia of unknown etiology has important clinical significance.