Objective To obeserve the influence of comprehensive intervention on ventilator associated pneumonia (VAP) in neonatal iatensive care unit. Methods From January 2013 to January 2014, 98 neonates received intubation and mechanical ventilation in neonatal intensive care unit (NICU) were selected and divided into treatment group and control group by 1:1 matched case-control study. And each group had 49 neonates. Preventive factors of treatment group were included levating patient's head and chest to 30 degrees to the horizontal level, closed endotracheal suction systems, washing hands, intensiving frequency of oral-pharyngeal nursing with thorough suction, changing ventiahor tube after three days. While the control group was given routine intervention. The incidence of VAP, the length of hos-pital stay and ventilator time were measured and compared between two groups. Results Compared with control group, neonates in treatment group had lower incidence of VAP (10.20%v s 28.57%) and shorter ventilator time [(60.36±9.23) h vs (67.52±8.55h)]. There was difference on hospital stay between the two groups(P<0.05). Conclusion The preventive factors including levating patient's head and chest to at least 30 degrees to the horizontal level, closed endotracheal suction systems, washing hands, intensiving frequency of oral-pharyngeal nursing with thorough suction, changing venti-ahor tube after three days can reduce incidence of ventilator-associated pneumonia, shorten ventilator time and length of hospital stay.

Objective:To evaluate the efficacy and safety of oral anisodine hydrobromide tablets in the treatment of nonarteritic anterior ischemic optic neuropathy (NAION).Methods:A multicenter nonrandomized controlled trial was conducted.A total of 282 acute NAION patients (282 eyes) were recruited from 16 hospitals in China from July 2020 to May 2021.Patients were divided into two groups according to treatment methods, which were control group (124 cases, 124 eyes) receiving regular treatment including citicoline sodium plus Ginkgo biloba leaf liquid extract or Ginkgo biloba leaf extract tablets plus mecobalamin, and experimental group (158 cases, 158 eyes) receiving treatment in control group plus oral anisodine hydrobromide tablets 1 mg, twice daily for 2 to 3 months.Best corrected visual acuity (BCVA), visual field index (VFI), peripapillary retinal nerve fiber layer (pRNFL) and radial peripapillary capillary vessel density (RPC) were assessed at 1, 2, 3, and 6 months after enrollment using the standard decimal visual acuity chart, 750i Humphery visual field analyzer, Cirrus HD-OCT 4000/Cirrus HD-OCT 5000, RTVue-XR optical coherence tomography respectively.The primary outcomes were BCVA and VFI, and the secondary outcomes were pRNFL, RPC, and the side effects during the follow-up.The study adhered to the Declaration of Helsinki.All patients were fully informed about the treatment and purpose of this study and voluntarily signed the informed consent form.The study protocol was approved by Chinese PLA General Hospital (No.S2020-021-01). Results:In all, 242 patients (242 eyes) completed the follow-up of BCVA, and 98 patients (98 eyes) completed the VFI follow-up.In terms of visual function, BCVA and VFI improved significantly over time in the two groups, and BCVA and VFI were better in experimental group than in control group at various follow-up time points (all at P<0.05). In terms of structure, pRNFL gradually decreased in both groups with the extension of treatment, and pRNFL was significanthy thinner in experimental group than in control group at various follow-up time points (all at P<0.05). There was no significant difference in RPC between the two groups at the last follow-up ( P>0.05). There were two cases with side effects and one case was discontinued due to side effects 25 days after enrollment. Conclusions:Oral anisodine hydrobromide can improve visual acuity and visual field in NAION and accelerate the regression of optic disc edema, with good safety.