Apoptosis is one of the most important causes, which results in the central neuronal system complication in hypoxic-ischemic brain damage (HIBD). Apoptosis occurs in the developing brain more than in the developed brain. Apoptosis can last several weeks and may be inverted its pathology by appropriate therapy. Caspase inhibitor, neurotrophic factors, anti-apoptosis gene Bcl-2, mild hypothermia,and early intervention play important roles in promoting neuronal cell survival and preventing from apoptosis through different mechanisms. It may be a new way for rehabilitation of HIBD. [

ving CQI(P＜0.05).Conclusion CQI program effectively reduces CRBSI incidenee in cancer patients with PICC.

ObjectiveTo investigate the value of remote consultation of heart sound acquisition in screening and referral of neonates with congenital heart diseases （CHD） in primary hospitals. MethodsA total of 4 030 neonates with non-critical diseases were selected. They were born in Shanghai Pudong New Area Maternal and Child Health Hospital from November 5， 2019 to March 31， 2021. After birth， routine cardiac auscultation was performed and remote consultation of heart sound collection were performed at the same time in combination with percutaneous oxygen saturation measurement to screen CHD. The children with any positive screening index were advised to verify the diagnosis by cardiac ultrasound examination in Shanghai Children's Medical Center. The diagnostic value of different screening methods was compared. ResultsA total of 110 cases were detected positive by routine screening. Among them， 16 cases were lost to follow-up， and 46 cases were confirmed by cardiac ultrasound examination， with a positive diagnosis rate of 48.94% （46/94）. A total of 51 cases were detected positive by routine screening and remote consultation of heart sound collection simultaneously. Among them， 42 cases were confirmed by cardiac ultrasound examination， with a positive diagnosis rate of 82.35% （42/51）. The difference between the two positive diagnosis rates was statistically significant （P<0.001）. ConclusionRemote consultation of heart sound acquisition on the basis of routine neonatal CHD screening can effectively improve the positive diagnosis rate of CHD screening in primary hospitals， and reduce unnecessary referrals. This method is simple and feasible. It has practical value in primary hospitals that lack professional technicians for the diagnosis and treatment of CHD.