Objective To explore the effect of different method in preventing broncho-pulmonary dysplasia(BPD) in very low birth weight infants(VLBWI) during mechanical ventilation.Methods The gestational age of 71 infants with VLBWI was (30?2) weeks and the average weight was (1235.2?160.6)g.The infants were randomly divided into three groups,they received different therapeutic regimens during mechanical ventilation:32 cases were treated with permissive hypercapnia(PHC) ventilation in group Ⅰ;20 cases were treated by intratracheal instillation of pulmonary surfactant(PS) in group Ⅱ;19 cases were treated by inhalation of becotide(beclomethasone dipropionate,BDP) in group Ⅲ.The ventilator settings,blood gas analysis,clinical symptoms and therapeutic effect were statistically analyzed and compared.Results The peak inspiratory pressure(PIP) and ventilation rate(VR) of ventilator parameter were (18.3?1.6)cmH_2O and (35?5)bpm in group Ⅰ,there was significantly lower than that in group Ⅱ and group Ⅲ(P0.05).The incidence of BPD was 16%(5/32) in group Ⅰ,5%(1/20) in group Ⅱ and 5%(1/19) in group Ⅲ;The mortality rate of PHC group(group Ⅰ) was 6%(2/32) and 5%(1/20) in group Ⅱ.Conclusion The application of permissive hypercapnia,intracheal instillation of pumlonary surfactant and inhalation of becotide all can prevent effectively the occurrence of severe broncho-pulmonary dysplasia in VLBWI during mechanical ventilation.

Objective To investigate the serum level of placental growth factor (PLGF) and explore its relationship with left ventricular structure and function in chronic kidney disease (CKD) patients.Methods Seventy-two non-dialysis CKD patients and sixteen age-and sex-matched healthy controls were included in this study.Serum PLGF level was measured by ELISA.Cardiac structure and function were assessed by two dimensional echocardiography.Results (1)The serum level of PLGF in CKD patients[3.32(2.97,19.77) ng/L] was significantly higher compared to the healthy controls [2.33(2.27,2.49) ng/L] (P ＜ 0.01).It progressively increased with the decline of renal function (P＜ 0.05/6).(2)The interventricular septum (IVS),left ventricular posterior wall (LVPW) was significantly higher while the ejection fraction was significantly lower in CKD patients.(3)The serum PLGF level was higher in patients with left ventricular hypertrophy (LVH) than those without LVH [19.05(3.31,21.05) ng/L vs 2.99(2.60,3.32) ng/L,P ＜ 0.05].The prevalence of LVH in the group above median PLGF level was significantly higher than that in the group below the median PLGF level (70％ vs 18％,P ＜ 0.01).(4)PLGF level was positively correlated with left ventricular mass index (LVMI),systolic pressure,diastolic pressure,24 h urine protein,Scr,UA,BUN,iPTH,the history of high blood pressure and was negatively correlated with LVEF,hemoglobin,albumin,eGFR (P ＜ 0.05).Multiple regression results showed that UA,Scr,LVEF,Hb were associated with PLGF level independently (P ＜ 0.01).Conclusions CKD patients have elevated level of PLGF.It has a relationship with cardiac structure and function.It may participate in the occurrence of cardiovascular events.

Objective To investigate the anti-oxidative effects of alprostadil on contrast-induced nephropathy(CIN)after percuteous coronary intervention (PCI)in patients with chronic kidney disease(CKD).Methods A total of 200 patients with CKD were enrolled in our hospital.According to the random number table was divided into alprostadil 100 cases,100 cases of conventional treatment group.The levels of serum creatinine (Scr),creatinine clearance (eGFR),serum cystatin C (ScysC)and 8-hydroxy-deoxyguanine (8-OHdG)were observed before and after operation at 72 h and 7 d after operation.Results The incidence of CIN in the alprostadil group was significantly lower than that in the conventional treatment group (6% vs 12%,P<0.05).There was no significant difference in the level of Scr,eGFR,ScysC and 8-OHdG between the alprostadil group and the conventional treatment group (P>0.05).The level of Scr in the alprostadil group was significantly lower than that in the conventional treatment group at 72 h and 7 d after operation.The level of eGFR was significantly higher than that of the conventional treatment group (P<0.05).The levels of ScysC and 8-OHdG in the two groups were significantly higher than those before operation at 72 h and 7 d(P>0.05).The levels of ScysC and 8-OHdG in the alprostadil group were significantly lower than those in the conventional treatment group at 72 h and 7 d after PCI(P<0.05).Conclusion Alprostadil may improve the oxidative stress in patients with CKD and provide a preventive effect on CIN.