Bronchopulmonary dysplasia (BPD)characterized as the abnormal development of premature lung and trachea influenced by perinatal factors is the most common respiratory disease in very premature infants,and is also one of the diseases confirmedly related to poor quality of life.With the advancement of neonatal research and the im-provement in clinical care,more very premature infants with BPD survived to discharge.BPD is becoming the disease which both neonatologists and pediatricians should pay much attention to.The definition of BPD in recent years is in controversy.In this paper,the physiologic definition of BPD was comprehensively reviewed as a recently more accepted definition.

Objective To determine the effectiveness of systolic blood pressure gradient between the right arm and the right leg(SBPG) tests in the diagnosis of neonatal aorta anomaly(AoA).Methods The SBPG of infants suspected of having critical congenital heart diseases were collected prospectively,who were admitted to Guangdong General Hospital from January 2013 to December 2015.The results of SBPG test were compared with those of echocardiography or cardiac computed tomography (golden standard).The rates of true positive,true negative,false positive,false negative were calculated under cutoff values of 5 mmHg(1 mmHg =0.133 kPa),10 mmHg,15 mmHg and 20 mmHg,respectively.Receiver operating characteristic (ROC) curves was used to compare tests of different cutoff and the areas under the ROC curve were also calculated.Results Among 664 enrolled infants,67 cases were confirmed by golden standard test.The systolic blood pressure in the right arm,the legs and SBPG in AoA group and non-AoA group were (88.0±20.4) mmHgvs.(73.4±9.3) mmHg (P＜0.01),(66.1 ±10.1) mmHg vs.(69.0 ±9.7) mmHg(P＞0.05) and (22.6±17.8) mmHgvs.(2.3 ±4.8) mmHg(P ＜0.01),respectively.In these patients,31 cases(46.3％),31 cases(46.3％),27 cases(40.3％) and 21 cases(31.3％) were diagnosed of AoA,and 36 cases(53.7％),36 cases (53.7％),40 cases(59.7％),and 46 cases (68.7％) were missed by SBPG tests of 5 mmHg,10 mmHg,15 mmHg and 20 mmHg,respectively (P ＜ 0.01).The rates of true negative among those groups were 94.1％,99.5％,99.7％ and 100.0％,and the areas under ROC curve were 0.656,0.722,0.695 and 0.657,respectively (P ＜ 0.01).Conclusions Almost half of AoA infants could be screened out by SBPG test.The cutoff of 10 mmHg could probably be used to screen potential AoA infants,with higher true positive rate and lower false positive rate.

Objective To determine the long term outcomes of laryngomalacia infants with anomalies and to determine the clinical practice guideline for these infants.Methods The charts of infants with moderate to severe laryngomalacia,who were admitted to our hospital between January 2013 and December 2015,were retrospectively reviewed.These infants were divided into two groups,anomaly(A) group(n=37) and non-anomaly (NA) group(n=19).Results Fifty-six cases were enrolled.Infants in A group were older at symptom relief than those in NA group[(10.00±3.56) months vs.(7.89±3.03) months,P＜0.05],and the weight percentiles of infants in A group were lower at 3,6 and 12 months than those in NA group(P＜0.05).There was no statistically significant difference between the two groups on the weights percentiles in infants at 24 months after diagnosis.Five of 37 cases in A group and 3 of 19 cases in NA group had supraglottoplasty.One infant in A group had tracheotomy.Conclusion Both breathing difficulty and development retardations of infants with moderate or severe laryngomalacia could gradually improved with age.There is not enough evidence to support the aggressive supraglottoplasty for infants with anomalies and laryngomalacia.

Chitooligosaccharides(COS),as the degradation products of the natural polysaccharide chitosan(CS),retain the good biocompatibility,non-toxicity,and biodegradability of CS.Additionally,due to the shortened sugar chains and reduced molecular weight,their water solubility and bioactivity are improved,making them more easily absorbed and utilized by organisms.In recent years,COS has received increasing attention.While there are numerous studies on the biological functions of CS and its applications in the biomedical field,the research on the functions and applications of COS is relatively limited.This study summarizes and analyzes the main biological functions of COS(anti-inflammatory,anti-tumor,antibacterial,and tissue regeneration promotion)and their possible mechanisms.It also discusses the research progress in the applications of COS in the biomedical field,in order to provide the theoretical basis and reference for the further research and broader application of COS in biomedicine.

Objective To know the psychological experience and the demand for psychological health services of secondary vocational nursing students, and explore the measures of improving their psychological health and provide psychological health services and strategies. Methods Phenomenological methods of qualitative research was used in this study, and nine secondary vocational nursing students were selected and investigated by in-depth personal interview. The data were analyzed by the thematic framework. Results Four themes were extracted from the data analysis: suffering from multiple pressures, common bad behaviors, weak psychological support system, look forward to psychological health services. Conclusions Secondary vocational nursing students have many psychological and behavioral problems. Families, schools and the society should work together to provide personalized and modern mental health services for them and reduce the psychological and behavioral problems.

Objective To explore the necessity and training needs of nursing students before nurse qualification examination.MethodsTotally 200 undergraduates and college nursing students who graduated in 2016 were investigated during March to April 2016 by using stratified random sampling method. The questionnaire survey was applied to investigate the necessity,needs,and demand degree of training before examination.Results The scores of training necessity were (4.492±0.726) for undergraduates and (4.634±0.653) for college students (P>0.05). Both undergraduates and college nursing students had high training needs,which related to the circulatory system,respiratory system,digestive system,pregnancy, childbirth,and puerperal diseases (P>0.05). But college students were less desired to have nursing training of traditional Chinese medicine compared with undergraduates [(3.909±0.913) vs. (4.299±0.675);P<0.05]. Furthermore,142 (71%) participants preferred to have training on weekends;186 (93%) participants advised to combine teaching with exercise;92 (46%) participants recommended to invite both their own teachers and professors from other schools;88 (44%) participants thought that it was reasonable to remain two review weeks between the training and the exam.ConclusionsThe training before nurse qualification examination is necessary for nursing students. Students' knowledge level and course content should be paid attention to since only reasonable and effective training can help to improve their examination pass rate.

OBJECTIVETo summarize anesthetic management of low birth weight infants undergoing surgical intervention of congenital heart disease without cardiopulmonary bypass.

METHODSFifty-three low birth weight infants (including 49 premature infants) with congenital heart disease underwent surgical treatment without cardiopulmonary bypass during the period from June, 2003 to July, 2013. The mean gestational age of the infants was 30.96∓3.09 weeks (26-40 weeks) with a mean age on the operation day of 32.81∓20.76 days (4-87 days), birth weight of 1429.90∓455.08 g (640-2460 g), and weight on the operation day of 1750.20∓481.59 g (650-2460 g). All the infants underwent cardiac operations without cardiopulmonary bypass under general anesthesia. The respiratory parameters and acid-base and electrolyte balance were adjusted according to blood gas analysis. The inotropic drug was used to maintain the hemodynamic stability.

RESULTSForty-seven of the infants received patent ductus arteriosus (PDA) ligation. Of these infants, 1 had cardiac arrest before the operation with failed cardiopulmonary resuscitation, and in another case, PDA ligation was aborted due to severe hypoplasia of the aortic valve and ascending aorta found intraoperatively by transesophageal echocardiography. Two infants underwent coarctation of the aorta (CoA), and 1 of them died during the operation due to cardiac arrest. The total mortality of these infants was 3.77% and the early postoperative mortality (<72 h) was 5.66%.

CONCLUSIONSNon-cardiopulmonary bypass surgery can be performed in low birth weight infants in early stage, and effective anesthetic management can reduce the perioperative mortality and improve the postoperative survival rate.

Anesthesia ; methods ; Anesthetics ; Birth Weight ; Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Gestational Age ; Heart Defects, Congenital ; surgery ; Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Ligation

Objectlve To explore the correlation between amplitude-integrated electroencephalographic(aEEG) findings and clinical features and to investigate the status of perioperative brain function in infants with critical congenital heart disease (CCHD) and its influencing factors.Methods Newborns and infants with critical CHD who were admitted to the NICU at our hospital were included.Postoperative aEEG was continuously monitored and analyzed,and its correlation with clinical conditions was compared.Results A total of 226 patients were enrolled.Of the 226 patients who underwent postoperative aEEG monitoring,approximately 5.8％ showed mild abnormal background patterns,0.9％ showed severe abnormalities,27.4％ demonstrated an immature SWC,and 3.5％ lacked SWC.The patients who had a history of hypoxia at birth exhibited delayed sternal closure or showed severe postoperative neurological symptoms and had higher probabilities of postoperative SWC abnormalities.Several infants,all with complex CHD,had postoperative seizures.Conclusion Gestational age and oxygen deficiency at birth were the risk factors of brain injury.Delayed sternal closure,severe postoperative infection,and postoperative neurological symptoms were risk factors for postoperative brain injury.Postoperative nervous system monitoring and prevention postoperative severe infection may obviously improve the brain function of neonates and small infants with critical congenital heart disease.

Objective To summarize anesthetic management of low birth weight infants undergoing surgical intervention of congenital heart disease without cardiopulmonary bypass. Methods Fifty-three low birth weight infants (including 49 premature infants) with congenital heart disease underwent surgical treatment without cardiopulmonary bypass during the period from June, 2003 to July, 2013. The mean gestational age of the infants was 30.96±3.09 weeks (26-40 weeks) with a mean age on the operation day of 32.81 ± 20.76 days (4-87 days), birth weight of 1429.90 ± 455.08 g (640-2460 g), and weight on the operation day of 1750.20±481.59 g (650-2460 g). All the infants underwent cardiac operations without cardiopulmonary bypass under general anesthesia. The respiratory parameters and acid-base and electrolyte balance were adjusted according to blood gas analysis. The inotropic drug was used to maintain the hemodynamic stability. Results Forty-seven of the infants received patent ductus arteriosus (PDA) ligation. Of these infants, 1 had cardiac arrest before the operation with failed cardiopulmonary resuscitation, and in another case, PDA ligation was aborted due to severe hypoplasia of the aortic valve and ascending aorta found intraoperatively by transesophageal echocardiography. Two infants underwent coarctation of the aorta (CoA), and 1 of them died during the operation due to cardiac arrest. The total mortality of these infants was 3.77%and the early postoperative mortality (<72 h) was 5.66%. Conclusion Non-cardiopulmonary bypass surgery can be performed in low birth weight infants in early stage, and effective anesthetic management can reduce the perioperative mortality and improve the postoperative survival rate.

Objective To summarize anesthetic management of low birth weight infants undergoing surgical intervention of congenital heart disease without cardiopulmonary bypass. Methods Fifty-three low birth weight infants (including 49 premature infants) with congenital heart disease underwent surgical treatment without cardiopulmonary bypass during the period from June, 2003 to July, 2013. The mean gestational age of the infants was 30.96±3.09 weeks (26-40 weeks) with a mean age on the operation day of 32.81 ± 20.76 days (4-87 days), birth weight of 1429.90 ± 455.08 g (640-2460 g), and weight on the operation day of 1750.20±481.59 g (650-2460 g). All the infants underwent cardiac operations without cardiopulmonary bypass under general anesthesia. The respiratory parameters and acid-base and electrolyte balance were adjusted according to blood gas analysis. The inotropic drug was used to maintain the hemodynamic stability. Results Forty-seven of the infants received patent ductus arteriosus (PDA) ligation. Of these infants, 1 had cardiac arrest before the operation with failed cardiopulmonary resuscitation, and in another case, PDA ligation was aborted due to severe hypoplasia of the aortic valve and ascending aorta found intraoperatively by transesophageal echocardiography. Two infants underwent coarctation of the aorta (CoA), and 1 of them died during the operation due to cardiac arrest. The total mortality of these infants was 3.77%and the early postoperative mortality (<72 h) was 5.66%. Conclusion Non-cardiopulmonary bypass surgery can be performed in low birth weight infants in early stage, and effective anesthetic management can reduce the perioperative mortality and improve the postoperative survival rate.