Acute kidney injury（AKI）is one of the risk factors leading to death in premature infants.The incidence of AKI showed a upward trend year by year.The pathogenesis may be related to preterm birth with insufficient nephrons，prenatal inflammatory injury and urinary podocyte loss.The occurrence rate of AKI in premature infants increased with the decreasing of gestational age and birth weight.It should be emphasized that AKI in premature infants does not exist independently，but interacts with other organs，such as heart，lung，intestine，brain，and other organs.Moreover，the involvement of these organs may increase the risk of AKI，and so does bloodstream infections.Blood creatinine and urine volume can be used for clinical diagnosis and classification of AKI in premature infants.Glucocorticoids and caffeine can protect kidney in premature infants.Due to the lack of specificity in the treatment of AKI，fluid management and medication are important for the development of AKI.Renal replacement therapy，the common of which are peritoneal dialysis and continuous renal replacement therapy，can be used in severe AKI.

Objective:To study the clinical characteristics and prognosis of necrotizing enterocolitis (NEC) in preterm infants with gestational age (GA) <34 weeks.Methods:From January 2016 to December 2022, preterm infants (GA <34 weeks) with NEC (Bell's stage Ⅱ/Ⅲ) admitted to our hospital were retrospectively analyzed. They were assigned into the conservative group and the surgical group. The perinatal data, clinical characteristics, laboratory results and prognosis were compared between the two groups.Results:A total of 4 526 preterm infants were enrolled. 298 (6.6%) had NEC and 188 were in stage Ⅱ/Ⅲ. 38(20.2%) infants received surgery and the remaining 150 were treated conservatively. Comparing with the conservative group, the surgical group showed higher incidences of the following: small for gestational age, blood in stool or positive fecal occult blood test (FOBT), apnea, poor response, increased heart rate, leukocytosis or leukopenia, thrombocytopenia, mechanical ventilation and elevated C-reactive protein and procalcitonin (all P<0.05). The surgical group also had higher incidences of concomitant shock and need for mechanical ventilation at the time of NEC diagnosis ( P<0.05). During NEC treatment, the surgical group had higher incidence of infectious pneumonia ( P=0.031). At 1, 3, 6, 12 and 18 months of follow-up, the surgical group had higher incidences of insufficient body weight gain ( P<0.05). At 1, 3 and 6 months of follow-up, the surgical group had higher incidences of smaller head circumference ( P<0.05). At 1 and 3 months of follow-up, the surgical group had higher incidences of shorter body length ( P<0.05). However, no significant differences existed in head circumference and body length as age developed ( P>0.05). At 12 months follow-up, no significant difference existed in the incidence of cerebral palsy between the two groups ( P>0.05). Conclusions:Blood in stool or positive FOBT, apnea, poor response and increased heart rate are common in GA <34 weeks preterm infants with NEC. Early diagnosis and identification of those requiring surgery are important. After surgery and later on, the infants may have a catch-up growth with the growth rate of head circumference and body length more pronounced than body weight.

OBJECTIVE：To o ptimize the t ype of nervous system medicines in National Essential Medicine List of China. METHODS：Various editions of WHO Essential Medicine Model List （WHO EML ）were consulted ，the collection of nervous system medicines was analyzed statistically ，and 2017 edition of WHO EML was compared with 2018 edition of National Essential Medicine List of China （NEML）. RESULTS ：During 1977-2017，the total number of nervous system medicines and disease coverage included in each edition of WHO EML had little change. Compared with 2017 edition of WHO EML ，2018 edition of NEML contained more medicines for nervous system disease （54 medicines vs. 30 medicines），and covered more disease types ， such as dementia （huperzine A ）and neuralgia （pregabalin），etc. However ，for the treatment of multiple sclerosis ，neuralgia， dementia and other diseases ，there were not many medicines to choose ，and some similar medicines （with the same or similar mechanism of action ）were collected repeatedly and some medicines had serious adverse reaction. CONCLUSIONS ：It is suggested that National Essential Medicine List should be continuously optimized and perfected ，the varieties of essential medicines for the treatment of nervous system diseases should be increased appropriately ，for improving the treatment effect of such diseases and reducing the cost burden of patients.