The new neonatal resuscitation guidelines was published in 2011 in China,which said no more neonatal asphyxia resuscitation guidelines as used,and showed a correct statement as the same as international that,also contained a deep essence meaning which would bring about some new thought and new behavior on neonatal resuscitation.There are three aspects should be realized:( 1 ) the diagnosis of neonatal asphyxia is extremely strict abroad now,which demonstrates that asphyxia is a after-resuscitation event instead of before-resuscitation one,and only failure of resuscitation will cause a asphyxia.Therefore,it is no suitable to say asphyxia resuscitation ; ( 2 ) in neonatal resuscitation algorithm,it never mentions asphyxia or not from birth to resuscitation finished; ( 3 ) under thinking shackle of the mistake concept asphyxia resuscitation,resuscitation behavior usually becomes more passive and inactive,and though the guidelines are the same,the resuscitation results are different between our country and abroad.So,changing conception,and resuscitation first,will be beneficial to decreasing neonatal asphyxia mortality to international level at which we might have arrived originally.

The development of cardiovascular system in very premature infants is immature.Hypotension and patent ductus arteriosus are common problems in the few days of life.The enormous difference that these infants receive cardiovascular support may affect the morbidity and mortality.Volume expansion,inotropes,cyclooxygenase inhibitor and glucocorticoid is commonly used drugs,but when and how to treat for these extremely low birth weight infants with cardiovascular problems has been plagued by clinical doctors.

Invasive fungal infection is an important cause of mortality and morbidity in preterm infants.Extremely preterm and extremely low birth weight infants are at highest risk because of the intensive and invasive nature of the care that these infants receive.How to prevent and treat the invasive fungal infection in preterm infants has become a new hot spot in the neonatologists.This review focused the progress on treatment and prevention of invasive fungal infections in preterm infants.

The article introduced and stressed laryngeal mask airway(LMA)'s invention and development,structure and classification,history and current situation of the applications of LMA in neonatal resuscitation,placement methods,recommendation of international guidelines for neonatal resuscitation on LMA,advantage and disadvantage when LMA versus bag-mask and endotracheal intubation ventilation for neonatal resuscitation,LMA extensions of research in neonate,and significance and prospects of its application in China.

Application of sustained lung inflation (SLI)during neonatal resuscitation can increase alveolar opening,promote lung fluid absorption and maintain the appropriate functional residual capacity (FRC) which can complete the transition from fetal phase of respiratory system to neonatal period.In recent years,SLI has also been confirmed by a large number of animal experiments and clinical studies,and it is expected to be practically applied in the resuscitation of newborns.However,more randomized controlled trials with a large number of samples is required for exploring suitable populations,methods of operation,and recent or long-term effects on newborns.Now,the application and research of SLI in neonatal resuscitation are described.

Objective:To determine the changes of intramucosal pH(pHi) after severe craniocerebral injuries and the correlation to bleeding from stress ulceration. Methods:Nineteen cases of severe head trauma patients were enrolled, their pHi were determined at different time point with tonometry. The pH of gastric juice and plasma gastrin concentrations were monitored for 7 days. Results:Five cases(bleeding group) developed stress ulcer bleeding. On admission, the pHi were not significantly different in the non bleeding group, but the differences between two groups at 12 hours, 24 hours, the 3rd day, the 5th day, the 7th day after admission were significant, pHi in the bleeding group was statistically lower than non bleeding group. The pH values of gastric juice and the plasma gastrin concentrations were not different significantly between two groups during each therapeutic periods. Conclusion:Bleeding group had significantly lower pHi than non bleeding group during the therapeutic periods. pHi was predictive for bleeding from stress ulceration after severe craniocerebral injury.

Objective To expolore the changes of coagulation index in newborns of different age and its clinical significance. Methods We studied 129 newborn infants without complication admitted to the neonatal department in an all-around hospital in Gnangzhou from January to December in 2005. These neonates were divided into two groups, including 63 cases of full-term infants and 66 cases of premature infants. Prothrombin time (PT), activated partial prothrombin time (APTT), Fibrinogen (Fg), thrombin time (TT), D-dimer (D-D) of these newborn infants were assayed on the first day, the third day and the tenth day. Results In the postnatal three periods of time, there was no difference in PT and D-dimer between two groups(P >0.05), but APTT and TT in premature infants were higher than that in full-term infants( P < 0.05), and Fg in premature infants were lower than that of full-term irfants(P<0.05). PT,APTT, TT,Ddimer were in decrease tendency and Fg increased as age increased( P < 0.05 ). Conclusion Geststional age and age had effect on coagulation index in newborn infants, and both can provide clinical references to clinical diagnosis and therapy.

Objective To demonstrate the association between fluid intake and sodium intake during the first 10 days of life and the risk of chronic lung disease (CLD) in very low birth weight (VLBW) infants.Methods A retrospective analysis of data from VLBW infants enrolled in the Neonatal Department of our hospital; 130 infants with birth weight between 790 and 1 470 g were randomized, among which 12 infants was diagnosised CLD. The daily fluid intake and sodium intake during the first 10 days of life were compared between the infants without CLD and those who developed CLD. Demographic and clinical neonatal variables were also compared. Results 118 infants survived without CLD and 12 infants developed CLD. Analysis showed that the daily fluid intakes were higher (day 2～10) and weight loss less (day 6～9) in the group of infants who developed CLD. In addition, the daily sodium intakes were also higher (day 2～6) in infants who developed CLD. Conclusion In the VLBW infants treated during the post surfactant era, higher fluid or sodi-um intake during the first 10 days of life were associated with an increased risk of CLD. The finding suggests that careful attention to fluid balance might be an important means to reduce the incidence of CLD.

Objective To evaluate the effect of hand hygiene (HH)promotion on awareness,correctness and compliance rates of HH among health care workers(HCWs).Methods HH promotion was started to carry out on May 8,2014,on-site questions,theoretical examination,and direct observation were adopted to survey the percent-age of HH awareness,correctness of six-step hand-washing method,and compliance to HH among HCWs before and at the phase five of promotion implementation,results before and after implementing promotion were compared. Results After implementing HH promotion,percentage of HH awareness,correctness of six-step hand-washing method,and compliance to HH among HCWs increased from 42.50%,35.45%,and 24.00% to 87.12%, 68.60%,and 43.20% respectively,differences were all significant (all P <0.05 ).Conclusion HH promotion has strengthened HCWs’HH awareness,standardized HH method,and enhanced compliance to HH.

Objective To investigate the expression and clinical significance of ER, PR and C-erbB-2 in breast cancer. Methods 82 cases of primary breast cancer were examined for ER, PR and C-erbB-2 by immunohistochemical S-P methods. Results The expressions of ER, PR and C-erbB-2 were 54.9 %, 40.2 %, 47.6 % respectively. There was a negative correlation between ER and C-erbB-2(P