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.

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.

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.

Objective To survey the state of internet addiction of vocational college students and explore the effect of perceived social support and loneliness on Internet addiction.Methods In accordance with random cluster sampling,this research used the Revised Chen Internct Addition Scale,Perceived Social Support scale,and UCLA Loneliness Scale to study lnternet addiction among a total of 1 602 vocational college students from three higher vocational colleges in Guangzhou.Results [nternet addiction rate was 9.87％,and Internet dependence rate was 24.78％.Internet addiction had a higher incidence rate among male students than that among female students (x2=19.775,P＜0.01).The perceived social support group of vocational college students was low,which indicated serious loneliness based on the Loneliness Scale,and their scores on Internet addiction tendency were higher than those of other groups (P＜0.01).The total scores in Internet addiction tendency and perceived social support were negative (r=-0.183,P＜ 0.01),which indicates positive correlation with loneliness (r=0.243,P＜ 0.01).The mediating effect of perceived social support and Internet addiction on loneliness was significant,with a mediation rate of 69.63％.Conclusion Internet addiction tendency of vocational college students is a problem that deserves more attention.Low social support and loneliness can increase the incidence rate of internet addiction tendency.Loneliness is also found to be a strong predictor of internet addiction.

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.

ObjectiveTo study the feasibility, efficacy and safety of laryngeal mask airway (LMA) Supreme (SLMA) in neonatal resuscitation.MethodsSixty neonates, who were born at South Medical University Affiliated Maternal & Child Health Hospital of Shenzhen from June 1, 2012 to June 1, 2013 and requiring positive pressure ventilation after 30 s primary resuscitation post born, with birth weight above 2 000 g or gestational age above 34 weeks, were randomly assigned into two groups: SLMA group (n=30) and LMA Classic (CLMA) group (n=30). The outcome indicators included the curative effect, insertion time and possible adverse reactions of the two kinds of LMA, and the serum bio-markers, heart rate and percutaneous pulse oxygen saturation (SpO2) of all neonates. Independent samplet test, non-parametric test andChi-square test were applied for statistical analysis.ResultsThe insertion time was shorter in SLMA group than in CLMA group [(4.9±1.0) vs (7.6±1.3) s,t=8.98,P<0.05]. And more displacement occurred in CLMA group than in SLMA group [13.3% (4/30) vs 0% (0/30), Fisher exact test,P<0.05]. The successful rate of resuscitation in SLMA group was higher [100.0% (30/30) vs 90.0% (27/30), Fisher's exact test,P<0.05], and both the onset time and the total ventilation time were shorter than those in CLMA group [(12.4±3.7) vs (15.6±3.8) s,t=3.31,P<0.05; (37.3±17.0) vs (48.2±20.1) s,t=2.29,P<0.05]. The heart rate at 1 min after delivery was higher in SLMA group than in CLMA group [(93.5±20.9) vs (74.2±17.8) bpm,t=-3.86,P<0.05], and the same results were shown for SpO2 at 1, 2 and 3 min after birth [(47.1±8.4)% vs (38.7±12.1)%, t=-3.13; (68.1±9.5)% vs (52.8±10.8)%,t=-5.82; (78.3±10.0)% vs (72.1±9.7)%,t=-2.46; allP<0.05]. In the CLMA group, vomit or regurgitation occurred in three neonates, abdominal distension in two cases, aerogastria in seven cases. However, none of the above was reported in the SLMA group. No laryngeal injury was found in any of the subjects.ConclusionSLMA is more potential than CLMA in neonatal resuscitation because of its simplicity, better airtight, less adverse effect, superior efficacy and less requirement for tracheal intubation.

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.