Objective To identify risk and protective factors of the periventricular-intraventricular hemorrhage (PV-IVH) in preterm infants. Methods By 1:1 case-control study, prenatal and perinatal data were collected and analyzed between preterm infants with PV-IVH and control group from January 2012 to October 2014. The risk and protective factors for the PV-IVH were identiifed by univariate analysis and multivariate conditional logistic regression analysis. Results There were one hundred and thirty-two preterm infants diagnosed of PV-IVH, in which, among whom 6 preterm infants could not be matched to the control infants in the protocol. Finally, 126 pairs of infants were enrolled in the study. There were no differences between two groups in gestational age and birth weight (all P>0.05). Multivariate conditional logistic regression analysis found that BE<-5 mmol/L in the initial blood gas analysis after birth (OR=1.986, 95.0%CI:1.039-3.796), mechanical ventilation (OR=2.913, 95%CI:1.390-6.101), weight gain≤10 g/d in the second week (OR=2.303, 95%CI:1.164-4.558) were risk factors, while number of previous pregnancies≥1 times (OR=0.426, 95%CI:0.229-0.792) was a protective factor for PV-IVH. Conclusions The risk factors of PV-IVH in preterm infants include the lower BE value in the initial blood gas analysis, required mechanical ventilation, and less weight gain in the second week.

Objective To investigate the effect on incidence of ventilator associated pneumonia(VAP),the cost of hospitalization with closed endotracheal suctioning and vital sign as well in postoperative cardiac patients.Methods 304 postoperative cardiac patients supporting by ventilation were enrolled in this cohort study during January,2012-November,2013 in The Second affiliated Hospital& Yuying Children Hospital of Wenzhou Medical University.All the subjects were randomly divided into observational group and control group by coin side.Closed endotracheal suctioning system was applied in observation group and opened mode was applied in control group.Compare the vital sign(heart rate,blood pressure,saturation) at the moment of aspiration,suction time,incidence of VAP,duration of ventilation,mortality,the cost of suction,hospital stays and hospitalization expense.Results The baseline is no significant difference between two groups.The fluctuation of blood pressure and heart rate is lower in observational group at 30 second since completed the suction(P ＜0.05),but saturation is higher at 30 second and 60 second since completed the suction respectively(P ＜ 0.05).There is no significant difference of incidence of unexpected tube displacement and pneumothorax between two groups.Average time of each suction of experimental groups is shorter than Control groups[(156 ± 6) s vs (225 ± 8) s,t =-84.86,P ＜ 0.01].VAP incidence is lower in experimental group (12.0％ vs.18.6％,x2 =4.37,P ＜ 0.05).Duration of ventilation is lower in experimental group[(72 ± 33) h vs.(98 ± 38) h,t =-6.35,P ＜ 0.05].The cost of suction is higher in observational group [(346 ± 15) RMB vs.(178 ± 26) RMB,t =69.00,P ＜ 0.01],but the hospitalization expense is lower in experimental group [(32 011 ± 2 525) yuan vs.(35 264 ± 3 846)yuan,t =-8.72,P ＜ 0.05].There is no significant difference in mortality between two groups (x2 =0.08,P ＞ 0.05).Conclusion Application of closed endotracheal suction system can result in reduction vital sign fluctuation and incidence of cross infection and reducing the workload of nurses and decreasing the complication of suction,shorting the duration of ventilation and hospitalization and saving the expense of hospitalization in postoperative cardiac patients comparing with open mode.It is worthy to be populized in cardiac care unit.

Objective To evaluate the clinical efficacy and clearance rate of pathogens of meropenem by different infusion therapies in treatment of severe sepsis for pediatric patients.Methods Sixty inpatients with serious sepsis from Pediatric Intensive Care Unit,Women and Children's Hospital of Ningbo University were randomly divided into three groups 20 in each.The meropenem was given according to the recommended therapeutic dose.Group A:The micropump was pumped for 0.5h at a rate of 100ml/h.Group B:The micropump was pumped for 3h at a rate of 16.7ml/h.Group C:Half of the menopenen was pumped for 0.5h at a rate of 50ml/h,and the other half was pumped for 2.5h at a rate of 10ml/h.Changes of indexes were compared before and after the treatment to estimate of the clinical effective rate,clearance rate of pathogens and side effects among the groups.Results There were observable improvements in the inflammatory indicators after treatment,such as white cell count,C-reactive protein and procalcitonin,etc.The total effective rate was 60％in group A,75％in group B,and 95％in group C.There were statistically differences among the groups(P＜0.05).Meanwhile,the bacterial clearance rates of the groups were 50％(group A),70％(group B)and 100％(group C),respectively(P＜0.05).The rate of side effect was 20％(group A),15％(group B)and 20％(group C),respectively(P＞0.05).Conclusion It can significantly improve the clinical efficacy and antibacterial efficacy by the two step infusion therapy of meropenem,compared with traditional infusion therapy and extended infusion.

Objective:To verify the clinical efficacy and safety of Qufeng Tongxuan method in treating low- and moderate-volume intracerebral hemorrhage at acute stage.Methods:A prospective, multicenter, randomized, double-blind, placebo-controlled study was performed; patients with low- and moderate-volume intracerebral hemorrhage at the basal ganglia and/or thalamus accepted treatment in 16 hospitals from September 2019 to April 2022 were enrolled. These patients were divided into experimental and control groups with a block randomized method by SAS software. Patients in control group were given conventional western medicine treatment; those in experimental group accepted Qufeng Tongxuan method (sequential therapy of Shexiang Huayu Xingnao granules and Zhilong Huoxue Tongyu granules) besides conventional western medicine treatment. NIHSS was used to assess neurological function before treatment and on 7 th, 14 th, 30 th, and 90 th d of treatment. Prognoses of these patients were assessed by modified Rankin scale (mRS) before treatment and on 180 th d of treatment. Brain CT was performed before treatment and on 7 th and 14 th d of treatment to calculate the hematoma volume. Before treatment and on 14 th d of treatment, changes of coagulation function, liver and kidney functions of the 2 groups were compared. Adverse reactions during treatment in the 2 groups were recorded. Results:No significant differences in NIHSS scores were noted between the 2 groups before treatment, on 7 th, 14 th, and 30 th d of treatment ( P>0.05); NIHSS scores in experimental group on 90 th d of treatment were signficantly lower than those in control group ( P<0.05); NIHSS scores in experimental group decreased gradually before treatment and on 7 th, 14 th, 30 th and 90 th d of treatment, with statistical significances ( P<0.05). No significant differences in mRS scores were noted between the 2 groups before treatment ( P>0.05); mRS scores in experimental group on 180 th d of treatment were signfciantly lower than those in control group ( P<0.05). No significant difference in hematoma volume was noted between the 2 groups before treatment and on 7 th and 14 th d of treatment ( P>0.05); both groups had gradually decreased hematoma volumes before treatment and on 7 th and 14 th d of treatment, respectively, with significant differences ( P<0.05); the volume difference of hematoma between 14 th d of treatment and before treatment in experimental group (6.42[4.10, 11.73]) was significantly higher than that in control group (4.00[1.25, 10.58], P<0.05). No significant differences in liver and kidney function indexes or coagulation function indexes were noted between the 2 groups before treatment and on 14 th d of treatment ( P>0.05). Adverse reaction incidence was 9.52% ( n=12) in experimental group and 10.34% ( n=12) in control group, without statistical difference ( P>0.05). Conclusion:Under premise of conventional western medicine treatment, Qufeng Tongxuan method can promote hematoma absorption and improve neurological deficit symptoms in low- and moderate-volume intracerebral hemorrhage at acute stage, without obvious adverse reactions.