Pulmonary hemorrhage is a common critical disease in neonates, with high mortality. Early and accurate diagnosis is the key to successful treatment. Recently, lung ultrasound has been successfully used to diagnose neonatal pulmonary hemorrhage. Main ultrasonographic manifestations of neonatal pulmonary hemorrhage are described in this article, including shred sign, lung consolidation with air bronchogram, pleural effusion, lung edema, pleural line abnormality and A-line disappearance.

Objective To summarize the routine application of neonatal lung ultrasound in neonatal and NICU department of our hospital in the past 2 years,and to explore the feasibility of using ultrasound in-stead of X-ray in diagnosing pulmonary diseases in neonatal ward. Methods From March 2017 to May 2019,a total of 2 874 children hospitalized in the department of neonatology in our hospital were collected to analyze the types of pulmonary diseases and the reliability of lung ultrasound diagnosis. Results A total of 2 874 children received lung ultrasound examination for 7 902 times,including 1 040 patients(36. 2%) with pulmonary disease and 1 834 patients(63. 8%)without pulmonary disease. There were 152 cases of neonatal respiratory distress syndrome,112 cases of wet lung,652 cases of pneumonia,87 cases of meconium aspira-tion syndrome,12 cases of pneumothorax ( including 1 case with mediastinal emphysema),and 25 cases of pulmonary hemorrhage. Among the 2 874 children,106 received X-ray examination of the lungs before admis-sion,and received dynamic monitoring of lung ultrasound. Ninety-six cases were found to have pulmonary lesions,among which 8 cases were diagnosed with neonatal respiratory distress syndrome by X-ray examina-tion and wet lung by lung ultrasound,and recovered quickly after treatment according to wet lung. In 2 cases, X-ray examination showed no pneumonia complicated with pneumothorax,while ultrasound diagnosis showed a small amount of pneumothorax, and ultrasound diagnosis showed pneumonia complicated with a small amount of pleural effusion in 1 case. The diagnostic coincidence rate was 91. 7%. Conclusion It is feasible to use ultrasound instead of X-ray to diagnose pulmonary diseases in neonatal wards. Ultrasonic diagnosis of neonatal pulmonary diseases is worth promoting.

Objective: To investigate the value of ultrasound in the localization of peripherally inserted central catheter (PICC) in neonates. Methods: A retrospective analysis of the PICC catheterization was conducted at Department of Neonatology, Beijing Chaoyang District Maternal and Child Healthcare Hospital from June 2017 to December 2018.The ultrasound monitoring was performed immediately after PICC catheterization.The probe was placed into the midline position of the lower xiphoid or the subclavian parasternal line for scanning, and it would be the PICC if a high-echo " equal sign" was observed by ultrasound.It was believed that the PICC was successfully placed when ultrasound detected that the PICC tip was located in the junction of inferior vena cava or superior vena cava in the right atrium. Results: (1)Among 112 infants with PICC catheterization, 103 cases (92.0%) were accurately placed, 9 cases (8.0%) were not placed in the ideal site, among them, 2 cases were too deep, 4 cases were too shallow and 3 cases were catheter heterotopia.The tip position was accurate after the readjustment under ultrasound monitoring in those patients whose the first ultrasound showed the tip position was not ideal.(2)The PICC indwelling time was as short as 2 days (removed due to severe arrhythmia) and as long as 56 days with an average of (15.1±10.7) days.(3)The catheter-related complications occurred in 3 cases with an incidence of 2.7%. Conclusions Using ultrasound to determine the PICC tips position is accurate and reliable, which is worthy of extensive application in the neonatal wards.

ObjectiveTo understand the status quo of palliative nursing knowledge of medical staff in He'nan Province, analyze its influencing factors and training needs, and provide theoretical basis for further improving palliative nursing knowledge level and formulating effective training measures. Methods? From October 2017 to February 2018, a total of 600 medical staff from six ClassⅢ Grade A hospitals in He'nan Province were selected as the research subjects. All the subjects were investigated with palliative care knowledge questionnaire (PCQN) and the palliative care training needs questionnaire. Multivariate linear regression analysis was used to analyze the influencing factors. A total of 600 questionnaires were sent out and 579 valid questionnaires were collected. Results? The score of PCQN of the 579 medical staff was (12.19±3.221). The factors influencing the knowledge level of palliative care among medical staff were discussed with dying patients or their families, heard of palliative care, educational level, professional title and experience of palliative care, which could explain 37.8% of the total variation of the factors. Conclusions? The knowledge level of palliative care among medical staff is generally low. The factors influencing the knowledge level of palliative care among medical staff were discussed with dying patients or their families, heard of palliative care, educational level, professional title and experience of palliative care. Medical staff have strong training needs in all aspects of palliative care. It is particularly important to train palliative nursing knowledge in relevant specialties.

Clinicians are familiar with neonatal brain damage caused by severe asphyxia, hypoxia and premature birth, but enough attention has not been paid on the correlation between cesarean section, polycythemia, disseminated intravascular coagulation, patent ductus arteriosus, and non-invasive high-frequency oscillatory ventilation and neonatal brain damage.Which would be introduced in this paper to further improve neonatal prognosis.

Objective:To investigate the feasibility and characteristics of ultrasound imaging in diagnosing fractures in neonates.Methods:Thirty neonates with bone fracture in Beijing Chaoyang District Maternal and Child Healthcare Hospital during January 2018 to June 2019 were retrospectively recruited. The causes and ultrasound imaging features of these cases were analyzed. The ultrasound findings were compared with the results of X-ray examination.Results:Among the 30 cases, 29 (96.7%) were diagnosed as fracture due to birth trauma, including 28 (93.3%) of clavicle fracture and one (3.3%) of humerus fracture, and one (3.3%) with rib fracture probably caused by metabolic osteopathy. The ultrasound imaging characteristics included interruption of bone continuity, dislocation and/or angulation of fracture ends, and callus formation during recovery. All of the 30 cases were diagnosed by ultrasound. However, X-ray examination failed in the diagnosis of one clavicle fracture.Conclusions:Ultrasound is an accurate and reliable method for the diagnosis of neonatal fracture. The main characteristics of ultrasound imaging include interruption of bone continuity, dislocation and/or angulation of fracture ends and callus formation.

Objective:To analized brain function monitoring results with amplitude- integrated electroencephalogram (aEEG) in neonatal ward.Methods:The clinical data of 1 370 newborns received aEEG monitoring in Neonatal Department of our hospital from September 2017 to August 2019 were retrospectively analyzed.Results:Among 1 370 neonates undergoing aEEG examination,abnormalities were demonstrated in 308 cases with an overall abnormal rate of 22.5%. The abnormal rate in critical neonates was 27.7% (240/868),while that in non-critical neonates was 13.6% (68/502) (χ2=36.304, P<0.01). Neonates with convulsion had the highest aEEG abnormal rate (57.1%, 16/28), followed by small for gestational age (SGA) (48.8%, 20/41), asphyxia (41.5%, 49/118), premature (31.1%, 92/296)and erythrocytosis (29.7%, 11/37). Among 308 cases of abnormal aEEG, the main types of abnormalities were abnormal background activity in 229 cases (74.4%),insignificant sleep-wake cycles in 139 cases (45.1%) and abnormal original EEG in 117 cases (40.0%). Among 308 cases of abnormal aEEG, 38.0%(117 cases) had corresponding clinical manifestations and 62.0%(191 cases) had no clinical manifestations. The sensitivity of aEEG monitoring is 73.6%(117/159), and the specificity is 84.2%(1 020/1 211). Conclusions:The abnormal rate of aEEG is high in hospitalized neonates,especially in critically ill neonates. It is necessary to carry out routine aEEG examination for hospitalized neonates in order to early detect brain function damage.

Objective To investigate the influencing factors and demand of clinical frontline nurses' thesis writing in He'nan Province providing a theoretical basis for improving the clinical nurses' thesis writing willingness and level.Methods From May 2015 to May 2016, a self-designed questionnaire was used to survey 1200 clinical nursing staff from 12 hospitals in He'nan Province by Lottery method and random number table method for general information, hinder factors of thesis writing, and the assist and guidance needed in thesis writing. The descriptive analysis, Kruskal-Wallis rank sum test, independent sample t-test, single factor analysis of variance, linear correlation analysis, multiple linear regression analysis were used to analyze the influencing factors of nurses' paper writing.Results A total of 1086 effective questionnaires were recycled. The differences of number of papers wrote by nurses who were different in hospital level, marital status, age, nursing age, work intensity, professional title, and final education were statistically significant (H=16.293, 206.350, 31.775, 56.393, 136.605, 484.600, 48.913;P<0.05). Hospital level, age, nursing age, marital status, professional title, and final education were all positively correlated with the number of papers (r=0.119, 0.161, 0.215, 0.410, 0.639, 0.093;P<0.01), while work intensity was negatively correlated (r= -0.367,P<0.01). The scores of five dimensions of factor hindering the thesis writing from high to low were lack of thesis writing skills (16.16±2.37), literature search obstacles (15.14±2.47), lack of statistical software operation (15.49±1.72), clinical sensitivity of problems identifying (14.63±2.74) and poor data collection methods (13.27±2.14). Multiple linear regression analysis showed that hospital level, professional title, nursing age and final education level were the main factors that impeded the writing of clinical nurses, which explained 93.1％ of the total variation. The main thesis writing training needs were research topic selection and project design, paper writing methods and skill training, and hospital policy support.Conclusions Thesis writing number by Class Ⅲ hospital nursing staff was higher than that by Class Ⅱ hospital in He'nan Province. Nursing age, title and final education level were the main factors hindering the clinical nurses from thesis writing. Hospital managers needs to train clinical nurses on paper writing according to the medical system of our country.