Objective:To develop a formula correlating body weight and the insertion length of peripherally inserted central catheters (PICC) in very low birth weight infants (VLBWI) undergoing lower limb PICC placement, aiming to improve the success rate of one-time catheter placement.Methods:A prospective research method was adopted, 205 VLBWI patients who were hospitalized in the NICU of Shenzhen Maternal and Child Health Hospital from May 2023 to February 2024 and had indwelling PICC in the lower extremities were selected as the research subjects using the convenience sampling method. Data including gender, insertion vein, body weight on the day of catheterization, and the vertical distance from the puncture site to the first popliteal crease were collected. Pearson correlation analysis and linear regression analysis were used to construct a predictive formula for estimating the insertion length of PICC based on body weight. The Bland-Altman plot was applied to evaluate the consistency between the predicted insertion depth using the formula and the actual correct insertion length.Results:A total of 182 VLBWI were included in the study, comprising 102 male infants and 80 female infants. The catheterization sites were the right lower extremity in 166 cases and the left lower extremity in 16 cases. The body weight was (1.08 ± 0.26) kg. The vertical distance from the puncture site to the first popliteal crease was (5.58 ± 1.72) cm. The prediction formula for the length of lower extremity PICC catheterization was constructed through linear regression analysis: PICC insertion length = 8.013 + [5.194×body weight (kg)] ± vertical distance from the puncture site to the popliteal crease (cm). Consistency evaluation showed good agreement between the predicted insertion depth and the actual correct insertion length, with 95% of the measurement differences falling within the limits of agreement. The mean difference was 0.07 cm ( P > 0.05). Conclusions:The weight-based formula derived for VLBWI provides a basis for predicting the optimal insertion length of PICC in clinical practice.

Objective:To develop a formula correlating body weight and the insertion length of peripherally inserted central catheters (PICC) in very low birth weight infants (VLBWI) undergoing lower limb PICC placement, aiming to improve the success rate of one-time catheter placement.Methods:A prospective research method was adopted, 205 VLBWI patients who were hospitalized in the NICU of Shenzhen Maternal and Child Health Hospital from May 2023 to February 2024 and had indwelling PICC in the lower extremities were selected as the research subjects using the convenience sampling method. Data including gender, insertion vein, body weight on the day of catheterization, and the vertical distance from the puncture site to the first popliteal crease were collected. Pearson correlation analysis and linear regression analysis were used to construct a predictive formula for estimating the insertion length of PICC based on body weight. The Bland-Altman plot was applied to evaluate the consistency between the predicted insertion depth using the formula and the actual correct insertion length.Results:A total of 182 VLBWI were included in the study, comprising 102 male infants and 80 female infants. The catheterization sites were the right lower extremity in 166 cases and the left lower extremity in 16 cases. The body weight was (1.08 ± 0.26) kg. The vertical distance from the puncture site to the first popliteal crease was (5.58 ± 1.72) cm. The prediction formula for the length of lower extremity PICC catheterization was constructed through linear regression analysis: PICC insertion length = 8.013 + [5.194×body weight (kg)] ± vertical distance from the puncture site to the popliteal crease (cm). Consistency evaluation showed good agreement between the predicted insertion depth and the actual correct insertion length, with 95% of the measurement differences falling within the limits of agreement. The mean difference was 0.07 cm ( P > 0.05). Conclusions:The weight-based formula derived for VLBWI provides a basis for predicting the optimal insertion length of PICC in clinical practice.

Objective: To investigate the correlation of early incubator temperature fluctuation on intraventricular hemorrhage (IVH) in very/extremely-low birth weight infants (E/VLBW). Methods: From July 2015 to September 2016, 270 patients of hospitalized E/VLBW were included in this study. Temperature changes including incubator temperature and abdominal temperature within 72 hours after admission and routine clinical data were collected,the E/VLBW were divided into IVH group and non-IVH group, as well as the occurrence and grading of IVH. Chi-square test, t test and nonparametric test and logistic regression analysis were used to explore the effect of early incubator temperature fluctuations in E/VLBW on IVH. Results: Of the 270 V/ELBW studied, the incidence of IVH was 24.4% (66/270) , severe IVH(grade Ⅲ and Ⅳ) was 5.2% (14/270) . Univariate analysis showed that in addition to common IVH risk factors such as gestational age, body weight, 1/5 min Apgar score, sex, delivery, hyperglycemia, prenatal steroid and mechanical ventilation, fluctuations of body temperature and incubator temperature were relevant for IVH in E/VLBW (P<0.05) . Logistic regression analysis of the above relevant risk factors showed fluctuations of temperature (OR=1.10) was also an independent risk factor for IVH in E/VLBW(P<0.05) , in addition to sex(OR=0.42) , 1 min Apgar score (OR=0.71) , and hyperglycemia (OR=3.67) . Conclusion Fluctuation of incubator temperature is an independent risk factor for IVH in V/ELBWI. During centralized nursing and nursing operations, the operating time should be shortened as much as possible to reduce the number of fluctuations of incubators and body temperature to reduce the incidence of IVH and improve the quality of life.

Objective To investigate the risk factors of severe hand,foot and mouth disease (HFMD).Methods 175 severe cases of HFMD and 183 mild cases of HFMD in the same period were randomly selected.Single factor analysis was first performed between severe and mild cases on age,gender,residence,symptoms,signs and laboratory examinations,etc,to screen out the related risk factors which P value ＜ 0.05.Then,binary logistic regression analysis was carried out to determine risk factors most related to severe HFMD.Finally,receiver operating characteristic curve (ROC) analysis was performed on severe HFMD related risk factors.Results Single factor analysis showed that there were obvious differences between children with mild HFMD and those with severe HFMD in the factors like difficulty in breathing,walking instability,vomiting,limb shaking,disturbance of consciousness,convulsions,cold sweat and weakness,thermal process,the degree of fever,pulmonary rales,heart rate,serum EV71 antibody,circulatory failure,leukocyte count,platelet count,neutrophil ratio,CRP,blood glucose,etc (x2 =15.236,19.819,33.823,52.670,12.984,10.180,29.318,52.932,34.544,14.615,46.633,31.407 and 5.303,t =3.184,3.144,2.256,2.244 and 2.828,,all P ＜0.05).Binary logistic regression analysis showed that the thermal process,startle tremor or limb jitter,serum EV71 antibody,vomiting,fever,neutrophil ratio were the related risk factors of severe HFMD (B value =2.605,2.129,1.409,1.185,0.841 and 0.103,all P ＜ 0.05).ROC analysis showed that the areas under the curve of the predicted probability and thermal process were larger than any other risk factors [(95％ CI (0.888 ～ 0.961) and (0.818 ～ 0.920)],and thus had better diagnostic values.Conclusion Children under 3 years old were the high risk population of HFMD.Such clinical symptoms as persistent high fever,vomiting,startle tremor orlimb jitter,EV71 antibody in serum and increasing neutrophil ratio were risk factors for severe HFMD.The predicted probability had more diagnostic value than any other risk factors.

Objective To investigate the premature infants′ pain operation during their hospitalization and thus provide evidence for the necessity of premature infants pain management. Methods Using the method of convenient sampling, we prospectively collected data of all painful procedures performed on 111 premature infants who recruited from admission to discharge in a Neonatal Intensive Care Unit in Shenzhen. The pain of premature infant was evaluated by premature infant pain profile ( PIPP ) . Results During hospitalization, 111 premature infants were exposed to 8 258 painful operations, with each preterm having (74. 4 ± 18. 22) times and averagely (3. 72 ± 1. 53) times each day. Below 1 500 g birth weight infants and equal and beyond 1 500 g birth weight infants were exposed to a median of 153 and 46 painful procedures, respectively. Among those painful procedures, 3M Transparent Dressing removal was the most frequently pain operation performed on preterm neonates, and peripheral arterial puncture, plantar blood sampling, and subcutaneous injection were top three reasons caused most pain. Conclusions Premature infants, particularly very/extremely low birth weight infants ( VLBWI/ELBWI ) , are exposed to numerous invasive painful procedures. It is necessary to train health-care workers to enhance their pain management ability, thereby to reduce the adverse effects of pain stimuli to the premature infants.

A New Combination membrane was prepared by chitosan and polyvinyl alcohol (PVA).The gas permeability and water content of the membrane are all improved better than that of simple chitosan membrane.