Objective:To analyze the accuracy of lung ultrasound and chest X-ray in the diagnosis of neonatal pulmonary disease.Methods:We prospectively collected newborns that needed chest X-ray examination to diagnose pulmonary disease from twelve neonatal intensive care units across the country between June 2019 and April 2020.Each newborn was examined by lung ultrasound within two hours after chest X-ray examination.All chest X-ray and lung ultrasound images were independently read by a radiologist and a sonographer.When there was a disagreement, a panel of two experienced physicians made a final diagnosis based on the clinical history, chest X-ray and lung ultrasound images.Results:A total of 1 100 newborns were enrolled in our study.The diagnostic agreement between chest X-ray and lung ultrasound(Cohen′s kappa coefficient=0.347) was fair.Lung ultrasound(area under the curve=0.778; 95% CI 0.753-0.803) performed significantly better than chest X-ray(area under the curve=0.513; 95% CI 0.483-0.543) in the diagnosis of transient tachypnea of the newborn( P<0.001). The accuracy of lung ultrasound in diagnosing neonatal respiratory distress syndrome, meconium aspiration syndrome, pneumonia and neonatal pulmonary atelectasis was similar to that of chest X-ray. Conclusion:Lung ultrasound, as a low-cost, simple and radiation-free auxiliary examination method, has a diagnostic accuracy close to or even better than that of chest X-ray, which may replace chest X-ray in the diagnosis of some neonatal lung diseases.It should be noted that both chest X-ray and lung ultrasound can only be used as auxiliary means for the diagnosis of lung diseases, and it is necessary to combine imaging with the clinical history and presentation.

The incidence of acute kidney injury (AKI) in Neonatal Intensive Care Unit (NICU) is about 30%.The morbidity and mortality of AKI are higher in very premature infants, very low birth weight infants and infants with long mechanical ventilation.Serum creatinine (Scr) and urine output are diagnostic indicators for AKI, which usually change within 12-48 hours after the onset of irreversible injury, and cannot be used for early diagnosis and clinical intervention.Therefore, it is necessary to search for indicators of early renal insufficiency, aiming to intervene and prevent early-stage AKI or reduce the occurrence of AKI.Near-infrared spectroscopy (NIRS) is a non-invasive, continuous, real-time monitoring method, which serves as a supplement to conventional biochemical markers.It provides evidence of early-stage renal ischemia and hypoxia, which contributes to prevent or reduce AKI.This study reviews the clinical application of neonatal renal oxygen saturation monitoring, thus providing clinical reference for renal function protection in critically ill neonates to reduce the occurrence of AKI and improve their prognosis.

Objective To compare the curative effect with high frequent oscillation ventilation (HFOV) and with HFOV + inhaled nitric oxide (iNO) in the treatment of neonatal hypoxic respiratory failure (NRHF).Methods Data of 60 NHRF patients in the People's Hospital of Dehong Prefecture from January 2015 to December 2016 were retrospectively analyzed.The patients were divided into HFOV group (32 cases) and HFOV + iNO group (28 cases) according to the treatment methods.The comparison between the 2 groups was established as following:oxygenation index(OI),arterial partial pressure of carbon dioxide [Pa (CO2)] and complications.Results There was no significant difference between the 2 groups in time of birth,gestational age,birth weight,gender ratio and original diseases (all P ＞ 0.05).As for OI there was no significant difference at 0 h between the 2 groups (27.8 ± 3.5 vs.27.6 ± 3.7) (t =0.04,P ＞ 0.05);OI of HFOV + iNO group (11.2 ± 3.4,7.3 ± 3.0,7.0 ± 2.6,respectively) was more significantly decreased than that in the HFOV group (14.5 ± 3.3,9.6 ± 3.0,8.5 ± 2.8,respectively) at 8 h,16 h,24 h,and there were significant differences between the 2 groups (t =3.81,5.16,2.14,all P ＜ 0.05).As for P a (CO2) there was no significant difference at 0 h [(65.14 ± 14.97) mmHg vs.(64.79 ± 13.40) mmHg] (t =0.095,P ＞ 0.05);the changes in Pa (CO2) had no statistically significance difference between HFOV + iNO group and HFOV group at 8 h,16 h,24 h [8 h:(50.71 ± 10.49) mmHg vs.(49.02 ± 11.74) mmHg,16 h:(40.99 ± 12.38) mmHg vs.(40.02 ± 12.04) mmHg,and 24 h:(39.01 ±9.80) mmHg vs.(38.00 ±7.85) mmHg,all P ＞0.05].As for the complications,there was no difference between the 2 groups in pulmonary air leak,pneumorrhagia,intracranial hemorrhage,blood platelet ＜100 × 109/L,methemoglobin concentration ＞ 3％,or dysfunction of blood coagulation (all P ＞ 0.05).Conclusion Both HFOV and HFOV + iNO methods are effective for NRHF.Treatment with HFOV + iNO method is more effective.Treatment for NHRF with HFOV + iNO is safe,effective,without complication increase in a short term.

Objective To observe the effect of heat needle treatment on the inflammatory reaction in the damaged tissues of rats with the third lumbar transverse process syndrome. Methods Ninety Sprague-Dawley rats were randomly divided into 6 groups, namely normal group, model group, drug group, heat needle group, conventional acupuncture group and warming acup-moxibustion group, 15 rats in each group. The rat model of the third lumbar syndrome was established by embedding gelatin sponge. Two weeks later, the rats in various groups were given corresponding treatment respectively. Before treatment and on the 7th, 14th and 28th day of treatment, the blood samples were collected from jugular vein, and then the serum inflammatory cytokines of tumor necrosis factor alpha (TNF-α), interleukin (IL)-1β and IL-6 were detected by enzyme-linked immunosorbent assay (ELISA). On the 28th day of treatment, all of the rats were sacrificed, the expression levels of TNF-α, IL-1βand IL-6 mRNA in the muscle tissue were detected by reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR), and the pathological changes in local muscle tissue were observed by HE staining method. Results The serum contents of the inflammatory cytokines of TNF-α, IL-1β and IL-6 in the model group and treatment groups after modeling were significantly higher than those in the normal group (P < 0.05). After treatment, the contents of TNF-α, IL-1β and IL-6 in various treatment groups were decreased significantly as compared with those in the model group, and the decrease was most obvious in the heat needle group. The expression levels of TNF-α, IL-1β and IL-6 mRNA in muscle tissues of drug group, heat needle group, conventional acupuncture group and warming acup-moxibustion group were lower than those of the model group (P < 0.05), and the heat needle group had the lowest levels. HE staining results showed that heat needle group had milder inflammatory reaction and better muscle fiber structure than the model group. Conclusion Heat needle treatment can improve the local inflammatory response and promote the repair of tissue damage through decreasing the expression levels of inflammatory cytokines of TNF-α, IL-1βand IL-6.

OBJECTIVESince 1986, the reference of birth weight for gestational age has not been updated. The aim of this study was to set up Chinese neonatal network to investigate the current situation of birth weight in China, especially preterm birth weight, to develop the new reference for birth weight for gestational age and birth weight curve.

METHODA nationwide neonatology network was established in China. This survey was carried out in 63 hospitals of 23 provinces, municipalities and autonomous regions. We continuously collected the information of live births in participating hospitals during the study period of 2011-2014. Data describing birth weight and gestational age were collected prospectively. Newborn's birth weight was measured by electronic scale within 2 hours after birth when baby was undressed. The evaluation of gestational age was based on the combination of mother's last menstrual period, ultrasound in first trimester and gestational age estimation by gestational age scoring system.

STATISTICAL ANALYSISthe growth curve was drawn by using LMSP method, which was conducted in GAMLSS 1.9-4 software package in R software 2.11.1.

RESULTA total of 159 334 newborn infants were enrolled in this study. There were 84 447 male and 74 907 female. The mean birth weight was (3 232 ± 555) g, the mean birth weight of male newborn was (3 271 ± 576) g, the mean weight of female newborn was (3 188 ± 528) g. The test of the variables' distribution suggested that the distribution of gestational age and birth weight did not fit the normal distribution, the optimal distribution for them was BCT distribution. The Q-Q plot test and worm plot test suggested that this curve fitted the distribution optimally. The male and female neonatal birth weight curve was developed using the same method.

CONCLUSIONUsing GAMLSS method to establish nationwide neonatal birth weight curve, and the first time to update the birth weight reference in recent 28 years.

Objective To evaluate the clinical efficacy of early enteral nutrition combined with additional parenteral nutrition (EEN + PN) versus TPN (total parenteral nutrition) in patients after conventional pancreaticoduodenectomy (PD).Methods From January 2009 to January 2013, 340 consecutive patients who underwent conventional PD with Child's reconstruction at the First Affiliated Hospital of Xi'an Jiaotong University were enrolled into this single-center retrospective comparative study.There were 87 patients in the EEN + PN group and 253 patients in the TPN group.The preoperative baseline characteristics,histopathological types, intraoperative parameters and postoperative outcomes were recorded and compared between the two groups.Results There were no significant differences in the preoperative general characteristics data, pathological patterns, and intraoperative details.There were significantly higher rates in delayed gastric emptying (DGE), morbidity (15.9％ vs 6.7％, P ＜ 0.05), and pneumonia (10.3％ vs 3.6％, P ＜ 0.05);significantly prolonged nasogastric tube removal time (5.6 ± 0.2 days vs 3.9 ± 0.1 days, P＜0.05), and increase in hospitalization expenses (65 397.0 ± 861.2) Yuan vs (50 663.9 ± 239.2) Yuan, P ＜ 0.05) in the EEN + PN group when compared with the TPN group.Conclusions EEN + PN after conventional PD was associated with increased rates of DGE and pneumonia, prolonged nasogastric tube removal time, longer EN duration and increase in hospitalization expenses.Hence, EEN should only be performed prudently and selectively.

The establishment of repairing and maintenance system for medical appliance promotes the equipment management in the skeleton sanitation units. The problems are analyzed from 3 aspects including the characteristics of the third-class maintenance station,the actuality of the skeleton sanitation units and the technique level of checking and repairing service. Solving methods are put forward to accelerate the development of the third-class maintenance station.

The e -procurement definition of the medical equipment is introduced from mainly aspects and correlated details,and e-procurements strategies and the concrete methods and actions for ensuring quality in the medical equipment are expatiated.

Objective To introduce the communication technology between the server and client in the manage ment and application software of the medical equipment and sanitation equipment based on the VC++6.0 software.Methods The au-thor made use of the asynchronism and no block encapsulation sort CAsyncSocket and thread of VC++6.0 software to sent and receive the transformed data in the client and sever.Results The method implemented the data transmission in the client and data receiving in the sever.Conclusion This study offers one method of data transmission in the dialog box pro-cedure.

The importance of avoiding adverse event of medical appliances is expatiated from such aspects as the purchase of medical appliances,the second check up,the transformation of service pattern of medical engineering,the measure and judging of medical appliances,etc.