Objective To investigate the application value of bedside ultrasound monitoring of quadriceps muscle changes in mechanically ventilated children in the early treatment of ICU-acquired muscle weakness (ICU-AW). Methods Eighty-two pediatric ICU patients with mechanical ventilation for>48 hours were selected. On the day of admission (D₀) and on day 7 (D₇), bedside ultrasound was performed to measure the thickness and cross-sectional area of the rectus femoris and vastus intermedius muscles. Patients were classified using Medical Research Council scores into control group (n = 63) and muscle weakness group (n = 19). Muscle parameters and atrophy rates were compared between groups. Diagnostic performance was assessed using receiver operating characteristic curves. Results The incidence of ICU-AW was 23.17%. At both D₀ and D₇, the average thickness of the rectus femoris, the average thickness of the vastus intermedius, the average area of the rectus femoris, and the average area of the vastus intermedius were significantly different between the two groups (P<0.05). The atrophy rates of the thickness of the rectus femoris and the area of the vastus intermedius were lower in the control group than in the muscle weakness group at both D₀ and D₇ (P<0.05). The area under the receiver operating characteristic curve for quadriceps parameters in diagnosing ICU-AW was 0.871, with a sensitivity of 89.47% and a specificity of 79.37%. Conclusion Bedside ultrasound dynamic monitoring of quadriceps changes enables early identification of ICU-AW and provides a basis for clinical intervention.

Objective To evaluate the effect of delayed ligature of the umbilical cord on the blood volume in premature infants in early time. Methods From Oct 2007 to Jun 2010,194 premature infants with vaginal birth in department of genecology and obstetrics were randomly divided into routine ligature of the umbilical cord group (100 cases) and delayed ligature of the umbilical cord group (94 cases), comparision were made on ligature time, blood routine examination,blood pressure,oxyhemoglobin saturation and anemia incidence in 24 h,48 h,and 72 h after birth,and hemobilirubin on 1 d,2 d,3 d,and 7 d after birth. Results There were significant differences between the two groups in delayed ligature time [(100. 14 + 10. 57) s vs (22. 40 +5.02) s,P ＜0. 05)]. The hemoglobin and blood pressure in delayed ligature umbilical group were increased significantly(P ＜ 0. 05). There was 3 cases (3. 19%) of anemia in delayed ligature of the umbilical cord group, and 11 cases (11.00%) in routine ligature of the umbilical cord group, which showed significant difference (P ＜ 0. 05). And the hemobilirubin on 7 d after birth showed no significant difference between the two groups(P ＞ 0. 05). Conclusion Delayed ligature of umbilical cord has a significant influence on hemoglobin and blood pressure of premature infant. It can increase the blood volume, and reduce the incidence of anemia in early time.