Objective:To investigate the effect of acupoint massage combined with oral immune therapy (C-OIT) on oral feeding and growth and development of very low birth weight infants, so as to provide reference for healthy growth of very low birth weight infants.Methods:A prospective randomized controlled study was conducted. The very low birth weight infants admitted to the neonatal intensive care unit, Affiliated Hospital of Jining Medical University from January 2020 to December 2021 were selected using the convenience sampling method. They were divided into group A and group B using the random number table method, with 150 cases in each group. Group A received routine nursing and C-OIT. On this basis, group B received acupoint massage. Oral feeding, growth and development, and other indexes were compared between the two groups.Results:Finally, 150 cases were included in group A and group B, respectively. In group A, there were 78 male cases and 72 female cases, with gestational age of (30.49 ± 1.57) weeks. In group B, there were 74 male cases and 76 female cases, with gestational age of (30.61 ± 1.63) weeks. The time for abdominal distension to disappear, time to oral feeding initiation, time to full oral feeding and gastric tube indwelling time in group B [(4.35 ± 2.19), (4.26 ± 1.02), (19.03 ± 1.84), (6.27 ± 1.23) d] were shorter than those in group A[(8.03 ± 2.34), (8.63 ± 1.74), (20.49 ± 1.62), (9.34 ± 1.85) d], and the differences were statistically significant ( t values were 7.29-26.54, all P<0.05). The total score of the Preterm Oral Feeding Readiness Scale in group B (32.49 ± 1.52) was higher than that in group A (29.40 ± 3.14), and the difference was statistically significant ( t=10.84, P<0.05). At discharge, the difference values of weight, head circumference and height of group B [(0.92 ± 0.10) kg, (4.31 ± 0.61) cm and (4.08 ± 0.53) cm] were higher than those of group A[(0.81 ± 0.09) kg, (3.47 ± 0.57) cm and (3.81 ± 0.42) cm], and the differences were statistically significant ( t=10.01, 12.32, 4.89, all P<0.05). The length of hospitalization in group B (30.26 ± 4.91) d was shorter than that in group A (38.54 ± 5.27) d, and the difference was statistically significant ( t=14.07, P<0.05). Conclusions:Acupoint massage combined with C-OIT can shorten the time to oral feeding, and improve feeding intolerance of very low birth weight infants. It is expected to improve the growth and development status and quality of life of very low birth weight infants in early stage.

Objective:To investigate the effect of acupoint massage combined with oral immune therapy (C-OIT) on oral feeding and growth and development of very low birth weight infants, so as to provide reference for healthy growth of very low birth weight infants.Methods:A prospective randomized controlled study was conducted. The very low birth weight infants admitted to the neonatal intensive care unit, Affiliated Hospital of Jining Medical University from January 2020 to December 2021 were selected using the convenience sampling method. They were divided into group A and group B using the random number table method, with 150 cases in each group. Group A received routine nursing and C-OIT. On this basis, group B received acupoint massage. Oral feeding, growth and development, and other indexes were compared between the two groups.Results:Finally, 150 cases were included in group A and group B, respectively. In group A, there were 78 male cases and 72 female cases, with gestational age of (30.49 ± 1.57) weeks. In group B, there were 74 male cases and 76 female cases, with gestational age of (30.61 ± 1.63) weeks. The time for abdominal distension to disappear, time to oral feeding initiation, time to full oral feeding and gastric tube indwelling time in group B [(4.35 ± 2.19), (4.26 ± 1.02), (19.03 ± 1.84), (6.27 ± 1.23) d] were shorter than those in group A[(8.03 ± 2.34), (8.63 ± 1.74), (20.49 ± 1.62), (9.34 ± 1.85) d], and the differences were statistically significant ( t values were 7.29-26.54, all P<0.05). The total score of the Preterm Oral Feeding Readiness Scale in group B (32.49 ± 1.52) was higher than that in group A (29.40 ± 3.14), and the difference was statistically significant ( t=10.84, P<0.05). At discharge, the difference values of weight, head circumference and height of group B [(0.92 ± 0.10) kg, (4.31 ± 0.61) cm and (4.08 ± 0.53) cm] were higher than those of group A[(0.81 ± 0.09) kg, (3.47 ± 0.57) cm and (3.81 ± 0.42) cm], and the differences were statistically significant ( t=10.01, 12.32, 4.89, all P<0.05). The length of hospitalization in group B (30.26 ± 4.91) d was shorter than that in group A (38.54 ± 5.27) d, and the difference was statistically significant ( t=14.07, P<0.05). Conclusions:Acupoint massage combined with C-OIT can shorten the time to oral feeding, and improve feeding intolerance of very low birth weight infants. It is expected to improve the growth and development status and quality of life of very low birth weight infants in early stage.

Objective:To understand the incidence of post-traumatic stress disorder(PTSD) in fathers with premature infants and analyze the risk factors.Methods:Conveniently, the 203 fathers of premature infants in NICU of Affiliated Hospital of Jining Medical University of Shandong Province from May to August 2021 were selected as the subjects to fill in the general data questionnaire, Perinatal Post-traumatic stress disorder Questionnaire-Chinese edition (PPQ-C), Parents, Perception of Uncertainty Scale, Social Support Rating Scale, Simplified Coping Style Questionnaire. Logistic regression was used to analyze the risk factors of PTSD and establish a nomogram model. ROC curve was used to verify the discrimination ofthe model. Hosmer-Lemeshow goodness-of-fit test and Calibration Plot were used to verify the calibration.Results:PPQ-C total score of 203 fathers was 17.17 ± 8.77, 81 fathers, symptoms were positive and the incidence of PTSD was 39.90%(81/203). Logistic regression analysis showed college degree ( OR = 0.297, 95% CI 0.116 - 0.763, P<0.05), very low birth weight ( OR = 2.491, 95% CI 1.027 - 6.044, P<0.05), sense of disease uncertainty ( OR = 1.038, 95% CI 1.012 - 1.066, P<0.05), negative coping style ( OR = 1.871, 95% CI 1.127 - 3.108, P<0.05) were risk factors of PTSD in fathers with premature infants. The nomogram model was established basing on the results of the Logistic regression analysis, and the ROC curve proved (AUC = 0.751) the model having a good discrimination.The Hosmer-Lemeshow goodness-of-fit test ( P = 0.974) and the calibration plot demonstrated that the prediction values tends to coincide with the actual monitoring values. Conclusions:A higher incidence of PTSD was observed in fathers with hospitalized premature infant. It was related to education level, the infants′s birth weight, disease uncertainty and coping style. Therefore, the nurses should give information support and psychological guidance according to the individual situation of the infants′ father to reduce the incidence of PTSD.

Objective:To explore the effects of family participation in nursing care in premature infants in neonatal intensive care units (NICU) .Methods:Totally 95 premature infants with very low birth weight hospitalized in a Class Ⅲ Grade A hospital from January to December 2019 were selected by convenient sampling and randomly divided into the control group ( n=47) and the observation group ( n=48) according to the random number table. Premature infants in the control group received routine care, while premature infants in the observation group received family participation in nursing care on the basis of routine care. The rate of weight gain, incidence of feeding intolerance, rate of breast feeding, stress and anxiety of the parents were compared between the two groups of children during hospitalization. Results:There were statistically significant differences in the rate of weight gain, incidence of feeding intolerance, and breast feeding between the observation group and the control group ( P<0.05) . The total score and the scores of all dimensions of the premature infants' parents stress anxiety scale in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.01) . Conclusions:The family participation in nursing care can improve the growth, development and feeding of premature infants in NICU, and ameliorate the stress and anxiety of their parents.

Objective:To analyze the risk factors of medical adhesive-related skin injury (MARSI) in preterm infants to establish a nomogram model to predict the risk of MARSI.Methods:From July to September 2018, 268 premature infants who were hospitalized in NICU were enrolled in this study. Their clinical data were analyzed and univariate analysis was used to detemine the risk factors related to MARSI, The significant variables were included in the multivariate logistic regression analysis to analyze the independent risk factors for MARSI. Then the R software was used to establish a predictive nomogram model, Bootstrap method was used to validate the nomogram model and the consistency test of the correction curve was used to explore the predictive efficacy of the model in predicting the MARSI.Results:A total of 64 cases out of 268 premature infants had MARSI. The prevalence rate was 23.9 % (64/268). Birth age (28 to 32 weeks) ( P value was 0.021, OR value was 2.736, 95 % CI 1.163-6.435), edema ( P<0.01, OR value was 33.782, 95 % CI 10.510-108.583), maternal diabetes ( P value was 0.039, OR value was 16.011, 95 % CI 1.146-223.692), easy to tear tape ( P value was 0.027, OR value was 13.567, 95 % CI 1.340-137.311) were all independent risk factors for MARSI. The nomogram model showed a conformance-index of 87.29 %, while the consistency test of the correction curve showed that the prediction probability is consistent with the actual occurrence probability. Conclusions:The nomogram built based on the indexes of fetal age, skin state, maternal disease, mucous product has good discrimination and accuracy which could be helpful for screening the patients with high risk, with potentially high clinical application value.

Objective:To evaluate the effect of oropharyngeal colostrum administration on building adequate enteral feeding process of very low birth weight neonates and extremely low birth weight neonates.Methods:A total of 62 very/extremely low birth weight neonates in NICU were selected from a tertiary hospital in shandong province. They were randomly assigned to the observation group ( n=32) and the control group ( n=30) according to the random number table. The observation group was given oropharyngeal colostrum administration. The control group was given oral care with 0.9% sodium chloride solution, and the wiping method and frequency was the same as the observation group. Gastric retention, enteral feeding time, adequate enteral feeding time, the weight at the time of discharge, etc. were compared between two groups. Results:Gastric retention times on the 10th day in the observation group (1.90±1.30) was significantly lower than that in the control group (2.77±1.50), and the two groups were statistically significant ( t value was -2.449, P<0.05). The duration of 100 ml·kg -1·d -1 enteral feeding and adequate enteral feeding (150 ml·kg -1·d -1) in the observation group [(24.63±9.42) days, (29.75±10.15) days] were significantly shorter than those in the control group [(33.90±2.73) days, (35.13±9.29)days], and the two groups were statistically significant ( t value was-4.621, P<0.01; t value was -2.362, P<0.05). The weight of the observation group was higher than that in the control group at the time of discharge ( t value was 4.677, P<0.05). Conclusion:Oropharyngeal colostrum administration can reduce gastric retention times, shorten the adequate enteral feeding time, promote growth and development in very low birth weight neonate and extremely low birth weight neonate.But it had not been proved to reduce the incidence of related infection indicators.

Objective:To explore the application effects of dual probiotic preparation and colostrum oral immunotherapy on improving feeding intolerance in very low birth weight infants.Methods:A systematic sampling method was used to select 173 very low birth weight infants who were admitted to the Neonatal Intensive Care Unit (NICU) from December 2017 to December 2018. According to the random number table method, they were divided into in group A ( n=56) , group B ( n=59) and group C ( n=58) . Group A was given routine nursing, parenteral nutrition and enteral nutrition and minimal breast feeding. Group B was given dual probiotic preparation on the basis of routine nursing. Group C was given colostrum oral immunotherapy on the basis of routine nursing. After 7 days of intervention, the improvement of feeding intolerance was observed, and the feeding intolerance rates were compared among the three groups after 3 d, 5 d and 7 d of intervention. Intestinal flora, incidence of complications, length of NICU stay and speed of birth weight recovery were compared. Results:The intake of milk in group B and group C were higher than those in group A, and the retention milk volume, retention times and duration of abdominal distension were all lower than those in group A, while retention times and duration of abdominal distension in group C were shorter than those of group B, and the differences were statistically significant ( P<0.05) . On the 3rd, 5th and 7th day of intervention, the feeding intolerance rates of the three groups continued to decrease. The feeding intolerance rates of group B and C were lower than those of group A, and the feeding intolerance rate of group C was lower than that of group B on the 3rd day of intervention , and the differences were statistically significant ( P<0.05) . The number of Enterococcus faecium, the number of Bacillus subtilis and the ratio of the logarithmic number of bifidobacteria to the logarithmic number of Escherichia coli (B/E value) in groups B and C were all higher than those in group A, and the incidences of sepsis and necrotizing enterocolitis in group B and group C were lower than those in group A, and the differences were statistically significant ( P<0.05) . The length of stay in NICU was ranked from long to short as Group A, Group B, and group C, and the speed of birth weight recovery was ranked from slow to fast as group A, Group B, and group C, and the differences were statistically significant ( P<0.05) . Conclusions:Colostrum oral immunotherapy can improve the feeding intolerance of very low birth weight infants, reduce complications related to premature delivery, promote the growth and development of neonates and shorten the length of stay in NICU. The clinical effect is slightly better than that of probiotics.

Objective To study the relationship between the lung ultrasonography and the chest X-ray and to study the value of lung ultrasonography score (LUS) in evaluating the effect of pulmonary surfactant (PS) on respiratory distress syndrome (RDS) of newborn.Method Preterm infants admitted to the neonatal intensive care unit of our Hospital from January 2016 to December 2017 and diagnosed with RDS were prospectively studied.LUS examinations were performed prior to,and within the first 6～12 hours after surfactant administration,chest X-rays were also performed at the same time so as to evaluate the effects of surfactant replacement therapy and the correlation between the lung ultrasonography and the chest X-rays.Lung ultrasonography findings at a total of six sites,with three sites in each lung were scored based on the presence of normal finding,the amount of B-lines and subpleural consolidations.Result A total of 45 preterm infants with RDS were enrolled.The cases of X-ray grades Ⅰ,Ⅱ,Ⅲ and Ⅳ before PS administration were 5 cases,21 cases,12 cases and 7 cases respectively.The scores of LUS 0～6,7～12,13～ 18 were 5 cases,37 cases and 3 cases respectively,and the median of LUS was 10 points.Chest X-ray grades Ⅰ,Ⅱ,Ⅲ and Ⅳ within 6～12 hours after PS administration were 18 cases,17 cases,8 cases and 2 cases respectively.LUS of 0～6,7～12,13～18 were 21 cases,20 cases and 4 cases respectively.The median of LUS after PS was 7 points.LUS after PS application was significantly lower than that before PS application (P＜0.001).The LUS was positively correlated with the grades of X-ray before and after surfactant administration (before surfactant administration r =0.688,P＜0.001,after surfactant administration r =0.777,P＜0.001).Conclusion LUS is positively correlated with the grade of chest X-ray and might enable an early detection of the surfactant replacement therapy effects in RDS.Further studies are necessary to define the role of LUS in this field.

bjective? To explore the effects of animation demonstration combined with health education on the knowledge-attitude-practice and psychological status of parents of neonates with hyperbilirubinemia. Methods? Totally 136 neonates with hyperbilirubinemia and their parents admitted from February 2017 to February 2018 in Affiliated Hospital of Ji'ning Medical University were selected for the study and were divided into the observation group and control group according to the random number table method, with 68 cases in each group. The control group was given routine health education, and observation group was given animation demonstration combined with health education. The parents knowledge-attitude-practice level of jaundice prevention and treatment,compliance degree, Self-rating Anxiety Scale(SAS) score were compared between the two groups. Results? After intervention,the parents knowledge-attitude-practice level of jaundice prevention and treatment significantly increased in the two groups,and the observation group increased more than the control group with statistical difference (P＜ 0.05). After intervention, the parents compliance level in the observation group was higher than the control group with statistical difference (P＜ 0.05); SAS score of the observation group declined more than the control group with statistical difference (P＜ 0.05). Conclusions? Animation demonstration combined with health education can effectively improve the knowledge-attitude-practice level and execution compliance of parents of neonates with jaundice,and improve the psychological status of the parents.

Objective To compare the pathogenicity between Ureaplasma urealyticum serotype 1 (Up1)and 8 (Uu8) in the genital tract of BALB/c mice.Methods A total of 48 BALB/c mice were randomly and equally divided into four groups:blank control group receiving no treatment,estradiol group pretreated with intramuscular injection of estradiol followed by intravaginal inoculation with sterial liquid culture media,Up1 and Uu8 groups pretreated with intramuscular injection of estradiol followed by intravaginal inoculation with suspensions of Up1 and Uu8 respectively.Three mice were randomly selected from each group to be sacrificed after the collection of vaginal lavage fluid on day 3,7,14 and 21 after the inoculation.Vaginal and uterine tissue specimens were obtained from these sacrificed mice and underwent hematoxylin and eosin (HE) staining.Vaginal lavage fluid samples were subjected to culture of Uu and measurement of tumor necrosis factor-α (TNF-α).Results No evidences were observed for Uu growth in either the blank control group or estradiol group at any of the time points after the inoculation,with the average level of TNF-α in vaginal lavage fluid being (4.17 ± 0.85) pg/ml at these time points in both groups.Uu grew in all the vaginal lavage fluid samples from the Up1 and Uu8 groups at the four time points,with the color change unit (CCU) value decreasing with time.The level of TNF-α in vaginal lavage fluid peaked on day 14 after the inoculation in the Up 1 ((14.93 ± 1.11) pg/ml) and Uu8 ((27.04 ± 24.26) pg/ml) groups.Both Up1 and Uu8 infection caused acute and chronic inflammatory responses in the mice,which were mainly located in the uterus,and Up1 might cause intrauterine adhesion.Conclusions At the same inoculation concentration,no significant difference is found in the pathogenicity between Up1 and Uu8,both of which appear to mainly cause cervicitis.Upl might be partially responsible for intrauterine adhesion in mice.