Fluid intake and central venous pressure within 4 days after birth in very low birth weight premature infants complicated with bronchopulmonary dysplasia / 中国新生儿科杂志

Objective To study the characteristics of fluid intake and central venous pressure (CVP) within 4 days after birth in very low birth weight (VLBW) premature infants complicated with bronchopulmonary dysplasia (BPD).Method From February 2015 to March 2019,VLBW preterm infants without serious complications were enrolled in two hospitals.Their CVP were measured every 4 ～ 6 hours after birth.They were assigned into BPD group and non-BPD group,and the fluid intake and CVP within 4 days after birth were compared between these two groups.Result A total of 45 VLBW preterm infants were included,including 17 in the BPD group and 28 in the non-BPD group.The fluid intake in the BPD group showed no significant difference with the non-BPD group within 4 days after birth (P ＞ 0.05).No significant correlation existed between the mean liquid intake and the mean CVP in 1 ～ 4 days after birth (r =0.093,P=0.542).From day1 to day4,the CVPs of the BPD group were (3.97 ± 0.68),(4.49 ± 0.75),(4.55 ± 0.66),(4.02 ± 1.05) cmH2O,and the non-BPD group were (3.66 ± 1.09),(3.96 ±0.76),(3.81 ± 0.69),(3.91 ± 0.65) cmH2O.The differences between the BPD group and the nonBPD group were statistically significant (P ＜ 0.05).The CVP of the BPD group was increasing from day 2 to day 3 (P ＜ 0.05).Conclusion VLBW premature infants complicated with BPD may have higher CVP at the early stage of life,which may not be related with the fluid intake.

The pilot study of the central venous pressure of very low birth weight infant within 1 week after birth / 中国新生儿科杂志

Objective To study the range of central venous pressure (CVP) in very low birth weight (VLBW) infants within the first week after birth.Method From February 2014 to February 2018,50 VLBW infants without serious diseases during the first 7 days of life received umbilical venous catheters were prospectively enrolled.CVPs were measured every 4～6 h.The trend of CVP and the correlation of CVP (within 24 h) and birth weight,gestational age were analyzed.Result A total of 50 VLBW infants and 1 291 CVP measurements were included.The CVP increased slightly within 48 h after birth,and then declined.The 95％CI of CVPs were 3.67～4.21,4.03～4.49,3.90～4.33,3.67～4.19,3.29～3.97,3.14～3.94 and 2.64～ 3.55 cmH2O from day 1 to day 7.No significant correlation existed between CVP in the first day and birth weight,nor gestational age (r=-0.267,P=0.073;r=0.106,P=0.762).Conclusion The CVP of VLBW infants increased slightly within 48 h after birth,and then declined.There was no significant correlation between CVP in the first day and birth weight,nor CVP and gestational age.

Influence of small-dose dexmedetomidine on recovery of patients undergoing vertebral operation / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the influence of small-dose dexmedetomidine infusion on recovery of patients undergoing vertebral operation.</p><p><b>METHODS</b>Sixty ASA I-II patients undergoing vertebral operation were randomly divided into two groups (n=30). In group I, dexmedetomidine infusion was pumped at the rate of 0.5 µg·kg(-1)·h(-1) from tracheal intubation to incision suture, and in group II, 0.9%saline was pumped instead. The mean arterial pressure, heart rate, Riker Sedation-Agitation Scale and Ramesay sedation score were recorded at the time points of autonomous respiration (T1), eye opening (T2), extubation (T3), 1 min after extubation (T4), 10 min after extubation (T5), and 30 min after extubation (T6).</p><p><b>RESULTS</b>The recovery time of autonomous respiration and eye opening time in group I were significantly longer than those in group II, and the extubation time was significantly shorter in group I (P<0.05). Riker Sedation-Agitation Scale scores in group II were significantly higher than those in group I at T2 and T4, and Ramesay sedation scores in group I were significantly higher than those in group II at T1, T2 and T5 (P<0.05). The mean arterial pressure and heart rate at each time point was significantly lower in group I than in group II (P<0.05), especially at T3 and T4 (P<0.01). In both groups, the mean arterial pressure and heart rate at T3 and T4 were significantly higher than those at rest (P<0.05).</p><p><b>CONCLUSIONS</b>Small-dose dexmedetomidine infusion can reduce dysphoria and lower the risks during recovery from general anesthesia following vertebral operation.</p>

Design and application of project teaching scheme in higher vocational nursing clinical cur-riculum / 中华医学教育探索杂志

Objective To explore the effect of designing and applying project teaching scheme in higher vocational nursing clinical curriculum. Methods Sophomores of nursing major in grade 2009 and 2010 were selected as experiment subjects. Lecture-based traditional teaching method was applied in tradition group (121 students in grade 2009) while project teaching was applied in reorga-nization group (128 students in grade 2010). The teaching method was evaluated through thoretical exam, vocational skill test, professional quality test and questionnaine surrey. Data were input by us-ing SPSS17.00. T-test and Ranksum test were applied. Results Vocational skill test results of tra-dition group and reorganization group were (76.67 ±13.072) and (85.48 ±10.085) respectively;professional quality test results were (74.77±13.865) and (87.04±8.982), respectively. Differences in both groups had statistical significances (P<0.001). Evaluation on the teaching method was carried out in both groups through a questionnaire. (716/1408) of students in reorganization group thought that project teaching can improve 11 items including comprehensive quality. Except for the item of the-oretical knowledge comprehension, the rest 10 items of both groups had statistical significances (P<0.001). Conclusion Implementation of project teaching in nursing clinical curriculum helps to im-prove students' professional core competence.