Effects of sustained lung inflation combined with pulmonary surfactant on neonatal respiratory distress syndrome: a prospective randomized controlled trial / 中华围产医学杂志

Objective@#To investigate the efficacy and adverse effects of sustained lung inflation (SLI) combined with pulmonary surfactant (PS) in the treatment of neonatal respiratory distress syndrome (NRDS).@*Methods@#This prospective randomized controlled trial included 124 premature infants (gestational age <34 weeks and birth weight <2 000 g) diagnosed with NRDS and in need of PS treatment in Shenzhen Maternity & Child Healthcare Hospital affiliated to Southern Medical University from July 1, 2016 to October 31, 2018. They were randomly divided into experimental or control group, with 62 cases in each. Infants in the experimental group were treated with SLI using T-piece and intratracheal PS, while those in the control group were given PS only. Blood gas analysis and measurement of fraction of inspiration O2 (FiO2) and ratio of partial pressure of oxygen (PO2) over FiO2 were performed before and 1 h after PS injection. Results of the treatments and incidence of complications were compared. Paired samples t-test, two independent samples t-test, rank-sum test and Chi-square test were used for statistical analysis.@*Results@#There were 56 participants in the experimental group and 54 in the control group who were eventually analyzed. In the experimental group, the pH value, partial pressure of carbon dioxide (PCO2), FiO2 and PO2/FiO2 at 1 h after PS injection were all improved compared with those before treatment [pH value: 7.26±0.09 vs 7.19±0.09, t=3.814; PCO2: (51.5±12.6) vs (59.8±16.3) mmHg (1 mmHg=0.133 kPa), t=2.610; FiO2: 26.0 (21.0-31.5)% vs 40.5 (38.5-51.5)%, U=392.000; PO2/FiO2: (284.6±117.9) vs (173.4±59.7) mmHg, t=6.427; all P<0.05]. The overall decrement of FiO2 after PS injection in the experimental group was more significant than that in the control group [-10.0 (-15.0 to -5.0)% vs -5.0 (-8.0 to 0.0)%, U=706.500, P<0.001]. The experimental group had a higher rate of extubation within 24 h than the control group [80% (45/56) vs 71% (32/54), χ2=5.830, P=0.016]. However, no significant differences were shown in total mechanical ventilation time, non-invasive/high-flow nasal cannula ventilation time, the ratio of re-intubation within 72 h, or the incidence of air leak, bronchopulmonary dysplasia, periventricular-intraventricular hemorrhage, necrotizing enterocolitis or patent ductus arteriosus between the two groups (all P>0.05).@*Conclusions@#SLI combined with PS for NRDS babies can increase the rate of extubation within 24 h and promote the down-regulation of FiO2 without causing significant complications.

Update on bordetella pertussis epidemiology / 国际儿科学杂志

Pertussis or whooping cough is an acute infectious disease of the respiratory system,which is mainly caused by Bordetella pertussis and Bordetella parapertussis. It can occur at any age,but is most serious in young infants. Despite widespread use of vaccination, pertussis has not been eliminated. On the contrary, increased incidence rates have been reported worldwide during the last two decades,also called reemergence of pertussis. So it is necessary to evaluate current state on pertussis research,in order to better provide basis for mo-nitoring and control pertussis. This paper reviews the pertussis epidemiological changes and the related cause analysis and immunization strategy.

Analysis on Death Causes and Years of Life Lost of Malignant Tumors among Inhabitants in Liwan District of Guangzhou City from 2003 to 2007 / 中国慢性病预防与控制

Objective To investigate the death cause of malignant tumors among Inhabitants in Liwan district of Guangzhou city. Methods Mortality rate, standardized mortality rate,Potential Years of Life Lost (PYLL), PYLLR, Standardized Potential Years of Life Lost (SPYLL) and SPYLLR were used to analyze the death cause of malignant tumors. Results The annual average mortality rate of malignant tumors was 198.81 / 105. Among malignant tumors, 1ung cancer taken the 1ead with a mortality rate of 63.08 / 105. The next sequences were as follows: liver cancer, intestine cancer, stomach cancer, nasopharyngeal cancer. The sequence of death causes was mostly influenced by gender and age. The sequences of PYLL rate of main death causes were: liver cancer (0.371%), 1ung cancer (0.353%), nasopharyngeal cancer(0.137%), intestine cancer(0.116%)and mammary cancer(0.090%). Conclusion The mortalities of malignant tumors in Liwan district of Guangzhou city decreased in the past five years while the rank of top 5 cancer sites kept unchanged.

Ethical Consideration on the SARS Patients / 中国医学伦理学

Medical staff must pay attention to the following ethical questions during the salvage of SARS patients: (1)respecting SARS patients' dignity and personality; (2)respecting SARS patients' right of hospitalizing equally ; (3)adjusting SARS districts' ethical relationship between patients and doctors; (4)respecting SARS patients' informed consent right; (5)not ignoring the caring of SARS patients until the last;etc.