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Neurally adjusted ventilatory assist(NAVA)is a mode of ventilation in which both the timing and degree of ventilatory assist are controlled by the patient.Since NAVA uses the diaphram electrical activity (Edi)as the controller signal,it is possible to deliver synchronized non-invasive NAVA(NIV-NAVA)regardless of leaks and to monitor continuously patient respiratory pattern.Advantages of NIV-NAVA over conventional modes include improved patient-ventilator interaction,reliable respiratory monitoring and self-regulation of re-spiratory support.In theory,these characteristics make NIV-NAVA an ideal mode to provide effective,appropri-ate non-invasive support to newborns with respiratory insufficiency.NIV-NAVA has been successfully used clini-cally in neonates as a mode of ventilation to prevent intubation,to allow early extubation,and as a novel way to deliver nasal continuous positive airway pressure.
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OBJECTIVE:To evaluate clinical efficacy and safety of mouse nerve growth factor combined with ganglioside in the treatment of hypoxic-ischemic encephalopathy (HIE). METHODS:A total of 150 HIE children in pediatric department of our hospital during Jan. 2013-Jan. 2015 were divided into control group and observation group according to random number table,with 75 cases in each group. Both groups received routine treatment as correcting hypotension,reducing intracranial pressure,etc. Con-trol group was additionally given Monosialotetrahexosylganglioside sodium injection 20 mg added into 10% Glucose injection 30-50 mL,ivgtt,qd. Observation group was additionally given Mouse nerve growth factor for injection 30 μg added into Water for injection 2 mL,im,qd,on the basis of control group. A treatment course lasted for 10 days,and both groups received 2 courses of treatment. Clinical efficacies of 2 groups were compared as well as NBNA score,the levels of related lab test indexes (IL-10, TNF-α,SOD,NSE,VEGF) before and after treatment,the occurrence of ADR and sequela (following up to 1 year old). RE-SULTS:The response rate of observation group was 86.7%,which was significantly higher than 72.0% of control group,with sta-tistical significance(P0.05). On 4th,7th,10th day after treatment,NBNA scores of 2 groups were increased significantly, compared to before treatment;the observation group was significantly higher than the control group,with statistical significance (P<0.05). After treatment,serum levels of IL-10,TNF-α,NSE and VEGF in 2 groups were decreased significantly,compared to before treatment,SOD levels were increased significantly,and the observation group was significantly better than the control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups during treatment. Totally 64 children in ob-servation group and 60 in control group completed follow-up. The total incidence of sequela in observation group was 10.9%, which was significantly lower than 25.0% of control group,with statistical significance(P<0.05). CONCLUSIONS:For neonatal HIE,mouse nerve growth factor combined with ganglioside can effectively relieve brain tissue inflammatory reaction and oxidative stress injury,accelerate the recovery of cerebral tissue and reduce the occurrence of sequela with good safety.
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cleaning and disinfection.Results All 28 surveyed medical institutions had separate endoscope disinfection rooms, 89.29% of which had integrated endoscopic cleaning station,17.86% had automatic endoscope washer/disinfector;100% used multi-enzymatic detergent,chose the right disinfectant,monitored disinfectant concentration every day, and implemented standard disinfection time.But only 39.29% changed multi-enzymatic detergent for each endo-scope,cleaning and disinfection personnel in 78.57% of medical institutions wore personal protective equipment correctly.77 digestive endoscopes were detected,the qualified rate was 88.31%.Conclusion Cleaning and disin-fection management of digestive endoscope in secondary and above medical institutions in Suzhou City is generally standardized,there are still some problems in the manipulation procedures,relevant national regulations should be strictly complied with,efficacy of cleaning and disinfection of digestive endoscope should be further improved.
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Objective To investigate the clinical manifestations and pathogen distribution of the neonatal sepsis, and to analyze the antibiotic resistance of the pathogens. Methods Review the Medical records of 38 sepsis cases of full-term and premature neonates in our hospital from October 2011 to February 2014 were col-lected and analyzed. Results Ten cases were caused by Gram-positive bacteria among the 18 full-term neonates with sepsis. Eight of ten of the isolates were resistant to oxcillin. Nine of ten of the cases were belonged to late onset infection, and the cases with no nosocomial infection were found. In the other eight full-term neonatal cases caused by Gram-negative bacteria , six cases were nosocomial infection. Among the 20 premature neonates with sepsis , 17 cases were infected Gram-negative bacteria , in which Escherichia coli , Klebsiella pneumonia and En-terobacter cloacae were the most common agents (16/17). Early onset type and nosocomial infection were identi-fied for 11 (11/20) and 9 (9/20) cases in the premature neonates, respectively. The penicillin G, methicillin resistant rates of the Gram-positive bacteria were close to or over 70%. All the Gram-positive bacteria were sensi-tive to vancomycin. All the Gram-negative bacteria were resistant to amoxicillin , but over 60% of them were sen-sitive to piperacillin-tazobactam and other compounds containing enzyme inhibitor , and 100% of them were sensi-tive to carbapenems and aminoglycoside. Conclusion The full-term neonatal sepsis admitted into our hospital were mainly caused by Gram-positive bacteria , which were usually resistant to oxcillin. The premature sepsis were mainly caused by Gram-negative bacteria , which were always sensitive to carbapenems and aminoglycoside.
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Objective To explore the influence of early intervention on physical and intelligent development of premature infants with very low birth weight. Methods Selected 32 premature infants of very lowbirth weight treated in neonatal intensive care unit during November 2011 to October 2012 as the intervention group. To avoid the violation of medical ethics, we select another 32 premature infants with very low birth weight who were born before November 2011and aged between 9 to 15 months as the control group. The intervention group was treated with early intervention, including regular physical development evaluation, neuromotor examination and test of intelligence. The intervention group was followed-up until correction age of 1 year and the control group was only at the year of correction age of 1 year. Results The physical development in the intervention group was better than the control group at the age of 1, the mental development index (MDI) and psychomotor development index (PDI) significantly higher than those of the control group as well. The incidences of low intelligence and cerebral palsy were lower than those of the control group. The differences were statistically significant. Conclusion Early intervention is obviously effective in promoting the physical and intelligent development of very low birth weight premature infants, reducing the incidence of low intelligence and cerebral palsy, and improving the long-term living quality of the survivors. Still, the method centers on family, and therefore, is feasible and effective. So the doctors for children′s care from basic hospitals should vigorously promote the method.