Progress in clinical application of neonatal renal oxygen saturation monitoring / 中华实用儿科临床杂志

The incidence of acute kidney injury (AKI) in Neonatal Intensive Care Unit (NICU) is about 30%.The morbidity and mortality of AKI are higher in very premature infants, very low birth weight infants and infants with long mechanical ventilation.Serum creatinine (Scr) and urine output are diagnostic indicators for AKI, which usually change within 12-48 hours after the onset of irreversible injury, and cannot be used for early diagnosis and clinical intervention.Therefore, it is necessary to search for indicators of early renal insufficiency, aiming to intervene and prevent early-stage AKI or reduce the occurrence of AKI.Near-infrared spectroscopy (NIRS) is a non-invasive, continuous, real-time monitoring method, which serves as a supplement to conventional biochemical markers.It provides evidence of early-stage renal ischemia and hypoxia, which contributes to prevent or reduce AKI.This study reviews the clinical application of neonatal renal oxygen saturation monitoring, thus providing clinical reference for renal function protection in critically ill neonates to reduce the occurrence of AKI and improve their prognosis.

Pilot test of an online training module on near-infrared spectroscopy monitoring for the randomised clinical trial SafeBoosC-III.

BACKGROUND: SafeBoosC-III is an international randomised clinical trial to evaluate the effect of treatment of extremely preterm infants during the first 3 days of life based on cerebral near-infrared spectroscopy (NIRS) monitoring versus treatment and monitoring as usual. To ensure high quality of the trial intervention as well as of patient care, we have developed a multilingual web-based training program to train relevant staff and test their competence. As we enter an under-explored area of e-learning, we have conducted a pilot study on the first of the five modules comprising the web-based training program to test the feasibility of developing such a program for an international trial with limited resources. METHODS: The module in this study focuses on the principles and practice of NIRS monitoring. The pedagogical idea was to integrate training and certification. One-hundred doctors and nurses from five Neonatal Intensive Care Units across China, Spain and Denmark were invited to participate in the pilot study. Upon completion of the NIRS module, participants were invited to evaluate their experience by completing an online survey. Data from closed-ended questions were analysed using descriptive statistics while data from open-ended questions underwent thematic analysis. RESULTS: In total, 81 of 100 invited staff members entered the training module and completed the online survey. The median time and the number of questions to pass the module was 15 minutes and seven questions, respectively. Most staff found the academic level of the learning material and quiz appropriate (85% and 93% of all staff members, respectively), as well as agreeing that the module was relevant to prepare them to 'use the NIRS device' (90%). Thematic analysis revealed issues such as a discrepancy between learning material and quiz questions, lack of clarity, and technical issues. CONCLUSION: We provide evidence of the feasibility of developing a multilingual web-based training program for an international trial, despite challenges such as low budget, language barriers and possibly differences in the clinical training of staff. Exploring the integration of training and certification for international trials, the positive results of this study motivate further developments. TRIAL REGISTRATION: ClinicalTrial.gov, NCT03770741. Registered 10 December 2018.

Analysis of curative effect of high frequent oscillation ventilation combined with inhaled nitric oxide for neonatal hypoxic respiratory failure / 中华实用儿科临床杂志

Objective To compare the curative effect with high frequent oscillation ventilation (HFOV) and with HFOV + inhaled nitric oxide (iNO) in the treatment of neonatal hypoxic respiratory failure (NRHF).Methods Data of 60 NHRF patients in the People's Hospital of Dehong Prefecture from January 2015 to December 2016 were retrospectively analyzed.The patients were divided into HFOV group (32 cases) and HFOV + iNO group (28 cases) according to the treatment methods.The comparison between the 2 groups was established as following:oxygenation index(OI),arterial partial pressure of carbon dioxide [Pa (CO2)] and complications.Results There was no significant difference between the 2 groups in time of birth,gestational age,birth weight,gender ratio and original diseases (all P ＞ 0.05).As for OI there was no significant difference at 0 h between the 2 groups (27.8 ± 3.5 vs.27.6 ± 3.7) (t =0.04,P ＞ 0.05);OI of HFOV + iNO group (11.2 ± 3.4,7.3 ± 3.0,7.0 ± 2.6,respectively) was more significantly decreased than that in the HFOV group (14.5 ± 3.3,9.6 ± 3.0,8.5 ± 2.8,respectively) at 8 h,16 h,24 h,and there were significant differences between the 2 groups (t =3.81,5.16,2.14,all P ＜ 0.05).As for P a (CO2) there was no significant difference at 0 h [(65.14 ± 14.97) mmHg vs.(64.79 ± 13.40) mmHg] (t =0.095,P ＞ 0.05);the changes in Pa (CO2) had no statistically significance difference between HFOV + iNO group and HFOV group at 8 h,16 h,24 h [8 h:(50.71 ± 10.49) mmHg vs.(49.02 ± 11.74) mmHg,16 h:(40.99 ± 12.38) mmHg vs.(40.02 ± 12.04) mmHg,and 24 h:(39.01 ±9.80) mmHg vs.(38.00 ±7.85) mmHg,all P ＞0.05].As for the complications,there was no difference between the 2 groups in pulmonary air leak,pneumorrhagia,intracranial hemorrhage,blood platelet ＜100 × 109/L,methemoglobin concentration ＞ 3％,or dysfunction of blood coagulation (all P ＞ 0.05).Conclusion Both HFOV and HFOV + iNO methods are effective for NRHF.Treatment with HFOV + iNO method is more effective.Treatment for NHRF with HFOV + iNO is safe,effective,without complication increase in a short term.

Analysis of curative effect of high frequent oscillation ventilation combined with inhaled nitric oxide for neonatal hypoxic respiratory failure / 中华实用儿科临床杂志

Objective To compare the curative effect with high frequent oscillation ventilation (HFOV) and with HFOV + inhaled nitric oxide (iNO) in the treatment of neonatal hypoxic respiratory failure (NRHF).Methods Data of 60 NHRF patients in the People's Hospital of Dehong Prefecture from January 2015 to December 2016 were retrospectively analyzed.The patients were divided into HFOV group (32 cases) and HFOV + iNO group (28 cases) according to the treatment methods.The comparison between the 2 groups was established as following:oxygenation index(OI),arterial partial pressure of carbon dioxide [Pa (CO2)] and complications.Results There was no significant difference between the 2 groups in time of birth,gestational age,birth weight,gender ratio and original diseases (all P ＞ 0.05).As for OI there was no significant difference at 0 h between the 2 groups (27.8 ± 3.5 vs.27.6 ± 3.7) (t =0.04,P ＞ 0.05);OI of HFOV + iNO group (11.2 ± 3.4,7.3 ± 3.0,7.0 ± 2.6,respectively) was more significantly decreased than that in the HFOV group (14.5 ± 3.3,9.6 ± 3.0,8.5 ± 2.8,respectively) at 8 h,16 h,24 h,and there were significant differences between the 2 groups (t =3.81,5.16,2.14,all P ＜ 0.05).As for P a (CO2) there was no significant difference at 0 h [(65.14 ± 14.97) mmHg vs.(64.79 ± 13.40) mmHg] (t =0.095,P ＞ 0.05);the changes in Pa (CO2) had no statistically significance difference between HFOV + iNO group and HFOV group at 8 h,16 h,24 h [8 h:(50.71 ± 10.49) mmHg vs.(49.02 ± 11.74) mmHg,16 h:(40.99 ± 12.38) mmHg vs.(40.02 ± 12.04) mmHg,and 24 h:(39.01 ±9.80) mmHg vs.(38.00 ±7.85) mmHg,all P ＞0.05].As for the complications,there was no difference between the 2 groups in pulmonary air leak,pneumorrhagia,intracranial hemorrhage,blood platelet ＜100 × 109/L,methemoglobin concentration ＞ 3％,or dysfunction of blood coagulation (all P ＞ 0.05).Conclusion Both HFOV and HFOV + iNO methods are effective for NRHF.Treatment with HFOV + iNO method is more effective.Treatment for NHRF with HFOV + iNO is safe,effective,without complication increase in a short term.

Chinese neonatal birth weight curve for different gestational age / 中华儿科杂志

<p><b>OBJECTIVE</b>Since 1986, the reference of birth weight for gestational age has not been updated. The aim of this study was to set up Chinese neonatal network to investigate the current situation of birth weight in China, especially preterm birth weight, to develop the new reference for birth weight for gestational age and birth weight curve.</p><p><b>METHOD</b>A nationwide neonatology network was established in China. This survey was carried out in 63 hospitals of 23 provinces, municipalities and autonomous regions. We continuously collected the information of live births in participating hospitals during the study period of 2011-2014. Data describing birth weight and gestational age were collected prospectively. Newborn's birth weight was measured by electronic scale within 2 hours after birth when baby was undressed. The evaluation of gestational age was based on the combination of mother's last menstrual period, ultrasound in first trimester and gestational age estimation by gestational age scoring system.</p><p><b>STATISTICAL ANALYSIS</b>the growth curve was drawn by using LMSP method, which was conducted in GAMLSS 1.9-4 software package in R software 2.11.1.</p><p><b>RESULT</b>A total of 159 334 newborn infants were enrolled in this study. There were 84 447 male and 74 907 female. The mean birth weight was (3 232 ± 555) g, the mean birth weight of male newborn was (3 271 ± 576) g, the mean weight of female newborn was (3 188 ± 528) g. The test of the variables' distribution suggested that the distribution of gestational age and birth weight did not fit the normal distribution, the optimal distribution for them was BCT distribution. The Q-Q plot test and worm plot test suggested that this curve fitted the distribution optimally. The male and female neonatal birth weight curve was developed using the same method.</p><p><b>CONCLUSION</b>Using GAMLSS method to establish nationwide neonatal birth weight curve, and the first time to update the birth weight reference in recent 28 years.</p>

E-procurements Strategies for Ensuring the Quality in Hospital Medical Equipment / 医疗卫生装备

The e -procurement definition of the medical equipment is introduced from mainly aspects and correlated details,and e-procurements strategies and the concrete methods and actions for ensuring quality in the medical equipment are expatiated.

Methods for Avoiding Problems in Third-class Medical Appliance Maintenances Station / 医疗卫生装备

The establishment of repairing and maintenance system for medical appliance promotes the equipment management in the skeleton sanitation units. The problems are analyzed from 3 aspects including the characteristics of the third-class maintenance station,the actuality of the skeleton sanitation units and the technique level of checking and repairing service. Solving methods are put forward to accelerate the development of the third-class maintenance station.

Communication Between Client and Sever Based on VC++6.0 Software / 医疗卫生装备

Objective To introduce the communication technology between the server and client in the manage ment and application software of the medical equipment and sanitation equipment based on the VC++6.0 software.Methods The au-thor made use of the asynchronism and no block encapsulation sort CAsyncSocket and thread of VC++6.0 software to sent and receive the transformed data in the client and sever.Results The method implemented the data transmission in the client and data receiving in the sever.Conclusion This study offers one method of data transmission in the dialog box pro-cedure.

Database Information Query and its Printing Technology Based on VC++6.0 / 医疗卫生装备

Objective To introduce database information query and its printing technology with the Sql Sever 2000 software based on the VC++6.0 software. Methods The data query from the sql Sever 2000 database made use of ADO technology of VC++6.0 and implemented the print and print preview via append document and view frame in the procedure of the dialog box. Results The data query from Sql Sever 2000 database was implemented and the queried data was printed. Conclusion It offers one printing method in the dialog box procedure.

Avoidance of Adverse Event of Medical Appliances / 医疗卫生装备

The importance of avoiding adverse event of medical appliances is expatiated from such aspects as the purchase of medical appliances,the second check up,the transformation of service pattern of medical engineering,the measure and judging of medical appliances,etc.

Reinforcement of Servicing Support and Establishment of EconomicSupport System / 医疗卫生装备

The foundation of the health equipment overhaul joint logistic system in the army is suited for the new military affairs' change.As a grass-root unit,the third class servicing station perfects the support system.The significance and requirements of establishing economic support system are discussed in such aspects as enforcement of information communication,emphasis on demands information collection,improvement of servicing quality,boost in support response speed,training for equipment operation,etc.