To summarize the nursing care of a very low birth weight premature infant with severe type Ⅱ bronchopulmonary dysplasia（BPD） during the transition period from hospitalization to home. The care of the infant was provided one-on-one by a BPD specialist nurse throughout the period. The key points of transitional care from hospitalization to home include：implementing tracheotomy and mechanical ventilation care to ensure stable blood oxygen saturation of the infant；providing nutritional support to improve the nutritional status of the infant；implementing step-by-step rehabilitation measures to improve the neuromotor development of the infant；implementing family integrated care to promote the primary caregivers of the infant to master nursing knowledge and skills；conducting personalized discharge follow-up with a multidisciplinary team to improve the quality of home care for this infant. After being hospitalized for 106 days，the infant was successfully discharged with a tracheotomy tube. At the age of 2 years and 6 months，a tracheotomy closure surgery was performed. After the surgery，the infant was able to breathe autonomously without symptoms of breathing difficulties and returned to normal family life.

Objective To investigate the effect of a phased oral feeding promotion program in preterm infants with gestational age less than 32 weeks. Methods 128 preterm infants less than 32 gestational weeks admitted to the neonatal intensive care unit（NICU） of a tertiary Children’s Hospital in Shanghai from January to December 2020 were consecutively enrolled as the subjects of this study. They were randomly divided into an experimental group and a control group by block method. The modified phased oral feeding promotion program was applied in the experimental group. The control group received the traditional feeding method. The days of life，corrected gestational age and weight of 2 groups at attaining full oral feeding，at the beginning of oral feeding and the first oral intake of 50% of the meal were compared. The hospital stays and the occurrence of feeding related complications were also compared. Results There were 5 cases lost，and finally 61 cases were included in the experimental group and 62 cases were included in the control group. The corrected gestational age at attaining full oral feeding in the experimental group was lower than that in the control group（P<0.05）. The days of life，corrected gestational age and body weight of the experimental group were significantly lower than those of the control group at the beginning of oral feeding and the first oral intake of 50% of this meal（P<0.05）. There was no significant difference between 2 groups in hospital stay（P>0.05）. No feeding related complications occurred in 2 groups. Conclusion For premature infants with gestational age less than 32 weeks，the phased oral feeding promotion program can achieve full oral feeding at an earlier time.

Objective To investigate the effect of non-nutritive breast sucking on oral feeding ability in very low birth weight preterm infants. Methods From July 2020 to June 2021，148 very low birth weight preterm infants admitted to the NICU of a tertiary children’s hospital in Shanghai were consecutively included，and they were divided into an experimental group and a control group with 74 cases in each group by block randomization. After the mechanical ventilation weaned，infants in the experimental group received non-nutritive breast sucking once a day for 5 minutes each time，and sucked the pacifier for 5 minutes before each tube feeding. The infants in the control group only sucked the pacifier for 5 minutes before each tube feeding. The time to achieve full oral feeding，the corrected gestational age at full oral feeding，the score of the Breastfeeding Behaviour Scale for premature infants，the days of breast feeding，and the breast feeding rate on the day of discharge were compared between 2 groups. Results There were 2 cases dropped in the experimental group and no cases dropped in the control group. The time to achieve full oral feeding was（12.29±4.12） d in the experimental group and（16.87±7.42） d in the control group. The difference between 2 groups was statistically significant（P<0.001）. The corrected gestational age at the time of full oral feeding was（36.45±1.54） weeks in the experimental group and（36.13±4.59） weeks in the control group，and there was no significant difference between 2 groups（P=0.574）. At the time of discharge，the Breastfeeding Behavior Scale score was[12.0（10.0，13.0）] in the experimental group and[6.0（1.5，8.5）] in the control group. The difference between 2 groups was statistically significant（P<0.001）. During hospitalization，the days of breastfeeding in the experimental group were[47.0（33.8，62.8）] d，while those in the control group were[37.5（19.0，56.3）] d. The difference between 2 groups was statistically significant（P=0.021）. The breastfeeding rate on the day of discharge was 84.7% in the experimental group and 66.2% in the control group，and the difference between 2 groups was statistically significant（P=0.012）. Conclusion The implementation of non-nutritive breast sucking can shorten the time to achieve full oral feeding in very low birth weight preterm infants，promote their breastfeeding behaviour，increase the days of breast feeding with their own mother’s milk during hospital stay，and improve breast feeding rate.

Objective To explore the trajectory of oral sucking function of premature infants with gestational age and its relationship with oral feeding progression. Methods From April 2018 to April 2019，we conveniently selected premature infants from a tertiary children’s hospital in Shanghai，and used a self-developed oral sucking evaluation tool to measure the oral sucking function of premature infants when their corrected gestational age was 32~36 weeks. The measurement parameters included average sucking negative pressure peak，average sucking positive pressure peak，average sucking peak interval of negative pressure，average sucking peak interval of positive pressure，average sucking peak interval of positive pressure to negative pressure，number of sucking negative pressure，number of sucking positive pressure. At the same time，the time for premature infants to start and complete oral feeding was recorded，and the correlation between oral sucking function and corrected gestational age at 32 weeks was analyzed. Results A total of 132 premature infants completed the evaluation of oral sucking function and were finally included. The results showed that with the increase of gestational age，the amplitude and number of positive and negative sucking pressure of premature infants increased significantly（P<0.001），and the interval duration decreased significantly（P<0.001）. At the same time，the positive sucking pressure amplitude at the time of correcting the gestational age of 32w was negatively correlated with the gestational age of starting oral feeding（r=-0.217，P=0.040），and the negative sucking pressure duration at the time of correcting the gestational age of 32w was positively correlated with the gestational age of complete oral feeding（r=0.334，P=0.002）. Conclusion The positive sucking pressure and negative sucking pressure of premature infants showed the same trend with the increase of gestational age. The average sucking peak of negative pressure at 32 weeks of gestational age was negatively correlated with the time to start oral feeding，and the average sucking negative pressure peak interval was positively correlated with full oral feeding. Caregivers should pay attention to the peak of positive sucking pressure at the beginning of oral feeding readiness assessment and its effect on sucking frequency when performing oral motor interventions to promote full oral feeding.

Objective To understand the clinical characteristics of fasting glucose in patients with acute-on-chronic liver failure（ACLF）,and to analyze the risk factors of fasting hypoglycemia,to provide reference values that can help with the early clinical recognition and prevention of hypoglycemia. Methods The clinical data of 931 patients with ACLF hospitalized from May 2013 to December 2019 in the department of infectious diseases of a tertiary hospital in Guangzhou city,were retrospectively analyzed. ACLF patients were divided into hypoglycemic and non-hypoglycemic groups according to the fasting blood glucose levels. The demographics,clinical characteristics,comorbidities and laboratory indicators of patients in the 2 groups were compared,and the risk factors of hypoglycemia were obtained by Logistic regression analysis. Results There were 399 cases（42.86%） of hypoglycemia,including 207 cases（51.88%） of mild hypoglycemia. Binary Logistic regression analysis showed that the length of hospital stay（OR=1.008）,prothrombin time（OR=1.022） and cirrhosis（OR=1.745） were independent risk factors for hypoglycemia in patients with ACLF. Conclusion ACLF patients have a high incidence of mild hypoglycemia,longer hospital stays,longer prothrombin time,and cirrhosis which increase the risk of hypoglycemia. During clinical practice,more emphasis should be placed on screening high-risk patients via early assessment of their hypoglycemic risk,and hence provide timely interventions to reduce the occurrence of hypoglycemia.

Premature infants with immature physiological function often delay discharge due to poor oral feeding ability. This paper summarized the importance of promoting oral feeding of premature infants，the role of non-nutritive breast sucking in promoting oral feeding，the implementations and precautions of non-nutritive breast sucking. The difficulties and challenges that may exist by developing non-nutritive breast sucking in China were also presented in this review. The corresponding suggestions were advanced to provide references for clinical improvement of oral feeding strategies of premature infants.

Objective To analyze the application status of different dairy products for very and extremely low birth weight infants in Yangtze River Delta，so as to provide evidence for making better feeding choices in clinic Practice. Methods From January 2019 to December 2019，the self-made “form of feeding situation in very low birth weight infants（VLBW） in neonatal intensive care unit（NICU）” was used to collect data and uploaded to the database，and the clinical data of VLBW infants with gestational age ≤35 weeks and admitted to the NICU within 24 hours after birth in 5 tertiary hospitals in the Yangtze River Delta were retrospectively analyzed，and the composition ratio of different dairy types was obtained. At the same time，the clinical outcomes related to feeding in the exclusive breastfeeding group and the formula supplement group were compared. Results 830 cases of VLBW infants were admitted to the NICUs of 5 hospitals，among which 667 cases met the inclusion criteria. Among them，82（12.3%） received exclusive maternal breast milk;5（0.8%） received exclusive donated breast milk;65（9.8%） received both maternal and donated breast milk，the above three feeding types were collectively referred to as exclusive breastfeeding, a total of 152（22.9%） cases. 34（5.1%） received both donated breast milk and formula;75（11.2%） received exclusive formula;333（49.9%） received both maternal breast milk and formula;73（10.9%） received formula，maternal and donated breast milk. The number of days of parenteral nutrition in the donor breast milk supplement group was less than that in the formula supplement group，and the incidence of necrotizing enterocolitis and septicemia was lower than that in the formula supplement group，with statistical significance（P<0.05）. Conclusion The exclusive breastfeeding rate of VLBW infants in various institutions in the Yangtze River Delta region is not optimistic. When the mother’s breast milk is insufficient，formula supplement feeding is still not as effective as exclusive breastfeeding.

Fathers are also the primary caregivers of premature infants. When kangaroo mother care is not available,kangaroo father care is an important alternative. At present,kangaroo father care has been widely carried out abroad while China is in the initial stage. This paper reviewed the significance and practice methods of kangaroo father care of premature infant abroad,and analyzed the influence factors and countermeasures of kangaroo father care,aiming to provide references for clinical practice in China.

Objective To construct and implement professional personnel-premature infant-parents three-dimensional integrated education program and observe its effects.Methods The three-dimensional integrated education team was established. Education curriculum was developed according to the characteristics of development of premature infants. Education platform was established,multiple approaches were set up including parents’ school,WeChat class,video education,bedside care teaching hand by hand,etc.Results After training,parents’ satisfaction score was（191.90±0.20）,which was significantly different from that before training（176.00±4.40）（t=-41.68,P<0.001）. There were significant differences in knowledge and information dimension,parental involvement dimension and professional personnel’s attitude dimension before and after training（t₁=-20.83,P₁<0.001;t₂=-27.30,P₂<0.001;t₃=-27.10,P₃<0.001）.Conclusion The three-dimensional integrated education program for premature infants can improve parents’ caring knowledge and ability,and improve their satisfaction with professional personnel’s attitude.