Many PICU and NICU have been gradually established from 80's in China,and the rescueing success rate of critically ill pediatrics is increasing fast.However,to assess the severity of disease and to determine the ICU admission standards is a quite complex job.Using scoring systems to predict hospital mortality in critically ill patients can be more objectively,scientifically and effectively.There are some scoring systems widely used in the world.Hospitals in china use PCIS more and these in foreign prone to PRISM score highly in pediattic field.PCIS was made in china and it achieves great success on the side of risk adjustment and mortality prediction.But pediatrics are special,sometimes the severity of disease is not completely consistent with the prognosis and the differences among individuals cannot be ignored yet,so PCIS have unavoidable limitations.The scoring systems and clinical symptoms and signs and therapeutic effect should be combined to assess the severity of disease more accurately.Acute physiology and chronic health evaluation(APACHE),and sequential organ failure estimation score(SOFA) are rarely used in the field of pediatric applications,but both are useful tools for clinical research,if it can be introduced into the pediatric field,there may be a new breakthrough.Besides,Pediatric Risk of Mortality Score and Pediatric Risk of Mortality are not widely used in our country.

0.05).Among the test group.the number of medium nebulization were significatly more than that in the contrast group(P0.05).Conclusions: Early continuous and administration of oxygen nebulization with 0.45%sodium chloridecan not only decrease the Visco-elasticity of sputum, but aslo sustain the stability of oxygen partial pressure in blood in the study.

Objective To compare the effects of mammaplasty, non mammaplasty and prosthesis reconstruction in the treatment of quadrant or massive mastectomy. Methods One hundred and twenty patients with segmental or quadrant mastectomy in the First People′s Hospital of Huizhou from February 2015 to December 2016 were selected for the study. The patients were divided into three groups:the mammaplasty group (48 cases),the non mammaplasty group (40 cases),and the prosthesis reconstruction group (32 cases). The patients in the mammaplasty group were treated with quadrant or massive mastectomy, patients in the non mammaplasty group were treated with chest wall fat fascia flap and the prosthesis reconstruction group was treated with the application of the skin flap of the lateral chest wall. The general operation situation of the three groups were recorded,including operation time,indwelling time of drainage tube,hospitalization time and postoperative hospitalization time. The satisfaction and complications of breast reconstruction were compared among the three groups. Results The operation time of the mammaplasty group, non mammaplasty group and prosthesis reconstruction group were (71. 5±18. 4) min,(55. 9±14. 3) min and (89. 7±21. 3) min respectively,there was significant difference among the three groups (F=31.32,P<0.01).The operation time of the mammaplasty group was longer than that of the non mammaplasty group, but less than that of the prosthetic reconstruction group, the difference was statistically significant ( P< 0. 05 ) . The hospitalization time and postoperative hospitalization time in the prosthesis reconstruction group were ( 13. 7 ± 3. 4 ) d and ( 10. 9 ± 2. 6 ) d, mammaplasty group (11. 4±2. 2) d and (8. 6±1. 9) d respectively,non mammaplasty group (11. 3±2) d and (8±1. 8) d respectively. The differences among the 3 groups were statistically significant (F=10. 20,18. 88,P <0. 01) . The postoperative hospitalization time of the prosthesis group was significantly longer than those in the other two groups ( P<0. 05) . The indwelling time of the drainage tube was close in the 3 groups. The overall satisfaction of breast reconstruction in the mammaplasty group, non mammaplasty group and the prosthesis reconstruction group were respectively ( 9. 2 ± 0. 8 ) points, ( 9. 1 ± 0. 6 ) points, ( 7. 9 ± 1. 3 ) points, and the difference was statistically significant ( F=23. 22,P<0. 01) . The satisfaction degrees of breast reconstruction in the mammaplasty group and the prosthesis reconstruction group were equal, higher than that in the non mammaplasty group,the differences were statistically significant ( P<0. 05) . The incidence of wound infection in the mammaplasty group, non mammaplasty group and prosthesis reconstruction group were 10. 4% ( 5/48 ) , 10. 0% (4/40) and 6. 3% (2/32),respectively,the difference was not statistically significant (χ2=1. 29,P=0. 08) . Conclusion In quadrant or massive mastectomy,lateral chest wall fat fascia flap has simple operation and high safety,and the restoration effect is good,which can be widely used in clinical practice.

In this paper,the structural analysis of a case of Hb TaiBei ?22(B4)Glu-Gly found in the Naxi nationality in Yunnan Province was described.This is the first case of Hb variant found in this nationality.

This paper reports a reseach of abnormal Hb for Naxi Moosus minorities nationalities in Lijiang District yunnan,The number of total research is 2230,The ratio of detection is 0.81%, and studied.The variant type of abnormal Hb.These result are Hb E,G-Taibei,US (unstable)respectically,and a case of homozygote of fetal hemoglobin which is found and re- ported in Chima for the first time.

The resuets of the screening of abnormal Hb among people of Hani and Yi minority nationalitios in Honghe, Yunnan were reported in this paper, It was found that the inci- dence of abnormal Hb in This area was 1.25%, By studying the types of abnormal Hb, we found that the main abnormal Hb in Hani and Yi minority nationalities was Hb E. In addi- tion, a slow-mouing Hb was found, Primary structural analysis showed that it was a ?-Chaim variant designated as Hb G-Yuanyang (?43 (CD2) Glu-Gly),. it is a new vari- ant type of abnormal Hb found and reported for the first time in Yunnan, China.

Objective To investigate the brain protection effect of cinnamon water extract on chronic cerebral ischemia rats. Methods We selected male Wistar rats to make chronic cerebral ischemia model by bilateral carotid artery ligation permanently,and the models were randomized into a model group,cinnamon high or low dose group,with 20 in each group. A control group with 20 rats was treated with sham operation. The cinnamon high and low dose groups were given cinnamon water extract 4.2g/kg and 2.1g/kg respectively by gavage in succession for 4 weeks. Y-maze test was used to test the cognitive ability of the rats. The superoxide dismutase (SOD) activity,malondialdehyde (MDA) content,and the expressions of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) were determined. Results Compared with the sham-operated group,the cognitive ability of the model group declined,the SOD activity of brain tissues decreased,and the MDA content increased. Cinnamon improved the SOD activity,reduced the MDA content,increased the NGF and BDNF expressions,and the effect of high-dose group was better than that of the low-dose group. Conclusion Cinnamon plays its role in cerebral protection through increasing the SOD activity and expression of NGF and BDNF and reducing content of MDA.

The article expounds the advantages and existing problems of TCM differentiation by signs,puts forwards the concept of “sign factor”,including sign factors of disease location and disease nature;the contents of the new system are as well provided,finally it points out the great meaning of the said system to the development of TCM.

Objective To investigate the effects of hyperoxaluria on rat renal tubular epithelium intracellular calcium concentration ([Ca~(2+)]i) and cell apoptosis, and explore the protective effects of calcium antagonist-nifedipine. Methods Sixty male SD rats were randomly divided into six groups (n=10). Rats in water-drinking group were treated with deionized water, nifedipine group with deionized water and nifedipine 10 mg·kg~(-1)·d~(-1), calculi-induced group with deionized water containing 1% ethylene glycol, and three calculi-induced+nifedipine-intervening groups with deionized water containing 1% ethylene glycol plus nifedipine 3, 6 and 10 mg·kg~(-1)·d~(-1), respectively. Four weeks later, the 24 h oxaluria concentration was measured, the apoptosis index of renal tubular epithelial cells was detected with TUNEL method, and Ca~(2+) fluorescence intensity of cells of renal proximal tubules was determined by flow cytometry using Fluo-3/AM staining. Results The 24 h oxaluria concentrations in calculi-induced group and calculi-induced+nifedipine-intervening groups were higher than those in water-drinking group and nifedipine group (P＜0.01). The apoptosis index and Ca~(2+) fluorescence intensity were significantly higher in calculi-induced group than those in water-drinking group (P<0.01). The Ca~(2+) fluorescence intensity in calculi-induced+nifedipine (3, 6 and 10 mg·kg~(-1)·d~(-1))-intervening groups was 76.7%, 62.7% and 56.4% of calculi-induced group, respectively, with a significant dose-effect relationship (r=0.839, P<0.01). The apoptosis index of renal tubular epithelial cells was significantly correlated with Ca~(2+) fluorescence intensity (r=0.826, P<0.01). Conclusion Hyperoxaluria can increase apoptosis and [Ca~(2+)]i concentration of renal tubular epithelial cells in rats, and nifedipine can effectively protect renal tubular epithelial cells to resist hyperoxaluria.

Objective To observe the clinical efficacy and prognosis of nimotuzumab combined with intensity modulated radiotherapy(IMRT) in the treatment of advanced local nasopharyngeal carcinoma.Methods 82 patients with advanced nasopharyngeal carcinoma were selected, and they were randomly divided into observation group(40 cases) and control group(42 cases) according to the digital table.The observation group was treated with nimotuzumab plus IMRT plus cisplatin, and the control group was treated with IMRT plus cisplatin.After 7 weeks of treatment, the clinical efficacy, adverse reactions and T cell subsets were observed.And the patients were followed up for 1 year, 2 years and 3 years to evaluate the survival rate.Results In the observation group, the total remission rate was 75.00%,which was higher than that in the control group(59.09%),the difference was statistically significant(x2=35.81,P<0.05).The CD+4,CD+8 and CD+4/CD+8 levels in the observation group were similar to those in the control group(tCD+4=0.59,P=0.56;tCD+8=1.70,P=0.01;tCD+4/CD+8=0.13,P=0.89).The incidence rates of Ⅰ degree and Ⅱ degree mucosal reaction and dermatitis in the observation group were 35.00%,40.00%,40.00%,35.00%,respectively,which were higher than 9.09%,9.09%,9.09%,9.09% of the control group,the differences were statistically significant(x2Ⅰmucous membrane=4.18,P=0.04;x2Ⅱmucous membrane=5.52,P=0.02;x2Ⅰdermatitis=5.52,P=0.02;x2Ⅱdermatitis=4.18,P=0.04).The 2-year and 3-year survival rates in the observation group were 65.50%,60.00%,respectively,which were significantly higher than 31.82%,27.27% in the control group, the differences were statistically significant(x2=4.11,P=0.04;x2=4.58,P=0.03).Conclusion Nimotuzumab combined with IMRT in the treatment of advanced nasopharyngeal carcinoma has good short-term clinical efficacy, good long-term efficacy and controllable adverse reactions.It is worthy of clinical application.