Objective To explore the application and effect of scene imitation method in the education of patients before fiberoptic bronchoscopy.Methods 264 elective bronchoscopy patients between March 2007 and Decembet 2007 were randomly divided into control group(120 patients)and the experiment group(144 patients)Traditional health education was applied in the control group before bronehoscopy.Scene imitation method in health education was applied in the experiment group before bronchoscopy.Results The examination succes rate in the experiment group was significantly improved(P＜0.05).The medical order obeying behavior(MOOB)of the patients was significantly different between the two group(P＜0.01).Conclusion Before the use of fiberoptic bronchoscopy,the new scene simulation method Can help patients on the list obtain more cognitive ability about the testing.Comparing the traditional education,it establishes a sound relationship between doctors and patients,reduces complication and leads to more accurency of testing,thus helping patients to recover soon.

AIM: To investigate the effect of recombinant human interleukin-10 (rhIL-10) on IL-6 and TNF-? levels in serum and liver of mice exposed to lipopolysaccharide (LPS). METHODS: rhIL-10 was prepared by using genetic engineering technology. Mice were intraperitoneally with 500 ?g of LPS, and then were treated intravenously with various dosages of rhIL-10. The levels of IL-6 and TNF-? in hepatic tissue and serum were determined by ELISA at 12 h, 24 h, 48 h and 72 h post rhIL-10 treatment. RESULTS: rhIL-10 markedly inhibited the increase in IL-6 and TNF-? levels in hepatic tissue and serum at 12 h after rhIL-10 treatment in LPS-challenged mice, and the inhibition effect was significant at 24-48 h after rhIL-10 treatment (P

OBJECTIVE To evaluate the capabilities of nosocomial infection control in local general hospitals in handling public health emergencies,and to provide reliable data for future work.METHODS A random sampling questionnaire method was adopted to investigate how nosocomial infection control in local hospitals performed their functions and handled public health emergencies.RESULTS The 15 hospitals which were surveyed had all been equipped with computer network of directly reporting epidemic situations of infectious diseases.Four from 15 hospitals had full-time employees reporting epidemic situations,and 11 had part-time employees.Twelve hospitals established,according to standards,a department of infectious diseases or a department of pre-examination and sorting diagnosis.Seven hospitals did not have full-time staff of infection control till 2003.The rate of the staff's knowledge of nosocomial infection control was 73.7%.The medical wastes of the 15 hospitals were all disposed at the local medical waste disposal center.CONCLUSIONS Our city,in terms of nosocomial infection control,has acquired certain capabilities of handling public health emergencies.But the capabilities vary from hospital to hospital.Further improvement in some work is still needed.

Objective To study the pathogenesis, the diagnoses and the pre-hospital emergency treatment of comatose patients. Methods 314 comatose patients admitted to our hospital from September 2003 to September 2004 were analyzed retrospectively and followed in the hospital. Results Among 314 comatose patients, 119 had cerebrovascular accidents, 91 with poisoning, 42 with metabolic diseases, 37 cardiovascular diseases and 25 others. After pre-hospital treatment, 68 patients were recovered, 199 with stable conditions, 31 deterioated and 16 died. Conclusion Among the comatose patients, cerebral diseases and poisoning accounted for the most. The pre-hospital treatment could improve the successful rate of rescue.

Objective To investigate effects of different concentrations of dexmedetomidine on onset time and clinical time-effect of rocuronium in the processes of the total intravenous anesthesia.Methods Sixty patients with elective anesthesia breast modified radical mastectomy,aged 26 to 55 years,were randomly divided into four groups of 15 patients.Group A (control group):uniform within 10 min before induction of anesthesia saline infusion (NS ; 0.25 ml/kg) ; group B:dexmedetomidine given initial dose 0.3 μg/kg uniform within 10 min before induction of anesthesia infusion finished,anesthesia period 0.3 μg/(g · h) continuous infusion until the end of surgery; group C:dexmedetomidine given initial dose 0.6 μg/kg uniform within 10 min before anesthesia infusion finished,during anesthesia with continuous infusion 0.6 μg/'(kg · h) until the end of surgery ; and group D:dexmedetomidine given initial dose 1 μg/kg uniform within 10 min before anesthesia infusion finished,during anesthesia to 1 μg/(kg · h) continuous infusion to the end of surgery.Patients after the burglary were under multi-monitor vital signs monitoring blood pressure (BP),heart rate (HR),oxygen saturation (SPO2),electrocardiogram (ECG),and after intubation monitoring end-tidal carbon dioxide (EtCO2),recording time T0 and T25.Results No significant difference was found at the T0 time in each group.However,the T25 time (48 ± 6) min in group C and (51 ±6) min in group D was significant longer than that (40 ±6)min in group A (P ＜0.05).The mean artery pressure(MAP) of group C and D [(88.76 ± 7.06)mmHg,(87.89 ± 6.95)mmHg] were significantly lower than group A after dexmedetomidine infusion 5 min later(P ＜ 0.05); The HR of groups B and C [(60.80 ± 7.11)bpm,(63.31 ± 5.78)bpm] were significantly lower than group A before induction (P ＜ 0.05).The HR of group D was significantly lower than group A before induction and after infusion 5 and 30 min later[(66.40 ± 9.49) bpm,(60.52 ± 7.45) bpm,(61.32 ± 7.11) bpm,P ＜ 0.05].Conclusions Under the status of total intravenous anesthesia,different concentrations of dexmedetomidine did not affect the onset time of rocuronium,but dexmedetomidine given up to a certain concentration could enhance the clinical time-effect of rocuronium.

Objective To explore the correlation between matrix metalloproteinase‐9(MMP‐9) and cardiac function ,aneu‐rysm volume in the process of left ventricular aneurysm (LVA) formation .Methods Rabbit models of LVA were established in 20 New Zealand rabbits by lighting left anterior descending artery and left circumflex artery .Two‐dimensional echocardiography were performed at preoperative and postoperative 1 d ,2 d ,3 d ,1 w ,2 w ,3 w ,4 w .The survived animals which had LVA formed were en‐rolled .Real time three‐dimensional echocardiography was performed to obtain left ventricular volume ,LVEF and LVA volume ,The MMP‐9 serum concentration was measured by ELISA .Results (1)There were a significant increase in the serum concentration of MMP‐9 from postoperative 1 d and arrived at the peak at postoperative 3 d ,there were higher than preoperative at postoperative 4 w (P<0 .05) .(2)Compared with preoperative ,the LVEDV ,LVESV and LVAV volume at postoperative showed an increase trend (P<0 .05) ,while there was a decreasing trend in LVEF(P<0 .05) .(3)The MMP‐9 had the better relationship with LVEF at post‐operative 1 d ,2 d ,3 d ,1 w ,2 w ,3 w ,4 w ,in which MMP‐9 had the tightest relationship with LVEF at postoperative 3 d (r=0 .731 , P<0 .05) .MMP‐9 had the better relationship with LVA volume at postoperative 2 d ,3 d ,1 w ,2 w ,3 w ,4 w ,in which MMP‐9 had the tightest relationship with LVA volume at postoperative 3 d (r=0 .636 ,P<0 .05) .Conclusion The MMP‐9 had an effect on cardiac function and LVA volume in the process of LVA formation .

Objective To develop a mobile medical information system based on informatized monitoring to enhance staff efficiency and patient safety.Methods The acquired information on vital signs was integrated into mobile terminal, which could be called, analyzed and processed along with the clinical data of the patient.Results The doctor might write and edit the prescription based on the clinical data. The nurse could read the prescription at real time, and could treat the patient timely in case of alarming.Conclusion The system lays a foundation for patient-centered medical service.

[Objective] To research the sedative effect of intranasal dexmedetomidine and sufentanil for pediatric sedation for stomatological operation of outpatient department.[Methods] 60 children undergoing stomatological operation of outpatient department,age 3 ～ 7 years,weighing 10 ～ 32 kg,of ASA physical status Ⅰ ～ Ⅱ,were divided into the three groups (n =20) randomly using a random number table:group dexmedetomidine and sufentanil (group DS),group dexmetomidine (group D),group sufentanil (group S).Recorded the children's behavior using the Ohio State University behavior rating score (OSUBRS),the University of Michigan Sedation Score (UMSS),SBP,HR and side-effects when entry,during and leave operation and in post-anesthesia care unit,side-effects,the satisfaction of stomatological doctors and parents.[Results] The OSUBRS of group DS when entry,during operation were lower than group D (P ＜ 0.01).The UMSS of group DS were higher than group D and group S when entry and during operation (P ＜ 0.05).The success rate of group DS was higher than group D and group S (P ＜ 0.01).There was no different of mean percentage change in systolic blood pressure and heart rate from baseline between group DS and group D (P ＞ 0.05).There were no instances of respiratory depression,hypotension and bradycadia.[Conclusion] Intranasal dexmedetomidine and sufentanil provides satisfactory pediatric sedation for stomatological operation of outpatient department without side effects such as respiratory depression,bradycadia and hypotension.

Objective:To explore the application value of automated machine learning (autoML) model in predicting the risk of preeclampsia in the first trimester.Methods:From January 2017 to October 2020, 2 180 singleton pregnant women who were registered in Jinan Second Maternal and Child Health Hospital and underwent pregnancy examination at 12 weeks of gestation were selected. The pregnant women were divided into preeclampsia group (103 cases) and control group (2 077 cases) according to the occurrence of preeclampsia. The differences in clinical data and hematological indexes in the two groups were compared, and the correlation between each index and the risk of preeclampsia was analyzed too. All the pregnant women were randomly divided into training set and test set according to the ratio of 7∶3, and the autogluon autoML algorithm was used to build a variety of machine learning models, and training and cross-validation were performed in the training set to compare the accuracy of the different models. The importance of each index in the autoML model was analyzed, and the autoML model and the logistic regression model were used to predict the risk of preeclampsia in pregnant women in the test set respectively, and the receiver operating characteristic (ROC) curve was used to evaluate the prediction performance of the autoML and the logistic regression model.Results:The age, pre-pregnancy body mass index, body mass index at 12 weeks of gestation, waist circumference at 12 weeks of gestation, proportion of drinking history, high-sensitivity C-reactive protein (hs-CRP), triglyceride, low-density lipoprotein cholesterol (LDL-C), aspartate aminotransferase (AST), platelet distribution width (PDW), mean platelet volume, thyroid stimulating hormone (TSH) and β-human chorionic gonadotropin were all significantly higher than those in the control group (all P<0.05), and the free tri-iodothyronine (free T3), free thyroxine (free T4), placental growth factor (PIGF), soluble fms-like tyrosine kinase-1 (sFlt-1) and pregnancy-associated plasma protein-A (PAPP-A) were all significantly lower than those in the control group (all P<0.05). Correlation analysis showed that the correlation between pre-pregnancy body mass index, body mass index at 12 weeks gestation, waist circumference at 12 weeks gestation, hs-CRP, triacylglycerol, AST, TSH, free T3, free T4, β-HCG, PIGF, sFlt-1, PAPP-A and preeclampsia risk were obviously higher; but the correlation between each index were lower. A total of 18 models in 8 categories were constructed with the autoML model algorithm, and the neural network _L2 based on FastAI had the highest accuracy in the training set (0.963) and the validation set (0.971). The TSH, LDL-C, PDW, waist circumference at 12 weeks of gestation, sFlt-1, AST were more important in the model, while the free T4, total cholesterol, pregnancy times, drinking history, parity and family history of hypertension were less important indicators. The area under the ROC curve of the autoML model for predicting the risk of preeclampsia in the first trimester was significantly higher than that of the logistic regression model (0.984 vs 0.765, P=0.002), while there was no statistical difference in the prediction accuracy of the two prediction models in the training set ( P>0.05). The prediction accuracy and sensitivity of the autoML model in the test set were both significantly higher than those of the logistic regression model (99.54% vs 98.32%, 93.75% vs 75.00%, both P<0.05). Conclusions:Factors such as TSH, LDL-C, PDW, waist circumference, sFlt-1 and AST in the first trimester of pregnancy have a certain correlation with the risk of preeclampsia. The autoML model based on the indicators of the first trimester has a high predictive value for the risk of preeclampsia.

Objective To investigate the neurodevelopmental outcomes and its risk factors of very low birth weight infant (VLBWI) and extremely low birth weight infants (ELBWI).Methods Data of 85 VLBWI and ELBWI hospitalized in Children's Hospital of Fudan University from October 2005 to November 2009 who had finished infant development test of Baley Scales of Infant Development Ⅱ (Bayley Ⅱ) for neurological development at corrected gestational age between 18 to 42 months were retrospectively reviewed.Twelve infants who accepted treatment in other hospital over 10 days were excluded; the rest 73 infants were divided into normal (neurodevelopment) group or abnormal group according to the definition of neurodevelopmental impairment reported by National Institute of Child Health and Human Development (NICHD) Neonatal Network.Potential risk factors of neurodevelopmental impairment were analyzed with Logistic stepwise regression.Results The mean gestational age of 73 infants was (30.4±2.3) weeks; among which 13 were smaller than 28 weeks,42 between 28 and 32 weeks,and 18 older than 32 weeks.The mean birth weight was (1208.0±208.5) g; among which 15 (20.6％) ＜1000 g,and 58 (79.4％) were between 1000 g and 1500 g.Four babies (5.5％) were diagnosed as movement retardation,and neurodevelopmental impairment occurred in 16 cases (21.9 ％),psychomotor developmental index ＜70 occurred in 6 cases (8.2％,one case complicating with cerebral palsy); mental developmental index ＜70 occurred in 2 cases (2.7％); both psychomotor developmental index and mental developmental index ＜70 occurred in 7 cases (9.6 ％,two cases complicating with cerebral palsy),and one case (1.4 ％) was cerebral palsy only.Blind in either eyes and hearing impairment requiring deaf-aid were not found in any of the 73 babies.Logistic stepwise regression showed that use of mechanical ventilation was related to neurodevelopmental impairment (OR =6.183,95％ CI:1.664-22.983,P =0.003).Psychomotor developmental index of infants who needed mechanical ventilation (77.5±15.1) was lower than that of infants did not need (87.3±15.1)(t=2.646,P=0.010).Conclusions VLBWI and ELBWI are in high risk of neurodevelopmental impairment,especially those who need mechanical ventilation.