Objective To investigate the relationshp among Gp Ⅱ b/ⅡⅢ a、CD62p in platelet activation mark-er and high-sensitivity C-reactive protein (hs-CRP) in elderly patients with chronic cor pulmonary exacerbation. Methods The subjects were divided into four groups (42 elderly patients with cor pulmonary exacerbation,42 eld-erly patients with cot pulmonary remission,30 cases of healthy elderly subjects and 30 cases of healthy non-elderly subjects) . The expression of Gp Ⅱ b/Ⅲ a and CD62p were measured with tricolor flow cytometry. Hs-CRP levels were measured by nephelometry and turbidimetry in patients and normal controls. Results Compared with cor pul-monary remission group,healthy elderly group and healthy non-elderly group, the levels of Gp Ⅱ b/Ⅲ a, CD62p and hs-CRP increased significantly in patients with chronic cor pulmonary exacerbation ( all P < 0.001 ). Gp Ⅱ b/Ⅲ a and CD62p results of the elderly patients with cot pulmonary remission were higher than those in healthy elderly subjects (P <0.05) and healthy non-elderly subjects (P < 0. 001 ) . The expressions of both Gp Ⅱ b/Ⅲa and CD62p in healthy elderly subjects were statistically higher than that in healthy non-elderly subjects ( P < 0.05 ). There was a positive con'elation between the Gp Ⅱ b/Ⅲ a、CD62p and hs-CRP in elderly patients with chronic cot pulmonary exac-erbation(r =0.59,P<0.01 ; r=0.54,P<0.01 ). Conclusions The platelet in elderly patients with chronic cot pulmonary exacerbation is overactivated,which is correlated with hs-CRP.

Objective To explore the application effect of modified early warning score ( MEWS ) information system based on nursing electronic medical records .Methods A total of 725 patients were chosen as the research objects, and were allocated to observation group (n=360) and control group(n=365) according to their hospitalized wards . Patients in control group received routine monitoring record and observation according to orders while patients in observation group had an extra MEWS information system grading and different levels of care and treatment scheme based on Early Warning Process .Level of patients care and corresponding MEWS score of observation group and incidence of accident , rescue success rate and mortality rate for patients of two groups were observed and compared .Results MEWS of critical care patients of observation group was the highest (6.81 ±2.19), while MEWS of tertiary care patients was the lowest (1.80 ±0.72). Accident rate in observation group was obviously lower than the control group , rescue success rate was higher than control group(P<0.05);mortality rate of two groups had no difference (P<0.05).Conclusions On the basis of nursing electronic medical records , development of MEWS information system could help clinical nurses assess elderly patients rapidly and accurately , identify potential critical care patients early , and improve patients safety management to ensure patients safety .

Objective:To analyze the clinical data and genetic characteristics of a child with CLN1 neuronal ceroid lipofuscinosis in conjunct with hereditary hyperferritinemia cataract syndrome (HHCS).Methods:A child who was admitted to the PICU of the First Affiliated Hospital of Zhengzhou University in November 2020 was selected as the study subject. Clinical data of the child was collected. Genetic testing was carried out for the child, and the result was analyzed in the light of literature review to explore the clinical and genetic characteristics to facilitate early identification.Results:The patient, a 3-year-old male, had mainly presented with visual impairment, progressive cognitive and motor regression, and epilepsy. Cranial magnetic resonance imaging revealed deepened sulci in bilateral cerebral hemispheres, and delayed myelination. The activity of palmitoyl protein thioesterase was low (8.4 nmol/g/min, reference range: 132.2 ~ 301.4 nmol/g/min), whilst serum ferritin was increased (2 417.70 ng/mL, reference range: 30 ~ 400 ng/mL). Fundoscopy has revealed retinal pigment degeneration. Whole exome sequencing revealed that he has harbored c. 280A>C and c. 124-124+ 3delG compound heterozygous variants of the PPT1 gene, which were respectively inherited from his father and mother. Neither variant has been reported previously. The child has also harbored a heterozygous c. -160A>G variant of the FTL gene, which was inherited from his father. Based on the clinical phenotype and results of genetic testing, the child was diagnosed as CLN1 and HHCS. Conclusion:The compound heterozygous variants of the PPT1 gene probably underlay the disorders in this child. For children with CLN1 and rapidly progressing visual impairment, ophthalmological examination should be recommended, and detailed family history should be taken For those suspected for HHCS, genetic testing should be performed to confirm the diagnosis.