Point-of-care testing technology has been widely used in clinical practice, especially in the emergency department of intensive care unit, operating room, and so on.Clinicians should correctly select patients, standardize specimen collection and strict operation according to the indications of different POCT items, and correctly interpret the results of POCT based on the clinical characteristics of children and other auxiliary examination results, so as to guide clinical diagnosis and treatment.From the perspective of pediatric emergency, this review analyzed the application of POCT technology in infection-related indicators, etiology, coagulation indicators, myocardial injury, and so on.

Objective To compare the shapes of posterior corneal surface after laser subepitheliar keratomileusis(LASEK)and laser in situ keratomileusis(LASIK).Methods The 268 eyes of 134 cases were divided into two groups:The first group had 158 eyes of 79 cases,which were accepted the LASEK and whose average diopter was(-5.67?0.59)D.The second group had 110 eyes of 55 cases,which were accepted the LASIK and whose average diopter was(-5.97?0.83)D.Orbscan corneal topography system was used to follow up for 6 month postoperatively.Results In the sixth month after operation,we observed the posterior corneal power within 3mm of corneal center and the changes of the diff value between two groups.There were significantly statistical difference(P

Excimer laser was found in 1975, and has been used in corneal refractive surgery, which made a great progress and become rapidly developed. ArF laser of 193 nm has high accuracy because it can gasify corneal tissue molecule. Moreover, it does not produce heat effect on tissues surrounding irradiated sites, so not produce adverse effect on corneal structure. At present, excimer laser has been successfully used in corneal radial incision, excimer laser corneal refractive surgery, laser in situ keratomileusis, laser epithelial keratomileusis and laser subepithelial keratomileusis. With increasing understanding of excimer laser and accumulating clinical experience, novel, accurate and predictive excimer laser corneal refractive surgery will be developed.

目的观察急性心肌梗死患者早期康复护理的远期效果。方法40例老年急性心肌梗死患者随机分为实验组20例(早期康复组)和对照组20例(常规治疗组),前者接受2周的康复护理,后者接受3周的康复护理。对两组患者进行为期18个月的随访,观察其心功能、活动情况,及心绞痛和再梗死的发生率。结果两组患者的心功能无明显差异,但实验组患者心绞痛的次数和再梗死的发生率低于对照组(P<0.05)。结论对急性心肌梗死患者进行早期康复是安全、可行的,可改善心功能和降低再梗死的发生率,减少并发症的发生。

ObjectiveTo investigate the clinical features of intramedullary spinal cord tumors(IMSCT) in children.MethodsThe clinical data including sex,age,pathohistology,clinical manifestations and medical check-up collected from 16 children diagnosed as IMSCT in Shengjing Hospital Affiliated to China Medical University,were retrospectively reviewed and analyzed.ResultsThe study subjects inclu-ded 11 male and 5 female,with an average age of(8.55?4.28) years old,ranged from 15 months to 14 years old.The interval lasted 1 day to 9 years from onset of the syndrome to confirmed diagnosis of IMSCT.The first clinical manifestation was mostly pain.The main clinical mani-festations included limb dyskinesia in 14 cases,pain in 12 cases,urine and stool disturbance in 9 cases,gait irregularity in 8 cases,extremity atrophy in 3 cases.Medical check-up included abnormal tendon reflex in 14 cases,abnormal superficial reflex in 9 cases,sphincter dilatation in 6 cases,positive Babinski's signs in 5 cases,spinal deformity in 4 cases,region masses in 3 cases,paraesthesia in 2 cases,inequality of lower limb in 1 case,dermai sinus in 1 case,pigmentation in 1 case.The cases were evaluated by magnetic resonance imaging,which presented thickened spinal cord and intramedullary abnormal signals in all the cases.Pathological types: teratoma in 5 cases,dermoid cysts in 2 cases,epidermoid cyst in 2 cases.Misdiagnoses included urinary tract infections in 2 cases,rheumatoid arthritis in 1 case,and lumbar disc protrusion in 1 case.ConclusionsThe main pathohistology of pediatric IMSCT is congenital tumor.First clinical manifestation is pain.MRI can show a reliable evidence for the diagnosis.It is important to improve the outcomes of pediatric IMSCT by establishing the diagnosis and administering proper management as early as possible.

Objective The residency training questionnaires survey made at the hospital identified major residency training requirements.Methods Literature review and expert consultation were used in questionnaire design, to survey the residents of 2014 and 2015 and discover matters of their concern, and assess the policy outcomes.Results Matters of their concern were found to be professional strength, teaching and management level, and income respectively.Compared to residents of other hospitals, these residents regard the rationality of the merit pay and subsidies as higher(27.45％ vs.3.70％)in 2014.As to the new policies introduced in 2015, the gap between residents of the hospital and those from other hospitals in seeing the rationality of merit pay and subsidies tends to narrow.Conclusion The new policies have increased the residents' satisfaction on their income.

To study the therapeutic effectiveness of “Gongxuening Capsule” in the treatment of prolonged lochia. The therapeutic effectiveness of “Gongxuening Capsule” was observed in the treatment of prolonged lochia to compare with the use of antibiotic combined with Yimucao electuary. Out of 42 cases treated, significant therapeutic effectiveness was observed in the treatment of prolonged lochia by using “Gongxuening Capsule”, with the total effective rate of 95 2%. The result was better than the group of patients in whom antibiotic combined with Yimucao electuary was used ( P

Objective To evaluate the clinical value of minimally invasive methods for non-anastomotic biliary stricture (NABS) after orthotopic liver transplantation.Methods The clinical data of 403 patients who underwent liver transplantation during recent 10 years in Liver Transplantation Center at General Hospital of Guangzhou Military Commanmol were analyzed retrospectively,and 13 patients with NABS were selected.The outcomes of 3 types of NABS patients treated by endoscopic retrograde cholangiopancreatography(ERCP) or percutaneous transhepatic cholangial drainage(PTCD) were compared and the indication for re-transplantation was identified.Results PTCD treatments of 4 patients were proved ineffective.The shortterm curative rate of minimally invasive treatments was 8/13.Five patients eventually required surgical treatments (re-transplantation in 4,Roux-en-Y anastomosis in 1).According to cholangiography results,NABS were divided into 3 types,namely hepatic bile duct strictures (n =4,type Ⅰ),multiple extra-hepatic and intrahepatic biliary strictures (n =7,type Ⅱ),intrahepatic biliary strictures (n =2,type Ⅲ).The success rates of minimally invasive treatment in 3 types of NABS were 3/4,4/7 and 1/2,respectively.Nearly half of type Ⅱ and type Ⅲ patients needed re-transplantation,which was more likely for those patients with hepatic artery stenosis (2/3).Conclusion NABS treated with minimally invasive methods are preferred.Based on the appearance of biliary stricture,type Ⅰ patients had the best prognosis.For those type Ⅱ and type Ⅲ patients who failed minimally invasive treatment,especially combined with hepatic arterial stenosis,surgical treatment should be timely,so as not to lose a chance for re-transplantation.

Objective To compare the effect of crystalloid and crystalloid plus albumin in the treatment of pediatric septic shock.Methods Data of 63 pediatric patients with septic shock admitted to Department of Critical Care Medicine of Hebei Provincial Children's Hospital were collected and retrospectively analyzed.The patients were divided into two groups according to whether they received albumin for volume resuscitation within 1 day after admission or not.The patients in observation group (crystalloid + albumin group,n =33) received normal saline (20 mL/kg) followed by 1 g/kg albumin 30 minutes after admission,and those in control group (crystalloid group,n =30) received only normal saline (20 mL/kg) 30 minutes after admission,and normal saline resuscitation was continued according to the effect of fluid therapy.Anti-infection and vasoactive drugs strategies were the same in both groups.The first-hour infusion volume,time showing stable hemodynamics,the incidence of pulmonary edema,and blood lactate levels at 0,6,12 hours after achieving the goals were compared,and blood lactate clearance rates were calculated.Results The first-hour infusion volume time in the observation group was lower than that in control group (mL:41.56 ± 10.50 vs.57.24 ± 7.54,t=4.596,P=0.000),and time showing stable hemodynamics was shorter than that in control group but without statistically significant difference (minutes:219.87 ±70.23 vs.287.10 ± 67.00,t=2.047,P=0.360).The incidence of pulmonary edema in observation group was slightly lower than that in control group [6.1％ (2/33) vs.10.0％ (3/30),x2±2.272,P=0.259].The lactic acid levels were decreased gradually along with rehabilitation time,while lactate clearance rate was increased in both groups.At 0 hour and 6 hours after resuscitation,the lactate level (mmol/L) in the observation group was significantly lower than that in control group [0 hour:3.65 ± 2.84 vs.5.72 ± 2.11,t＝ 1.940,P=0.046; 6 hours:2.12 ± 1.21 vs.4.09 ± 1.45,t=2.892,P=0.005],while the lactate clearance rate was significantly increased compared with control group [0 hour:(0.38 ± 0.15)％ vs.(0.18 ± 0.09)％,t=1.447,P=0.018; 6 hours:(0.62 ± 0.14)％ vs.(0.51 ± 0.11)％,t=1.920,P=0.047].However,at 12 hours after resuscitation,there were no statistically significant differences in the lactic acid level (mmol/L:1.46 ± 0.39 vs.1.54 ± 1.90,t=0.450,P=0.072) and the lactate clearance rate [(0.78 ± 0.19) ％ vs.(0.77 ± 0.18) ％,t =0.091,P=0.928] between observation group and control group.Conclusion Albumin resuscitation in children with septic shock can stabilize hemodynamics earlier,reduce the incidence of pulmonary edema,and improve the successful rescue rate of refractory septic shock.

ObjectiveTo systematically review the curative effect and safety of compound realgar and natural indigo tablet (CRNIT) therapy in acute promyelocytic leukemia (APL). MethodsThe clinical data of randomized trials on SinoMed, CNKI, VIP,WANFANG DATA,CBA, PubMed, MEDLINE, EMBASE, the Cochrane Library were searched by internet,in addition to manual retrieval and collecting all published literatures randomized controlled trials (RCT) about CRNIT therapy in APL home and abroad.Retrieval line was up to March 2011. According to the inclusion criteria and exclusion criteria, screening all literatures and evaluating their qualities. The rate of complete remission (CR), time to CR, recurrence rate, mortality, rate of adverse reaction and so on were used as evaluation indicators for meta-analysis by RevMan 5.1.Results Data from six RCTs involving 391 APL patients,including 2 RCTs about comparison of CRNIT and Arsenic Trioxide (ATO), 4 RCTs about comparison of CRNIT and all-trans retinoic acid (ATRA) (including adding 1 RCT about comparison of CRNIT + ATRA and ATRA). Time to CR: CRNIT was longer than ATRA and ATO (WMD = 3.14, 95 ％ CI 0.99-5.29, P= 0.004). Headache incidence: CRNIT was lower than ATRA (OR = 0.10, 95 ％ CI 0.02-0.45, P = 0.003). 5-year disease-free survival rate: CRNIT was better than ATRA (OR = 7.22, 95 ％ CI 1.40-37.25, P = 0.02). There were no statistical significance in the rest of the Meta-analysis results.ConclusionThe time to CR of CRNIT is longer than that of ATRA and ATO.The short-term effect of CRNIT is similar to that of ATRA and ATO.The 5-year disease-free survival rate of CRNIRT may be higher than that of ATRA.