Objective To investigate the application of pediatric early warning score (PEWS) in neurology department.Methods The clinical data and PEWS of 1,158 children with neurologic diseases (764 febrile seizures,259 viral encephalitis and 135 bacterial meningitis) admitted into neurology department from August 2013 to November 2016 were analyzed retrospectively.PEWS was compared among the three different diseases.According to the disease severity,cases were categorized into no-monitor-required group (n =996,697 febrile seizures,203 viral encephalitis and 96 bacterial meningitis),monitor-required group (n =138,67 febrile seizures,41 viral encephalitis and 30 bacterial meningitis) and PICU group (n =24,0 febrile seizures,15 viral encephalitis and 9 bacterial meningitis).PEWS was assessed at admission in both no-monitor-required group and monitorrequired group.PEWS was recorded 12 hours before PICU transfer in PICU group.Then PEWS was compared among all groups in different diseases respectively.Results The median (minimum ～ maximum) of PEWS in febrile seizures,viral encephalitis and bacterial meningitis was 0 (0 ～ 3),2(0 ～ 8) and 2(0 ～ 8),respectively and there was significant difference among three diseases (P ＜ 0.01).No patient of febrile seizures was transferred to PICU.PEWS of febrile seizures in monitor-required group was higher than that in no-monitor-required group (P ＜ 0.01).For both viral encephalitis and bacterial meningitis,PEWS in monitor-required group was higher than that in no-monitorrequired group,and the score in PICU group was higher than that in monitor-required group.The difference was significant (P ＜ 0.01).Conclusion PEWS is effective for the assessment of illness severity of hospitalized children in neurology department,and can be used for the prediction PICU transfer as an excellent screening tool.

Objective: To assess the effectiveness of anterior subcutaneous internal fixation (INFIX) combined with posterior percutaneous iliosacral screw for the treatment of unstable pelvic fractures. Methods: Between August 2016 and November 2017, 19 cases of unstable pelvic fractures were treated with anterior subcutaneous INFIX combined with posterior percutaneous iliosacral screw. There were 14 males and 5 females, with an average age of 40.6 years (range, 17-69 years). Causes of injury included traffic accident injury in 11 cases, falling from height in 5 cases, bruise injury by heavy object in 3 cases. According to Tile classification, there were 2 cases of type B1, 6 cases of type B2, and 11 cases of type C. Anterior ring injuries included bilateral pubic ischial ramus fractures in 12 cases, unilateral pubic ischial ramus fractures in 5 cases, and symphysis pubis separation in 2 cases. Posterior ring injuries included sacroiliac ligament injuries in 2 cases, unilateral iliac bone fractures in 3 cases, unilateral sacral fractures in 11 cases, unilateral sacroiliac joint dislocation in 2 cases, and bilateral sacral fracture in 1 case. The intraoperative blood loss and operation time were recorded, and the fracture healing and postoperative complications were observed. Matta score was used to evaluate the reduction of fracture, and Majeed score was used to evaluate the postoperative function of patients. Results: The operation time was 47-123 minutes (mean, 61.4 minutes) and the intraoperative blood loss was 50-115 mL (mean, 61.1 mL). One case had superficial infection at the site of screw implantation, and 1 case had unilateral cutaneous nerve stimulation, which were cured after corresponding treatment. There was no damage of urinary system, reproductive system, and intestine. All cases were followed up 12-25 months (mean, 18.1 months). All the fractures healed after operation, the average healing time was 9.5 weeks (range, 8-13 weeks); no nonunion, delayed healing, internal fixation loosening, fracture, and other situations occurred. Of the 2 patients with lumbosacral plexus injury before operation, 1 recovered completely and 1 had residual mild claudication. At last follow-up, the reduction of fracture was evaluated by Matta scoring standard, the results were excellent in 13 cases and good in 6 cases, with an excellent and good rate of 100%; the function was evaluated by Majeed scoring standard, the results were excellent in 15 cases and good in 4 cases, with an excellent and good rate of 100%. Conclusion: Minimally invasive pelvic stabilization by using anterior subcutaneous INFIX and posterior percutaneous iliosacral screw for treatment of unstable pelvic fractures, can achieve good fracture reduction and definitive stabilization with minimum complications and obtain excellent functional outcomes.

Objective: To review the research progress of the application of internal fixation (INFIX) in the treatment of pelvic anterior ring injuries. Methods: The recent literature about INFIX in the treatment of pelvic anterior ring injury concerning the surgery technique, biomechanical characteristics, indications, contraindications, advantages, complications, and effectiveness was extensively consulted, reviewed, and summarized. Results: INFIX is a relatively novel technique for the treatment of pelvic anterior ring injuries at present. The advantages include good biomechanical properties, extensive indications, minimally invasion, convenient nursing, less complications, and excellent effectiveness. Conclusion: It is a clinical method with obvious advantages and development potential for treatment of pelvic anterior ring injuries using INFIX, and further study is needed to improve its effectiveness.

Objective: To discuss the efficacy of skin stretcher applied for repair of postoperative skin and soft tissue defects in tibial fractures. Methods: Between April 2016 and March 2017, 15 cases with skin and soft tissue defects after tibial fractures fixation were treated with the skin stretcher. There were 11 males and 4 females with an age of 24-59 years (mean, 37.5 years). The causes of injury included traffic accident in 7 cases, bruise in 3 cases, falling from height in 3 cases, and falling in 2 cases; without nerve and vascular injury in all patients. These cases were followed up 1-3 months after their first surgery, consisting of 3 closed fractures treated with open reduction and plate and screw fixation, 12 open fractures treated with external fixation after debridement. The area of skin defects ranged from 14 cm×5 cm to 20 cm×7 cm, all of which were stripped or spindle shaped skin defects. First, the skin was penetrated by two Kirschner wires which were locked by skin stretchers on both sides of the skin defect longitudinally. Then, the tension of skin stretchers was timely adjusted according to the skin flap blood supply and muscle compression. Finally, Kirschner wires and skin stretchers were removed when the edge of skin contacted and been sutured. Results: All skin and soft tissue defects were covered after stretching for 6-13 days. The interrupted sutured wounds healed at 12 days. Clinical scores of wound healing decreased from 3.40±0.51 at immediate postoperatively to 1.27±0.46 at 12 days postoperatively, showing significant difference ( t=12.911, P=0.000). All the patients were followed up 4-12 months (mean, 6.5 months). After stretching, the skin color, elasticity, and pain and touch feeling were similar with the normal skin, and the hair growth was normal. After operation, 1 case of nail tract infection and 2 cases of calf discomfort occurred, and all were relieved after treatment. Conclusion: It is an effective method for repairing postoperative skin and soft tissue defects in tibial fractures with the application of skin stretchers.

Objective: To evaluate the effect of bone morphogenetic protein 7 (BMP-7)/poly (lactide-co-glycolide) (PLGA) microspheres on in vitro proliferation and chondrogenic differentiation of rabbit bone marrow mesenchymal stem cells (BMSCs).

Objective To characterize the urinary microbial profile of male non-muscle invasive bladder cancer patients compared to healthy controls.Methods Between March,2017 and September,2017,mid-stream urine from 26 non-muscle invasive bladder cancer and 18 non-neoplastic controls were collected by the clean method,then centrifuged and processed for 16S rRNA gene sequencing.Sequencing reads were processed for evaluating alpha diversity and beta diversity using QIIME.LEfSe algorithm was performed to identify potential bacterial genera biomarker.Results The smoking cases were more in tumor group than those in control group(21 vs.7,P ＜ 0.01).The urinary microenvironment of bladder cancer was characterized by increased bacterial richness (Observed species index,Chaol index and Ace index,125.77 ± 69.64 vs.80.38 ± 46.24;142.82 ± 76.74 vs.90.68 ± 47.62;and 147.92 ± 77.68 vs.88.19 ± 45.38,all P ＜ 0.05) and by the enrichment of some bacterial genera (e.g.,Acinetobacter and Anaerococcus).Significant difference in β diversity was found between cancer and non-cancer group (ANOSIM,P =O.009).A clear hierarchical clustering of cancer samples was observed,suggesting a common dysbiosis associated to bladder cancer.Conclusions Patients with non-muscle invasive bladder cancer exhibit a different microbial community compared to non-neoplastic controls,suggesting a possible pathophysiological correlation between microbiome and bladder cancer.Urinary microbial community may be associated with the prognosis of NMIBC.

Traditional Chinese medicine culture contains the essence of Chinese traditional culture and provides inspiration and inexhaustible power for the construction of the socialist core value system.Great medical sincerity,harmony between man and nature,reconcile to harmony,people-oriented idea and other philosophical thoughts and ethical moralities are the common value orientation and inner requirement between traditional Chinese medicine culture and socialist core value system and also the foundation and direction for the peripheral extension of their connotation.In a particular sense,traditional Chinese medicine culture and socialist core value have the intersection of internal attributes.Promoting the interaction and internal harmony between the two will have important reference significance for contemporary culture,social construction and the development of Chinese medicine itself.

OBJECTIVETo explore the feasibility of genetic algorithm (GA) on multiple objective blending technology for extractions of Cortex Fraxini.

METHODAccording to that the optimization objective was the combination of fingerprint similarity and the root-mean-square error of multiple key constituents, a new multiple objective optimization model of 10 batches extractions of Cortex Fraxini was built. The blending coefficient was obtained by genetic algorithm. The quality of 10 batches extractions of Cortex Fraxini that after blending was evaluated with the finger print similarity and root-mean-square error as indexes.

RESULTThe quality of 10 batches extractions of Cortex Fraxini that after blending was well improved. Comparing with the fingerprint of the control sample, the similarity was up, but the degree of variation is down. The relative deviation of the key constituents was less than 10%.

CONCLUSIONIt is proved that genetic algorithm works well on multiple objective blending technology for extractions of Cortex Fraxini. This method can be a reference to control the quality of extractions of Cortex Fraxini. Genetic algorithm in blending technology for extractions of Chinese medicines is advisable.

Algorithms ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; analysis ; Medicine, Chinese Traditional ; standards ; Plants, Medicinal ; chemistry ; genetics ; Quality Control

Objective To observe the expression levels change and it's clinical significance of TNF-α, SP-A in chil-dren with varying degrees of pneumonia. Methods A total 195 cases of pneumonia children patients were divided into ordinary pneumonia and severe pneumonia patients , another 65 cases of non-pneumonic children patients as the con-trol group, ELISA assay was used to detect serum TNF-α and SP-A level. Results The levels of serum SP-A and TNF-αof pneumonia children group were higher than the control group's , and severe pneumonia patients ’ were high-er than ordinary pneumonia. Conclusion The expression level of TNF-α and SP-A increased significant in the patho-genesis of children with severe pneumonia which could reflect the degree of lung injury and as a indicator in clinical testing.

Histiocytic necrotic lymphadenitis is known as Kikuchi-Fujimoto disease (KFD).KFD is a systemic disease,which is characterized by fever,necrotizing lymphadenopathy and leukopenia.However,involvement of the central and peripheral nervous system is rare.It can present as aseptic meningitis,encephalomyelitis,peripheral neuropathy,cerebellar ataxia and tremor,which makes it difficult to be differentiated with other nervous system diseases.Our review summarizes the clinical manifestations and differential diagnoses of KFD involving nervous system in order to reduce misdiagnoses and mistreatments.