Objective Demonstrate the implication of Emergency Severity Index (ESI) in pediatric emergency room (ER). Method ESI categories of 21 904 visitors to ER of Beijing Children's Hospital's international department were reviewed. SPSS statistic software was employed to compare the results of ESI categories by doctors and nurses separately using x2 analysis. Results There are highly consistency in ESI categories by doctors and nurses. ESI is an easy-learned and effective triage method. Conclusions ESI is capable in pediatric emergency room regarding recognizing serious cases and saving clinical resources.

Objective To study the changes of nitric oxide synthase in placenta during fetal cardiac bypass. Methods Eight pregnant ewes (gestation 120～140 d)were divided equally into control group and bypass group. Bypass group underwent fetal cardiac bypass with centrifugal pump and placenta. Fetal hemodynamic date and blood gas value were recorded before and after bypass. Placenta vascular resistance was calculated. Fetal serum nitric oxide (NO), serum endothlin-1(ET-1) and nitric oxide synthase (NOS) of placenta tissue were assayed. Transcriptions of endothelial NOSmRNA in placental tissue were assayed with RT-PCR technique. Results Acidosis and pressure of oxygen decreased after bypass appeared in fetal lamb of bypass group. Placenta vascular resistance of bypass group elevated significantly (P

Objective To investigate the effects of Tong Xin-Luo on cultured human umbilical vein endothelial cells (HUVECs) impaired by Lysophosphatidylcholine.Methods The herbage-contained serum of TXL was prepared,HUVECs were cultured in vitro.The study was designated to 4 group:normal control,LPC group,TXL group,and TXL + LPC intervened group.The cell function was determined by cell morphology and MTT colorimetric assay.Results Compaired with normal control group (0.380 ±0.023 ),LPC ( 0.320 ± 0.024 ) could significantly decrease the cells activity,promote cells death ( P ＜0.05 ).After TXL intervened(0.424 ±0.034),cells activity was significantly increased,cells death was d significantly decreased( P ＜0.05 ).Conclusions Tong Xin-Luo could protect human umbilical vein endothelial cells function by against the LPC-induced damage.

Objective Studies on the changes of ? EP, 5-HT, 5-HTR immunoreactive cells in pancreatic islets during experimental gastric ulcer. Methods The immunohistochemical technique was used. Results The numerical densities on area of ? EP, 5-HT, 5-HTR cells in experimental gastric ulcer group were higher than control group on the 4day,10day after operation.The peak of the numerical densities on area of ? EP and 5-HT cells appeared on the 4th day, while the peak of 5-HTR cells as on the 10th day. Part of ? EP, 5-HT,5-HTR immunoreactive material were located in A or B cells neighbourly section. Conclusion The present work proved that the ? EP, 5-HT,5-HTR cells of pancreatic islets were directly or indirectly participated in the regulation balance of endocrine during the self-healing process of the experimental gastric ulcer and here we provided morphological evidence.;

Objective To evaluate quantitative examination of urinary sediment bacteria as a basic feasibility of screening indicators for urinary tract infection .Methods 191 outpatients and inpatient specimens were gathered firstly to implement a urine culture ,and then the rest of the urine were used for sediment bacteria quantitative testing .Meanwhile ,bacterial culture was conducted as the standard .According to the results of bacterial culture ,receiver operating characteristic(ROC) was drawn ,the threshold values of leukocyte and bacteria counts for diagnosis of urinary tract infection were found out and its sensitivity ,specificity ,positive / negative predictive value ,false positive/false negative rate and accuracy were calculated .Results The positive rate of urine culture was 39 .7% ,and the most common pathogen was Escherichia coli .The threshold value of bacteria and leukocyte counts for diagnosis of urinary tract infection was 1 024 .5/μL and 135 .8/μL respectively .When combined leukocyte and bacteria counts for urinary tract infection ,the optimum sensitivity was 62 .5% ,specificity was 98 .1% ,positive predictive value was 95 .7% ,negative predictive value was 79 .6% ,false positive rate was 1 .9% ,false negative rate was 37 .5% ,and accuracy was 83 .8% .Conclusion With UF‐1000i urinary sediment analyzer ,the combined determination of leukocyte and bacteria counts can remove the great mass of negative results ,Especially the results of bacterial culture positive predictability is higher ,but still can not replace of quantitative bacterial culture .

Objective Studies on the changes of gastrin and SS immunoreactive cells in pancreatic islets during experimental gastric ulcer. Methods The immunohistochemical ABC technique was used. Results The gastrin immunoreactive cells were located in most of the pancreatic islet. The mumber of G cells in experimental gastric ulcer group were higher than that of control group on the 4th and 10th day after operation.The D cells raised on the 10th day.Conclusion The present work provides the evidence that the G and D cells of pancreatic islets might be involed in the self-healing process of the experimental gastric ulcer by endocrine or paracrine regulation.

Objective:To investigate the clinical application of noninvasive high frequency oscillatory ventilation(nHFOV)and heated humidified high flow nasal cannula(HHHFNC)in sequential ventilator evacuation of preterm infants with very low birth weight with respiratory distress syndrome(RDS).Methods:A total of 88 preterm infants of very low birth weight with RDS were enrolled in the study, who had received endotracheal intubation invasive ventilation and were ready to be replaced by non-invasive ventilation at neonatal intensive care unit(NICU)of Xuzhou Central Hospital from May 2017 to January 2020.All premature infants were routinely treated with caffeine citrate.They were divided into two groups through random number table: nHFOV/HHHFNC group(45 cases)and continuous positive airway pressure(nCPAP)/oxygen hood group(43 cases). nHFOV was given after invasive ventilator removal and HHHFNC transition was followed after nHFOV withdrawal in the nHFOV/HHHFNC group, while nCPAP was given after invasive ventilator removal and oxygen hood was followed after nCPAP withdrawal in the nCPAP/oxygen hood group.The main observation consequences were compared with arterial blood gas indexes after invasive ventilator evacuation, weaning effect and the incidence of related complications.Results:(1)There were no statistically differences between the two groups in terms of gender, gestational age, birth weight, Apgar score at 1 min and 5 min after birth, the number of glucocorticoid usage in 24 h before delivery, the number of pulmonary surfactant usage, invasive ventilation time and RDS grading( P>0.05). (2)The PaO 2, PaCO 2and oxygenation index(OI=100×MAP×FiO 2/PaO 2)of the nHFOV/HHHFNC group at 1 h and 24 h after invasive ventilator removal showed significant difference compared with the nCPAP/oxygen hood group( P<0.05). The differences as the following listed were statistically significant( P<0.05)between the two groups, including the failure rate of invasive ventilation weaning during 72 h [9%(4/45)vs.26%(11/43)], the incidence of frequent apnea [7%(3/45)vs.23%(10/43)], the failure rate of nHFOV and nCPAP noninvasive ventilation weaning [4%(2/45)vs.21%(9/43)], the oxygen-used time [12.02(9.08~12.31)d vs.14.44(11.32~13.26)d] and the incidence of nasal injury [4%(2/45)vs.26%(11/43)]. (3)The time of the first noninvasive ventilation of nHFOV and nCPAP, the incidences of lung air leakage, neonatal necrotizing enterocolitis, grade Ⅲ to Ⅳ intraventricular hemorrhage, above stageⅡretinopathy, bronchopulmonary dysplasia and the mortality rate between the two groups showed no statistical significance( P>0.05). Conclusion:nHFOV and HHHFNC used in the sequential ventilator evacuation of RDS in preterm infants with very low birth weight could improve oxygenation, reduce CO 2retention, improve the success rate of machine weaning and reduce the occurrence of apnea and nasal injury.

Objective To investigate the effect of 17-β-estradiol (17-β-E2) on the expression of glucose transporter 4 (GLUT4) in rat primary culture skeletal muscle cells with insulin resistance (IR) induced by palmitinic acid (PA).Methods Rat skeletal muscle was primarily cultivated.The cells were identified by the technology of immunofluorescence.Cells were inclubated with 0.6 mmol/L palmitinic acid for 24 h to induce IR.The concentration of glucose in the medium was measured.The mRNA and protein expressions of protein kinase B (PKB/Akt) and GLUT4 were measured by real time polymerase chain reaction (PCR) and Western blot respectively.Results Compared the control with PA treated rats,the concentration of glucose in the medium was increased [(3.86±0.64)mmol/L vs.(5.43±0.55) mmol/L,q＝4.13,P＜0.05],uptake of glucose stimulated by insulin was decreased (P＜0.01),the expressions of GLUT4 and phosphorylation PKB/Akt were reduced in the PA group (all P＜0.05).In the 17-β-E2 (100 nmol/L) versus control,the concentration of glucose in the medium was higher [(3.86±0.64) vs.(3.77±0.35)mmol/L,q＝ 4.76,P＜0.05],uptake of glucose stimulated by insulin was increased (P＜0.01) and the expressions of GLUT4 and p-Akt were also increased (all P＜0.05).17-β-E2 (10 nmol/L and 100 nmol/L) reversed the decrease of basal and insulin-stimulated uptake of glucose induced by PA,reversed the decrease of GLUT4 and p-Akt expression induced by PA compared with the PA group (all P＜ 0.05).Conclusions 17-β-E2 inhibits insulin resistance induced by PA in rat primary culture skeletal muscle cells,the mechanism may be correlated with the up-regulation of expression of phospho-Akt and GLUT 4 induced by 17-β-E2.

Objective To study the effectiveness and safety of different endoscopic papillary balloon dilation time in treatment of common bile duct stones. Methods 45 patients with common bile duct stones received ERCP treat﹣ment, and they were randomly divided into short-term and long-term balloon dilatation group, then compared opera﹣tive time, intraoperative and postoperative complication rate, hospitalization days and the total cost of hospitalization between the two groups. Results Short-term group included 22 people, the long term group included 23 people, there were no significant difference in stones' size, number and diameter of common bile duct between the two groups (P> 0.05), however, the success rate of surgery, time of stones' extraction, intraoperative complications and postoperative fistula were significant differences (P<0.05). Conclusion Long-term balloon dilation during ERCP for treatment of common bile duct stones can improve the success rate of stone removal and reduce complications.

Objective To explore the effect of sitting and lateral sputum aspiration on the retention time of tracheal cannula in patients with neurosurgical tracheotomy. Methods Totally 120 cases of neurosurgery tracheotomy in hospitalized patients complicated with pulmonary infection by random number table method, 58 cases were divided into experimental group and control group 62 examples, two groups of patients with sputum top all joint taps to the back of the chest, the experimental group after taps take seat effectively causes cough; In the control group, the lateral position was used to effectively cough or induce cough, and the daily sputum volume of the two groups of patients was observed. To observe the time when the body temperature was restored to normal after the phlegm of the two groups of patients, the time of the lung auscultation, and the time of the tracheal tube retention. Results Implementing position row of phlegm daily sputum volume within a week the experimental group were (44.84±6.85) ml, (44.60±6.80) ml, (43.79±5.98) ml, (44.38±5.42) ml, (42.22±5.45) ml, (38.12±4.77) ml, (36.88±4.57) ml and control group were(36.13±7.34) ml, (35.15±7.34) ml, (36.13±7.34) ml, (37.13±7.34) ml, (37.13±7.34) ml, (32.97±7.17) ml, (31.35±4.36) ml, the difference had statistical significance (t=4.30-7.31, P<0.01);In the two groups, the time of normal body temperature recovery, the time of hearing and the time of the lung and the time spent in the tracheal tube were compared, and the experimental group were respectively (9.93±2.02) d, (32.33±1.50) d, (37.33±1.50) d, while control group were(15.77±1.05) d, (37.63 ± 2.33) d, (42.63 ± 2.33) d, the difference had statistical significance (t=20.04, 14.71, P<0.01). Conclusions It is better to reduce the retention time of tracheal tube in patients with neurosurgical patients than the lateral position.