Objective To survey on the condition of critically ill children in emergency room (ER) for improving the care for them.Methods Data of 374 critically ill children in emergency intensive care unit (EICU) were recorded in the respects of mode of sending them to ER,rescue during transport,length of stay in ER,blood gas,electrolytes,accuracy of assessing pediatric critical illness score/neonate critical illness score (PCIS/NCIS) and Glasgow Coma Scale (GCS),correctness of determining SIRS,sepsis and septic shock.Results Of 374 patients,neonates were 29.9％,and the mean age of children patients not including neonate was 37.4 months.The mean length of ER stay was 4.7 hours (0.42-96 hours).Of 374 patients,those with infection diseases were 47.6％,and the main vehicles for transportation of patient sent to ER were Taxi (38.3％),ambulance (28.4％) and private cars (21.5％).Total fatality was 12.3％ and ER fatality ( 15.6％ ) was higher than in - hospital fatality ( 10.3％,P ＜0.01 ).The mean PCIS/NCIS of 374 patients were 81.92 ± 9.66,and the PCIS/NCIS ≤ 90 accounted for 81％.Of assessed GCSs of 172 patients,GCS≤8,GCS 9-12 and GCS 13-15 accounted for 35.5％,21.5％ and 43.0％ respectively,and fatalities were 26.23％,10.81％ and 5.41％ correspondingly (P ＜0.01 ).The PCIS values of GCS≤8 and GCS 9-12 patients were lower than those of GCS 13-15 patients (P ＜ 0.01 ).There was no significant difference in PCIS between GCS≤8 and GCS 9-12 ( P ＞ 0.05 ).PCIS and GCS were positively correlated (r=0.454,P=0.01).Of374 patients,41.7％ had SIRS,and 25.7％ had sepsis.Of 262 children not including neonates,43.5％ had shock,and 61.4％ of these shock children were septic shock.In 374 patients,those with hyponatremia accounted for 37.2％,and those with hyperkaliemia accounted for 22.0％.The rate of hypoglycemia found in neonates was 20.91％ and rate of hyperglycemia occurred in neonates was 29.1％.The rate of hypoglycemia found in children patients was 9％ and hyperglycemia was 66.7％.Patients with pH ＜ 7.35 accounted for 67.8％ and those with pH ＜ 7.2 were 33.1％.Conclusions The majority of children patients in pediatric ER were neonates and infants.The length of ER stay was short with mean value of 4.7 hours (0.42-96 hours).ER fatality was higher than in - hospital fatality,suggesting the critically ill children patients should be admitted as early as possible.The rate of using ambulance was only 28.4％.The Emergency Medical Service (EMS) should be improved to enhance the public sense of the EMS available.PCIS/NCIS can be used in ER for assessing the conditions and prognosis of critically ill children.GCS ≤8 and GCS 8-12 patients accounted for 57％ with majority of nontrauma brain injury.The values of PCIS in GCS≤8 and GCS 9-12 patients were much lower than those in GCS 13-15 patients.Patients with GCS ＜ 13 might be in critical settings.Majority of shock patients were septic shock (61.4％).Hyponatremia,hyperkalemia,hyperglycemia and hypoglycemia often occurred in critically ill pediatric patients and hypoglycemia not excepted in the neonates should have attention paid to.The main factor of acid -base balance disorder in critically ill children was acidosis (67.8％).

Objective To compare biological properties of ehitosan composite artificial neural type Ⅰ collagen scaffold material cross-linked with ultraviolet rays (UV), genipin (GP) and glutaraldehyde (GTA) in aspects of uhrastrueture, porosity, swelling rate, degradation rate, crosslinking degree and cytotoxicity. Methods (1) According to different cross-linking methods, biomaterials were divided into three groups, ie, UV group, GP group and GTA group. (2)The mierostrueture of three groups was observed under scanning electron microscope (SEM) to measure pore size, porosity rate and pore-size distribution. (3)Swelling rate and in vitro degradation rate:the biomaterials were weighed (W_0) after crosslinking and then immersed in culture medium containing 10 ml aseptic phosphate buffer solution (PBS). The samples were drawn from the culture medium after 24 hours, wiped with filter paper to remove excess liquid and weighed (W_1). Swelling rate(%) = W_1-W_0/W_0×100%. The remaining sampies from each group were weighed (W_2) at 4, 8, 12 weeks with the same procedure. Degradation rate (%) = W_1-W_2/W_1×100%. (4)Determination of cross-linking index: 10 samples were prepared from each group, five samples from which were reacted with trinitro-benzen-sulfonic acid(TNBS)and sodium bicarbonate and then were hydrolyzed with hydrochloric acid. The absorbance of the diluted solution was measured at 346 nm. The other five samples were prepared by the same procedure, except for hydrochloric acid was added before addition of TNBS, when the absorbance was measured as control (A_(control)). The absorbance after crosslinking:A_(after)=ATNBS-A_(control). Another 10 samples without any crosslinking were detected with the same procedure to measure the absorbance before crosslinking (A_(before)). Crosslinkiag index = (A_(before)-A_(after))/A_(before)×100%. (5) Determination of cytotoxicity : two international standard experimental methods were adopted in the study according to experimental principle of GB/T 16886-ISO 10993 on medical apparatus. L929 fibroblasts of mouse were used for in vitro experimental study of cytotoxicity of modified scaffold. Results The biomaterials without any cross-linking were circular cylinder, with parallel arranged microscopic channel and uniform pore size of 30-120 μm. The pore size of UV group remained basically unchanged, while the pore size in GP group and GTA group was smaller than that in UV group. (2) The porosity rate in GP group and GTA group was higher than that in UV group, but there was no statistical difference between GP group and GTA group. The swelling rate of GP group was higher than that GTA group, which was higher than UV group. (3)The crosslinking index of GP group and GTA group were 55.3% and 82.5%. (4) No statistical difference was found in regard of in vitro degradation rate after GP group and GTA group were put in PBS for4, 8 and 12 weeks, respectively. But in vitro degradation rate in UV group was significantly higher than that in GP group and GTA group. (5) Cell culture in GTA group presented partial necrosis, while cells cultured in GP group and UV group grew well. Conclusion Collagen/chitosan scaffolds cross-linked with GP have sound biostability and good biocompatibility and hence are potential alternatives for nerve tissue engineering.

This study was aimed to analyze the plasma metabolicomics pathway in rats with heart blood stasis syn-drome. KEGG database was used in the signal pathway analysis. HMDB was used in the analysis of molecular metabolite annotation, enzyme or transporter associated and its related properties. The metPA network software was used in the visualization of metabolite path. The results showed that 9 metabolites involved in 15 metabolic pathways. Among them, the P-value of metabolic pathway of pantothenate and CoA biosynthesis, propanoate metabolism, biosynthesis of unsaturated fatty acids was less than 0.05. It was concluded that the metabolic pathways of pan-tothenate and CoA biosynthesis, propanoate metabolism, biosynthesis of unsaturated fatty acids were involved with the pathological process of rats with heart blood stasis syndrome.