OBJECTIVE To report the investigation on validating clinical moist sterilizer by applying wireless thermo-loggers in accordance with the advanced Euro and British standards.METHODS The validation had been implemented with microbiological tests and thermometric tests to measure the temperature distribution of the chamber of sterilizer,the temperature and time relation inside the tested package of small and challenge loads,the pressure of the chamber and the temperature beside the drainage.RESULTS The measurements presented the relation between temperature and time measurements of the spots inside the chamber of the tested sterilization loads.CONCLUSIONS The measurement results indicate directly the operation condition and the temperature-time relation inside sterilization loads.These measurements are helpful for controlling sterilization quality.The results of microbiological tests are negative,which are consistent with that of thermomeric tests.

Objective To investigate the change of plasma vitamin D, A and E levels in infant with infantile hepatitis syndrome (IHS) and to provide reliable basis for clinical treatment. Methods Seventy-three infant with IHS (IHS group) from January 2015 to May 2016 and 82 cases of physical examination infant (control group) were enrolled in this study.The levels of plasma vitamin D, A and E were tested and compared between two groups. Results The levels of vitamin D, A and E in IHS group were significantly lower than those in control group:(37.871 ± 20.111) nmol/L vs. (97.708 ± 28.827) nmol/L, (1.082 ± 0.657)μmol/L vs. (1.810 ± 0.517)μmol/L, (21.252 ± 7.596)μmol/L vs. (26.647 ± 6.495)μmol/L, P<0.01 or <0.05. The nutritional status of vitamin D, A and E in two groups had significant differences (P<0.01). Conclusions There have obvious deficiency in fat-soluble vitamin D, A and E in infant with HIS , and vitamin D deficiency is the most obvious. The levels of vitamin D, A and E are the dynamic monitoring indicators of treatment, nutritional status evaluation and long-term complications development.

Objective To analyze the risk factors for the failure of noninvasive mechanical ventilation (NIV) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD),and to help the clinical risk assessment and decision making.Methods A retrospective case control study was conducted.The patients with AECOPD undergoing NIV admitted to Kaifeng Emergency Center from June 2011 to March 2016 were enrolled,and they were divided into two groups according to whether NIV was successful or not within 12 hours.The nutritional status,blood gas analysis,serum electrolytes,D-dimer,renal function,serum pre-albumin,as well as kinetic vital signs,Glasgow coma scale (GCS) score,expression of respiratory distress,and spontaneous expectoration were recorded.Logistic forward stepwise regression analysis was used to analyze the factors for failure of NIV.Results 122 patients.with the initial NIV were enrolled,with NIV failure in 41 patients within 12 hours,accounted for 33.6％.Compared with NIV success group,the percents of respiratory rate ≥ 25 breaths/min (75.6％ vs.17.3％),expectoration disorders (78.0％ vs.19.8％),circulatory disorders (61.0％ vs.18.5％),malnutrition (61.0％ vs.11.1％),decreased serum pre-albumin (58.5％ vs.17.3％),and GCS score ＜ 12 (75.6％ vs.28.4％) in NIV failure group were significantly increased (all P ＜ 0.05).But there were no significant differences in gender,age,body temperature,blood gas analysis,D-dimer,serum creatinine between two groups.It was shown by the results of binary logistic regression analysis that respiratory rate,expectoration disorders,circulatory disorders,malnutrition,serum pre-albumin,and GCS score were the factors of NIV failure [odds ratio (OR) values were 10.879,6.338,9.860,23.273,8.862,6.774,and P values were 0.011,0.038,0.024,0.003,0.015,0.041,respectively].It was shown by the results of logistic stepwise regression analysis that respiratory rate ≥ 25 breaths/min,expectoration disorders,circulatory disorders,malnutrition,decreased serum pre-albumin,and GCS score ＜ 12 were independent risk factors of NIV failure (OR values were 6.610,5.403,5.138,8.153,4.979,5.100,and P values were 0.007,0.013,0.023,0.007,0.027,0.023,respectively).Conclusions The multiple independent risk factors can induce NIV failure within 12 hours in emergency patients with AECOPD,i.e.increased respiratory rate,expectoration dysfunction,circulatory disorders,malnutrition,decreased serum pre-albumin,and decreased GCS score.Emergency physicians should pay attention to these early risk factors in AECOPD patients,which can be taken as correct judgment and guide.

Objective To investigate the prevalence and trend of Helicobacter pylori (HP) infection in children with gastrointestinal symptoms in Kunming area, and to provide basis for prevention and cure. Methods All of 12 932 cases with gastrointestinal symptoms were adopted by retrospective analysis method from January 2013 to December 2016, and HP infection was detected by 13C-urea breath test (13C-UBT). The epidemioloqical characteristics of children with HP infection in including prevalence trend and gender and age HP were statistically analyzed. Results The rates of HP from January 2013 to December 2016 were respectively 17.85%, 18.26%, 20.41% and 32.93%.The rate of HP positive was 24.08%(3 114/12 932), which was 24.82%(1 706/6 874) in boys and 23.24%(1 408/6 058) in girls. The rate of HP infection was significantly higher in boys than that in girls, and there was statistical differences (P＜0.05). The rate of HP infection showed a gradual upward trend with age. There was statistical differences in gender between age 11 and 14[(29.03% (349/1 202) vs. 22.62% (190/840)] (P＜0.05). Conclusions HP infection rate is high in the children with gastrointestinal symptoms in Kunming, and the rate of HP infection in children is related with gender .The rate of HP infection is significantly higher in boys than that in girls, and the positive rate is directly proportional.

Objective:To explore the clinical characteristics and etiology of children with alimentary tract hemorrhage so as to optimize the diagnosis and treatment.Methods:The clinical data of 2 054 children with alimentary tract hemorrhage in Kunming Children′s Hospital from January 2014 to December 2018 were retrospectively analyzed.Results:Among 2 054 children with alimentary tract hemorrhage, males was in 1 274 cases, females was in 780 cases, and the ratio of males to females was 1.6∶1; <3.0 years old was in 647 cases (31.5%), 3.0 to 5.9 years old was in 488 cases (23.8%), 6.0 to 8.9 years old was in 413 cases (20.1%), 9.0 to 11.9 years old was in 281 cases (13.7%), and ≥12 years old was in 225 cases (11.0%); upper alimentary tract hemorrhage was in 991 cases, lower alimentary tract hemorrhage was in 1063 cases. The top three causes of children with upper alimentary tract hemorrhage were acute or chronic gastritis/ gastric ulcer, anaphylactoid purpura and systemic serious infection; the top three causes of children with lower alimentary tract hemorrhage were intestinal polyps, anaphylactoid purpura and food protein allergic colitis. A rare causes of alimentary tract hemorrhage had Peutz-Jeghers syndrome, cavernous transformation of portal vein, Bartter syndrome, systemic lupus erythematosus, Budd-Chiari syndrome, annular pancreas, Reye syndrome, Klippel-Trenaunay syndrome, Evans syndrome and perianal angiectasia and so on.Conclusions:Alimentary tract hemorrhage is a common disease in pediatrics. With the increase of age, the proportion of children with alimentary tract hemorrhage decreased. The main causes of upper and lower alimentary tract hemorrhage are different in different age stages. In addition to paying attention to common causes, the rare causes of alimentary tract hemorrhage should be vigilant and recognized.

OBJECTIVETo compare the differences of postoperative patient-controlled intravenous analgesia for laparoscopic cholecystectomy and gynecological laparoscopy in female patients.

METHODSThis retrospective study included 645 female patients received laparoscopic cholecystectomy or gynecological laparoscopy (laparoscopic oophorocystectomy/myomectomy) between January 2011 and July 2012 in Tongji Hospital. Among them, 207 cases of sufentanil-tramadol patient-controlled intravenous analgesia (PCIA) were enrolled and divided into 2 groups:77 cases in laparoscopic cholecystectomy group, and 130 cases in gynecological laparoscopy group. The pressing frequency and consumption of PCIA, localization and quality of postoperative pain, visual analogue scale (VAS) at 4-6 h, 8-12 h, 18-24 h after surgery, and adverse effect were compared by t-test,χ(2) test, Fisher exact test or Mann-Whitney test.

RESULTSThere was no statistical difference of age, body mass index, and operation time between the two groups (all P > 0.05). As compared with the gynecological laparoscopy group (3 (4)), PCIA pressing frequency was higher in the laparoscopic cholecystectomy group (5 (7)), but there was no statistical difference (Z = -1.747, P = 0.081). PCIA consumption in the laparoscopic cholecystectomy group (79 (33) ml) was higher than that in the gynecological laparoscopy group (48 (30) ml) (Z = -6.267, P = 0.000). The postoperative pain localization and quality were different in the two groups, the patients in the laparoscopic cholecystectomy group experienced dull pain in lower abdomen, but the ones in the gynecological laparoscopy group had distending pain in upper abdomen and piercing pain around scapula. The differences of 4-6 h, 8-12 h, 18-24 h VAS scores in the two groups had no statistical significance (all P > 0.05). The total incidence of postoperative adverse effect between the two groups had no statistical significant difference (laparoscopic cholecystectomy group:11.7%, gynecological laparoscopy group:16.2%) (χ(2) = 0.778, P = 0.378). The incidence of dizziness was higher in the gynecological laparoscopy group (6.2%) than that in the laparoscopic cholecystectomy group (0) (Fisher exact test:P < 0.05).

CONCLUSIONIn the case of sufentanil-tramadol PCIA, laparoscopic cholecystectomy needs more postoperative analgesia, while gynecological laparoscopy has higher incidence of dizziness.

Analgesia, Patient-Controlled ; Cholecystectomy, Laparoscopic ; Female ; Gynecologic Surgical Procedures ; Humans ; Laparoscopy ; Pain Measurement ; Pain, Postoperative ; Retrospective Studies ; Sufentanil ; Tramadol