Objective To evaluate the influence of laboratory critical value reporting on the efficacy of pediatric critical care.Methods A comparative analysis was conducted to evaluate the changes after the establishment of laboratory critical value reporting system.The parameters chosen for assessment included laboratory test turnaround time,medical intervention start time,survival rate,etc.Results Before the establishment of laboratory critical value reporting system,laboratory test turnaround time was (44.5±14.6)min,medical intervention start time was (40.7±5.3)min,and the success rate of the emergency treatment in ICU was (80.36±6.32)%[the rate in normal ward was(82.64±9.21)%].But after the establishment of laboratory critical value reporting system,laboratory test turnaround time,medical intervention start time,the success rate of the emergency treatment in ICU (normal ward) were (18.7±8.8)min,(23.9±6.7)min and (89.49±4.58)% [(90.04±6.45)%].Laboratory critical value reporting system shortened laboratory test turnaround time and medical intervention start time (P<0.05),and the successful rate of the emergency treatment improved evidently.Conclusion Laboratory critical value reporting system can improve successful rate of the emergency treatment significantly.

Objective To study the renal toxicity of arsenic trioxide (As2O3) with therapeutic dose in acute promyelocytic leukemia (APL) in childhood. Methods Renal toxicity of 37 APL was monitored. The examinations of urinary routine, urinary microproteins[αt1-microglobulin (α1-MG), microalbumin (mAlb),β2-microglobulin (β2-MG), transferrin(TRF)] and renal function were performed. Results Five cases with leukocyturia, three cases with hematuria, six cases with proteinuria were observed before therapy. Ketonuria occurred in six cases associated with fever and less diet; overall abnormality disappeared in the first week. No significant changes of blood uric nitrigen(BUN), serum creatinine(Cr) and uric acid (UA) were founded in induction remission. Compared with tests before As2O3 infusion, obvious increase of uric α1-MG occurred in second week with arsenic trioxide, obvious increase of uric β2-MG in third week (P ＜0.01), slow recovery of uric α1-MG and β2-MG in fifth week. No significant changes of uric mAlb and TRF were seen in induction remission. Conclusion The renal toxicity of As2O3 was gentle in general therapeutic dose, renal tubercular damage could be seen. The important monitoring period were the second to fifth week in induction remission.Influence of As2O3 cumulant on renal function was not serious in the near future in childhood. The combined detection of urinary microproteins with dynamic variety could detect early renal damage with As2O3.

Objective To study the methods and clinical effects of joint expansion of double fascia flaps wrapping the Medpor to perform full-ear reconstruction on congenital microtia deformity.Methods 60 patients with congenital microtia deformity were selected.including 22 left ears and 38 right ears.Majority had loss of ear auricle or only partial earlobe.Phase Ⅰ procedures included:temporal-parietal branch was used for the vascular pedicle,and mastoid area behind the ear was moved and expanded for fascia flap.Phase Ⅱ included:the joint expansion of double fascia flap wrapped Medpor to do full-ear reconstruction.Results Flaps survived and no complications for all 60 patients.Reconstructed ears had lifelike appearance and clear anatomical structures.Auriculocephalic angulars positions and sizes were consistent with the healthy ears.None of them had exposed prosthesis and scar contraction.Three-dimensional shapes were good.Conclusions Joint expansion of double fascia flap wrapping Medpor could avoid the chest wall deformity and exposed prosthesis.The fine structure of the reconstructed ear is satisfactory.