Patent ductus venous is a kind of the congenital portosystemic shunts (CPSS). In recent years, the related case report increased gradually, but the domestic research is rare. In this article, we review the current diagnosis and treatment of neonatal patent ductus venous based on literature available.

Objective Random allocation concealment is important in ensuring high-guality randomized controlled clinical trial.In this paper , we aimed to design a more convenient and effective two couplet random allocation method through improving the random allocation concealment technology which uses the envelope method . Methods According to the randomized sequence , a two-couplet random allocation should be prepared for every subject and bound into a book in order , which named random assignment book with cover and instructions .The first couplet is to collect the enroll information and the second couplet is to show the allocation informa -tion.The serial numbers of the two couplets which around sealant are the same , and leave blank at the same areas of the two couplets for signing the enter information .The content of the first couplet can be completely copied to the second couplet .In order to avoid expo-sing the allocation information in advance , the back of the second couplet should be black-printed. When the subjects are sure qualified, the researchers selected the corresponding two couplet in a sequential order .Exposing the allocation infromation in the second couplet, and the subjects will be allocated to the group designated on the second couplet .This random allocation book should be entrusted to professional printing mechanism ,printing according to the random assignment sequence table and in the strict quality control .For the multicenter clinical trials , it can be printed in parts . Results The method has been implemented in nearly ten randomized controlled trials and obtained the consistent high praise . Conclusion The random allocation book method is easy to produce , simple operation and convenient in monitoring , which can effectively achieve the random allocation concealment in a clinical trial as well as having a sig -nificantly practical value in ensuring the quality of randomization .

OBJECTIVE:To establish a method for simultaneous determination of rutin,quercetin and nuciferine in Heye gran-ule. METHODS:HPLC was performed on the column of Hypersil ODS2 with mobile phase of acetonitrile-water(containing 0.3%phosphoric acid and 0.4% triethylamine)(gradient elution)at a flow rate of 1.0 ml/min,the detection wavelength was 256 nm,the column temperature was 25 ℃,and the injection volume was 10 μl. RESULTS:The linear range was 0.012-0.240 μg for rutin(r=0.999 9),0.010 4-0.208 μg for quercetin(r=0.999 9)and 0.015-0.300 μg for nuciferine(r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 2.0%;recoveries were 98.5%-101.3%(RSD=1.1%,n=6),99.1%-101.6%(RSD=1.0%, n=6)and 98.9%-101.7%(RSD=1.2%,n=6). CONCLUSIONS:The method is simple,accurate and reliable,and can provide ref-erence for quality control of Heye granule.

In recent years, the number of ICU survivor is ever-growing with the increase of cure rate. The survivors′ outcome has aroused more and more attentions from medical personnel. ICU survivors tend to experience lasting physical, psychological and cognitive injuries, the post-traumatic stress disorder is one kind of significant psychological injury associated with patients′ critical experience. This review aims to summarize relevant literatures, introduces the prevalence, risk factors, complications, and interventions of ICU survivors′ post-traumatic stress disorder symptom, in order to prevent ICU survivors from post-ICU psychological injury and improve their long-term outcome.

Objective To explore the clinical value of two-dimensional speckle tracking imaging (2DE-STI) by measuring global longitudinal strain (GLS) in normal children.Methods Totally 176 normal children underwent cardiac ultrasound examination,the left ventricular GLS were measured,and the difference of GLS between gender was analyzed.And the changes of GLS with body surface area (BSA) and age were discussed.Results GLS had no significant difference between male and female ([-24.90 ± 2.06]％ vs [-24.93 ± 2.01]％,t =0.83,P =0.934).GLS had significant differences among different BSA groups (F=3.84,P =0.003),and the differences of GLS in BSA＞ 1.0 group and the other five groups were statistically significant (all P＜0.05).GLS had statistically significant differences among different age groups (F=4.81,P=0.001),and the differences of GLS in ＞9 years old group and the other four groups were statistically significant (all P＜0.05).Conclusion Left ventricular GLS presents certain regularity with children's growth.

Objective To evaluate the effect of recombinant human annexin A5 on the expression of phosphorylated protein kinase C alpha (p-PKCα) and p120-catenin during endotoxin-induced damage to cardiomyocytes.Methods H9c2 cells cultured in vitro were randomly divided into 3 groups (n=18 each) using a random number table:control group (group C),endotoxin group (group L),and recombinant human annexin A5 group (group A).Recombinant human annexin A5 (final concentration 5 ng/ml) was added,and the cells were incubated for 2 h in group A,and then lipopolysaccharide (final concentration 1 μg/ml) was added,and the cells were incubated for 4 h in L and A groups.At 4 h of incubation,cell apoptosis was detected using the cell apoptosis detection kit,the intercellular space was measured using the confocal microscopy,and the expression of p-PKCα and p120-catenin was determined by Western blot.The apoptosis rate was calculated.Results Compared with group C,the apoptosis rate was significantly increased,the intercellular space was significantly widened,the expression of p120-catenin was significantly down-regulated,and the expression of p-PKCα was significantly up-regulated in group L (P＜0.05).Compared with group L,the apoptosis rate and intercellular space were significantly decreased,the expression of p120-catenin was significantly up-regulated,and the expression of p-PKCα was significantly down-regulated in group A (P＜0.05).Conclusion Recombinant human annexin A5 can inhibit phosphorylation of PKCα and up-regulate the expression of p120-catenin,thus attenuating endotoxin-induced damage to cardiomyocytes.

The lung ultrasound develops rapidly in recent years. We investigated the ultrasonic diag-nostic value of neonatal infectious pneumonia on the basis of our experience in diagnosing adults′ and chil-dren′s infectious pneumonia. The result confirms the reliability and effectiveness of lung ultrasound in diagno-sing neonatal infectious pneumonia. We believe that the diagnostic performance of lung ultrasound will be im-proved a lot with the popularization of lung ultrasound, in combination with the supervision of patients′con-ditions as well as routine clinical diagnosis and treatment procedures.

Objective:To explore the feasibility of artificial intelligence ultrasound to diagnose of biliary atresia (BA) based on deep learning.Methods:A total of 531 gallbladder ultrasound images in 177 cases of BA patients (BA group) and 585 gallbladder ultrasound images in 195 cases of Non-BA patients (Non-BA group) were collected in Hunan Children′s Hospital from September 2018 to October 2020. For the BA and Non-BA groups, all images were divided into training set and test set according to the ratio of 2∶1. The Mask R-CNN model was trained by training samples, and then the model was tested, according to patient and image as a unit respectively, to evaluate the gallbladder organ detection rate and the diagnostic accuracy of BA. In addition, the images of the test set were randomly numbered.Four sonographers were invited to interpret the images to calculate the diagnostic accuracy individually. Last, the diagnostic accuracy of the Mask R-CNN model was compared with that of sonographers.Results:In terms of the automatic detection of gallbladder organs, the detection rate in both BA and Non-BA group reached 100%, but there were 17 false alarms in 372 test images, with a false alarm rate of 4.57%. In terms of the diagnostic rate of gallbladders, when taking patient as a unit, the total diagnostic accuracy of the model in the test set was 95.97%, which was higher than that of the sonographers in other hospitals and the sonographer with intermediate professional title in our hospital, and the difference was statistically significant ( P<0.005). It was slightly higher than that of sonographer with senior professional title in our hospital (91.94%), but the difference was not statistically significant ( P=0.183). When taking picture as a unit, the total diagnostic accuracy of the model was 97.04%, which was higher than that of the sonographers in other hospitals and the sonographer with intermediate professional title in our hospital, and the difference was statistically significant ( P<0.001). It was slightly higher than that of sonographer with senior professional title in our hospital (94.09%), but the difference was not statistically significant ( P=0.05). Conclusions:The artificial intelligence technology based on Mask R-CNN can automatically and accurately detect gallbladder organs and diagnose BA, which is worthy of further study.

Objective: To explore the application value of pulmonary ultrasound for the treatment of severe acute respiratory distress syndrome in children with extracorporeal membrane oxygenation(ECMO). Methods: Seven children with severe acute respiratory distress syndrome (ARDS) who were treated with ECMO in the PICU ward of Hunan Children Hospital from August 2018 to March 2019 underwent pulmonary ultrasound before treated with ECMO, after each bronchoscopy and lavage, before ECMO withdrawal, and within 24 hours after ECMO withdrawal. Performance of pulmonary ultrasound and clinical data were retrospectively reviewed. Results: Seven patients treated with ECMO for 11.5(3-27)days, and 1 patient underwent ECMO transport. Six (86.7%) patients were successfully weaned from ECMO, and 1 (14.2%) patient failed to exit ECMO successfully. Four(57.1%) patients were discharged from hospital, and 3(42.8%) patients eventually died. In various diagnostic signs of pulmonary ultrasound were detected in 7 patients, including pulmonary edema (7 cases), lung consolidation (5 cases), followed by pleural effusion (4 cases), atelectasis (3 cases) and pneumothorax (3 cases). Pulmonary ultrasound showed that the lungs were re-expanded and suggested that the child could attempt to evacuate the ECMO. Conclusions Pulmonary ultrasound can comprehensively evaluate the various lung lesions in children with ECMO treatment, and can dynamically monitor the process of lung recruitment in real time, providing a reference for guiding the evacuation of ECMO.

OBJECTIVETo observe the clinical efficacy on senile female bladder neck obstruction treated with acupoint application, therapy and western medication.

METHODSFifty cases of senile female bladder neck observation were randomized into an obstrvation group and a control group, 25 cases in each one. Tamsulosin hydrochloride capsules were taken orally in the two groups, 0.2 mg every night, continuously for 100 days. In the observation group, with radix aconiti lateralis preparata, semen brassicae and fructus ligustri lucidi contained, bushentongyu plaster was used at Shenque (CV 8), Sanyinjiao (SP 6), Pangguangshu (BL 28), Zhongji (CV 3) and Sanjiaoshu (BL 22), once every two days. Eight treatments made one session and 6 sessions were required totally. The international prostate symptom score (IPSS), the bother score (BS), the residual volume (RV) and the maximal urinary flow rate (MFR) were observed before and after treatment in the two groups. The clinical efficacy was compared between the two groups.

RESULTSEvery score in IPSS after treatment was reduced apparently as compared with that before treatment in the two groups (all P < 0.01). The improvements in feeling of incomplete, bladder emptying, intermittency < 2 h, urgency, interupted urination and nocturia in the observation group were more advantageous than those in the control group (all P < 0.05). The total effective rate was 95.65% (22/23) in the observation group, higher than 85.71% (18/21) in the control group (P < 0.05). After treatment, RV, MFR and BS were significantly different as compared with those before treatment (all P < 0.05).

CONCLUSIONThe combined therapy of acupoint application of bushentongyu plaster and oral administration of tamsulosin hydrochloride capsules achieves the significant efficacy on senile female bladder neck obstruction as compared with the simple administration of tamsulosin hydrochloride capsules.

Acupuncture Points ; Aged ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Middle Aged ; Treatment Outcome ; Urinary Bladder Neck Obstruction ; drug therapy ; physiopathology ; Urination