Objective To compare the clinical effect of intraosseous versus traditional infusion in critical pediatric patients under resuscitation.Methods 56 critical pediatric patients under resuscitation,who were difficult to establish a venous access,were divided into two groups:intraosseous infusion group (IOI group)and traditional group.The clinical characteristics,lab tests,clinical efficacy and complications of all patients were recorded in detail. Results The general characteristics of two groups were comparable.The mean operation time to establish an emergency infusion access in the IOI group was (1.01 ±0.53)min,which was significantly shorter than (8.97 ±2.36)min of the traditional group(t =4.856,P <0.01).The IOI group had a greater efficacy over the traditional group (50.0% vs 36.7%),in the IOI group,the patients showed obvious positive effect and less patients had no efficacy(χ2 =18.476, P <0.05 ).In addition,lower complication rate and mortality were observed in the IOI group.Conclusion For critical pediatric patients under resuscitation whose intravascular access cannot be achieved through peripheral venous,intraosseous infusion is prior to traditional infusion.

Objective To analyze the therapeutic effect of qiweiqingyan aerosol combined with ribavirin in the treatment of herpetic angina of children hand-foot-mouth disease,and to compare the clinical effects with sim-ple use of ribavirin.Methods 160 children with hand foot and mouth disease were divided into two groups by random number table.They were the observation group (80 cases)and control group (80 cases),respectively.Two groups were both given ribavirin aerosol in the treatment,the observation group were added with qiweiqingyan aerosol agent to carry out treatment,then the clinical curative effects of the observation group and control group were copared.Results In the observation group,the total effective rate was 96.25%,and the total effective rate of the control group was 85.00%,the difference between the two groups had statistical significance (χ2 =5.959,P<0.05).Marked effective rate of the observation group was 86.25%.In the control group,the significant efficiency was 37.50%.The difference between the two groups had statistical significance (χ2 =40.300,P<0.05 ).Defervescence time and bleb disappear time were shorter in the observation group compared to the control group,the difference between the two groups was statistically significant (t=47.880,8.063,5.100,all P<0.05).The adverse reactions in the observation group were significantly lower than those in the control group (χ2 =9.608,P<0.05 ),after statistical analysis.Conclusion Using qiweiqingyan aerosol combined with ribavirin in the treatment of children hand foot and mouth herpangina,can significantly shorten the time of treatment,reduce adverse reactions and improve the cure rate.

Objective To investigate the effect of different temperature moxibustion on serum IL-1β, IL-2 and TNF-αcontents in acute adjuvant arthritis rats and provide a basis for the mechanism of local anti-inflammatory and immune action of moxibustion. Methods A rat model of adjuvant arthritis (AA) was made by Freund’s complete adjuvant (FCA) modeling method. Of 32 SD rats, 8 were randomly selected as a normal group and the other 24 for model making. After successful model making, the rats were randomly allocated to model, treatment 1 and treatment 2 groups, 8 rats each. Treatment 1 and 2 groups received moxibustion. Local temperature at moxibustion point was controlled at (38±1)℃in treatment 1 group and at (45±1)℃in treatment 2 group. Rat serum IL-1β, IL-2 and TNF-αcontents were measured by enzyme-linked immunosorbent assay (ELISA). Results There were statistically significant differences in serum IL-1β, IL-2 and TNF-αcontents between the model, treatment 1 or treatment 2 group and the normal group (P<0.01). There was a statistically significant difference in serum IL-2 content between treatment 1 and the model groups (P<0.01). There were statistically significant differences in serum IL-1β, IL-2 and TNF-αcontents between treatment 2 group and the model or treatment 1 group (P<0.01). Conclusions Moxibustion has a reducing effect on serum IL-1βand TNF-αcontents and a raising effect on IL-2 content. 45℃moxibustion temperature can improve the effect of moxi bustion. The anti-inflammatory action of moxibustion may be through the mechanism of reducing serum IL-1βand TNF-αcontents and raising IL-2 content, which relieve body inflammatory reaction. The action of moxibustion needs proper moxibustion temperature.

To establish a method to detect cardiac troponin I by using time-resolved fluoroimmunoassay ( TRFIA) and apply to the clinic.Methods:The assay were measured by TRIFA and double antibody sandwich method .Standard protocols were evaluated with the standard curve , the limit of detection , stability, precision and cross reaction .Healthy reference populations and clinical serum specimens were measured to established the reference interval and evaluated the perspective of the clinical application . Results:The standard curve was Y=7485 .878+1400.924 X with a correlation coefficient of 0.999.The limit of detection was 0.052 ng/ml.The intra-and inter-assay coefficients of variation ( CV) were all <10%.Reference values was <0.14 μg/L.The AUC of ROC curve was 0.971 while the sensitivity was 96.45%,the specificity was 91.43% and the accuracy was 95.69%, with 98.45% of positive predictive value and 82.05%of negative predictive value.The correlation coefficient was 0.993 between our proposed method and the commercially available CLIA kits.There was no significant difference in statistics compared with ECG , CK-MB and cTnT ( P>0.05 ).There was significant difference in statistics compared before and after treatment with AMI ( P<0.001 ) .Conclusion: The TRFIA method for detecting cTnI achieves clinical application standards and may be used for the diagnosis and serosurveillance of acute myocardial infarction patients.

Objective:to investigate clinical significance of serum and urine NGAL (Neutrophil gelatinase-associated lipocalin) in the early kidney damage with primary hypertension.Methods:According to UAER ( urinary microalbumin excreting rate ) ,we divided 90 patients with primary hypertension into three groups (<30 mg/24 h,30-300 mg/24 h and >300 mg/24h),and selected 30 healthy people as the control group.Serum and urine NGAL and cystatin C ,serum creatinine,urea nitrogen,high sensitive C reactive protein , transferrin,and basis of blood pressure were detected and followed up one year.Results:Compared with healthy group ,GFR( glomerular filtration rate ) and serum NGAL were decreased significantly in medium and severe proteinuria groups , while urine NGAL was increased.Conclusion:Serum and urine NGAL have been a clear trend changes in kidney damage ,which could be used as a reliable indicator in monitoring renal function of patients with primary hypertension.

Objective To investigate the relationship between the onset of lower extremity venous thrombotic disease and seasons.Methods A retrospective study was conducted, 300 patients with lower extremity venous thrombotic disease admitted to HandanCity Hospital of Traditional Chinese Medicine (TCM) from August 2012 to February 2014 were enrolled, the incidences and TCM syndromes of patients with lower extremity venous thrombotic disease in different seasons were observed, and the pathogenesis and relationships between the types of TCM syndrome and seasons were analyzed.Results There were 142 patients with lower extremity superficial thrombophlebitis, and 158 cases with lower extremity deep venous thrombosis, the incidence of lower extremity venous thrombotic disease in spring was significantly higher than that in summer and autumn [32.8% (86/262) vs. 21.3% (54/254), 18.4% (50/272), bothP < 0.01], but lower than that in winter [32.8% (86/262) vs. 37.2% (110/296)], the difference was not statistically significant (P > 0.01); while the incidence of lower extremity venous thrombotic disease in winter was significant higher than those in summer and autumn (allP < 0.01). The incidences of damp and heat downward flow type in autumn and summer were increased compared with those in winter and spring [55.6% (30/54), 60.0% (30/50) vs. 20.0% (22/110), 23.3% (20/86), allP < 0.01], while the incidences of lower extremity venous thrombotic disease with damp heat and stasis syndrome in winter and spring were increased compared with those in summer and autumn seasons [80.0% (88/110), 76.7% (66/86) vs. 44.4% (24/54), 40.0% (20/50)].Conclusions The incidence of lower extremity venous thrombotic disease is related to seasons, and the onset is high in winter and spring, damp heat and stasis syndrome being the main type; according to different seasons, clinical treatment can direct to different pathogenic factors to adopt different preventive measures interfering with the patient's constitution in order to eliminate or reduce the risk factors, achieving the effect of the disease prevention.

Objective To explore the clinical efficacy,adverse reactions and serum levels of IL -10 and TNF-αin children with peptic ulcer undergoing sequential therapy.Methods 68 children with peptic ulcer were selected and randomly divided into two groups,34 cases in each group.The control group received quadruple therapy, namely omeprazole,amoxicillin,clarithromycin and bismuch treatment for seven days.The treatment group underwent sequential therapy:the first 5 d of oral omeprazole,amoxicillin treatment,and the next 5 d omeprazole,amoxicillin and inidazole treatment.The clinical efficacy,adverse reactions,IL-10 and TNF-αlevels of the two groups were com-pared.Results The total effective rates after treatment of the control group and treatment group were 88.24% and 91.18% respectively,there was no statistically significant difference between the two groups(χ2 =1.21,P>0.05). After treatment,the levels of IL-10 and TNF-αin the control group were (24.93 ±6.29)pg/mL and (37.93 ± 8.28)pg/mL,which were significantly decreased (t=5.52,P<0.05,t=8.51,P<0.01).And the levels of IL-10 and TNF-αin the treatment group were (21.36 ±6.31)pg/mL and (29.67 ±6.38)pg/mL,which were significantly decreased(t=11.15,12.29,all P<0.01).The levels of IL-10 and TNF -αof the treatment group were much significant than those of the control group after the sequential therapy (t=3.32,P<0.05,t=8.71,P<0.01). Conclusion Sequential therapy for the treatment of children with peptic ulcer has better effect than the quadruple therapy,and can reduce serum IL-10 and TNF-αlevels,it is worthy of promoting.

Objective To investigate the change of blood lactate level in children with severe sepsis,and its relationship with clinical prognosis.Methods 90 children with severe sepsis who treated in our hospital from February 201 3 to May 201 4 were selected as the study subjects.According to the prognosis of children,they were divided into survival group and death group,45 cases in each group.The blood lactate levels at different time points, blood lactate clearance rates between the two groups at different time points as well as fibrin,oxygenation index and D -dimer levels were compared after admission.Results After treatment,the fibrin,oxygenation index and D -dimer levels in the two groups were improved.The fibrin and D -dimer levels in the survival group[(2.71 ±0.31 )ng/mL, (0.89 ±0.1 0)mg/L)]were lower than those in the death group[(2.89 ±0.21 )ng/mL,(1 .26 ±0.1 8)mg/L)],the differences were significant(t =3.224,P =0.001 ;t =1 2.053,P =0.000).The oxygenation index of the survival group[(1 96.23 ±1 4.69)mmHg)]was higher than that of the death group [(1 80.23 ±21 .03 )mmHg)],the difference was significant(t =4.1 84,P =0.000).The EGOT compliance rate,APACHE Ⅱscore and MODS incidence rate of survival group were significantly lower than those of the death group,the differences were significant(t =7.200,P =0.007;t =9.1 49,P =0.000;t =29.298,P =0.000).The blood lactate levels at each time points in the survival group were significantly lower than the death group,the differences were statistically significant(t =50.543, P =0.000;t =33.932,P =0.000;t =1 7.91 5,P =0.000;t =28.703,P =0.000).The 6 h,24 h blood lactate clearance rates≥1 0% of the survival group (73.33%,80.00%)were significantly higher than those of the death group(37.78%,44.44%),the differences were significant(χ2 =1 1 .520,P =0.000;χ2 =1 2.1 00,P =0.000). Conclusion Lactate level in children with sepsis is an important indicator of prognosis in children with severe sepsis,with guidance for the treatment of children with sepsis.

Objective:To analyze the effects of protein intake of varied dietaries on the pregnancy of pregnant women.Methods:The pregnant women who had their medical records in our hospital were included in this study.Their dietary were collected based on the respective review of their food during 24 hours when they visited the Nutrition Clinics between 24 weeks and 28 weeks.The subjects were divided into six groups according to the dietary calories and protein intake:group A (normal calorie and normal protein),group B (normal calorie and low protein),group C (normal calorie and high protein),group D (high calorie and normal protein),group E (high calorie and high protein) and group F (low calorie and low protein).The gestational diabetes mellitus incidence rates,levels of fasting blood glucose (FBG),blood glucose (BG),hemoglobin Alc (HbAlc),and blood lipids,and bone mineral density were compared among six groups.Results:The gestational diabetes mellitus incidence rate,levels of postprandial blood glucose at 1 hour and 2 hour in groups of B,C,D,and E were significantly higher than those in group A (P ＜ 0.05).The levels of triglyceride,total cholesterol,and low density lipoprotein cholesterol were remarkably higher in groups of B,D,and E than those in group A (P ＜ 0.05).The bone mineral density was significantly lower in group A than that in groups of C,E,and F (P ＜ 0.05).Conclusion:The diet with normal calorie and normal protein is the scientific dietary structure.The pattern with high calorie and high protein intake is not recommended for pregnant women.

Objective : To identify the factors affecting donation-associated adverse reactions among volunteer blood donors, so as to provide the evidence for improving the quality of blood donation services. Methods : The volunteer blood donors in Quzhou Blood Center in 2019 were recruited. The Self-rating Anxiety Scale ( SAS ), Social Support Rating Scale ( SSRS ) and Pittsburgh Sleep Quality Index ( PSQI ) scores were measured prior to blood donation, and the presence of donation-associated adverse reactions was observed in the field of blood donation and within one week through short-message-service follow-up. The factors affecting donation-associated adverse reactions were identified using multivariable logistic regression analysis. Results : A total of 8 240 volunteer blood donors were enrolled, and adverse reactions occurred in 236 subjects, with an incidence rate of 2.86%. The SSRS, PSQI and SAS scores were 37.68±7.14, 5.97±1.25 and 52.82±3.25 among the donors with adverse reactions, respectively. Multivariable logistic regression analysis identified the educational level ( high school, OR=0.508, 95%CI: 0.289-0.891; diploma and above, OR=0.306, 95%CI: 0.253-0.734 ), SSRS score ( OR=0.399, 95%CI: 0.175-0.913 ), PSQI score ( OR=1.962, 95%CI: 1.116-3.450 ) and SAS score ( OR=2.013, 95%CI: 1.279-3.903 ) as factors affecting donation-associated adverse reactions. Conclusion The development of donation-associated adverse reactions correlates with educational level, social support, sleep quality and anxiety among volunteer blood donors.