Objective To study the relations between CD23 expression on peripheral blood B lymphocytes and IgE in asthmatic children and their pathogenesis. Methods CD19 +, CD23 +, CD19 +/CD23 + expressions of peripheral blood lymphocytes were measured by flow cytometry and serum total IgE level by chemiluminescence immunoassay in 22 children with classical asthma, 18 cough variant asthma (CVA), 20 with asthmatiod bronchitis ,20 with pneumonia and 25 healthy controls. The correlations between CD23 expression on peripheral blood B lymphocytes and IgE in serum were analysed. The 20 children with asthmatiod bronchitis were divided into two groups by the scores whether it reached that for diagnosing asthma after ten months: Group Ⅰ (10 cases) and Group Ⅱ (10 cases). Results CD19 +, CD23 +, CD19 +/CD23 + expressions on lymphcytes were significantly elevated in peripherial blood and serum IgE from children with classical asthma [(13.56?5.87)%,(26.56?7.61)%,(12 86?5.01)%, (12.67?7.56) ?mol/L respectively] and CVA [(13.10?5.15)% ,(24.66?8.15)% , (12 10?4.97)%, (9.45?4.16) ?mol/L respectively] as compared with those in the children with pneumonia and healthy controls [(7.95?3.65)%, (14.92?3.02)% ,(6.82?2.95)% , (3.10?1.68) ?mol/L respectively] ( P

Objective To investigate the value of bone turnover markers(BTMs) in forecasting the variance of bone mineral density (BMD) by studying the relationships between BTMs and BMD in persons aged 80 and above.Methods A sample of 1 509 subjects aged 80 and above was recruited.All subjects underwent BMD measurement by dual energy X-ray absorptiometry,and BTMs (C-telopeptide of type 1 collagen,N-terminal propeptide of type 1 procolagen,osteocalcin) measurements.The relationships among all the BTMs,and between BMD and BTMs were analysed.Results In subjects aged 80 and above,the relationships among BTMs were moderately positive(all P＜0.05).In men aged 80 and above,BMDs were inversely associated with BTMs(all P＜0.05),and in women,BMDs were inversely associated with osteocalcin (P＜ 0.05).Conclusions The clinical significance of BTMs in persons aged 80 and above indicates bone resorption when BTMs are raised.In men aged 80 and above any of BTMs may be selected to evaluate bone metabolism ; while in women,osteocalcin should be selected.

Objective To investigate whether perfusion-weighted imaging (PWI) can be used to evaluate blood perfusion of patients with leukoaraiosis (LA), its relationship to clinical features, and the therapy effect of LA. Methods The 44 patients with LA were recruited in the study. All the subjects were examined with both conventional and dynamic susceptibility contrast-enhanced perfusion MR imaging, 13 of them repeated the examinations after the treatment. The shapes and sizes of the biggest lesions in each patient were confirmed by conventional MR imaging, then the values of relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF) and relative mean transit time (rMTT) in each lesion were calculated respectively. Furtherly, a Pearson's correlation analysis was performed to show whether these values were correlated with mini-mental state examination (MMSE)scores or activities of daily living (ADL) scores. Results The 44 lesions of all the subjects showed significant decreases in rCBV (0. 797 ± 0. 160) and rCBF (0. 779± 0. 164) but increase in rMTT (1. 029±0. 073). There were positive correlations between rCBV and MMSE (r = 0. 524, P =0. 000), between rCBV and ADL (r=0. 621, P=0. 000), between rCBF and MMSE (r=0. 555, P=0. 000), and between rCBF and ADL (r= 0. 690, P= 0. 000), and negative correlations between rMTTand MMSE (r=-0.307, P=0.043), and between rMTT and ADL (r=-0.434, P=0. 003). The blood perfusion was enhanced in 10 out of 13 patients who received the repeated examinations after the treatment, most of whom showed the improvement of clinical symptoms.Conclusions Perfusion MR imaging can assess hemodynamic alterations in LA, which could reflect the clinical symptoms. Moreover, the changes of blood perfusions can be used to evaluate and monitor the therapy effect of LA.

Object To isolate the immunoactive polysaccharide from Astragalus mongholicus Bunge and elucidate its chemical structure Methods The polysaccharide was purified from water extracts of A mongholicus by ethanol precipitation, deproteination, selective precipitation with hexadecyltri methylammonium bromide, ion exchange and gel filtration chromatography Its homogeneity and molecular weight were estimated by gel filtration chromatography, the structure was deduced from sugar analysis, methylation analysis, Smith degradation, IR and 13 CNMR spectrophotometry Results A homogeneous polysaccharide A2Nb was obtained with a molecular mass of 360 000 , and composed of D glucose with a major linkage form of ? D (1→4) glucose Side chains were found at 6 O positions once in every 25 glucose residues Conclusion A high molecular weight glucan A2Nb was obtained from A mongholicus for the first time It showed the ability of promoting the proliferation of the splenocytes of mice

Objective To investigate the safety and effectiveness of different intravenous anesthesia methods for pediatric ERCP . Methods Data of 45 children undergoing ERCP at the Affiliated Hangzhou Hospital of Nanjing Medical University from August 2013 to July 2016, including intravenous anesthesia,the procedure of ERCP, adverse reactions and the waking time were retrospectively studied. Results A total of 45 patients in two groups under intravenous anesthesia successfully underwent ERCP . Seventeen patients ( 37. 8%) whose body weights were over 20 kg and the duration of surgery was predicted less than 30 minutes received deep sedation without airway intubation. Twenty?eight patients ( 62. 2%) with an initial weight of less than 20 kg and the duration of surgery was predicted more than 30 minutes received general anesthesia with airway intubation. In patients with deep sedation, the mean time of waking was 7. 2±6. 3 minutes, body movement reaction occurred in 1 case ( 5. 9%) and with transient decreasing of pulse blood oxygen ( beyond 95%) occurred in 2 cases ( 11. 8%) . In patients receiving endotracheal anesthesia with intubation, the mean waking time was 10. 5±8. 7 minutes without adverse reactions associated with anesthesia. Conclusion Both deep sedation and general anesthesia with airway intubation are safe for pediatric ERCP. However, general anesthesia with airway intubation is an ideal method ensuring the airway safety and oxygen supply for children less than 20 kg undergoing first?time ERCP or the duration of surgery lasting over 30 minutes.

Objective To explore the application effect of quality control circle in the quality management improvement of the occupational disease diagnostic and code.Methods To established across departmental team of medical record QCC,we Select 132 cases of the occupational disease departmentin specialized Hospital from May 1,2022 to June31,2022,Analyze the reasons of inaccurate that main diagnosisselection and code mapping.After formulating a series of improvement measures,we Se-lect 71 cases of occupational disease department from November 1,2022 to December 31,2022.To compared effect that before and after the implementation of QCC.Results After6 months of improvement,The utilization rate of main diagnosis mapping Z-code was decreased from 36.3%to 12.7%,goal achievement rate of 106.3%,improvement rate of 65.0%.Enrollment rate of major diagnostic was increased from 53.0%to 86.3%,goal achievement rate of 116.4%,Improvement rate of 62.8%.Conclu-sion We have changed the quality control management mode of diagnosis and coding by the QCC,implement targeted feedback,supervision,and training,establish a reward and punishment mechanism that matches indicators to improved accuracy of enroll-ment.Upgrading the quality management level of medical records and medical safety at the same time.Should continue to pro-mote theimplementation.

Objective:To investigate the prevalence of overactive bladder (OAB) in Chinese boys and risk factors, and to evaluate the psychological and behavioral status of OAB patients.Methods:Cross-sectional study.From October 2020 to July 2021, 2 800 boys aged 6-15 years from 6 primary and secondary schools in a county of Henan Province were selected by stratified random cluster sampling method.An anonymous questionnaire was used to investigate the epidemiological situation of OAB, including the basic information, lower urinary tract symptoms, Overactive Bladder Score Scale (OABSS) scores, pediatric sleep questionnaire (PSQ) and strengths and difficulties questionnaire (SDQ). In addition, the correlation between OAB and residence, body mass index (BMI), nocturnal enuresis (NE), overuse of diapers, history of urinary tract infection, abnormal stool, phimosis, redundant prepuce, and concealed penis by Chi- square test, Logistic multivariate regression analysis, and t-test. Results:A total of 2 333 valid questionnaires were collected.The overall prevalence of OAB in boys was 6.0%(141/2 333 cases). NE, history of urinary tract infection, abnormal stool, overuse of diapers, phimosis, redundant prepuce, concealed penis were risk factors for OAB in boys ( OR>1, P<0.05), while BMI was not a risk factor for OAB in boys ( OR<1, P>0.05). The emotional symptoms[ (7.64±2.03) scores vs.(6.51±2.53) scores], conduct problems [(8.14±1.62) scores vs.(7.31±1.88) scores], hyperactivity[(5.64±2.27) scores vs.(4.98±2.03) scores], peer communication problems [(7.16±1.63) scores vs.(6.59±1.60) scores], difficulty scores[(30.26±6.48) scores vs.(27.69±6.44) scores] and PSQ scores [(5.36±3.00) scores vs.(3.94±2.53) scores] in OAB group were significantly higher than those of non-OAB group ( t=-5.117, -5.005, -3.310, -4.056, -4.553, -5.006, respectively, all P<0.05). Conclusions:OAB in boys is common and affects mental health and sleep quality.Meanwhile, NE, history of urinary tract infection, abnormal stool, overuse of diapers, phimosis, redundant prepuce, or concealed penis are the risk factors for OAB in boys.

With the development of clinical related disciplines, the update and establishment of relevant standards/guidelines at home and abroad, GBZ 185-2006 Diagnostic Criteria for Occupational Medicamentose-like Dermatitis due to Trichloroethylene (hereinafter referred to as “GBZ 185-2006”) was unable to meet clinical needs. Therefore, the GBZ 185-2006 was revised based on the principles of evidence-based medicine, in accordance with relevant laws/regulations and relevant standards/guidelines in combination with review of research data on occupational medicamentose-like dermatitis due to trichloroethylene (OMDT) home and abroad, and the development of clinical practice and clinical related disciplines. The main modifications include: adding terms and definitions of OMDT, modifying the description of clinical manifestations of the diagnostic principles, adjusting the description of latency, deleting the diagnostic requirement of the incidence probability, adding the specific allergen patch test as the etiological diagnostic index, standardizing the application scope, operating procedure and precautions of the specific allergen patch test. In addition, the relevant content of “Basic Characteristics and Clinical Types of Skin Damage of Medicamentose-like Dermatitis due to Trichloroethylene” in Appendix A is improved, the treatment principles are revised, and the content of new progress in treatment, artificial liver application, are added. The revised GBZ 185-2024 Diagnostic Standard for Occupational Medicamentose-like Dermatitis due to Trichloroethylene is more scientific and practical, and can provide technical basis for the standardized diagnosis and treatment of OMDT in medical and health institutions.

January to October 2018 were selected by convenience sampling method. The clinical data and the occurrence of unplanned extubation were retrospectively collected. The influencing factors of unplanned extubation were analyzed by univariate analysis and binary unconditional Logistic regression analysis. Results? Among 1 682 patients with indwelling nasobiliary tube, 44 patients had unplanned extubation during hospitalization, the incidence was 2.62%. Logistic regression analysis showed that age, sex, education level, sensory disturbance and indwelling time were the influencing factors of unplanned extubation. Conclusions? The unplanned extubation in patients with indwelling nasobiliary tube is the result of multiple factors. Comprehensive and effective measures should be taken to prevent unplanned extubation in clinical nursing.

Objective:To explore the clinical application values of modified esophagus metal stent auxiliary line device in improving the comfort level of patients.Methods:By the convenient sampling method, a total of 16 patients with tracheoesophageal fistula who were admitted and treated in Hangzhou First People's Hospital Affiliated to Zhejiang University School of Medicine from March 2014 to September 2016 were selected as the control group. After the implantation of the esophageal stent with an auxiliary line, an ulcer patch was used to protect the skin behind the ears and cheeks, and there was no protection for the nasal cavity and throat mucosa. A total of 19 patients with tracheoesophageal fistula who were admitted from October 2016 to November 2019 were selected as the experimental group. On the basis of using ulcer patch to protect the skin, the auxiliary line of the stent was passed through the infusion hose. The infusion hose entered the nasal cavity along the auxiliary line and reached the front of the stent through the throat. The comfort degree and the incidence of nasal ulcer were compared between the two groups.Results:The self-perceived comfort level of patients on 10 days after implantation of the esophageal stent with an auxiliary line in the experimental group was (4.16±0.83) and that on 20 days after implantation was (6.05±0.97) , both of which were superior to the control group, and the differences were statistically significant ( t=-8.340, -7.030; P < 0.01) . At 30 days after surgery, the incidence of nasal ulcers in the experimental group was 47.37% and that in the control group was 100.0%. The difference between the two groups was statistically significant ( P<0.01) . Conclusions:The modified esophageal metal stent auxiliary line device can improve comfort level of patients and reduce the incidence of nasal ulcers, which has certain clinical application value.