ObjectiveTo explore the determinants of average length of stay of three county hospitals and eleven countryside hospitals of Xinjiang province.MethodsRelative data of the county and the countryside hospitals from 2009 to 2010 were collected,and descriptive analysis and rank sum test were employed to explore the determinants of average length of stay.ResultsThe average length of stay of the county hospital was longer than the countryside hospital,the average length of stay had significant differences between the gender,age,and the disease classfication.ConclusionThe average length of stay of the county hospitals and countryside hospitals had difference significantly.

Objective:To investigate the expression of serum eosinophil cationic protein (ECP) in children with respiratory syncytial viruses (RSV) pneumonia and its clinical significance.Method:One hundred and six children with RSV pneumonia (RSV pneumonia group) and 70 healthy children (control group) from January 2017 to October 2019 in the Affiliated Suzhou Science & Technology Town Hospital of Nanjing Medical University were selected. Among children with RSV pneumonia, low risk was in 68 cases, intermediate risk was in 25 cases and high risk was in 13 cases. The serum ECP level was measured by enzyme-linked immunosorbent assay. The lung function indexes were measured, including the forced expiratory volume in one second as a percentage of predicted value (FEV 1%), forced expiratory volume in one second (FEV 1)/forced vital capacity (FVC) and fractional exhaled nitric oxide (FeNO). Risk factors of severity in children with RSV pneumonia were analyzed by multivariate Logistic regression analysis. The area under the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of serum ECP for RSV pneumonia. Results:The FEV 1% and FEV 1/FVC in RSV pneumonia group were significantly lower than those in control group: (81.47 ± 14.08)% vs. (96.80 ± 17.10)% vs. (72.17 ± 21.63)% and (93.46 ± 26.57)%, the FeNO and ECP were significantly higher than those in control group: (17.88 ± 2.55) ppb vs. (9.79 ± 2.35) ppb and (64.00 ± 20.05) μg/L vs. (41.59 ± 16.99) μg/L, and there were statistical differences ( P<0.01). The serum ECP in RSV pneumonia children with intermediate risk and high risk were significantly higher than that in RSV pneumonia children with low risk: (70.82 ± 20.84), (90.71 ± 19.75) μg/L vs. (58.05 ± 14.72) μg/L, the serum ECP in high risk children was significantly higher than that in intermediate risk children, and there were statistical differences ( P<0.05). Multivariate Logistic regression analysis result showed that FEV 1%, FEV 1/FVC, FeNO and ECP were independent risk factors of severity in children with RSV pneumonia ( OR=12.913, 17.845, 0.002 and 0.126; 95% CI 2.641 to 63.139, 2.972 to 107.139, 0.000 to 0.017 and 0.028 to 0.566; P<0.01). ROC curve analysis result showed that the optimal cut-off value of serum ECP for the diagnosis of RSV pneumonia was 51.84 μg/L, AUC was 0.809, and the sensitivity and specificity were 78.57% and 75.47%; the optimal cut-off value of serum ECP for early diagnosis of RSV pneumonia was 43.17 μg/L, AUC was 0.714, and the sensitivity and specificity were 58.57% and 82.35%. Pearson correlation analysis result showed that serum ECP was negatively correlated with FEV 1% and FEV 1/FVC ( r=-0.632 and-0.604, P<0.01), and it was positively correlated with FeNO ( r=0.707, P<0.01). Conclusions:Serum ECP level in children with RSV pneumonia is significantly increased, which is negatively correlated with FEV 1% and FEV 1/FVC, and positively correlated with FeNO. Serum ECP can be used as one of the reference indicators for the diagnosis and severity assessment of children with RSV pneumonia.

Objective:To investigate the targeted motion and controllable release of tumor drugs based on micromotor. Methods:The directional movement of Janus micro-capsules was achieved through an external magnetic field,and the controllable release of tumor drugs was induced by near-infrared laser.Results:During the same period, the movement speed of the Janus capsules micromotor was the fastest(36.8 μm·s-1,approximately equalled to 3 body length·s-1) in 15% H2O2solution. Under the control of the external magnetic field, the Janus capsules micromotor could move along the scheduled trajectory close to the area of HeLa cells. Through the irradiation of near-infrared laser, the Janus capsules micromotor was broken and released the loaded drugs quickly. Conclusion:The Janus capsule micromotor studied in the paper can be used for targeted drug delivery safely and effectively,therefore,it shows good application prospect in the field of tumor diagnosis and treatment.

Objective:To explore the effects of two dimensional gray-scale blood flow imaging (hereinafter referred to as " B-flow" ) combined with color Doppler flow imaging (CDFI) in guiding arterial puncture and catheterization through wounds in patients with large burns.Methods:Sixty-seven patients with large burns who met the inclusion criteria and hospitalized in the First Hospital of Jilin University from January 2017 to January 2019 were enrolled in the prospectively randomized control study. According to the random number table, CDFI alone group was allocated with 35 patients (23 males and 12 females) and B-flow+ CDFI group with 32 patients (22 males and 10 females), aged 19-60 and 18-58 years, respectively. According to the progress of the disease, arterial puncture and catheterization were performed in the right time. During the operation, CDFI was used alone for guidance in patients of CDFI alone group, while B-flow and CDFI were used together for guidance in patients of B-flow+ CDIF group. Based on the first time of catheterization, the catheterization location, one-time catheterization success rate, post-back stitching re-catheterization success rate, catheterization failure rate, catheterization duration, and incidences of wound sepsis, catheter-related bloodstream infection, and arterial thrombosis within post catheterization day (PCD) 3 of patients in the two groups were recorded. Data were statistically analyzed with the independent-sample t test, chi-square test or Fisher′s exact probability test. Results:(1) All the patients underwent catheterization through wounds, and there was no statistically significant difference in catheterization location of patients between the two groups ( χ2=0.574, P>0.05). The one-time catheterization success rate of patients in B-flow+ CDFI group was 81.25% (26/32), which was obviously higher than 51.43% (18/35) in CDFI alone group ( χ2=6.594, P<0.05). The catheterization failure rate of patients in B-flow+ CDFI group was 3.12% (1/32), which was obviously lower than 20.00% (7/35) in CDFI alone group ( P<0.05). The post-back stitching re-catheterization success rate of patients was similar between the two groups ( χ2=1.029, P>0.05). (3) The catheterization duration of patients was (15.7±1.1) min in B-flow+ CDFI group, which was obviously shorter than (17.1±2.2) min in CDFI alone group ( t=11.316, P<0.01). (4) Within PCD 3, the incidences of wound sepsis and catheter-related bloodstream infection of patients in CDFI alone group were 2.86% (1/35) and 0, close to 0 and 3.12% (1/32) in B-flow+ CDFI group ( P>0.05); the incidence of arterial thrombosis of patients in B-flow+ CDFI group was 0, which was obviously lower than 20.00% (7/35) in CDFI alone group ( P<0.05). Conclusions:Compared with CDFI alone, B-flow combined with CDFI can improve the success rate of arterial puncture and catheterization through wounds in large area burn patients, shorten the catheterization duration, and effectively reduce the incidence of arterial thrombosis after catheterization, with a good clinical application value.

Suspension bed are often used to treat and nurse the wounds of burn patients in clinic. Because of the suspension force, the patients′ activities are limited, and they stay in bed for a long time, which is very easy to cause foot drop, affecting the recovery of the patients. Aiming at this problem, we designed and made a foot drop prevention baffle made of stainless steel, which could withstand the buoyancy of the suspension bed, adjust the feet forwardly and backwardly, to the left and right according to the height of the patients and the distance of the feet to be separated, and keep the foot in a positive and external rotation position according to the comfort of the patients, which achieved good results in clinical application.

Objective    To research the influence of anticoagulation to blood clotting function in patients who experienced cardiopulmonary bypass surgery under continuous renal replacement therapy (CRRT) with regional citrate anticoagulation (RCA), low molecular weight heparin (LMWH) anticoagulation and non-anticoagulation. Methods    We retrospectively analyzed the clinical data of 146 patients who underwent CRRT after cardiopulmonary bypass surgery between January 2014 and December 2016. There were 98 males and 48 females at age of 60.51±14.29 years. All CRRT patients were allocated into three groups including a RCA group, a LMWH group, and a non-anticoagulation group, which were compared in terms of convention coagulation tests, platelet counts, thromboelastography, circuit lifespan and transfusion. Results    Three hundred and fifty four CRRT patients were selected from patients above, including 152 patients in the LMWH group, 160 in the RCA group, and 42 in the non-anticoagulation group. The difference of CRRT circuits time among three groups was statistically different (P=0.023). And multiple comparison showed that the circuit lifespan of the RCA group was significantly longer than that of the non-anticoagulation group (34.50 h ranged 14.00 h to 86.00 h vs.15.00 h ranged 12.00 h to 50.88 h, P=0.033). One hundred and fifty-five CRRT patients last beyond 24 hours  with same anticoagulation were selected, the results of coagulation tests, and the difference between CRRT starting and after 24 hours were compared. The difference of Angle and maximum amplitude(MA) of pre- and post-CRRT were significantly different among three groups by one-way ANOVA (P=0.004, 0.000), as well as between the RCA group and the LMWH group by multiple comparison (P=0.004, 0.000). There was no statistical difference in frequencies and doses of the transfusion of fresh frozen plasma and platelet among three groups. Conclusion    RCA is an effective anticoagulation which may prolong circuit lifespan and has small impact on the coagulation function of patients who undergo CRRT after cardiopulmonary bypass surgery.

Tripterygium glycosides tablet(TGT),the classical commercial drug of Tripterygium wilfordii Hook.F.has been effectively used in the treatment of rheumatoid arthritis,nephrotic syndrome,leprosy,Behcet's syndrome,leprosy reaction and autoimmune hepatitis.However,due to its narrow and limited treatment window,TGT-induced organ toxicity(among which liver injury accounts for about 40％of clinical reports)has gained increasing attention.The present study aimed to clarify the cellular and molecular events underlying TGT-induced acute liver injury using single-cell RNA sequencing(scRNA-seq)technology.The TGT-induced acute liver injury mouse model was constructed through short-term TGT exposure and further verified by hematoxylin-eosin staining and liver function-related serum indicators,including alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase and total bilirubin.Using the mouse model,we identified 15 specific subtypes of cells in the liver tissue,including endothelial cells,hepatocytes,cholangiocytes,and hepatic stellate cells.Further analysis indicated that TGT caused a significant inflammatory response in liver endothelial cells at different spatial locations;led to marked inflammatory response,apoptosis and fatty acid metabolism dysfunction in hepatocytes;activated he-patic stellate cells;brought about the activation,inflammation,and phagocytosis of liver capsular macrophages cells;resulted in immune dysfunction of liver lymphocytes;disturbed the intercellular crosstalk in liver microenvironment by regulating various signaling pathways.Thus,these findings elaborate the mechanism underlying TGT-induced acute liver injury,provide new insights into the safe and rational applications in the clinic,and complement the identification of new biomarkers and ther-apeutic targets for liver protection.

Sepsis is characterized by a severe and life-threatening host immune response to polymicrobial infection accompanied by organ dysfunction.Studies on the therapeutic effect and mechanism of immunomod-ulatory drugs on the sepsis-induced hyperinflammatory or immunosuppression states of various im-mune cells remain limited.This study aimed to investigate the protective effects and underlying mechanism of artesunate(ART)on the splenic microenvironment of cecal ligation and puncture-induced sepsis model mice using single-cell RNA sequencing(scRNA-seq)and experimental validations.The scRNA-seq analysis revealed that ART inhibited the activation of pro-inflammatory macrophages recruited during sepsis.ART could restore neutrophils'chemotaxis and immune function in the septic spleen.It inhibited the activation of T regulatory cells but promoted the cytotoxic function of natural killer cells during sepsis.ART also promoted the differentiation and activity of splenic B cells in mice with sepsis.These results indicated that ART could alleviate the inflammatory and/or immunosuppressive states of various immune cells involved in sepsis to balance the immune homeostasis within the host.Overall,this study provided a comprehensive investigation of the regulatory effect of ART on the splenic microenvironment in sepsis,thus contributing to the application of ART as adjunctive therapy for the clinical treatment of sepsis.

Objective: To evaluate the feasibility of CT angiography of pediatric complex congenital heart disease by using low radiation dose and low isotonic contrast agent dose combined with iDose⁴ iterative reconstruction technique. Methods: Prospectively, a total of 57 continuous patients with suspected congenital heart disease under or equal to 2 years old in our hospital between Mar 2016 and Jan 2017 were divided into 2 groups according to the reservation number. " double low" group included 32 patients using 80 kVp, 80 mAs, Iodixanol (270 mg I/ml) and iDose⁴ - 4iterative reconstruction algorithm; routine group included 25 patients using 100 kVp, 100 mAs, Iopromide (370 mg I/ml) and filtered back projection algorithm. Individualized injections were taken on the weight of children and the iodine intake was calculated. CT values of left atrium, left ventricle, right atrium, right ventricle, ascending and descending aorta at the level of tracheal bifurcation, midpoint of aortic arch, pulmonary trunk, left and right pulmonary artery, pectoralis major and erector spinae on both sides as well as background noise at the level of aortic arch were measured, and signal to noise ratios (SNR) and contrast to noise ratios (CNR) were calculated. The quality of all images was evaluated subjectively. Scan length (L), volume CT dose index (CTDI_vol) and dose-length-product (DLP) were recorded, and the effective dose (E) and size-specific dose estimate (SSDE) were calculated. The diagnostic coincidence rates for CTA examinations of these two groups were calculated and compared with the surgery or cardiac catheterization examination called the " gold standard" . Results: The iodine intake of " double low" group and routine group was (2.53±1.09) and (3.46±1.29)g, respectively, with statistically significant difference (t=2.976, P<0.05). No statistically significant difference existed in CT value of heart cavities, large blood vessels or CT value of muscles, background noise, SNR, CNR at the level of aortic arch or subjective evaluation for image quality between the two groups (P>0.05). The consistency of subjective evaluation for image quality of the two groups was good(Kappa=0.55, 0.76). Compared with routine group, CTDI_vol, SSDE, DLP, E of double low group descended by 57.19%, 56.71%, 56.74%, 53.33% respectively (t=54.107, 28.269, 15.338, 11.441, P<0.05). The diagnostic coincidence rates of the two groups were 96.6% and 97.1% respectively (P>0.05). Conclusions: Using 80 kVp, 80 mAs and Iodixanol (270 mg I/ml) combined with iDose⁴ iterative reconstruction technique for CT angiography of pediatric complex congenital heart disease, the image quality could meet the requirements for clinical diagnosis, and the radiation dose and the iodine dose of contrast agent could be lowered. Trial registration Chinese clinical trial registry, ChiCTR1800016576.