Objective To investigate the value of prognosis of NT-proBNP in severe sepsis and septic shock patients .Methods 70 patients with sepsis admitted to our hospital were divided into general sepsis group (n=23) ,severe sepsis group(n=28) and sep-tic shock group(n=19) according to the severity of the disease ,the plasma NT-proBNP ,lactic acid ,C-reactive protein were meas-ured within 1 h after admission ,and calculated the 24 h acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) .Results (1) Plasma NT-proBNP concentration ,lactic acid ,CRP and APACHE Ⅱ score in severe sepsis group ,septic shock group was sig-nificantly higher than that of general sepsis group(P< 0 .05);Plasma NT-proBNP concentration ,CRP and APACHE Ⅱ score in septic shock group was significantly higher than severe sepsis group (P<0 .05) .(2)70 cases of patients with sepsis with 15 cases died and 55 cases survived .Plasma NT-proBNP concentration ,lactate ,CRP and APACHEⅡscore of death patients was significantly higher than the survival patients(P<0 .01) .(3) Plasma NT-proBNP concentration at the time of sepsis patients admitted to hospi-tal with positively correlated to APACHE Ⅱscores(r=0 .528 ,P<0 .01) .Conclusion The plasma NT-proBNP is closely related to the prognosis of patients with sepsis ,early detection of plasma concentration of NT-proBNP helps to evaluate the prognosis of pa-tients w ith sepsis .

Objective To analyze the safety of laparoscopic splenectomy for traumatic splenic rupture.Methods The clinical data of 62 patients with traumatic splenic rupture treated by laparoscopic splenectomy in our hospital from Jan 2013 to Jan 2018 were retrospectively analyzed.Results All 62 patients successfully underwent laparoscopic surgery except for 1 case who was converted to open surgery.One case suffered from postoperative bleeding.There was no infection,serious pancreatic leakage and other major complications.The total amount of intraoperative bleeding was 1 600 ml on average,the average operation time was 135 min,the average splenectomy time was 55 min,and the average hospital stay was 12.5 d.Conclusion Laparoscopic splenectomy is a safe and reliable minimally invasive operation for traumatic splenic rupture.

Objective To investigate the value of multiple parameter analysis in spectral CT scanning for the diagnosis of pulmonary nodules or masses.Methods The spectral CT scanning data in arterial phase of 319 patients with pulmonary nodules or masses confirmed by pathology and/or follow-up were analyzed retrospectively.The patients were divided into 3 groups:inflammatory group,lung cancer group and tuberculosis group.The Iodine(water)concentration,water(Iodine)concentration,the effective atomic number and the CT value of 60,70 and 80 keV single energy in the leisons were measured.One way A NOVA and LSD-t test were used for statistical analysis.Results One way A NOVA showed that the Iodine(water)concentration,water(Iodine)concentration,the effective atomic number and the CT value of 60,70 and 80 keV single energy among 3 groups in the arterial phase were all statistically different(P<0.05).T he LSD-t test showed there were statistical differences of Iodine content and effective atomic number between tuberculosis group and inflammatory group,lung cancer group and inflammation group(P<0.05).There were statistical differences between tuberculosis group and lung cancer group,inflammation group and lung cancer group in water concentration(P<0.05).The statistical differences in CT value of 60,70 and 80 keV single energy between tuberculosis group and inflammatory group,inflammation group and tuberculosis group were also found(P<0.05).Conclusion Multiple parameter analysis of spectral CT scanning in arterial phase could attribute to the diagnosis and differential diagnosis of pulmonary nodules or masses.

The social communication impairment is one of the core impairments of children with autism spec-trum disorder(ASD).This paper introduced five play-based intervention models that can improve social communica-tion skills of children with ASD.Guided by the concept of precision rehabilitation,practitioners who master these methods may effectively tailor interventions to different cases,by integrating personalized therapy for prescriptive treatment,may ensure healthy mind and body development of children with ASD while solving social communication problems,thus provide practice reference for parents of children with ASD,researchers and clinical educators in China.

Objective To explore the value of plasma procalcitonin (PCT)detection in dif-ferentiation and judgment of severe pyemia.Methods 70 patients with pyemia were divided into general pyemia group (n =23),severe pyemia group (n =28)and pyemia shock group (n =19), and plasma PCT,lactic acid,c-reactive protein,the acute physiology and chronic health evaluationⅡ 24 hours (APACHE Ⅱ)and 1,2,3 days in hospital as well as serum PCT,lactic acid,c-reac-tive protein were detected and compared.Results Plasma PCT,lactic acid,CRP and APACHE Ⅱscore of pyemia shock patients were significantly higher than the general pyemia group (P <0.05). Serum PCT,CRP and APACHE Ⅱ score of pyemia shock patients were significantly higher than that of severe pyemia group (P <0.05).15 patients with pyemia died,55 patients survived.72 hours plasma PCT,lactic acid,CRP and APACHE Ⅱ score in death group were significantly higher than the survival group (P < 0.01).When pyemia patients were admitted to hospital,PCT were positively correlated with APACHE Ⅱ scores (r =0.528,P <0.01).Conclusion PCT is superior to the current clinical application of CRP inflammatory response parameters,and it can be used as an early identification of systemic infection,judgment of pyemia severity and prognosis judgment in-dex.

Objective To explore the value of plasma procalcitonin (PCT)detection in dif-ferentiation and judgment of severe pyemia.Methods 70 patients with pyemia were divided into general pyemia group (n =23),severe pyemia group (n =28)and pyemia shock group (n =19), and plasma PCT,lactic acid,c-reactive protein,the acute physiology and chronic health evaluationⅡ 24 hours (APACHE Ⅱ)and 1,2,3 days in hospital as well as serum PCT,lactic acid,c-reac-tive protein were detected and compared.Results Plasma PCT,lactic acid,CRP and APACHE Ⅱscore of pyemia shock patients were significantly higher than the general pyemia group (P <0.05). Serum PCT,CRP and APACHE Ⅱ score of pyemia shock patients were significantly higher than that of severe pyemia group (P <0.05).15 patients with pyemia died,55 patients survived.72 hours plasma PCT,lactic acid,CRP and APACHE Ⅱ score in death group were significantly higher than the survival group (P < 0.01).When pyemia patients were admitted to hospital,PCT were positively correlated with APACHE Ⅱ scores (r =0.528,P <0.01).Conclusion PCT is superior to the current clinical application of CRP inflammatory response parameters,and it can be used as an early identification of systemic infection,judgment of pyemia severity and prognosis judgment in-dex.