Objective To explore the effect of heating temperature and heating time on the dissolution characteristics of phenolic acids in water extract of Danshen Decoction. Methods The contents of tanshinol, protocatechuic aldehyde and salvianolic acid B in water extract of Danshen Decoction were determined by reverse-phase high performance liquid chromatography (RP-HPLC) . The changes of the contents were monitored by classic constant temperature acceleration method. Results Of the three components, the content of salvianolic acid was decreased with the increase of heating temperature and the prolongation of heating time, and the degradation characteristics of the salvianolic acid B met the first-order kinetics equation. Conclusion The water-soluble components have less stability in the water extracts of Danshen Decoction. Lignum Santali Albi and Fructus Amomi accelerate the degradation speed of Radix Salviae Miltiorrhizae, suggesting that we should pay attention to the influence of heating temperature and heating time on the content of salvianolic acid B in the extraction and concentration process.

Objective To investigate the correlation of PICC tip position and weight gaining in very low birth weight infants.Methods We performed a retrospective study using chest X-ray films of very low birth weight infants in NICU who had PICCs inserted in a tertiary hospital.We recorded the tip positions on plain radiographs and calculated the position change,and calculated weight gaining ratio.Spearman regression model was used to analyze the relationship between tip position migration and weight gaining ratio.Results A total of 57 cases of very low birth weight infants were included,containing 246 X-ray films.On the first day of taking X-ray,weight was 0.6-1.46 (1.06±0.25) kg,the median and interquartile spacing are 5(3,7)d.The last time of taking X-ray was(24.0±9.1) dafter PICC placement;weight gaining ratio was 11.8％～114.8％,the median and interquartile spacing are 41.5％ (27.1％,65.3％).All PICCs tip position changed,75％ of which migrated more than 2 vertebrae,50％ of which migrated 3 vertebrae,and the median and interquartile spacing are 3 (1.8,3.5) vertebrae.The distances of tip migration were correlated with weight gaining ratio.With an approximate 2,3 and 4 vertebrae of PICC tip migration,the corresponding weight gaining ratio was about 40％,70％ and 100％.The correlation coefficient between PICC tip position migration and weight gaining ratio was-0.7(P＜0.01),but there was difference in different insertion sites.Conclusion PICC tip position is greatly influenced by weight gaining among very low birth weight infants.By considering the initial placement position,the crucial moment to assess catheter location is at 40％ and 70％ weight gaining ratio.After 100％ weight gaining,PICCs should be removed or replaced.PICCs can easily be affected by bone growth and limb movement,require higher frequency of catheter localization.

Administrative multi-disciplinary team (MDT) is an efficient management approach that involves multiple administrative departments working together to solve cross functional systemic problems. Grid management improves management efficiency by constructing a three-level management network, efficiently transmitting information and coordinating resources. Starting from 2021, Children′s Hospital, Zhejiang University School of Medicine has adopted a combination of administrative MDT and grid management, with the average length of stay as the starting point to carry out medical efficiency management. Through the three stages of pre-, during-, and post-treatment, the hospital has reconstructed processes from technological innovation, information construction, team collaboration, and other aspects to shorten ineffective length of stay. After 3 years of practice, the average length of stay has been reduced from 6.41 d to 5.54 d, achieving an improvement in service efficiency while ensuring medical quality and safety.

OBJECTIVE:To optimize the extraction technology of Compound radix fici hirta granule. METHODS:Using the transfer rate of psoralen and amygdalin in extraction liquid of Compound radix fici hirta granule and extraction rate as indexes, U12(6×4×3)uniform design was used for the test,the effects of amount of adding water,extraction time,extraction times on the extraction technology were investigated,and optimized technology was verified by three pilot scale tests. RESULTS:The optimal technology was as follow as 10-fold water,extracting for 3 times,60 min each time. Under the conditions,transfer rate of pso-ralen and amygdalin and extraction rate were 82.51%(RSD=1.45%,n=3),93.69%(RSD=0.85%,n=3),18.89%(RSD=0.74%,n=3),respectively. The validated results were in the 95% confidence interval of predictive value. CONCLUSIONS:The optimized extraction technology is stable and feasible,and provides the scientific basis for the follow-up development of the prepa-ration.

December 2019 witnessed the outbreak of COVID-19 in Wuhan, Hubei province of China, which has soon spread nationwide and across national borders, posting a menacing pandemic threat. Children are themselves highly susceptible infectious diseases in normal times not to mention an epidemic period. Coupled with the high incidence of seasonal influenza, it is imperative to strengthen epidemiological screening of children, along with effective isolation, treatment, prevention and control measures. In view of specifics of the hospital, the authors proposed to further improve the medical emergency procedure, strictly enforcing screening and isolation regulations, and standardizing medical procedure. They also proposed scientific layout and use of the infection wards. These measures are designed to control the epidemic and protect the safety of medical staff.

Objective:To investigate the uncertainty level of caregivers of children with imperforate anus, and determine the influence factors.Methods:Two hundred and twenty-nine caregivers were enrolled from three tertiary children′s hospital in Eastern China. The caregivers completed the Perception of Uncertainty Scale, Parent Stigma Scale and Social Support Scale. The demographic information of caregivers and affected children were also collected during the survey.Results:The average score of uncertainty of caregivers was (72.58±14.06) points, and multiple analysis showed that education level, the acceptance level of disease, social support and stigma were independent determinants of uncertainty ( P<0.01), and these factors could account for 26.9% of the variance. Conclusions:The caregivers of children with imperforate anus experience a high level of uncertainty, especially those with low education level, share low acceptance level of disease, receive low social support and experience higher level of stigma.

Objective To understand the discharge readiness of fathers of preterm infants in the Neonatal Intensive Care Unit(NICU),analyze its influencing factors,and provide a basis for formulating individualized discharge health education plans and continuous care plans.Methods A convenience sampling method was employed to select fathers of preterm infants admitted to the NICU in a tertiary A hospital in Zhejiang Province from March 2022 to June 2022 as the subjects of the study.A general information questionnaire and the Discharge Readiness-Parent Version scale were used for the survey.Multiple linear regression analysis was applied to analyze the factors influencing the discharge readiness of fathers of NICU preterm infants.Results A total of 186 fathers of NICU preterm infants were included in the study.The total score of the Discharge Readiness-Parent Version scale was(179.97±28.20)points;the standardized score was(7.82±1.16)points;33.3％of the fathers of preterm infants had a standardized score of＜7 points.Multiple linear regression analysis results showed that the factors influencing the discharge readiness of fathers of NICU preterm infants included the gestational age at birth,birth weight,length of hospital stay,distance to access healthcare service,as well as the fathers'age,annual family income,and number of children in the family.Conclusion The discharge readiness of fathers of NICU preterm infants is at a moderate level.Nursing staff need to pay attention to the discharge readiness of fathers of preterm infants who have lower gestational age at birth,lower birth weight,longer hospital stays,longer distance to healthcare service,and who are younger,have lower annual family income,and are having their first child.Individualized discharge health education plans and continuous care plans should be formulated for them to improve their caregiving knowledge and skills.

Objective To explore the survival factors for oral squamous cell carcinoma (OSCC). Methods A total of 492 patients with OSCC were recruited from the First Affiliated Hospital of Fujian Medical University from June 2003 to December 2014. Then, 456 cases were included in the present study according to inclusion and exclusion criteria. Clinical and follow-up data were collected to evaluate survival factors of OSCC. Survival rates were calculated using the Kaplan-Meier method and compared using the Log-rank test. The Cox proportional hazards regression model was used to estimate the hazard ratio (HR) and 95% confidence intervals (CI) of survival factors. We also stratified by TNM Classification of Malignant Tumours stage and BMI to assess the association between treatments and OSCC outcomes. Results The age of the recruited patients was (57.89±11.61) years, and the proportions in TNM stagesⅠ,Ⅱ,Ⅲ, andⅣwere 14.0%(64), 23.7%(108), 16.1%(73) and 42.5%(194), respectively. The multivariate Cox regression indicated that the HR (95% CI) of the increase to mortality risk associated with stage T2-T3, T4(T1 as reference), stage N2-N3 (N0 as reference), poor-moderate differentiation, BMI<18.5 kg/m2 (compared with BMI 18.5-23.9 kg/m2), alcohol consumption≥20 g/d (compared with no alcohol) before treatment were 2.69 (1.21-5.95), 3.40 (1.54-7.53), 2.65 (1.17-6.00), 2.56 (1.39-4.71), 2.00 (1.15-3.50), 2.09 (1.11-3.93), and 1.68 (1.03-2.73), respectively. The stratification analysis demonstrated that, compared with surgery alone, surgery combined with radiotherapy reduced the mortality risk of stage Ⅲ-Ⅳ, HR (95% CI) 0.33 (0.12-0.93). Surgery combined with chemoradiotherapy reduced the mortality risk of OSCC with normal BMI, HR(95%CI) were 0.39 (0.17-0.87). Conclusions Clinical stage and histological grade are survival factors for patients with OSCC.

Objective To explore the survival factors for oral squamous cell carcinoma (OSCC). Methods A total of 492 patients with OSCC were recruited from the First Affiliated Hospital of Fujian Medical University from June 2003 to December 2014. Then, 456 cases were included in the present study according to inclusion and exclusion criteria. Clinical and follow-up data were collected to evaluate survival factors of OSCC. Survival rates were calculated using the Kaplan-Meier method and compared using the Log-rank test. The Cox proportional hazards regression model was used to estimate the hazard ratio (HR) and 95% confidence intervals (CI) of survival factors. We also stratified by TNM Classification of Malignant Tumours stage and BMI to assess the association between treatments and OSCC outcomes. Results The age of the recruited patients was (57.89±11.61) years, and the proportions in TNM stagesⅠ,Ⅱ,Ⅲ, andⅣwere 14.0%(64), 23.7%(108), 16.1%(73) and 42.5%(194), respectively. The multivariate Cox regression indicated that the HR (95% CI) of the increase to mortality risk associated with stage T2-T3, T4(T1 as reference), stage N2-N3 (N0 as reference), poor-moderate differentiation, BMI<18.5 kg/m2 (compared with BMI 18.5-23.9 kg/m2), alcohol consumption≥20 g/d (compared with no alcohol) before treatment were 2.69 (1.21-5.95), 3.40 (1.54-7.53), 2.65 (1.17-6.00), 2.56 (1.39-4.71), 2.00 (1.15-3.50), 2.09 (1.11-3.93), and 1.68 (1.03-2.73), respectively. The stratification analysis demonstrated that, compared with surgery alone, surgery combined with radiotherapy reduced the mortality risk of stage Ⅲ-Ⅳ, HR (95% CI) 0.33 (0.12-0.93). Surgery combined with chemoradiotherapy reduced the mortality risk of OSCC with normal BMI, HR(95%CI) were 0.39 (0.17-0.87). Conclusions Clinical stage and histological grade are survival factors for patients with OSCC.

The epidemic of COVID-19 has become the topmost public health threat worldwide. The authors suggested that in addition to strengthening the organization and leadership of the abovementioned work, greater attention be paid to establishing and improving the prevention and control mechanism.Furthermore, special efforts should be given to the safety of the medical workers, by strengthening their infection monitoring and outbreak management. Medical workers in different work areas and positions should be placed under careful protection with due cleaning and disinfection measures. The protection during specimen collection, transportation and medical waste management should also be prioritized. Such special issues in the management of pediatric patients, as allocation of nurses, the screening and management of caregivers, the problem of breastfeeding, and the disinfection of children′s toys and diapers were discussed. This paper also put forward management suggestions for the outpatient department, isolation ward and other key departments, which aim to guide the prevention and control of COVID-19 nosocomial infection in the pediatric outpatient and ward.