Objective To explore the pediatric emergency medical mode in critical ill children by pediatrics specialty and nurses,using equipments of ICU for adults in second class general hospital. Methods We retrospectively analyzed the effect of establishing the pediatric observation unit in the adult observationdistrict and the prognosis and disease spectrum of pediatric critical patients in our emergency ICU in the past five years. Results 5 076 pediatric patients had been admitted to the emergency observation unit accounting for 3.40% of outpatient yearly. There were 464 critically ill children,accounting for 9. 14% of children into the observation unit,251 cases (54. 09%) were transported to other hospitals,35 cases (7.54%) were admitted to emergency ICU due to transport high-risk, 14 cases required ventilator support. The disease spectrum based mainly on childhood accident,including trauma,poisoning and drowning,etc. The other major diseases were severe infection and fulminant myocarditis. After the treatment such as stopping bleeding, respiratory supporting ,correcting shock, and maintaining the function of important organs,77. 14 % were improved or recovered. The survival rate of children with mechanical ventilation was > 85%. Conclusion In our country,the pediatric emergency medical service system is inadequate. The critical illness treatment model of using the advantages of equipments and nurse' s team of adult ICU in second class general hospital ,combining with pediatrician trained in PICU is feasible and consistents with our national conditions.

[Objective]To evaluate curative effects of Osteoset~ synthetic bone transplants and internel fixations on calcaneus fracture.[Method]Twenty-three patients with calcaneus fracture,who were treated by Osteoset~ synthetic bone transplants and internel fixation,were followed up by plain X-Rays and JOA functional questionnaires.Fracture patterns were based on Sanders methods.[Result]A series of 23 patients,7 of which were sanders Ⅱ,15 were sanders Ⅲ,3 were sanders Ⅳ,were treated with ORIF and Osteoset~ implants.The preoperative Blher's angle was 4.8 degrees(standard deviation 6.6 degrees).Blher's angle increased to a mean of 26.8 degrees(SD 8.6 degrees) postoperatively.In the first 3 months after surgery,a mean decrease in the Blher's angle of 0.4 degrees(SD 2.27 degrees) occurred.One month after surgery osteoset synthetic bone transplants,which was replaced by new bone,were gradually absorbed and degraded.JOA questionnaires suggested that the whole effective rate was 92 percent.[Conclusion]Osteoset synthetic bone transplants and internel fixations has good therapeutic effects on patients with comminuted calcaneus fracture.Osteoset~ synthetic bone has the same effects as autogenous bone.

Objective To investigate and establish thyroid function reference range during 3 pregnant stages in Chaoshan area:thyrotropin (TSH),free thyroxin (FT4).Methods 863 healthy pregnant women visited antenatal clinic in the Second Affiliated Hospital were included in this study.By detecting serum levels of TSH,FT4,thyroglobulin antibody (TgAb),and thyroid peroxi-dase antibody (TPOAb)in these women,the euthyroid reference ranges of serum TSH and FT4 in different pregnant stages were established based on the standards of the United States National Institute of Clinical Biochemical (NACB)guidelines.Results The ranges of serum TSH in the first,second and third trimester of pregnancy were 0.13-3.93 mIU/L,0.14-4.55mlU/L,and 0.42-3.85 mIU/L,respectively.The ranges of serum FT4 levels in these 3 stages were 12.00-23.34 pmol/L,6.27-12.65pmol/ L, and 9.80-18.20 pmol/L,respectively.The range of serum TSH levels in our study were similar with the reference range recom-mended by the guidelines in China,but were different compared with the American Thyroid Association (ATA)guidelines.Conclu-sion TSH,FT4 levels show dynamic changes during different stages of pregnancy.The thyroid function ranges of healthy pregnant women in Chaoshan area are quite different compared with non-pregnant population and pregnant women in distinct area.Due to the differences of diet,iodine intake,economy and culture in Chaoshan area,regional thyroid function reference ranges specific for differ-ent stages of pregnant women should be established.

Objective To observe the expression of polysialic acid-neural cell adhesion molecule (PSA-NCAM) in the rat hippocampus after infrasound exposure. Methods Ninety-six Sprague-Dawley rats were random-ized into a 16 Hz 130 dB infrasound exposure group (n =72) and a control group (n =24). Rats of the infrasound exposure group were exposed to 16 Hz 130 dB infrasound in a barochamber 2 h/d for 1, 7, 14 and 21 d. The rats' brains were removed and immunohistochemieal methods were used to detect the expression of PSA-NCAM in the hip-pocampus on the 1st, 7th, 14th, and 21st day during treatment and on the lat, 7th, and 14th day after the treatment ended. Results The expression of PSA-NCAM in the rats' hippocampuses increased after exposure for 1 d, reached its peak at the 14th day, then had decreased by the 21st day but remained at a higher level than in the controls (P≤ 0.05). Conclusion The expression of PSA-NCAM in the rat hippocampus is increased by exposure to 16 Hz 130 dB infrasound, but the levels recover somewhat after infrasound exposure ends. lnfrasound could induce neural injury and promote the migration of neural stem cells. PSA-NCAM might participate in the repair of neural injuries re-suiting from infrasound exposure.

Objective To study the clinical characteristics and treatment of neurofibromatosis type Ⅱ (neuro-fibromatosis type 2 ,NF2 ,bilateral acoustic neuroma) ,and the effects of auditory brainstem implant for treating to-tal deafness after bilateral acoustic neuroma resection .Methods One case of bilateral acoustic neuroma and all clini-cal data in terms of diagnosis ,treatment and hearing -speech rehabilitation after surgery were retrospectively stud-ied .Results The patient was a thirteen years old boy .His clinical symptoms were hearing loss on the right ear ,tin-nitus ,hoarseness and gait instability three years .MRI showed space occupying lesion in the cerebellopontine angle . The postoperative pathological diagnosis was bilateral acoustic neuroma .The initial switch -on was peformed six weeks after the surgery ,and confirmed that all electrodes generated listening responses .As the extension of recov-ery time ,the correct recognition rate of patients on the natural environment sound ,vowel ,monosyllabic were on the rise and the pure tone hearing threshold gradually decreased .The vowel correct recognition rate of postoperative 6 , 9 ,12 ,24 ,and 36 months were 14% ,18% ,20% ,24% ,and 20% ,respectively .The recognition rate of monosyl-labic and open words at each postoperative rehabilitation stage were 0 .Conclusion The clinical characteristics and treatment of bilateral acoustic neuroma were different from the unilateral acoustic neuroma .The individualized treat-ment should be followed .Auditory brainstem implant could be performed in patients with post - bilateral acoustic neuroma resection .The accurate location of the cochlear complex during the surgery was the crucial point for the success of ABI .

One hundred elderly patients with hyperthyroidism were enrolled in a paired design study.The outcome of ~(131)Ⅰand antithyroid drug(ATD)treatments was examined after 2 years.The results showed that ~(131)Ⅰcould be recognized as the safer,more convenient and effective treatment than ATD for the elderly patients with hyperthyroidism.

Objective To study the effect of 16 Hz infrasound on the proliferation of the neural stem cells in rats' hippocampus.Methods72 SD rats were randomized into 16 Hz-130 dB infrasound exposure group(n=24),16 Hz-90 dB infrasound exposure group(n=24)and control group(n=24).Rats of the infrasound exposure groups were exposed to 16Hz 90dB/130dB infrasound barochamber system,2 h/d for 1 d,7 d,14 d,or 21 d.Their brains were removed and anti-nestin immunohistochemistry was used to observe the neural stem cells in rats' hippocampus.ResultsThe expression of nestin in rats' hippocampus increased after exposure for once and increased with the exposure time.It reached its peak on the 14th day,decreased on the 21st day but remained higher level.The reaction of 90 dB group was weaker than that of 130 dB group.ConclusionThe brain injuries result from 16 Hz infrasound exposure can enhance the proliferation of neural stem cells in rats' hippocampus which might participate in the repair of neural injuries.

Aged, 80 and over ; Aorta, Abdominal ; pathology ; Embolism, Cholesterol ; therapy ; Female ; Humans

Objective To report the clinical outcomes of open reduction and internal fixation for capitellum fractures in adolescents.Methods From January 2010 to January 2015,14 adolescents with capitellum fracture were admitted to our department.They were 12 males and 2 females,aged from 12 to 16 years (13.7 years).By the Dubberley classification,we had 2 cases of type ⅠA,8 cases of type ⅡA,3 cases of type Ⅲ A and one of type Ⅲ B.We summarized their clinical characteristics and injury mechanisms.At the last follow-up,the therapeutic efficacy was assessed by the Mayo elbow function scores,and the ranges of motion of the elbow and forearm on the affected side were recorded.Results The 14 patients obtained an average follow-up of 12 months (from 6 to 18 months).All the cases achieved fracture union within 3 months,but malunion appeared in one.At the last follow-up,the ranges of flexion and extension of the affected elbow averaged 120.6° (from 110° to 135°),and the ranges of lateral rotation of the affected forearm averaged 160.3° (from 150° to 175°).According to the Mayo scores at the last follow-up,the elbow function was rated as excellent in 12 and as good in one.Mild traumatic arthritis occurred in 3 cases.Conclusions Capitellum fractures in adolescents are often Dubberley type A ones without a complicated fracture of the posterior condyle.Usually,the capitellum is impacted by the radial head in the process of elbow extension with valgus stress.After definite diagnosis,open anatomical reduction and reasonable and reliable internal fixation can result in good clinical results.