Objective To explore the effect of Q-Syte separated membrane sealed without pin connector in children with blood disease. Methods Using random digit table, the children using Q-Syte separation membrane enclosed needle-free connector and heparin cap were divided into the observation group and the control group with 260 children in each group. The two groups were compared in terms of the incidence of using Q-Syte membrane closure cap pin connector and heparin. Results The result showed a significant positive relation between the two groups (P<0.05). The incidence of using Q-Syte separation membrane sealed without pin connector was lower than that of the control group. Conclusion Q-Syte separation membrane sealed without pin connector can reduce the incidence of infusion, which is easy, safe and worth clinical application.

Objective To evaluate the feasibility of three-dimensional contrast-enhanced ultrasound (3D-CEUS) in showing vascular patterns of renal tumors.Methods The images of 3D-CEUS examination were retrospectively analyzed in one hundred and twenty one renal tumors which were confirmed sequentially by pathology.3D-CEUS was performed after conventional ultrasound and contrast-enhanced ultrasound (CEUS).The 3D-CEUS images were reconstructed by QLAB workstation and classified into 4 grades based on the blood supply characteristics.Results All the tumors were confirmed by pathology and operations,including clear cell renal cell carcinoma (CCRCC) (n=91),papillary renal cell carcinoma (PRCC) (n=5),chromophobe renal cell carcinoma (CRCC) (n=5),renal angiomyolipoma (RAML) (n=19),and cystic nephroma (n=1).Three-dimensional reconstruction could provide clear stereoscopic views of the interested structures and morphological characteristics of lesions.The three-dimensional ultrasonography of a particular renal tumor could be a mixture of different basic grades.There were significant differences between benign and malignant renal tumors in 3D-CEUS.The image quality was the best in early parenchymal phase comparing to other phases.In early parenchymal phase,84 RCCs (83.17%) were tortuous expansive reticular or irregular messy dendritic,61 cases (60.40%) with filling defect areas and 15 cases (14.85%) with pseudocapsules.Grade Ⅲ and Grade Ⅳ were the main vascular patterns in maglinant tumors.In early parenchymal phase,6 RAMLs (31.58%) were nebulous with dendritic in part,12 cases(63.16%) were reticular on the basis of nebulous with homogeneous internal structures.The vascular pattern was shown better in 3D-CEUS than CEUS.Conclusions 3D-CEUS can provide clear stereoscopic structures and morphological characteristics of the lesions,it is a useful adjuvant of CEUS for the diagnosis of renal tumors.

Objective To evaluate the feasibility of virtual touch tissue quantification (VTQ) for the assessment of renal allograft.Methods A total of 72 kidney recipients were examined with conventional ultrasound and VTQ after transpantation.Biopsies were performed in 34 patients,20 patients were with acute rejection (AR),14 with chronic allograft nephropathy (CAN),38 patients as control group.The peak systolic velocity (PSV) and resistance index(RI) were measured on main,infrarenal and arcuate arteries with conventional ultrasound and shear wave velocity (SWV) of the renal cortex was obtained by VTQ.All the data were compared among three groups.Results There were no significant differences of PSV between two groups.An increased RI was presented in the CAN group(P ＜0.05).The mean SWV was (2.67 ± 0.27) m/s,(2.90 ± 0.31)m/s and (2.28 ± 0.24)m/s for AR,CAN and normal group,respectively.There were significant differences of SWV among the three groups (P ＜ 0.05).Conclusions VTQ technique could provide a new method for the assessment of transplanted kidney.

Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) with high mechanical index(MI) in the diagnosis of renal artery stenosis(RAS). Methods Twenty-one patients with RAS including 3 patients after renal transplantation were studied. Ultrasound contrast agent SonoVue was used and MI was set at about 1 when the CEUS was performed. All patients were examined with conventional color Doppler sonography and CEUS. The diagnostic results of ultrasound were compared with those of intravenous digital subtraction angiography ( DSA), CT angiography(CTA) and MR angiography (MRA). Results The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of conventional color Doppler sonography were 85. 7%, 57. 1 % , 80. 0% , 66. 7% and 76. 2%, respectively, those of CEUS were 100%, 66.7%, 88.2%, 100% and 90.5%, respectively. Conclusions CEUS with high MI which improves the imaging of renal artery depicts the margin of the vascular lumen directly and clearly. It may be more helpful in the diagnosis of RAS.

Objective:To investigate the application of tracheal intubation by the endoscopic-assisted mouth floor-submandibular approach(EAMFA) for general anesthesia and the operation of craniofacial multiple fractures.Methods:8 patients with complex craniofacial fractures and associated with the contraindication of nasal trachea cannula underwent EAMFA general anesthesia and operation.Blood pressure(BP),saturation of blood oxygen(SPO2),heart rate(HR) and electrocardiogram(ECG) were monitored timely.Results:The intubation and anesthesia were successfull in all patients;BP,SPO2,HR and ECG were normal in all operation procedure in the patients.No complication was observed.Conclusion:EAMFA is an effective anesthesia approach for the surgical treatment of craniofacial multiple fractures.

Objective To evaluate contrast-enhanced ultrasound imaging of carotid atherosclerosis with different stenostic degree as a clinical tool to study intraplaque neovascularization.Methods Fifty-eight patients suspected of carotid stenosis with 73 plaques were studied by standard and contrast-enhanced ultrasound.Plaque echogenicity at standard ultrasound were evaluated.Contrast enhancement within the plaques was categorized as 0 - 4 degree and compared to the stenosis degree and the plaque echogenicity.The degree of stenosis was determined by intravenous digital subtraction angiography.Results In the group with stenosis less than 90% ,stenosis degree was not associated with the grade of contrast enhancement (P =0.358),while the grade of enhancement was significantly higher in the group with sever stenosis(＞90%).The grades of enhancement were significantly different between plaques with different echogenicity (P =0.000).Conclusions Contrast-enhanced real-time ultrasound imaging can demonstrate the enhancement of carotid plaques non-invasively,which is helpful for assessing intraplaque neovascularization and provide valuable information for plaque risk stratification

Objective:The major aim of this study is to analyze the point mutation at the codon 54th of MBL in healthy North Huis,and to measure the plasma levels of MBL, and to analyze the association between the mutation frequency and plasma MBL concentrations.Methods:PCR-RFLP was used to detect MBL point mutation.MBL plasma concentrations were measured using MBL Oliger ELISA kit.Results:Frequency of point mutation at the codon 54th of MBL in healthy Huis was 0.15. The plasma MBL concentration was (3.40?2.55)mg/L. There was negative correlation between MBL concentrations and gene mutation frequency in huis(r=-0.67).Conclusion:The relationship between frequency of mutation at codon 54 of MBL gene and the plasma MBL concentrations in healthy Huis is negative correlation.

Objective:To investigate the value of color Doppler ultrasound in the evaluation of carotid artery restenosis after ca-rotid artery stenting (CAS) and carotid endarterectomy (CEA) .Methods :A total of 53 patients with 62 carotid artery stenosis diagnosed by digital subtraction angiography (DSA) were enrolled .All of them underwent CAS and CEA .The postoperative and preoperative ultrasound datum including the minimum luminal diameter ,the peak systolic velocity (PSV )of the internal ca-rotid artery (ICA) and common carotid artery (CCA) ,end diastolic velocity (EDV) of ICA were retrospectively analyzed . Results:A total of 52 arteries were normal or had <50% restenosis ,while 10 arteries had ≥50% restenosis after the treat-ment .Compared with those before treatment ,the minimum luminal diameter was significantly wider ,and PSVICA decreased significantly in patients with <50% restenosis(P<0 .01) ,whereas the minimum luminal diameter and PSVICA were not sig-nificantly changed in patients with≥50% restenosis(P>0 .05) .PSVICA ,EDVICA and PSVICA/PSVCCA in patients with≥50% restenosis significantly increased compared with that in patients with <50% restenosis(P<0 .01) .PSVICA/PSVCCA≥2 was set as the cut-off point ,the sensitivity and specificity for detecting ≥50% restenosis were 80 .0% and 98 .1% respective-ly .Conclusions :Color Doppler ultrasound can effectively evaluate carotid artery restenosis after CAS or CEA .

Objective:To understand the status quo of pediatric nurses' traits and adversity quotient (AQ) , and explore the effects of pediatric nurses' traits on their AQ.Methods:In this cross-sectional study, totally 480 pediatric nurses from Children's Hospital of Nanjing Medical University between March and April 2019 were selected by convenient sampling and investigated with the general information questionnaire, Chinese Big Five Personality Inventory Brief Version (CBF-PI-B) and Adversity Response Profile (ARP) to analyze the effects pediatric nurses' traits on their AQ. Totally 480 questionnaires were distributed, and 469 valid questionnaires were collected, accounting for an effective recovery rate of 97.7%.Results:In the CBF-PI-B of the 469 pediatric nurses, the agreeableness score was (39.36±5.84) ; the rigor score was (38.21±4.32) ; the openness score was (32.78±5.64) ; the extraversion score was (27.29±6.72) ; the neuroticism score was (25.53±5.24) . The total ARP score of the pediatric nurses was (134.63±9.27) . The agreeableness, rigor, openness and extraversion dimensions in the pediatric nurses' traits were positively correlated with their AQ ( P<0.05) , and the score of neuroticism was negatively correlated with their AQ ( P<0.05) . The results of hierarchical regression analysis showed that the rigor and neuroticism in the five traits of pediatric nurses had a predictive effect on their AQ ( P<0.05) . Conclusions:The AQ of pediatric nurses is mostly in the upper middle level. The traits of pediatric nurses have a predictive effect on their AQ. Nursing managers should pay attention to the training of pediatric nurses' AQ and take effective measures to improve their AQ.

Objective:To summarize the clinical features and treatment of pneumocystis jirovecii pneumonia(PCP) in children with non-human immunodeficiency virus(HIV) infection.Methods:A retrospective study was performed on seven cases of severe PCP children with non-HIV infection who were admitted to PICU of The University of Hong Kong-Shenzhen Hospital and PICU of Xianyang Rainbow Hospital from May 1, 2015 to May 1, 2021.The risk factors, clinical manifestations, laboratory results, pulmonary radiological features, treatment and outcomes were observed.Results:Seven children with PCP, including four males and three females, aged from 13 months to 85 months[(42.4±26.8) months], were all associated with underlying diseases, and most of which was hematological malignancies.Six children had a history of using TMP-SMX for PCP prevention, but four of them stopped by themselves and infected PCP in 2 to 4 weeks.All children had hypoxic respiratory failure, whose OI was 30.6±3.4, and presented with fever, dry cough, progressive dyspnea but no lung rales in the early stage.LDH[(745.7±317.0) U/L] and β-D-glucan[(513.8±225.0) pg/mL] increased in all patients.Chest CT showed diffused interstitial changes in bilateral lung fields associated with multiple exudative lesions.Among the anti-Pneumocystis Jirovecii treatment regimens, all cases began the treatment in the first three days during the admission, five cases were treated with intravenous TMP-SMX, and two cases were treated with oral TMP-SMX + caspofungin, with a course of 21 days.All children were also treated with glucocorticoid at the same time.Three days after the treatment of PCP, two children were worsened and one of them died, while another one started to recover on the 6th day of the regimen.The remaining five cases began to show clinical improvement after 3~7 days of PCP treatment.Finally six children were cured and one was died.Conclusion:PCP infection of children without HIV has high risk of destruction in immune system.TMP-SMX can prevent PCP effectively.In the severe PCP cases, early commencement of intravenous TMP-SMX can reduce the mortality rate.In the absence of intravenous TMP-SMX, oral TMP-SMX can be used with caspofungin.