Objective To investigate the clinical value of the detection of serum procalcitonin (PCT) and plasma D-dimer (D-D) levels in the early diagnosis of infection in critically ill children.Methods Solid-phase immune chromatography and immune nephelometry were used to determine the levels of serum PCT,plasma D-D,plasma C reactive protein (CRP) and WBC count in 302 critically ill children.Results The positive rate of serum PCT and the level of plasma D-D in the infected group (208 children) were significantly higher than those in the non-infected group (94 children)[96.6％(201/208) vs.10.6％(10/94),(1.65 ± 0.73) mg/L vs.(0.45 ± 0.21) mg/L,P ＜ 0.05].But there was no significant difference of plasma CRP level and WBC count between the 2 groups (P ＞0.05).The levels of serum PCT and plasma D-D were positively correlated to the severity of the illness (P ＜ 0.05).Conclusions The levels of serum PCT and plasma D-D are between important sensitivity markers for early diagnosis of critically ill children,illness severity assessment and therapeutic evaluation.The detection of plasma D-D plays an important role in early diagnosis of the degree and the width of coagulation disorder,and also provides the theoretic basis to use anticoagulation drugs for treating the critically ill children with infection.

Objective To assess the efficacy of submucosal injection of thiotepa for the prevention of recurrence of superficial bladder cancer. Methods Sixty-six patients with superficial bladder cancer were chosen, they were randomly divided into injection group(33 cases)and control group(33 cases). In injection group, 33 patients had submucosal injection of thiotepa, after 30 minutes resection of bladder tumor were treated by PKRBt, after one week, they were given perfusion 27 mg BCG. In control group, 33 patients after the PKRBt were given perfusion BCG. Results The recurrence rate in injection group was 15.2%, and that of the control group was 27.3%. There was significant difference between the twO group (P<0.05). Con-clusions The submucosal injection of thiotepa , PKRBt and perfusion BCG could prevent tumor recur-rence,it has the following advantage,such as simple , safe, less side effect ,more economical. The submu-cosal injection is a practical method to prevent tumor recurrence and is worth popularizing.

Objective To summarize the practices of national emergency medical rescue team in the fourth ASEAN regional forum disaster relief exercise.Methods The establishing principle and training mode of national emergency medical rescue team were introduced,and the advantages and disadvantages of the team were described in the preparation for exercise and rescue practice.Results The experience in Malaysia improved the team in emergency support.Conclusion The medical preparedness and rescue practice in transnational disaster relief are of great value for rapid response of national emergency medical rescue team.

BACKGROUND: Ankle fracture combined with deltoid ligament rupture and distal tibiofibular syndesmosis injury occurs occasionally. Its treatment with distal tibiofibular syndesmosis screw fixation or deltoid ligament repair remains controversial. The former appears with poor reduction, broken nails, secondary surgery and other problems.OBJECTIVE: To observe the clinical effectiveness of suture anchor repair for ankle fracture combined with deltoid ligament injury.METHODS: Twelve patients with ankle fracture combined with deltoid ligament injury were selected from the First Affiliated Hospital of Guangzhou University of Chinese Medicine between January 2013 and December 2015. All patients were treated with open reduction, internal fixation, and anchor repair, but without distal tibiofibular syndesmosis screw fixation. The curative efficacy and joint stability were observed.RESULTS AND CONCLUSION: (1) All patients were followed-up for more than 12 months. (2) The modified Baird-Jackson scoring system showed excellent in nine cases, good in two cases, average in one case, poor in none case, and the excellent and good rate was 92%. (3) At 1 year after internal fixation, the X-ray examination showed the malleolus gap and talus slope angle of the affect side were (3.47±0.12) mm and (0.45±0.18)°, and the malleolus gap and talus slope angle of the healthy side were (3.44±0.05) mm and (0.43±0.14)°, and there was no significant difference between two sides (P > 0.05). (4) These results indicate that the suture anchor can repair the anatomy and biomechanics of deltoid ligament with stable ankle joint, and secondary surgery is unnecessary.