Through introducing the current situation of systemic pediatric emergency protocol,including five-level triage system,pediatric critical rescue protocol,pediatric trauma life support,emergency observation and guidelines for the pediatric intrahospital transport,we reviewed the issues of pediatric emergency to put forward recommendations.

OBJECTIVE To investigate the frozen section and surgical margin predicting the prognosis of laryngeal carcinoma after partial laryngectomy and decides the circumscription of surgical margin because of the balance between the function of the larynx and the recurrence rate of cancer.METHODS 77 cases of laryngocarcinoma were reviewed in this retrospective study.All of the laryngocarcinoma patients were treated in our hospital during 1996.1～2001.12 frozen section, surgical margin, and pathological section were compared to the recurrence rate of cancer and the survival rate of patients.RESULTS To those Partial laryngectomy whose surgical margin are larger than 0.5 cm, whether carrying out the frozen section is not significant.But to those Partial laryngectomy whose surgical margin are smaller than 0.5 cm, we should carry out the surgical margin to decrease the positive rate of the pathological section.Recurrent rate of the negative group is lower than the positive group(P

OBJECTIVE:To prepare Weikang capsule and establish its quality standard METHODS:Weikang capsule was prepared with gentamycin sulfate,vitamin B1,vitamin B2,vitamin B6 and vitamin B12 A polarimetry was established for determining the content of gentamycin sulfate in Weikang capsule RESULTS:There was a good linearity between optical rotations and concentrations of gentamycin sulfate from 2 000IU/ml to 12 000IU/ml with a regression equation of ?=0 00 767+1 77 003C,r=0 9 999 The average recovery rate of gentamycin sulfate in Weikang capsule was 100 1%,RSD was 0 79%(n=6) The results of polarimetry and microbioassay were nearly equivalent CONCLUSION:The preparation process of Weikang capsule is simple,and polarimetry for determination of the content of gentamycin sulfate in Weikang capsule wes rapid and reliable

Objectives To compare the co-infection statues of HSV, HBV and HCV in patients with STD and HIV infection for providing evidence of developing prevention and control strategies. Methods Serum samples confirmed to be infected with HIV/AIDS by Western blot, and serum samples of patients with STDs (syphilis, gonorrhoea and chlamydial infection) were tested for HSV2-IgG, HSV2-IgM, HBsAg and HCV-IgG by ELISA. The detection levels were compared between the two groups. Results Out of 76 specimens in STD group, HSV2-IgG was detected in 24 specimens (31.58%), HSV2-IgM in one specimen (1.32%), HBsAg positive in 8 (10.53%), and HCV antibody positive in 4 (1.32%). In 14 specimens of HIV/AIDS group, HSV2-IgG were detected in 7 (50.00%); HSV2-IgM in 5 (35.71%);8 (578.14%) were positive for HBsAg and 3 (21.43%) for HCV. In a total of 90 specimens, both HSV and HBV were detected in 6 specimens, both HSV-IgM and HBV in 2, and the four above-mentioned antibodies in 2. The infection rates of HSV, HBV and HCV were significantly higher in HIV-infected specimens than those in the STD specimens (P

Objective To study the effects of Vitamin D (VitD) supplementation on growth and immune function in neonatal mice.Methods A total of 120 mice were divided into four groups (30 mice in each group) according to dose of VitD.The high-dose group,medium-dose group and low-dose group was given 3.44,1.72,0.86 IU VitD drops,respectively.The control group was not treated with VitD drops.Rat body weight,level of peripheral blood 25-(OH)D3 were observed.The cellular immune function (determined by using delayed hypersensitivity reaction experiment),humoral immune function (assessed by antibody producing cells counts and HC50 determination) and mononuclear-macrophage phagocytic function (assessed by mouse peritoneal macrophage phagocytosis of chicken red blood cells test and carbon clearance test) were detected.The flow cytometry assay was carried out to differentiate T lymphocyte subsets.Results With the increase of dose of VitD,levels of peripheral blood 25-(OH)D3 and calcium ion were gradually increased,there were statistically significant differences when compared with the control group(P＜0.05);the body weight and body length were gradually increased,while no statistically significant difference was found among the groups treated with VitD(P＞0.05).Compared to the control group,the toes swelling,phagocytic percentage,number of antibody producing cells,serum soluble HC50 in the high-dose group and medium-dose group were increased significantly,while carbon clearance test phagocytic index were decreased significantly (P＜0.05).With the increase of dose of VitD,the number of CD4+,CD8+ T lymphocytes and the CD4+/CD8+ ratio were gradually increased.Conclusion VitD could promote the growth and development of offspring mice,and enhance the immune function of the body.

Objective To establish the model of pancreatoduodenal allotransplantation in pigs with enteric drainage (ED) and portal venous drainage (PVD). Methods Forty-six hybrid landraces were divided into two groups (donor and recipient groups) randomly, for pancreatoduodenal allotransplantation. Donors were perfused via abdomial aorta without clamping the portal venous outflow with UW solution after heparinization. Whole pancreatoduodenal graft was harvested with segments of abdomial aorta and portal vein and shaped under cold UW solution. Then, the end-to-end anastomosis was performed with the donor iliac artery bifurcation “Y” graft to the recipient superior mesenteric arteries and celiac artery. Furthermore, type Ⅰdiabete model was made by removal of the recipient pancreas. The venous anastomosis was reconstructed between the donor portal vein and the recipient superior mesenteric vein. Meanwhile, the end-to-side anastomosis was performed with the donor common iliac artery bifurcation “Y” graft to the recipient abdomial aorta and the side-to-side intestinal anastomosis was performed between the donor duodenum and the recipient jejunum. External jugular vein was intubated for transfusion. The levels of blood glucose, insulin and glucagon in blood were measured before and during the operation and 1, 3, 5, 7 d after operation. Results Twenty-three cases of pancreatoduodenal allotranplantations were performed on pigs. One died from complication of anesthesia. Success rate of operation was 95.7%.Complications of operation happened in 2 cases in which one was phlebothrombosis, incidence 4.5% and the other was duodenojejunal anastomotic leak, incidence 4.5%. The level of blood glucose increased within 30 min and recovered on the 2nd day after removal of pancreas. The levels of insulin and glucagon decreased within 30 min and recovered on the 2nd day after removal of pancreas. Rejection curred at the 1st day and reached the worst level on the 9th day after transplantation without the change of insulin and glucagon in blood and clinical symptoms of rejection. Conclusion Pancreatoduodenal transplantation in pigs can treat type Ⅰ diabete. ED and PVD can keep the function of endocrine in normal. The techni- que of duodenal transplantation with ED and PVD may pave the way for the further development of pancreas transplantation in clinic.

Objective To observe the recovery process of hind limb function following complete spinal cord transection injury and discuss corresponding mechanism. Methods The spinal cords of 15 SD rats were transected at T9 plane and a 3 mm spinal cord removed for a complete transection. The functional recovery of the hind limb was evaluated using CBS (combined behavioral score) and Basso Beattle Bresnahan (BBB) 1, 2, 4 and 6 weeks after injury. At the 6th week after injury, also experiment was done on histology, immunohistochemistry, motor evoked potential (MEP) of spinal cord and repeated transection. Results The hind limb function of the injured animals recovered at different degrees, most obvious at the 4th week and BBB was up to 12 at the 6th week. MEP result was related to the site of the stimulating electrode. No MEP was recorded when the stimulating electrode was placed above the injured site. But when the stimulating electrode was placed below the injury level, MEP was normal. The again transection of the spinal cord above the injury level took no effect on the recovered hind limb. However, again transection below the injury level resulted in complete paralysis. Histologic results showed that the injured site was filled with glial scars without axons. There existed a little scattered positive fibers of neurofilament protein 200 (NF200). Conclusions After complete spinal cord injury, there is a significant spontaneous recovery of the hind limb function that is a kind of autonomous functions of the injured distal spinal cord unrelated to repair of descending conducting fasciculus of the spinal cord. The distal spinal cord is intact in function.

Objective To study the etiology, diagnosis and treatment of acute occlusion of abdominal aorta(AOAA). Methods Clinical data of 35 patients with AOAA admitted to our hospital from January 1980 to August 2001 were analyzed retrospectively. Results There were 17 patients with acute aortic embolism(AAE) and 18 patients with acute aortic thrombosis(AAT) . All cases had total occlusion of abdominal aorta,and bilateral iliac arteries were involved. All the 35 cases underwent operations, including bilateral transfemoral thromboembolectomy by Fogarty balloon catheter in 18 cases, thromboembolectomy via laparotomy aortotomy in 11 cases, aortobiiliac reconstruction in 2 cases, aortobifemoral bypass in 2 ( 1 had profundaplasty) and axillobifemoral bypass in other 2 cases. Operative mortality was 25.7%(9/35). After the operations, artery embolism recurred in 3 cases; 3 patients required amputation; renal failure occurred in 3 cases and paraplegia in 4; ischemic colitis occurred in 5, impaired sexuality in 1 and incomplete intestinal obstruction in 1. Conclusions AOAA is an urgent disease with high mortality. Fast preoperative diagnosis and prompt operation are the keys to salvage the patient. Color Doppler is the first choice of diagnosis. Fogarty balloon catheter thromboembolectomy and vascular reconstruction are effective treatments for this disease.

ObjectiveTo analyze the effect of external valvuloplasty of the superficial femoral vein for primary deep venous valvular incompetence in the lower limbs (PDVI). Methods Consecutive seventy four cases(96 limbs) of PDVI were enrolled for prospective study, and color Doppler velocity profile technology and APG were performed preoperatively, the first month, the third month and the first year postoperatively. Results Postoperative venous reflux volume, VFI and score of venous dysfunction significantly decreased ( P

Objective To investigate the efficacy of gastric bypass surgery for the treatment of nonobese type 2 diabetes mellitus. Methods From November 2008 to August 2009, 40 patients with gastric diseases and nonobese type 2 diabetes mellitus were admitted to the Changhai Hospital, and their clinical data were prospectively studied. All patients were randomly divided into 4 groups; 10 patients received Billroth I distal gastrectomy +gastroduodenal anastomosis (BⅠ group) , 10 received proximal gastrectomy + remanant gastric esophageal anastomosis ( PG group), 10 received total gastrectomy + esophagoduodenal Y-anastomosis ( RY group) and 10received subtotal gastrectomy Billroth Ⅱ gastro-jejunostomy (BⅡ group). The length of hospital stay, pre- and postoperative body mass indexes (BMIs) , waist circumferences, levels of fasting blood glucose (FBG) , glycated hemoglobin ( GHbA1) , fasting serum insulin (FSI) and fasting C-peptide (FCP) of patients in the 4 groups were compared. All data were analyzed using analysis of variance, LSD-t test, paired t test or chi-square test. Results The clinical effects of the 4 different operative procedures on the gastric diseases were similar. The levels of FBG were (8.0 ±2.9)mmol/L before operation and (5.9 ±0.7)mmol/L after operation in the RY group, with a significant difference (t = 2. 342, P < 0. 05). The preoperative level of GHbA1 in the RY group was 7.7% ± 1.1%, which was significantly higher than 6. 9% ± 0. 6% at 2 months after the operation and 6. 1 % ± 0. 4% at 6 months after the operation (t = 4. 920, 3.012, P < 0.05). The preoperative level of FCP in the RY group was (1.30 ±0.54) μg/L, which was significantly lower than (1.95 ± 0.86) μg/L at 2 months after the operation and (2.18 ± 0.63)μg/L at 6 months after the operation (t =6. 063, 4. 651, P < 0.05). The levels of FSI in the RY group at postoperative month 1, 2 and 6 were (18 ±5) , (19 ±3) , (21 ±3) mU/L, which were significantly higher than the level of FSI [(11 ±4) mU/L]before operation (t =3. 158, 4. 502, 7. 517, P <0. 05). Preoperative levels of FBG, GHbA1, FSI and FCP in the B Ⅱ group were (8. 3 ± 1. 3) mmol/L, 7. 7% ±0. 9% , (13±4)mU/L and (1.34±0.48) μg/L, which were ignificantly different from (6.7 ± 1.2)mmol/L, 6.8%± 0.8%, (18±4)mU/L and ( 1.68 ±0.46) μg/L at postoperative month 1, (6.4 ± 1.3)mmol/L, 6.3% ±0.6% ,(18±4)mU/L and (1. 96 ± 0. 67) μg/L at postoperative month 2, and (5. 6 ±0. 7) mmol/L, 6.0%±0.3%, (19 ± 4) mU/L and (2.27 ± 0. 59) |μg/L at postoperative month 6 (t = 2. 468, 2. 598, 6. 028; 3. 055, 4. 586,4.572; 3.618, 5.860, 8.577; 2.300, 3.511, 3.943, P<0.05). The levels of FBG,GHbA1 and FCP in the 4 groups at 2 months after surgery were significantly different from those at 6 months after surgery (F = 4. 699,14. 378; 7.411, 29. 192; 3. 335, 9. 334, P < 0.05). The levels of FSI in the 4 groups at different time points were significantly different (F =2. 896, 7. 012, 11. 998, P < 0.05). Conclusion The efficacy of gastric bypass surgery for the treatment of nonobese type 2 diabetes mellitus is satisfactory.