Objective To evaluate the influence of laboratory critical value reporting on the efficacy of pediatric critical care.Methods A comparative analysis was conducted to evaluate the changes after the establishment of laboratory critical value reporting system.The parameters chosen for assessment included laboratory test turnaround time,medical intervention start time,survival rate,etc.Results Before the establishment of laboratory critical value reporting system,laboratory test turnaround time was (44.5±14.6)min,medical intervention start time was (40.7±5.3)min,and the success rate of the emergency treatment in ICU was (80.36±6.32)%[the rate in normal ward was(82.64±9.21)%].But after the establishment of laboratory critical value reporting system,laboratory test turnaround time,medical intervention start time,the success rate of the emergency treatment in ICU (normal ward) were (18.7±8.8)min,(23.9±6.7)min and (89.49±4.58)% [(90.04±6.45)%].Laboratory critical value reporting system shortened laboratory test turnaround time and medical intervention start time (P<0.05),and the successful rate of the emergency treatment improved evidently.Conclusion Laboratory critical value reporting system can improve successful rate of the emergency treatment significantly.

Objective: To investigate the efficacy of acupuncture and point injection in cooperation with Tuina and reposition for treating lumbar intervertebral disc protrusion.Methods: Treatment was given by first acupuncture, then point injection and last Tuina and reposition. It was administered once daily, 6 times as a course and compared with simple Tuina and reposition. Results: Both the effective rate in the clinical treatment and the cure rate in the same period were significantly higher in the treatment group than in the control group. Conclusion: A composite treatment by acupuncture and point injection in cooperation with Tuina and reposition is better in curative effect and shorter in the course of treatment than simple Tuina and reposition.

Cytokeratin 1 4 (CK1 4)has a different degree of expression in NSCLC,breast cancer,cer-vical cancer,esophageal cancer and other tumors,except in the normal basal cells.CK1 4 is mainly expressed in the peripheral part of the tumor,which is rarely expressed in the non-aggressive part.Usually the higher malignant of the tumor has the more expression of CK1 4.Given all that,CK1 4 gene plays an important role in the tumor progression and metastasis in a variety of tumors,which can be considered as an biomarker being used in the diagnosis,treatment and prognosis evaluation.

Objective To investigate the expression and correlation of P73 and PS3 proteins in esophagus squamous cell carcinoma. Methods The immunohistochemistry staining assay was conducted to detect the expression of PS3 and P73 proteins in 46 cases with squamous cell carcinoma of esophagus and 30 normal mucosa cases. The protein expressions and clinic pathological observation and the correlation between two proteins were statistically analyzed. Results The expression of P53 and P73 proteins showed differences between esophageal cancer tiksue and normal mucosa ( P = 0.007,0.008) . The expression of P53 appeared to be correlated with lymph node metastasis(P = 0.047) and gender(P =0.028),but not correlated with age, the depth of invasion , differentiation of cancer tissue, gross observation and position of the tumor( P > 0.05 ). The expression of P73 appeared to be correlated with differentiation of cancer tissue and lymph node metastasis ( P = 0. 023, 0.035), but not correlated with age, gender, the depth of invasion,gross observation and position of the tumor (P >0.05). P73 expression was positively corelated with P53 expression in squamous cell carcinoma of the esophagus ( r = 0.359 ,P = 0.014 ). Conclusion Both P73 and P53 proteins are associated with the occurrence of squamous cell carcinoma of the esophagus and participate in the development of esophagus squamous cell carcinoma.

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OBJECTIVE To investigate the causes and preventive measures of postoperative pneumonia due to cervical part and upper thoracic part esophageal carcinoma surgery. METHODS Fifty seven cases with cervical part or upper thoracic part esophageal carcinoma from 2001 to 2005 were studied restropectively. RESULTS One patient died of aspiration pneumonia,one died of anastomotic leakage,and three died of adult respiratory distress syndrome(ARDS).The tracheotomy and mechanical ventilation were applied.Pneumonia was confirmed among sixteen patients at different degree. CONCLUSIONS Many causes contribute to postoperative pneumonia on patients with cervical part or thoracic part esophageal carcinoma,and the lesion of recurrent nerve is an important reason.Protection of recurrent nerve may decrease postoperative pneumonia.

The theory of static and dynamic combination coincides with the effect of osteoblast stress, although there are few articles on molecular biology about the theory in recent years. The treatment of static and dynamic combination theory for fractures and other orthopedic disorders is to use the localized stress fracture, and the stress controls bone formation results through afffecting proliferation of osteoblast differentiation, which has proved by relevant experimental evidence. This article discussed the molecular biology basis about the correlation between theory of static and dynamic combination and osteoblast proliferation and differentiation by stress stimulation.

Invasion of glioma is a complex process with multiple steps and multiple factors,including the inhibition of tumor cell adhesion,the degradation of extracellular matrix,the promotion of tumor cells migration and angiogenesis.The abnormal activation of Wnt/β-catenin signaling pathway is closely related to the invasion of glioma.The study of Wnt/β-catenin pathway affecting invasion mechanism of glioma will provide new ideas and targets for the treatment of glioma.

Objective: To investigate the prevalence and influencing factors of falls among elderly patients with comorbidity of chronic diseases in Chongqing Municipality, so as to provide insights into preventing measures of falls. Methods: Elderly patients with comorbidity of chronic diseases admitted to a level A tertiary hospital of Chongqing Municipality from July 2022 to December 2022 were recruited. Participants' demographics, physical component and fall condition were collected using a questionnaire survey. Incidence of falls was descriptively analyzed, and factors affecting falls among elderly patients with comorbidity of chronic diseases were identified using a multivariable logistic regression model. Results: A total of 344 questionnaires were allocated, and 338 valid questionnaires were recovered, with an effective rate of 98.26%. There were 195 men (57.69%) and 143 women (42.31%), with a mean age of (77.10±7.29) years. There were 171 (50.59%), 115 (34.02%), 38 (11.24%) and 14 (4.14%) patients suffering from 2, 3, 4 and 5 chronic diseases, respectively. The incidence of falls during recent six months was 22.49%. Multivariable logistic regression analysis identified history of vertigo in last 6 months (OR=2.720, 95%CI: 1.409-5.249), fear of falling (OR=8.725, 95%CI: 4.572-16.653) and adaptation of living environments to ageing (OR=0.257, 95%CI: 0.130-0.509) as factors affecting elderly patients with comorbidity of chronic diseases. Conclusion The Elderly patients with comorbidity of chronic diseases who have a history of vertigo, fear of falling, and living environments that are not age-adapted are at higher risks of falls.

Objective To retrospectively demonstrate risk factors for mortality in multiple trauma patients with acute respiratory distress syndrome(ARDS).Method This wes a retrospective cohort stuay regarding multi-ple trauma as a single cause for intensive care unit admission.Patients identified multiple trauma with ARDS en-rolled in prospectively maintained database between May 2003 and April 2008 were observed,and 23 items of po-tential risk factors of impacting mortality were calculated by univariate and multivariate logistic analyses in order to find distinctive items in these multiple trauma patients.Information on patients demographics characteristics,treat-ment procedures and injury severity were collected at the time of EICU admission.The criteria used for ARDS met definition of the guideline(2006)of Chinese medical association.The commonly accepted definition of multiple injuries was consistent with both several injury sites(generated from two or more than two anatomic sites)and in-jury in one anatomic site at least threatening life.Severity of injury was quantified by injury severity seore and the simplified acute physiology score and chronic health evaluation score (APACHE Ⅱ)in EICU admission.We in-cluded adult patients(age≥18 years),those with an EICU length of stay longer than 48 hours,and those accept-ing mechanical ventilation more than 24 hours.Patients who were readmitted to EICU by virtue of non-traffic injury or transferred to EICU from other hospitals after long-term treatment were excluded.Mortality was assessed at the 28th clay after trauma.Results There were 269 multiple trauma patients with posttranmatic ARDS admitted to ICU during the study period,the unadjusted odds ratio(OR)and 95% confidence intervals(CI)of mortality were associated with six risk factors(APACHE Ⅱ score,duration of tratuna factor,pulmonary contusion,aspiration of gastric contents,sepsis and duration of mechanical ventilation)out of 23 items.The adjusted Odds Ratios(ORs) with 95% CI were denoted with respect to surviving beyond 96 hours ICU admission(APACHE Ⅱ score,duration of trauma factor,aspiration of gastric contents),APACHE Ⅱ score beyond 20 ICU admission(duration of trauma factor,scpsis,duration of mechanical ventilation)and mechanical ventilation beyond 7 days ICU admission(dura-tion of trauma factor and sepsis).Conclusions Impact of pulmonary contusion and APACHE Ⅱ score contribut-ing to prediction of mortality may exist in prophase after multiple trauma.Sepsis is still a vital risk factor referring to systemic inflammatory response syndrome,infection,and secondary multiple organs dysthnetion.Aspiration of gastric contents could lead to incremental mortality due to scvere ventilation associated pneumonia.Duration of trauma factor determined degree of injury and outcomes,longer duration generally manifested higher mortality.Long-standing mechanical ventilation should be constrained on account of occurring severe refractory complications.