Objective To survey on the condition of critically ill children in emergency room (ER) for improving the care for them.Methods Data of 374 critically ill children in emergency intensive care unit (EICU) were recorded in the respects of mode of sending them to ER,rescue during transport,length of stay in ER,blood gas,electrolytes,accuracy of assessing pediatric critical illness score/neonate critical illness score (PCIS/NCIS) and Glasgow Coma Scale (GCS),correctness of determining SIRS,sepsis and septic shock.Results Of 374 patients,neonates were 29.9％,and the mean age of children patients not including neonate was 37.4 months.The mean length of ER stay was 4.7 hours (0.42-96 hours).Of 374 patients,those with infection diseases were 47.6％,and the main vehicles for transportation of patient sent to ER were Taxi (38.3％),ambulance (28.4％) and private cars (21.5％).Total fatality was 12.3％ and ER fatality ( 15.6％ ) was higher than in - hospital fatality ( 10.3％,P ＜0.01 ).The mean PCIS/NCIS of 374 patients were 81.92 ± 9.66,and the PCIS/NCIS ≤ 90 accounted for 81％.Of assessed GCSs of 172 patients,GCS≤8,GCS 9-12 and GCS 13-15 accounted for 35.5％,21.5％ and 43.0％ respectively,and fatalities were 26.23％,10.81％ and 5.41％ correspondingly (P ＜0.01 ).The PCIS values of GCS≤8 and GCS 9-12 patients were lower than those of GCS 13-15 patients (P ＜ 0.01 ).There was no significant difference in PCIS between GCS≤8 and GCS 9-12 ( P ＞ 0.05 ).PCIS and GCS were positively correlated (r=0.454,P=0.01).Of374 patients,41.7％ had SIRS,and 25.7％ had sepsis.Of 262 children not including neonates,43.5％ had shock,and 61.4％ of these shock children were septic shock.In 374 patients,those with hyponatremia accounted for 37.2％,and those with hyperkaliemia accounted for 22.0％.The rate of hypoglycemia found in neonates was 20.91％ and rate of hyperglycemia occurred in neonates was 29.1％.The rate of hypoglycemia found in children patients was 9％ and hyperglycemia was 66.7％.Patients with pH ＜ 7.35 accounted for 67.8％ and those with pH ＜ 7.2 were 33.1％.Conclusions The majority of children patients in pediatric ER were neonates and infants.The length of ER stay was short with mean value of 4.7 hours (0.42-96 hours).ER fatality was higher than in - hospital fatality,suggesting the critically ill children patients should be admitted as early as possible.The rate of using ambulance was only 28.4％.The Emergency Medical Service (EMS) should be improved to enhance the public sense of the EMS available.PCIS/NCIS can be used in ER for assessing the conditions and prognosis of critically ill children.GCS ≤8 and GCS 8-12 patients accounted for 57％ with majority of nontrauma brain injury.The values of PCIS in GCS≤8 and GCS 9-12 patients were much lower than those in GCS 13-15 patients.Patients with GCS ＜ 13 might be in critical settings.Majority of shock patients were septic shock (61.4％).Hyponatremia,hyperkalemia,hyperglycemia and hypoglycemia often occurred in critically ill pediatric patients and hypoglycemia not excepted in the neonates should have attention paid to.The main factor of acid -base balance disorder in critically ill children was acidosis (67.8％).

Objective To discuss the clinical application of simplified neonatal critical illness score (sNCTS)in comparison with original neonatal critical illness score(oNCIS)published in 2001.Method A total of 705 neonates referred to neonate ICU(NICU)from 1 st January 2007 to 31th December 2009 were prospectively studied with control.The patients were scored by oNCIS on admission day,3rd,7th days after admission and on the day of discharge or dead.At the first scoring on admission,2 items of the PaO2 and pH were excluded from oNCIS's 10 items,and the remaining 8 items were used.Three items of plasma sodium,potassium and creatinine or BUN were scored out from 8 items and the still remained 5 items were used for the subsequent 3 scorings.The remaining 8 and 5 items were used as a simplified neonatal critical illness score.The simplified NCIS was evaluated by comparing the patients'condition that was assessed by the originat NCIS.The consistency rate between oNCIS and sNCIS should be over 80%.Results There were 8 items were used to evaluate the severity of disease on admission, and the consistence rate was 86.7%with the original NCIS.The 5 items selected from the original NCIS were used on the 3rd,the 7th days and the day of discharge or death.the consistence rate with original NCIS were 86.6%to 95.7%.A close correlation existed between the original NCIS and simplified NCIS(P<0.01).There were significant differences in mortality rates of the non-serious,serious and extremely serious groups between original NCIS and simplifled NCIS used for the first and the last seorings(P<0.01).Within a cohort of neonates with the same general condition,the assessments of mortality rates were not significantly different between these two methods (P>0.05).Conclusions Compared with the original NCIS.the simplified NCIS is consistent to a large extent in disease assessment,which is a concise way to evaluate the critical ill neonates objectively and can be easily applied to clinical practice.

Thyroid hormone is an important hormone for regulating cell differentiation,growth and metabolism.Many studies have shown that thyroid hormone can induce turmor angiogenesis after binding with the integrin ανβ3 receptor at cell surface.Tetraiodothyroacetic acid is the analogue of thyroid hormone,and can inhibit tumor angiogenesis by inhibiting the binding of thyroid hormone with integrin ανβ3.Studying the role of thyroid hormone in promoting tumor angiogenesis may provide a new approach for molecular targeted therapy of tumor.

Objective To investigate the expression of minichromosome maintenance protein 7 (MCM7) in sinonasal squamous cell carcinoma (SNSCC),and evaluate its relationship with tumor differentiation and prognosis of patients.Methods Using immunohistochemistry,MCM7 expression in SNSCC and nasal polyps with chronic sinusitis (NPCRS) were studied,and relationships between markers and clinicapathological features were analyzed.Results In NPCRS,MCM7 positive cells were mainly distributed in the epithelial basal layer and the expression rate was low,whereas in SNSCC,MCM7 positive cells were diffuse and the expression rate was high.MCM7 expression was significantly higher in SNSCC than in NPCRS (P ＜ 0.001) and related to tumor differentiation (P =0.001),increasing gradually with decreasing degree of differentiation.The overall 3-and 5-year survival rates of patients with SNSCC were 61.3％ and 46％,respectively.The 3-year survival rates for patients with stage Ⅰ and Ⅳ were 90％ and 25.6％,respectively,and the 5-year survival rates were 70％ and 17.1％,respectively;the difference was statistically significant (P ＜ 0.001).The 3-and 5-year survival rates of MCM7-negative patients were 36.0％ and 18.0％,respectively,and those of MCM7-positive patients were 59.9％ and 34.2％,respectively;the difference was not statistically significant (P =0.297).Conclusion In SNSCC,MCM7 expression is significantly increased,inversely associated with the degree of tumor differeutiation,and unrelated to the survival rates of patients.

Medical insurance system plays a key role in China's social security system.In the social insurance system,medical insurance features the widest coverage and the most complex in mechanism,while China' s medical insurance system itself is found with many setbacks.This paper probed into such risks found in the county-level medical insurance system as excessive cost growth causing overpayment of the medical insurance fund and poor supervision of the fund.On such basis,the authors recommended such policy changes as payment reform,and enhanced supervision over the fund,the demand side,and the government,in an effort to optimize China' s medical insurance system for theoretical and decision reference of other county-level hospitals in their reforms.

Objective To establish a simple diabetic peripheral neuropathy (DPN) rat model with the high fat-fed in GK rats. Methods A total of 30 GK rats (7-8 weeks) were fed with high-fat diet to establish the DPN model. Thirty normal Wistar rats were fed with ordinary diet (control group). The blood-sugar value, body mass, water-intake and food-intake were monitored every week in two groups. The serum level of glycosylated hemoglobin, the right sciatic nerve conduction velocity were detected at 8, 12 and 16 weeks respectively. The left sciatic nerve was used for HE and TUNEL staining. Results The manifestations of polydipsia, polyphagia and growth retardation were gradually appeared in GK rats. After 12 and 16 weeks, the blood-sugar and glycosylated hemoglobin were significantly increased in GK rats compared with those of normal Wistar rats (P < 0.01). The sensory nerve conduction velocity decreased obviously (P < 0.01). And motor nerve conduction velocity showed a certain decline trend (12 week P < 0.05,16 week P > 0.05). The sciatic nerve pathological features and Schwann cell apoptosis suggested that the model of DPN was successfully established (apoptosis index, P <0.01). Conclusion GK rats fed by high-fat diet are the satisfactory models of the DPN in experimental research. And 12-week is a suitable and economical time for molding.

Objective To discuss and analyze the issue in the catheter directed thrombolysis(CDT) treatment of acute lower extremity deep venous thrombosis.Methods The clinical data of 182 cases of acute lower extremity deep venous thrombosis from January 2011 to January 2013 which were treated by CDT were retrospectively analyzed,and the issues in these treatment were discussed and analyzed.Results The effect were classified into three degrees.Thrombosis clearance exceed 95 percent belonged to the first degree,among 50 percent and 95 percent belonged to the second degree,and below 50 percent belonged to the third degree.In this study,the respective number of each degree were 93/68/21.Sixty-one cases combined iliac venous compression syndrome were treated by stent.Twenty-two cases were treated with inferior vena cava filter.All the patients were followed up 10 months,148 cases of them maintained patency.Conclusions The effect of CDT treatment to acute lower extremity deep venous thrombosis is remarkable,meanwhile the patency is improved and the deep vein thrombosis were decreased through this method.But the issues of access,filter and iliac venous compression syndrome should also be considered.

Objective To explore the effect of double silicone balloon catheter used as nasal packing materials after functional endoscopic sinus sur?gery(FESS). Methods Totally 80 patients(47 males and 33 females,median age of 43 years)with bilateral chronic sinusitis who underwent en?doscopic surgery under general anesthesia were randomly divided into two groups,each group with 40 patients. The hemostatic sponge group used he?mostatic sponge for postoperative nasal packing and the hemostatic catheter group used double silicone balloon catheter plus medical sponge. Patients were observed for postoperative pain,ventilation and bleeding after packing removal to evaluate efficacy. Results Double silicone balloon catheter was superior to hemostatic sponge in ventilation maintenance(mean scores:78.8 vs 2.32)and pain relief(mean scores:0 vs 5.26),the difference was statistically significant(P<0.05). Moreover,double silicone balloon catheter was also superior to hemostatic sponge regarding to nasal bleeding after packing removal. Conclusion Double silicone balloon catheter is a preferable material for nasal packing after endoscopic surgery,which has reliable hemostatic effect and can better maintain the nasal ventilation,reduce pain in patients,and improve the patient's quality of life during treat?ment.

Objective To examine the expression of TLR7/8 in monocytes purified from HIV-1 infected individuals and to study its association with disease progression. Methods Sixty-three HIV-1 infected individuals and 18 normal controls were enrolled. Monocytes were purified by MACS system and RNA of them was extracted by RNA mini kit of QIAGEN company. TLR7/8 expression was tested by real-time RT-PCR with ABI7500. Results It was found that the expression of TLR7 was strongly correlated with absolute CD4 count (r =0.614, P＜0.01) , so was TLR8 (r =0.419, P＜0.01). The expression of TLR7 in slow progressor (SP) group was higher than that in HIV-1 infected patients group, AIDS patients group and normal group (P ＜ 0. 05 ) . HIV group and normal group were strongly higher than AIDS group (P ＜ 0. 05). It was no significant differentiation of expression of TLR7 between HIV infection group and normal control group. The expression of TLR8 in SP group and normal group were significantly higher than that in AIDS group (P ＜ 0. 05). The expression of TLR8 was no singnificantly difference between SP group and HIV group or normal control group, so was it between HIV group or normal control group and AIDS group. Conclusion The expression of TLR7/8 in monocytes from HIV-1 infected patients significantly correlated with disease progression.

In this paper, alpha-tricalcium phosphate (alpha-TCP) and tetracalcium phosphate (TTCP) respectively were chosen as basic compositions of phosphate bone cements. Other auxiliary materials such as hydroxyapatite (HAP), dicalcium phosphate dihydrate (DCPD), calcium carbonate (CaCO3), calcium oxide (CaO) and amorphous calcium silicate (CaSiO3) were added in the cements. Six kinds of composite bone cements were decided with 1.50 as their Ca/P ratio. Then the primary properties of them were studied. Ringer's simulated body fluid (SBF) tests were carried out for the samples. The changes of pH value in SBF and the compressive strength of the samples with the immersion time were studied. The results showed: the mixing liquid 0.25 M K2HPO4/KH2PO4 and amorphous CaSiO3 were effective for accelerating the setting of the cements; the initial setting time (It) was about 4-5.5 min and the final setting time (Ft) was about 18-19. 5 min. Amorphous calcium silicate can increase the compressive strength of the bone cements remarkably; the compressive strength of the alpha-TCP bone cement with the addition of suitable amount amorphous CaSiO3 reached 45.3 MPa after immersion in SBF for 14 days.
Bone Cements ; chemical synthesis ; chemistry ; Calcium Compounds ; chemistry ; Calcium Phosphates ; chemistry ; Compressive Strength ; Humans ; Silicates ; chemistry