In order to research into the relationship between atrial natriuretic peptide (ANP), aldosterone (Aldo) and pregnancy-induced hypertension (PIH), as well as normal pregnancy, the plasma concentrations of ANP and Aldo from normal pregnant women. PIH patients and their fetuses were measured by radioimmunoassay. It was found that maternal venous Aldo and ANP were higher in normal pregnant women than those in non-pregnant women. The plasma ANP was higher in PIH patients than that in normal pregnant women while plasma Aldo was lower. The plasma concentration of ANP was higher in the fetuses of PIH patients than that in the normal controls, but Aldo was lower. It is concluded that ANP concentration correlates significantly to the severity of PIH, and may be used for an early diagnosis of PIH.

Objective:To evaluate the reliability of flexural strength and subcritical crack growth(SCG)of WL and HT zirconia ce-ramics under cyclic loading.Methods:Bar-shaped speciments of WL(n =30)and HT(n =30)were fabricated and loaded in three-point bending and cyclically fatigued.The flexural strength and the number of cycles to fracture were obtained from three-point flexural test and cyclic fatigue test respectively.Data were examined using Weibull statistics.Pairs law was used to analysize the subcritical crack growth(SCG),the behavior of which was described in terms of crack velocity as a function of maximum stress intensity factor (KImax ).Results:The Weibull module(m)of WL and HT was 10.64 and 12.04,the stress corrosion cracking susceptive indexes(n) 23.71 and 32.87,the SCG 90% and 76.7%,the KImax 49.6% and 50.9% of its maximum stress intensity factor(KIC ),respectively. Conclusion:WL and HT produce pronounced SCG.The minimum fatigue crack growth rate of HT is lower than that of WL(νHT <νWL ).

English training is important for young doctors＇ career development in general hospital.The stagewise English training mode of Beijing Tiantan Hospital of Capital Medical University was introduced.By summarizing the experience of five years trial,viewpoints were brought forward that hospital English training in radiological department of general hospital should adopt a stagewise mode,create an English communication atmosphere,show the special feature of department and combine with clinical daily work.

Objective:To understand the effect of a new tracheal tube fixation device in the "double fixation" of oral tracheal intubation for critically ill patients in adult emergency department.Methods:A retrospective analysis of patients with oral tracheal intubation admitted to our EICU from January 2016 to June 2017 was performed using traditional tape and inch band fixation as a control group; the experience of treatment from July 2017 to December 2018 for patients with oral tracheal intubation, the new double-fixation method of tracheal tube fixation device was used as the observation group. The degree of displacement, oral cleanliness, facial skin allergies and injuries, and comfort of the two groups of patients was compared.Results:The rate of tracheal displacement in the experimental group was mildly 11.2% (11/98), moderately 5.1% (5/98), and the control group was mildly 24.2% (15/62), moderately 14.5% (9/62) and severe 6.5% (4/62). The incidence of facial skin allergy and skin damage was 6.1% (6/98), 0, and the control group was 24.2% (15/62), 11.3% (7/62), the difference was statistically significant ( Z value was -4.021, χ2 value was 24.48, P<0.05). The comfort score of the test group was (1.05±1.01) points, which was significantly higher than (2.10±1.71) points of the control group ( t value was 4.920, P<0.01). Conclusions:The new type of tracheal tube fixation device "dual fixation" for critically ill patients with mechanical ventilation through oral endotracheal intubation is visually beautiful, and has good firmness and comfort. It can effectively reduce the occurrence of adverse events and has good application value.

This article introduces an overview of management system for conflict of interest of the European Pharmacopoeia Commission (EPC) and the United States Pharmacopoeia Convention (USP). The EPC and USP have standardized the management system for conflict of interest in drug standard work in multiple management documents, such as the Guide for the Work, Code of Practice for the Work, Form for Declaration of Interests and Confidentiality Undertaking of the EPC, bylaws, Rules and Procedures of the Council of Experts, Code of Ethics, Standards of Conduct of the USP, in order to ensure the transparency and fairness of drug standard development, improve the credibility and rigor of drug standards. This article introduces the management system for conflict of interest of the EPC and USP, providing reference for the improvement of relevant management systems of the Chinese Pharmacopoeia Commission.

Objective To explore the effectiveness and safety of Linezolid (LIZ) in treating children with infective endocarditis (IE).Methods The clinical data of 112 children with IE and treated in the Shanghai Children's Medical Center of Shanghai Jiao Tong University School of Medicine from August 2008 to September 2015 were retrospectively analyzed.There were 64 boys and 48 girls,and the age of IE onset ranged from 1 month to 17 years [(6.0 ± 4.8) years].Twenty-nine patients received LIZ treatment ＞ 7 days (LIZ treatment group),including 21 males and 8 females,and the age ranged from 5 months to 15 years [(6.9 ±5.2) years].The remaining 83 patients were identified without LIZ treatment(non-LIZ treatment group),including 43 boys and 40 girls,and the age ranged from 1 month to 17 years [(5.7 ±4.7) years].The etiological results,curative effect and adverse reactions of the LIZ treatment group were observed.Results Among the LIZ treatment group,22 cases had congenital heart disease and 1 case had intravenous catheter.There were 10 cases with infection of staphylococcus aureus,6 cases with coagulase negative staphylococcus,5 cases with oral streptococci and Streptococcus bovis group,3 cases with streptococcus pneumonia,2 cases with enterococcus faecium and 3 cases with negative blood culture results.All cases of the LIZ treatment group received Vancomycin therapy at first,LIZ was given when the Vancomycin therapy failed(16 cases with temperature reiteration,1 case inadequate microbiological response),Vancomycin intolerance (6 neutropenia,2 renal toxicity,2 allergy),and oral maintenance therapy (2 cases).The duration of LIZ treatment ranged from 9 to 135 days [(39.2 ±27.2) days].Three patients (10.3％) had adverse effects during LIZ treatment,1 case with severe digestive symptoms after treatment,1 case with teeth discoloration,1 case with the indicators decreasing by 2 routine blood test.Meanwhile,16 cases of 85 patients (18.8％) had side effects during Vancomycin treatment,in which 7 cases with neutropenia,6 cases with rash and 3 cases with renal insufficiency.But there were no significant differences in adverse effects between LIZ and Vancomycin treatment (x2 =1.l19,P ＞0.05).Twenty-five cases were cured (86.2％) and 2 cases dead (6.9％) in the LIZ treatment group.And no significant difference was found in cure rate,or mortality between LIZ treatment group and non-LIZ treatment group (86.2％ vs.77.1％,x2 =1.090;6.9％ vs.8.4％,x2 =0.069,all P ＞ 0.05) at 6 to 84 (23.9 ± 19.1) months follow-ups.Conclusions LIZ can be used to deal with Vancomycin failure and IE caused by gram positive coccus.LIZ was generally well tolerated in patients with IE.It may be useful in cases of IE complicated by brain abscesses for the good distribution.It is 100％ orally bioavailable,allowing oral administration for outpatients.

By silica gel column chromatography, solvent extraction and preparative high performance liquid chromatography (HPLC), four new related substance were isolated and purified from the mass production and preparation process of alogliptin benzoate. Then it was analyzed and confirmed by various spectrum identification methods such as nuclear magnetic resonance (NMR) spectroscopy, high-resolution mass spectrometry (HR-MS) and Fourier-transform infrared spectroscopy (FTIR) according to its physical and chemical properties. The chemical structures of the four related substances produced in each step of the synthesis process of alogliptin benzoate were determined, and they were named as impurities L, M, T, and V. These four related substances were new impurities which were found for the first time. The isolation and identification of these impurities are of great importance to the quality control of alogliptin benzoate, and the optimization of manufacturing process.

Objective: To explore the clinical application of individualized design of facial artery perforator flap for the repair of midfacial defect caused by tumor resection. Methods: From January 2015 to January 2018, a total of 36 cases of midfacial defect were repaired by individualized designed facial artery. Flaps were designed and harvested according to the location and size of the midfacial defect resulted from tumor resection, including propeller flaps, droplet flaps and swallowtail-shape flaps. Flap size was between 1.3 cm × 1.6 cm and 2.0 cm × 4.2 cm with the donor site being sutured in the first stage. Results: During the 6 months to 3 years of postoperative follow-up, no tumor recurred. All the 36 cases of individualized designed facial artery perforator flaps survived well. Furthermore, flaps being designed according to the wound defect had a good appearance, the flaps matched the color and texture of the surrounding skin and had a favorable appearance. Besides, flaps had a certain degree of sensory recovery while there was no obvious scarring presented in the donor area. Conclusions Individualized design of facial artery perforator flap has great advantages of simple and flexible, easy manipulation, reliable flap blood flow and minimal donor injury, which render it valuable for clinical application.

Objective:To explore the inner experience and influencing factors of caregivers′ decision-making process in children with hematological tumors treated by Chimeric antigen receptor T cells (CAR-T) cell clinical trial, so as to provide reference for children and caregivers treated with CAR-T cells to carry out targeted health education and psychological support.Methods:Using the phenomenological method of qualitative study, the caregivers of 11 children were interviewed by semi-structured interview, the data were analyzed by Colaizzi analysis method, and the text data were managed, explored and searched by NVivo10.0 software.Results:The caregivers of children with hematological tumors had three topics: complex psychological experience in the initial stage of CAR-T treatment decision-making process, consultation approach and experience in the decision-making process, and overall decision-making quality evaluation.Conclusions:Pay attention to and understand the psychological experience of caregivers in CAR-T cell clinical trials, provide diversified decision-making counseling for caregivers, and ensure the right of caregivers to participate in decision-making, so as to improve caregivers′ treatment and nursing compliance.

Objective:To evaluate and summarize the best evidence related to the management of cancer-related fatigue in children with leukemia and provide an evidence-based basis for clinical practice.Methods:The search for the relevant guidelines and evidence synthesis from UpToDate, JBI, Cochrane Library, Registered Nurses′ Association of Ontario, Guidelines International Network, National Institute for Health and Clinical Excellence, National Guideline Clearinghouse, YiMaiTong Guideline Network, National Comprehensive Cancer Network, PubMed, CINAHL, EMbase, China National Knowledge Infrastructure, Wanfang, China Biology Medicine from January 1st, 2012 to May 1st, 2022. Two researchers evaluated the quality of the literature independently according to the unified standard and extracted the best evidence.Results:A total of 13 literatures were extracted, including three clinical practice guidelines, two evidence summaries and eight systematic reviews. Finally, 22 pieces of evidence were summarized, involving six aspects which were environmental management, cancer-related fatigue assessment, exercise management, adventure therapy, sleep management and psychosocial interventions.Conclusions:Best evidence for the management of cancer-related fatigue in children with leukemia, which should be used in conjunction with the environment, the child's age, physical ability, medical condition and psychological acceptability to develop an individualized symptom management plan to improve the quality of care and the child′s quality of life.