As a treasure of the traditional culture of China, TCM can be developed in long-term, that need the inheritance and innovation of scholars. During the process, it is an important responsibility and obligation that the development of TCM hospital. The development and improve of the hospital scientific research are important aspects for the development of hospital. The construction of scientific research team is an important approach to promote the hospital scientific research strength. By analyzing the whole current situation of hospital scientific research team, we will discuss the measures to strengthen the construction of hospital scientific research team from several aspects. These aspects include the system of scientific research team, talented person echelon structure, management system and the team overall strength, etc. These measures are aimed to strengthen the team construction characteristics of TCM, promote the scientific research level of TCM, contribute to the development of the career and hospital.

Objective: To investigate the current situation and influencing factors of knowledge, attitude and practice (KAP) of fall prevention among the elderly in Huzhou City, Zhejiang Province, so as to provide the evidence for the development of fall intervention for the elderly. Methods: The permanent residents aged 60 years and over in Huzhou City were selected using multi-stratified cluster sampling method from March to April 2023. Demographic information, activity of daily living (ADL), fall risk, and KAP of fall prevention was collected using questionnaire surveys. Factors affecting KAP of fall prevention were identified using a multivariable logistic regression model. Results: Totally 2 160 questionnaires were allocated, and 2 104 valid questionnaires were recovered, with an effective recovery rate of 97.41%. There were 1 063 males (50.52%) and 1 041 females (49.48%), and 861 residents aged 60 to <70 years (40.92%). The awareness of fall prevention knowledge was 84.13%, the percentage of attitude towards fall prevention was 85.88%, and the percentage of practice of fall prevention was 14.59%. Multivariable logistic regression analysis showed that age, educational level, exercise duration and fall risk were associated with the awareness of fall prevention knowledge; age, educational level, marital status, exercise duration, ADL and fall risk were associated with the attitude towards fall prevention; gender, age, educational level, marital status, exercise duration, chronic diseases, ADL and fall risk were associated with the practice of fall prevention (all P<0.05). The desired access to fall prevention knowledge was mainly dominated by medical personnel, accounting for 75.51% (589/780). Conclusions The practice towards fall prevention among the elderly is relatively low in Huzhou City. The KAP of fall prevention is related to age, educational level, exercise duration and fall risk.

Objective To investigate the respiratory burst function of neutrophils in very low birth weight infants (VLBWI).Methods Twenty two VLBWI was divided into two groups:neonatal respiratory distress syndrome (NRDS) and non NRDS (11 in each).The respiratory burst function of neutrophils in the peripheral blood of VLBWI within 48 hours after birth was determined using the flow cytometrydihydrorhodamine 1,2,3 method before and after the chemical stimulation of phorbol-12-myrismte 14 acetate (PMA),and the gp91Phox was also measured in resting neutrophils by flow cytometry.Twenty healthy term neonates served as controls.Mann-Whitney U test was used for statistical analysis.Results Before the stimulation of PMA,the percentage of activated neutrophils of VLBWI [(49.10±20.19) ％] producing a respiratory burst was higher than that of term neonates [(18.73 ±6.81) ％] (Z--4.911,P=0.000),however,after the stimulation of PMA,the percentage of activated neutrophils of VLBWI [(96.58 ± 3.44) ％] was lower than that of term neonates [(99.20±0.62) ％] (Z--3.186,P=0.001),and the stimulation index (SI) of VLBWI (171.40 ± 103.35) was lower than that of term neonates (306.30 ± 138.47),with significant difference (Z=-3.413,P=0.001).The geometric mean of gp91Phox in VLBWI (21.66± 19.87) was higher compared with term neonates (19.60±8.03),however,the difference was not significant (P=0.350).The percentage of neutrophils that expressed gp91Phox [(56.11 ± 29.40) ％] was lower in VLBWI than that in term neonates [(80.14± 14.87) ％],with significant difference (Z=-2.374,P=0.018).Before the stimulation of PMA,the percentage of activated neutrophils of VLBWI with NRDS (63.40± 16.45) ％] was higher than that of VLBWI without NRDS [(34.80± 11.65) ％],with significant difference (Z=-3.382,P=0.001),the SI of VLBWI with NRDS (129.46 ± 75.36) was significantly lower than that of VLBWI without NRDS (213.35 ± 113.49) (Z=-2.331,P=0.020).Conclusions Neutrophils producing a respiratory burst in both VLBWI and term neonates are active without stimulation of PMA,while the phenomenon is more obvious in VLBWI.Neutrophils in VLBWI and term infants can be activated by the stimulation of PMA,and express gp91Phox.The activation and gp91Phox expression of neutrophils in VLBWI with NRDS tend to be lower than those in VLBWI without NRDS.

Objective:To explore the clinical characteristics and prognostic risk factors of accidental injuries in pediatric intensive care unit(PICU).Methods:The children with accidental injuries admitted to the PICU at Shanghai Children′s Hospital from January 2017 to December 2019 were analyzed retrospectively.The patients were divided into survival group and death group according to outcome.We collected the patients′ clinical data and laboratory indexes, and analyzed the differences between two groups.Multivariate Logistic regression was used to screen the risk factors of death and receiver-operating characteristic(ROC)curve was used to determine the threshold.Results:(1)A total of 253 children were included, accounting for 5.2% of PICU hospitalization during the same period.There were 137 males(54.2%)and 116 females(45.8%), with an average age of 45(19, 96)months.The top three causes of accidental injuries were fall injury in 82 cases(32.4%), traffic accident in 70 cases(27.7%)and foreign body in 39 cases(15.4%). There were 22 cases of deaths, with a fatality rate of 8.7%.(2)The mean arterial pressure at admission in the death group was lower than that in the survival group( P<0.05), and the total length of stay was longer( P<0.001). There were significant differences in Glasgow coma scale, Pediatric Risk of Mortality Scoring Ⅲ(PRISM Ⅲ)between the two groups( P<0.001). In the death group, and the blood lactic acid(LA) significantly increased( P<0.001), hemoglobin and fibrinogen were lower than those in the survival group, the activated partial thromboplastin time and prothrombin time(PT)were significantly prolonged( P<0.001). (3)Multivariate Logistic regression analysis showed that PRISM Ⅲ score, LA and PT were independent risk factors for the death of accidental injuries.The area under curve(AUC)of PRISM Ⅲ score was 0.987(95% CI 0.976-0.999, P<0.001)and the cut-off value was 11 with a sensitivity of 100% and a specificity of 95.7%.The AUC of LA was 0.886(95% CI 0.810-0.961, P<0.001)and the cut-off value was 3.1 mmol/L with a sensitivity of 85.7% and a specificity of 77.3%.The AUC of PT was 0.835(95% CI 0.730-0.941, P<0.001)and the cut-off value was 13.9 s with a sensitivity of 86.6% and a specificity of 72.7%. Conclusion:The main accidental injuries in PICU of our hospital in the past three years are falling injuries, traffic accidents and foreign body injuries.PRISM Ⅲ score, LA and PT at admission are independent risk factors for predicting death.

The clinical manifestations of acute poisoning in children were nonspecific,most of all,the initial symptoms were disturbance of consciousness or even coma.The critical treatment of acute poisoning is quickly identify life-threatening situation,remove the unabsorbed toxins,promote the removal of poison which has been absorbed of blood,timely application the detoxification and organ functional support.The treatment of blood purification and extracorporeal membrane oxygenation technique are important progresses in children's severe poisoning.

Objective To investigate the correlation of the expressions of P170,topoisomerase Ⅱ(TOPⅡ)and the proliferation in gliomas.Methods Ki-67 was used as the marker of the proliferation in gliomas.The expressions of P170,TOPⅡ and Ki-67 were tested by S-P immunohistochemical technique using monoclonal antibody to their protein in 54 cases of low-grade gliomas(WHO Ⅰ～Ⅱ grade)and 54 cases of high-grade gliomas(WHO Ⅲ～Ⅳ grade),analysis of the clinical and follow-up were performed.Results The expressions of P170,TOPⅡ and Ki-67 had significant differences between low-grade and high-grade gliomas(P<0.01).Correlation analysis showed that the expression of P170 was negatively related with Ki-67(r=-0.276,P=0.019);the expression of TOPⅡ was positively related with Ki-67(r= 0.637,P<0.001);there was no correlation between the expressions of P170 and TOPⅡ.Conclusion The expressions of P170 and TOPⅡ are associated with the malignant prognosis in gliomas.

This paper summarized the current ethical dilemmas of living will in our country including life ethical dilemmas, medical ethical dilemmas and family ethical dilemmas, and then proposed several suggestions for the promotion of living will in China:strengthening the theoretical research on related contents of living will, increasing the intensity of death education, carrying out related activities in the communities, strengthening the policy support and establishing hospital or regional pilots, to provide the feasible problems for the advancement of our country's living will.

With the rapid development of information technology, artificial intelligence technology (AI) and how to use it have become the focus of current researches. The application of AI in the field of TCM has shown its uniqueness. The combination of artificial intelligence technology and traditional Chinese medicine provides a new direction and idea for the development of TCM. This paper analyzes the strengths, weaknesses, opportunities and threats (SWOT) of TCM development against the background of AI technology in China by SWOT analysis method. Based on these analyses, this paper puts forward some counter measures such as protecting personal information, avoiding negative effects and medical regulations etc. In order to facilitate and guarantee the development of TCM, we should take advantage of the AI, and avoid its disadvantages.

Objective To summarize the clinical features,treatment status and prognosis of severe community-acqnired pneumonia (CAP) caused by adenovirus in a single pediatric intensive care unit (PICU),and to explore the appropriate diagnosis and treatment strategies.Methods From August 2016 to January 2019,the clinical data of children with adenovirus pneumonia,including symptoms,organ function,laboratory features,rescue measures and results were analyzed retrospectively.Results A total of 531 cases with severe CAP were admitted in PICU,Shanghai Children's Hospital,Shanghai Jiaotong University.Among them,32 cases with adenovirus pneumonia accounted for 6.03％.The high incidence age was from 3 months to 2 years old (68.8％),and the average age was 18(12,37) months.High fever,respiratory distress and mental infirmity were the main symptoms.In acute stage,the pulmonary asymmetrical exudation lesion,partial exudation fusion and interstitial emphysema were observed by chest X rays.The main complications of extrapulmonary organ were cardiovascular disorder (63.1％),gastrointestinal disorder (50％),liver dysfunction (46.9％),coagulation dysfunction (31.3％) and nervous system dysfunction (26.1％).Respiratory support included high flow nasal oxygen therapy in 2 cases,mechanical ventilation in 30 cases,prone position ventilation in 12 cases,and continuous renal replacement therapy (CRRT) in 9 cases,extracorporeal membrane oxygenation (ECMO) therapy in 6 cases.There were 5 cases of death,and the hospital mortality was 15.6％.There were 4 cases survived by ECMO,and the discharge rate was 66.7％.Conclusion Adenovirus infection remains an important cause of CAP in PICU,and the mortality is high.Prone position ventilation,CRRT and ECMO may improve the survival rate of severe adenovirus pneumonia in children.

Objective To investigate the efficacy of venous-arterial extracorporeal membrane oxygenation (VA-ECMO) in the treatment of refractory septic shock in children.Methods From January 2016 to December 2018,the clinical data of children with refractory septic shock (RSS) treated by VA-ECMO in Department of Critical Medicine Affiliated Children's Hospital of Shanghai Jiao Tong University were retrospectively analyzed.The patients with refractory septic shock (RSS) treated by VA-ECMO were compared with those with non-refractory septic shock (NRSS).Results There were 8 cases in the RSS-ECMO group and 6 cases in the NRSS-ECMO group.The sex,age,PRISM score,complication showed no significant difference in the two groups.The median time of ECMO in the RSS-ECMO group was 182 (141,216) h,and 5 patients were survived and were discharged from the hospital.The blood lactic acid and vasoactive drug index in the RSS-ECMO group was significantly higher than that in the NRSS-ECMO group (P＜0.05 or P＜0.01).The time of vasoactive drugs use and the ratio of combined continuous renal replacement therapy (CRRT) in the RSS-ECMO group were higher than those in the NRSS-ECMO group,but there was no significant difference (P ＞ 0.05).Atter ECMO establishment,the mean invasive arterial pressure increased significantly at 6 h,and lactic acid decreased significantly at 12 h after ECMO support.SCVO2 returned to normal at 24-h ECMO therapy.Conclusions The success rate of VA-ECMO treatment in children with refractory septic shock complicated with MODS is similar to that of children with non-refractory septic shock.The relationship between ECMO and hemodynamic indexes in sepsis should be further explored.