Leukemia stem cell might cause relapse and resistance in leukemia.CD133 molecule is a new biomarker of hematopoietic stem,progenitor cell,similar with CD34.In recent years,CD133 has been found to be also expressed in some hematopoietic malignancies,especially in acute leukemia.A remarkable characteristic of CD133 is that the expression of CD133 will be down-regulated as cell differentiation.Therefore,it has become a biomarker to isolate and identify human stem cells and progenitor cells.As a feasible cancer stem cells marker,CD133 plays an important role in sorting cancer stem cells from many solid tumors.Some studies have demonstrated that CD133+ cells are related to signal transduction,immune escape and resistance to medicine and radiation.CD133 is expected to become a new target on leukemia treatment.

Objective To set up assessment indexes of nursing process quality in hospitals that are scientific, practical and in keeping with the times so as to provide hospital departments in charge of nursing with the basis for reasonable assessment and scientific decision-making. Methods Typical investigations were conducted to understand the content and methods of the current assessments of nursing process quality in hospitals; the basic scope of the assessment indexes was determined through meeting discussions; the indexes were selected, verified, and established by means of brainstorming and the Delphi method; field surveys were conducted to assess and analyze the nursing process quality in 25 departments. Results A system of comprehensive assessment of nursing process quality in hospitals was established. It covered four categories, viz. nursing services, nursing control, nursing skills and nursing safety, and decomposed into assessment indexes of different levels, with the overall structure consisting of 1 overall goal, 4 first-level indexes, 12 second-level indexes, 5 third-level indexes and 290 subindexes. Conclusion The new system of indexes, which stresses the idea of nursing services, highlights the quality control principle of focusing on the patients,and is characterized by clear-cut structure and easy operability, provides a reliable guarantee for scientifically and rationally assessing nursing process quality.

Objective To explore the clinical value of combined detection of human epididymis protein 4(HE4) ,carbohydrate an‐tigen 199(CA199) and carbohydrate antigen 125(CA125) in diagnosis of ovarian cancer and benign ovarian cysts .Methods The se‐rum levels of HE4 ,CA125 and CA199 were determined by using chemiluminescent immunoassay in 45 cases of patients with ovarian cancer(ovarian cancer group) ,60 cases of patients with benign ovarian cyst(benign disease group) ,and 30 cases of healthy individu‐al(control group) .Results The serum levels of HE4 ,CA199 and CA125 in the ovarian cancer group were higher than those in the ovarian cancer group and control group ,there were statistically significant differences(P<0 .05) .Compared with the control group , the serum level of CA125 in benign disease group was significantly higher(P<0 .05) ,while no statistically significant differences of serum levels of HE4 and CA199 were observed between the two groups(P>0 .05) .The sensitivity of combined detection of the three indicators increased to 82 .2% ,and the specificity remained at 90 .0% .Conclusion Combined detection of HE4 ,CA125 and CA199 might have clinical significance in early diagnosis and identification of ovarian cancer .

Objective To observe the efficacy and adverse reaction of the test drug hepatitis B immunoglobin on the post market.Method Employed by the methods of multiple center's clinical trials and using the recommended dosage of hepatitis B immunoglobulin for intravenous administration,the clinical efficacy of either prevention or treatment for hepatitis B recurrence and drug related adverse reactions were observed.This consisted of 22.1 months,13 hospitals,and 525 patients with hepatitis B related liver transplantation.Result The results showed a contrasting probability of adverse reactions for different doses among the observation period.Within 6 months postoperatively with a greater or equal to recommended drug dose,the infection rate was less than 4％.In contrast,the infection rate was greater than 12％ in the group with less than the recommended drug dose.Conclusion There was an obvious dose effect relationship,and the drug safety and recommended treatment rationality were verified.

Objective To discuss the expression level of serum procalcitonin( PCT) and clinical val-ue in acute viral diarrhea patients. Methods A total of 186 patients with acute viral diarrhea treated in our hospital from September 2013 to September 2015 were retrospectively reviewed. One hundred and seven were male and 79 were female,of which 171 cases were infected by rotavirus and 15 cases infected by norovirus. The average age was ( 1. 29 ± 0. 89 ) years old. All patients′ blood and stool cultures were negative. The patients were divided into three groups according to the degree of dehydration and whether complicated with multiple organ dysfunction or not:severe group( complicated with severe dehydration,shock or multiple organ dysfunction,n=33),mild-moderate dehydration group(n=68) and no dehydration group(n=85). Thirty-five healthy children with the same age were enrolled as the control group. Serum PCT levels,high sensitivity CRP(hs CRP) and blood routine were detected. Results The serum PCT levels increased in 73 patients with acute viral diarrhea,8 cases>100 ng/ml,21 cases 5 to 100 ng/ml and 44 cases 0. 5 to 5. 0 ng/ml. PCT( ng/ml)[0. 36(0. 14,1. 67),hsCRP(mg/L)[3. 50(0. 70,14. 83)] and WBC( × 109/L)[9. 06(6. 79,12. 50)] levels increased in the diarrhea patients compared with those in the healthy group[0. 09(0. 05,0. 13);1. 00 (0.40,2.50);6.90(5.90,8.20)](all P < 0.05). The level of PCT in patients with dehydration [0.54 (0. 19,7. 83)]was higher than that without dehydration[ 0. 26(0. 11,0. 55)](P<0. 05) and increased in severe group[13. 69(3. 41,60. 30)] compared with in those the mild-moderate group[0. 33(0. 13,0. 89)] and no dehydration group[0. 26(0. 11,0. 55)](all P<0. 017),but there was no difference among groups in hsCRP and WBC levels ( P>0. 05 ) . Conclusion PCT can increase in pediatric patients with acute viral diarrhea,especially in those with severe dehydration,shock and organ dysfunction. Continued high levels of PCT indicates critical condition and has poor prognosis. PCT can be used as a good indicator to evaluate the severity of disease and the prognosis.

Object To explore the bacteriostatic and anti inflammation activities of ultrasonically nebulized Houttuynai cordata Thunb in patients after pneumonectomy Methods The patients were randomized into 2 groups Patients of the experimental group, inhaled ultrasonically nebulized H cordata, while patients in the control group inhaled ultrasonically nebulized vapors without the addition of H cordata Results Total leucocyte counts on the third and fourth day in the experimental group were significantly lower than that in the control group Neutrophil ratio in experimental group was also lower in all the 5 days of treatment although nonsignificantly Meanwhile, occurrence of Gram negative bacilli colonization in experimental group occurred less than that in the control group But incidence of fungi colonization appeared higher Conclusion Inhalation of ultrasonically nebulized H cordata can ease the inflammation and inhibit the colonization of Gram negative bacilli in respiratory tract

Objective:To investigate the changes of left ventricular mass index(LVMI),plasma brain natriuretic peptide (BNP),interJeukin-6(IL-6)and interleukin-10(IL-10)in patients with congestive heart failure(CHF),and their values in risk stratification and prognostic evaluation of CHF thereof.Methods:Ninety-five patients with CHF in accordance with 2001ACC/AHA guidelines were enrolled and stratified as stage A(n=21),B(n=23),C(n=31)and D(n=20).The levels of plasma BNP,IL-6 and IL-10 were measured and compaired with those in 20 healthy subjects(control group).The patients were followed up every three months in two years.The end point was the rehospitalization and the cardiac death.Results:(1)The level of LVMI increased early in patients with CHF at stage B.(2)The plasma BNP levels were initially elevated in CHF patients at stage B,and the concentrations of BNP closely paralleled disease severity.(3)The levels of plasma IL-6 and IL-10 were increased,and the ratio of IL-10/IL-6 was decreased,with the progression of CHF at stage C and D.The plasma BNP level was positively correlated with the levels of IL-6 and IL-10.(4)The new CHF stratification was surperior to NYHA functional classification in regard to CHF prognosis prediction.(5)Multivariate COX regression analysis showed the levels of BNP and IL-6 were the independent risk factors in prognostic evaluation(P＜0.01,P=0.026).(6)Patients in high-risk groups stratified by the combination of BNP and stage classification had obviously higher end point events rate.Conclusion:(1)LVMI was a better marker for the evaluation of left ventrieular remodeling.(2)The intrinsic mechanism of CHF progression was inflammatory reaction deterioration.(3)BNP was a good marker in predicting onset and prognosis of CHF.The combination of BNP and the stage classification could improve the prognostic evaluation in patients with CHF.

Objective:In May 2019, the 2018 version of Criteria and practical guidance for determination of brain death in children in China was published, which was revised by Brain Injury Evaluation Quality Control Center of National Health Commission, making the determination of brain death for pediatric patients in China more standardized and orderly.However, there is currently lacking of direction for the implementation of the above criteria for determining brain death to patients supported on extracorporeal membrane oxygenation(ECMO) in China.We successfully completed the determination of brain death and the organ transplantation(as a donor)for a pediatric case with severe brain injury and pneumorrhagia supported by VA-ECMO in our PICU, which provided clinical references for the revision of the guidelines for determination of brain death for pediatric patients in China. Methods:By referring to the international guidelines of Determination of Brain Death/ Death by Neurologic Criteria: The World Brain Death Project published in JAMA in August 2020, we performed a determination of brain death for a case of pediatric patient with severe brain injury and pneumorrhagia supported by VA-ECMO(blood flow 720 to 750 ml/min, gas flow 600 mL/min, oxygen concentration 65% to 70%)in our PICU. Results:The results of the determination of brain death included: Glasgow coma scale was 2T, all brainstem reflexes disappeared, three confirmation tests(electroencephalography, transcranial Doppler, short latency somatosensory evoked potential)all met the criterias for determination of brain death, apnea test(AT)showed PaCO 2>60 mmHg and elevated >20 mmHg than that before AT.We performed twice determination of brain death, interval time was >12 h. Finally, we successfully completed the determination of brain death and the organ transplantation(as a donor)for the case. Conclusion:The successful experience in the determination of brain death in the pediatric patient with severe brain injury and pneumorrhagia supported by VA-ECMO will provide clinical references for the revision of the guidelines for determination of brain death for pediatric patients in China.

Bronchiectasis has the characteristics of long course,gradual aggravation,easy recurrence and difficult to treat.The characteristics are similar to those arouse by incubative pathogenic factors.Based on the theory of incubative pathogenic factors,this disease is often related to the incubative pathogenic factors in the body's areas with deficient healthy qi,which occur at regular times.The etiology can be external,congenital,or internal.Treatment should focus on different characteristics of incubative pathogenic factors.Attention should be paid to clearing and dispersing in external pathogenic factors,while attention should be paid to supporting and promoting healthy qi in congenital pathogenic factors,and do not forget to remove internal pathogenic factors.

Objective The Nuss procedure is a minimally invasive pectus repair.The aim of this study was to explore the changes in quality of life in patients who underwent a Nuss procedure.Methods 96 patients,who underwent a Nuss procedure in our institution,were interviewed at preoperation,1 year after operation with the bar in place,and before the planned bar removal.The Nuss Questionnaire modified by George Krasopoulos et al,which evaluates psychosocial and physical well-being,was independently used by patients.Results Most of the scoring of the individual questions and the total score of individual patients revealed a significant improvement,both in preoperation vs.1 year after operation and 1 year after operation vs.before the planned bar removal.Conclusion The Nuss procedure has been shown to improve the quality of life in patients with pectus excavatum deformity in the short term.