Objective To explore the effect of humidified high flow nasal cannula (HHFNC) in neonatal with severe pneumonia.Methods Forty-two cases of neonatal with severe pneumonia according to different treatment methods were divided into treatment group (20 cases) and control group (22 cases).Treatment group was given HHFNC,control group was given the wet bottle oxygen nasal cannula or mask.Disappearance of symptoms and hospital stay in two groups,blood oxygen saturation (SpO2),partial pressure of oxygen (PaO2),partial pressure of earbondioxidc (PaCO2) and respiratory rate in treatment group before and after the application of HHFNC were compared.Results The effective rate in treatment group was significantly higher than that in control group [90.00％ (18/20) vs.63.64％ (14/22)],which reached statistical significance (P ＜0.05).Disappearance of symptoms and hospital stay in treatment group were shorter than those in control group,and mechanical ventilation rate was lower than that in control group [10.00％(2/20) vs.45.45％(10/22)],which reached statistical significance (P ＜ 0.05).SpO2 and PaO2 at application of HHFNC after 12,24 h and 1 h after evacuation of HHFNC were significantly increased eompared with those before [0.921 ± 0.027,0.955 ± 0.021,0.958 ± 0.016 vs.0.865 ± 0.045; (83.4 ± 28.3),(89.8 ±20.4),(92.8 ±12.6) mmHg (1 mmHg =0.133 kPa) vs.(52.8 ±10.1) mmHg],PaCO2 at application of HHFNC after 24 h and 1 h after evacuation of HHFNC were significantly reduced compared with those before [(46.1 ±6.3),(43.7 ±7.2) mmHg vs.(59.7 ± 8.3) mmHg],which reached statistical significance (P ＜0.05).Respiratory rate was decreased with the treatment time,which reached statistical significance (P＜ 0.05).Conclusion Application of HHFNC in neonatal with severe pneumonia is effective and woorth promoting.

Objective To compare the safety and effectiveness between treatments with autologous platelet gel (APG) versus standard care for treating refractory diabetic dermal ulcers.Methods The 46 patients with proved nonhealing diabetic dermal ulcers were enrolled. Eligible for the study were patients with grade II/III ulcers according to Wagner, lasting for at least 2 weeks and with no signs of infection at recruitment.Patients were given their informed consent document and randomly assigned to two groups: standard care (ST, n=23) or standard care plus topic application of APG (APG, n=23) for twelve weeks.The treatment of blood glucose, blood pressure and lipids was optimized and the empiric antibiotic treatment was further adjusted according to the results of culture and sensitivity testing in all patients. APG treatment consisted of wound dressing with APG, followed by topical washing and cleaning. The APG was then covered with vaseline gauze for 72 hours, after which the ulcers were treated by standard care. Participants were seen thrice a week, twice a week, or at weekly intervals. Twelve weeks observation was set as the end point.Results The would of APG group were improved in 22 patients with ulcers healed completely and 1 case with would area reduced. In the ST group, 13 ulcers were healed, 6 worsened and 4 with would area reduced. The cumulative rate of ulcer healing was 95.7% in the APG group versus 56.5% in the ST group (P=0.002). The total effective rate in APG vs ST group was 100.0% vs 73.9% (P=0.009). By Kaplan-Meier analysis,the time-to-healing of ulcer and time-to-lutation of sinus were significantly different between two groups (log-rank, P=0.006, 0.000, respectively). No treatment-related adverse events were observed. Conclusions Treatment with APG in addition to standard care results in a significantly faster and better healing for a refractory diabetic dermal ulcer and does not raise any safety concerns. So APG treatment can be a valuable and effective aid in the management of diabetic foot ulcers.

Objective:To establish a liquid chromatography tandem mass spectrometry ( LC-MS/MS) method for the determination of 5-fluorouracil (5-Fu) in patient’s plasma and apply it in clinics patients validation. Methods:5-Fu was analyzed on an Agela Inno-val NH2 (2. 1 mm × 50 mm, 5 μm) column. Methanol:ultra pure water (2 ∶98) was used as the mobile phase with isocratic elution. The flow rate was 0. 3 ml ·min-1 and the column temperature was set at 40℃. The ion transitions with electrospray ionization negative model were m/z 128. 8→42. 1 and m/z 188. 6→42. 1 for 5-Fu and 5-bromouracil (the internal standard), respectively. The LC-MS/MS method was verified according to the guideline of quantitative analysis validation of biological samples ( Chinese Pharmacopoeia, 2015 edition, the fourth part) . Results:The calibration curve of 5-Fu was linear within the range of 10-1 000 ng · ml-1 . The lower limit of quantification was 10 ng · ml-1 . The precision, accuracy, matrix effect and stability within the linear range were all in line with the requirements of method validation. Conclusion:The LC-MS/MS method developed in the study for the determination of 5-Fu is simple, rapid, accurate and reproducible, which can be used for the plasma concentration detection of 5-Fu in patients.

Since initiation of training on laboratory of molecular biology in my school, we accumulated experience in teaching process especially among international students and application of pedagogy as well as technology. Strengths, weakness and opportunities are analyzed to improve teaching quality.

Objective:To analyze the application of video nystagmography in the diagnosis and treatment of benign paroxysmal positional vertigo (BPPV) so as to provide evidence for clinical diagnosis.Methods:A total of 120 patients with suspected BPPV who received treatment in Yueqing People's Hospital from January to July 2020 were included in this study. There were anterior ( n = 24), posterior ( n = 80) and horizontal semicircular canal ( n = 16) BPPV according to the disease type. The detection rates of anterior, posterior and horizontal semicircular canal BPPV by video nystagmography and naked eyes were determined. Therapeutic effects of video nystagmography on three types of BPPV were compared. Results:The diagnostic rates of anterior, posterior and horizontal semicircular canal BPPV were 91.68%, 92.50% and 93.75%, respectively, and the difference was not statistically significant ( χ2 = 0.06, P > 0.05). The detection rates of anterior, posterior and horizontal semicircular canal BPPV by video nystagmography were 91.68%, 92.50% and 93.75% respectively, which were significantly higher than those by naked eyes (58.34%, 78.75%, 56.25%, χ2 = 7.11, 6.14, 3.86, all P < 0.05). After 1 week of treatment, total response rates of anterior, posterior and horizontal semicircular canal BPPV were 62.50%, 66.25%, 68.75%, respectively. After 3 months of treatment, total response rates of anterior, posterior and horizontal semicircular canal BPPV were 95.83%, 96.25% and 100.00%, respectively. There were no significant differences between anterior, posterior and horizontal semicircular canal BPPV after 1 week and 3 months of treatment ( χ2 = 0.18, 0.64, P > 0.05). At 3 months after surgery, the recurrence rates of anterior, posterior and horizontal semicircular canal BPPV were 4.16%, 5.00% and 6.25%, respectively, and the difference was not statistically significant ( χ2 = 0.08, P > 0.05). Conclusion:Video nystagmography is highly effective in the diagnosis and treatment of BPPV. It can accurately judge the occurrence of nystagmus in BPPV and increase the detection rate, which is worthy of clinical application.

Objective:To correlate climate change with epistaxis in Yueqing of Zhejiang province and to provide evidence for the diagnosis and treatment of epistaxis.Methods:A total of 1 800 patients with epistaxis, who received treatment in Yueqing People's Hospital between October 2018 and October 2019, were included in this study. The data of these patients were input into the Microsoft Excel software. They were summarized and sorted as per admission time. Climate change was correlated with epistaxis.Results:Daily average temperatures were negatively correlated with epistaxis ( r = -0.65, P = 0.003). A non-linear, inverted-U-shaped relationship was observed between daily relative humidity and epistaxis. When the daily relative humidity was < 65%, daily relative humidity was positively correlated with epistaxis ( r = -0.54, P = 0.007).When the daily relative humidity was > 65%, daily relative humidity was negatively correlated with epistaxis ( r = -0.68, P = 0.002). There was a nearly linear positive correlation between diurnal temperature range and epistaxis ( r = 0.52, P = 0.009). There was a linear and positive correlation between daily average atmospheric pressure and epistaxis ( r = 0.60, P = 0.004). The risk of epistaxis increased by 1.48% (95% CI: -2.15 to -0.81) when the temperature decreased by 1 ℃. When daily relative humidity was < 65%, the effects of humidity change on the risk of epistaxis were not statistically significant ( P > 0.05). When the relative humidity of the day was > 65%, the risk of epistaxis decreased by 1.82% (95% CI: -2.71 to -0.93) for every unit of humidity rise. The risk of epistaxis increased by 2.86% (95% CI: 0.54 - 5.18) for every 1 ℃ increase in temperature. The risk of epistaxis increased by 1.18% (95% CI: 0.50 - 1.87) for every 1 Pa increase in air pressure. Conclusion:Temperature change is negatively correlated with epistaxis. Atmospheric pressure and diurnal temperature range are positively correlated with epistaxis. Temperature change, atmospheric pressure, and diurnal temperature have temporary effects on epistaxis. High humidity has an obvious long-term protective effect against epistaxis.

Objective: To analyze the clinical characteristics of allergic reactions in patients with colorectal cancer after routine premed-ication with dexamethasone (5 mg) before chemotherapy with an oxaliplatin-containing regimen and to provide a reference for reduc-ing the risk of oxaliplatin allergy. Methods: Retrospective analysis of 242 patients with colorectal cancer who received chemotherapy with an oxaliplatin-containing regimen at the Changzhou Cancer Hospital of Soochow University from January 2014 to October 2017 was performed, and the incidence of allergic reactions was calculated. The associations between multiple factors and allergic reactions were then assessed using univariate analysis. The independent factors of allergic reactions were assessed using multivariate Logistic analysis, and the treatment outcome of oxaliplatin rechallenge in allergic patients was discussed. Results: A total of 242 patients were studied. They received routine premedication with dexamethasone (5 mg) before chemotherapy with an oxaliplatin-containing regi-men. Twelve (4.9%) patients had type I allergic reactions, with a median onset time of 6 (5.5-10.5) cycles and a median cumulative dose of 895 (716.5-1 075.0) mg. Multivariate analysis identified undergoing an oxaliplatin-free interval as an independent risk factor (P=0.04). Rechallenging patients with prophylactic agents was successful in 1 (33.3%) of 3 patients who completed their treatment. Conclusions: Routine low-dose dexamethasone premedication before oxaliplatin administration is safe and exhibited a lower inci-dence of hypersensitivity reactions than that reported in literature. An oxaliplatin-free interval may increase the risk of hypersensitivity reactions. Caution should be exercised while rechallenging allergic patients with oxaliplatin.

Objective To investigate the effect of capillary electrophoresis﹣based multiplex PCR ( CEMP) in detecting pathogens for children respiratory tract infection,and to provide scientific basis for clin﹣ical diagnosis and treatment rapidly and accurately. Methods The cases were defined according to the na﹣tional monitoring program of febrile respiratory syndrome during the 12th Five﹣Year Plan,and the samples were collected from nasopharyngeal swabs,bronchoalveolar lavage fluid and sputum of children with respira﹣tory tract infection hospitalized in Changchun Children′s Hospital from January 2017 to February 2018. Multi﹣plex PCR amplification was performed by one﹣step method, then PCR products were separated by DNA length size with capillary electrophoresis and pathogens were analyzed by"Genemapper software" software. Detecting pathogens included Influenza A virus (InfA),Human Adenovirus (HADV),Boca virus ( Boca), Human Rhinovirus ( HRV), Novel InfA﹣09H1 ( InfA﹣09H1 ) and Seasonal Influenza virus H3N2 ( InfA﹣H3N2),Parainfluenza virus ( HPIV),Human metapneumonia virus ( HMPV), Influenza B virus ( InfB), Mycoplasma pneumoniae (Mp),Chlamydia pneumoniae ( CP),Human Coronavirus ( HCOV),Human Re﹣spiratory Syncytial virus (HRSV). Results The effective detection rate of the CEMP assay was 95. 71%. The positive detection rate of respiratory tract pathogens was 62. 84% and the mixed infection rate was 9. 61%. The mixed infection was mainly InfA and HRSV. The highest three positive rates were named InfA, HRSV and Mp. The positive rate of HRSV was significantly higher in the 0﹣3 age group than that in older group. Different pathogens were detected in different age groups,and the high﹣occurrence season of respiratory tract infection with virus was from December to March of the next year. InfA﹣09H1 was the main prevalent influenza virus in January,February and March 2017,InfA﹣H3N2 was the main prevalent influenza virus in November and December 2017,and the outbreak of InfB was happened in Changchun in late 2017 and early 2018. HRSV was detected only in the coldest season in Changchun from November to March of the next year. Different pathogens were detected in different respiratory infection. HRSV was the main pathogen detec﹣ted in pneumonia; InfA﹣03H2 and HPIV were the main pathogens detected in acute bronchitis; HRV and InfA were the main pathogens detected in upper respiratory tract infection. Conclusion CEMP is an effi﹣cient,rapid and accurate method for the detection of pathogens in patients with respiratory tract infections,and it will have a broad application prospect to develop reagents suitable for clinical diagnosis.

Objective:To explore the application effect of problem-based learning (PBL) combined with mind mapping and situational teaching in cardiology teaching of rural doctors.Methods:Twenty rural doctors of Batch 2017 and 24 rural doctors of Batch 2018 were selected as study subjects, and they were divided into the experimental group (Batch 2018) taught by PBL combined with mind mapping and situational teaching and the control group (Batch 2017) taught by traditional teaching. Classroom tests and questionnaires were used to compare the students' mastery of the teaching content, and the teaching effect and student feedback were evaluated. SPSS 18.0 was performed for t test, rank-sum test and χ2 test. Results:The theoretical results of the experimental group were significantly higher than those of the control group ( P<0.05). The scores of learning interest and initiative ( Z=-3.606, P<0.001), classroom attraction ( Z=-3.455, P=0.001), understanding ( Z=-3.757, P<0.001) and mastering ( Z=-4.259, P<0.001) in the study effect evaluation of the experimental group were significantly higher than those of the control group. The satisfaction to teachers about active classroom atmosphere ( χ2=4.556, P<0.05), flexible methods ( χ2=12.813, P<0.05), satisfaction ( P<0.05), theory with practice ( P<0.05), and thinking inspiration ( χ2=21.042, P<0.05) of the experimental group were significantly greater than those of the control group. Conclusion:PBL combined with mind mapping and situational teaching has a good effect on the teaching of cardiology of rural doctors, and it is worthy of promotion in the grassroots.

Objective To investigate the consistency between colonoscopic Boston bowel preparation score and the bowel cleanliness evaluated by pre-endoscopy naked eye faecal observation,so as to provide a guidance on bowel preparation.Methods From September 2018 to June 2019,convenience sampling method was used to select 150 inpatients who underwent colonoscopy in the Department of Gastroenterology of a tertiary hospital in Guangzhou as the research objects.Before colonoscopy,the compound polyethylene glycol electrolyte powder was taken orally according to the bowel preparation plan for cleaning the colorectum.Before the colonoscopic examination,the naked eye observation method by nurses was used to observe the transparency of the excreta to evaluate the cleanliness of colorectum.Then the colorectal cleanliness was evaluated by endoscope by the operator using the Boston bowel preparation assessment scale(BBPS)during colonoscopy.Results A total of 145 patients completed the study.The cleanliness of bowel preparation was 93.1%with the naked eye observation and 88.27%with colonoscopy.There was no significant difference between the two assessment methods in judging the effectiveness of bowel preparation(P<0.05).The sensitivity of naked eye observation in judging bowel preparation was 96.10%with a 29.41%of specificity.The positive predictive value was 91.11%,and the negative predictive value was 50%(Kappa=0.310,P<0.001).Conclusion The naked eye observation and evaluation method for bowel preparation has advantages in high sensitivity,low specificity,high positive predictive value and low negative predictive value.It can be used as a preliminary evaluation method for cleanliness of colorectum before colonoscopy.