Objective To explore the correlation analysis of plasma TNF-?,D-lactate levels and serious case score and clinical significance.Methods Plasma TNF-?,D-lactate levels and results from serious case'score was contrastingly studied in 120 cases of serious sick children during hospitalization in our PICU.Results The study findings showed that the plasma TNF-? and D-lactate levels had produced an obviously influence on score.Conclusions The more high plasma TNF-? and D-lactate levels,the lower score and the more dangerous condition in children with serious disease.

ObjectiveTo study the characteristics of the relationship between injury and disease in foren-sic identification cases of cervical trauma with cervical vertebra degeneration, and to explore the prob-lems about how to identify the participation rates of injury and disease using the clinical information, forensic examination and imaging examination.MethodsSeventeen forensic identification cases of cervi-cal trauma with cervical vertebra degeneration were collected. The age distributions, injury formations, injury severities and imaging findings of these cases were analyzed and the relationship between injury and disease was evaluated comprehensively.ResultsMiddle-aged and elderly were common in 17 cases and every case was involved with intervertebral disc herniation. The main reasons of injuries were hy-perextension. The degree of injury severity and vertebra degeneration were graded according to the imag-ing findings. The participation rates of injury and disease were also calculated comprehensively.Conclu-sionThe forensic identification cases of cervical trauma with cervical vertebra degeneration should be evaluated with clinical information, forensic examination and imaging finding.

【Objective】 To explore the value of controlling nutritional status (CONUT) score and related inflammatory indicators in predicting the prognosis of clear cell renal cell carcinoma (ccRCC) patients, to provide a reference for better clinical assessment and individualized treatment plan. 【Methods】 A retrospective study was conducted on 132 patients with ccRCC admitted to four comprehensive hospitals in Yibin during 2010 and 2018.Patients’ medical and follow-up records were collected, and receiver operating characteristic (ROC) curve was drawn to analyze the area under the curve (AUC) and optimal cut-off value of CONUT score and related indicators.Survival curve was plotted with Kaplan-Meier method, and the influencing factors of prognosis were analyzed with Log-rank test and Cox regression. 【Results】 During the follow-up of 62 (53, 71) months, 37 (28.03%) deaths occurred.The disease-specific survival (DSS) and progression-free survival (PFS) were 51 (41, 58) and 46 (35, 56) months, respectively.The 3-year and 5-year DSS and PFS were 84.09% and 71.97%, and 75.00% and 71.97%, respectively.The AUC of CONUT score, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocyte to monocyte ratio (LMR) were 0.980, 0.905, 0.899 and 0.884, respectively, with the optimal cut-off values of 3.50, 3.19, 89.07 and 3.56, respectively.Cox regression showed that CONUT score (HR=0.042, 95%CI:0.013—0.140) and PLR (HR=0.182, 95%CI:0.045—0.744) were associated with DSS; CONUT score (HR=0.029, 95%CI:0.010—0.086) and LMR (HR=2.984, 95%CI:1.227—7.258) were associated with PFS. 【Conclusion】 The prognosis of ccRCC patients is related to their nutritional, immune, and inflammatory status.CONUT score and inflammatory factors (PLR, LMR) may be important predictors of DSS and PFS.

OBJECTIVES: To study the effects of alfacalcidol on serum 25-(OH)D METHODS: A total of 200 children with HSP were prospectively enrolled from June 2018 to June 2020. According to the random number table method, they were divided into an observation group and a control group ( RESULTS: After treatment, the observation group showed a significantly higher serum 25-(OH)D CONCLUSIONS Alfacalcidol can increase the serum 25-(OH)D
Child ; Humans ; Hydroxycholecalciferols ; Interleukin-6 ; Prospective Studies ; Purpura, Schoenlein-Henoch/drug therapy*

Objective To investigate the effect of mechanical thrombectomy device Solitaire AB for the treatment of distal occlusion of the intracranial artery caused acute anterior circulation ischemic stroke. Methods The clinical data of 9 patients with arterial occlusion of distal anterior circulation treated by using the Solitaire AB thrombectomy device were analyzed retrospectively. Seven of them had M2 middle cerebral artery occlusion and 2 had A3 occlusion. Their clinical features,imaging data,treatment,and the results of 3-month clinical follow-up were analyzed. The effectiveness of treatment was evaluated through the recanalization rate after stent thrombectomy,the National Institutes of Health Stroke Scale (NIHSS)scores before and after treatment,the modified Rankin scale (mRS)scores,and the 3-month clinical follow-up results. The surgery-related complications and mortality of patients were used to evaluate the safety of the treatment. Results (1 )Of the 9 intracranial arterial occlusions,8 were recanalized successfully. The modified thrombolysis in cerebral infarction (mTICI)was 2b or grade 3. (2)The NIHSS score median 9. 5 (3. 0,15. 5)at discharge dropped significantly compared with 19. 0 (16. 0,22. 0)before procedure. (Z=2. 703,P=0. 007). No permanent complications related to operation occurred. Four of the recanalized patients had good prognosis (mRS 0-1)and 4 had disability (mRS 3-4 ). The mRS score of one non-recanalized patient was 4 at the 3 months follow-up. Conclusion The embolectomy effect is good whom using Solitaire AB device for acute occlusion occurred in the intracranial artery M2 or A3 segment. Its efficacy,safety,and indications still need to be further explored in a larger sample controlled trial.

Objective To investigate the feasibility and effectiveness of inducing rabbit common carotid fusiform aneurysms via the common carotid extravascular digestion method. Methods Sixteen New Zealand white rabbits were randomly assigned into either an experiment group ( n=12 ) or a control group (n=4). Porcine pancreatic elastase 80-400 U were used to incubate and digest 2 to 4 cm segment of artery distal to the origin of right common carotid artery. One week after modeling,intravenous angiography was performed and the length and width of fusiform dilatation of common carotid artery were measured. The fusiform dilated artery was examined with hematoxylin and eosin staining and the vascular morphological changes were observed with scanning electron microscope. Isotonic saline solution was used to incubate common carotid arteries of the 4 New Zealand white rabbits in the control group. After one week,the same method was used to observe the lumen of common carotid artery and intimal changes. Results After the digestion of common carotid artery adventitia,the angiography of 12 New Zealand white rabbits of the experimental group revealed fusiform dilatation of common carotid artery of the 10 model rabbits. The widest diameter of the fusiform artery was 3. 70 ± 0. 32 mm;two rabbits had common carotid artery occlusion. Compared with the control group,the right common carotid artery diameter enlarged significantly in the experimental group (1. 80 ± 0. 16 mm,P<0. 01). The HE staining showed that the lumen widened, adventitia and media reduced. Scanning electron microscope showed intimal inflammatory injury and thrombus attachment. Conclusion Using porcine pancreatic elastase to digest the adventitia of common carotid artery can make fusiform dilatation of common carotid artery in rabbits. Using this method may effectively induce a model of fusiform aneurysm,and it has certain feasibility.

Objective To analyze the MP infection status in children with respiratory tract disease and the correlation with gen‐der ,age ,season and clinical conditions .Methods To investigate the clinical data retrospectively of 655 children with respiratory tract infection from January to December 2013 .Results The positive rate of MP antibody was 48 .09% with a higher incidence in girls than boys ,and those above 3 were more susceptible to it .Winter and spring were the peak seasons .The older group had a higher positive rate of MP antibody ,together with high morbidity of MPP and LP ,the differences were statistically significant (P<0 .05) ,while the younger group was inclined to get higher WBC count and percentage of increasing CRP and neutrophils ,the differ‐ences were statistically significant(P<0 .05) .Conclusion MP is a common pathogenic bacteria causes respiratory tract infection in children above 3 years ,especially in winter and spring .The antibody positive rate rise with age and the infected children are more likely to have pneumonia meanwhile the younger group has higher WBC count ,in which more cases get higher level of CRP and neutrophils .

Objective To discuss the clinical effect of dynamic hip screw(DHS)and microtrauma dynamic hip screw(MTDHS)in treatment of comminuted intertrochanteric femur fractures in the elderly patients.Methods From September 2006 to July 2009,42 patients with comminuted intertrochanteric femur fractures were treated by DHS and MTDHS.According to Evans classification,there were 16 patients with type Ⅲ fractures and six with type Ⅳ fractures in MTDHS group and 15 patients with type Ⅲ fractures and five with type Ⅳ fractures in DHS group.The operation time,amount of bleeding,hospital stay and postoperative hip function were evaluated.Results All patients were followed up for 9-17 months(average 13 months).Harris score was 76.4 points in 20 patients treated by DHS and 89.8 points in 22 patients treated by MTDHS,with better functional restoration,shorter operation time and less amount of bleeding in MTDHS group than DHS group.Conclusions Compared with DHS,MTDHS has advantages of minimal invasion,minor trauma,sound recovery of hip joint function and low incidence of complications and hence is a good choice for treating intertrochanteric femur fractures.

Objective To clarify the role of the virtual reality (VR)in the training of trans-femoral cerebral angiography for novices without any experience of intravascular manipulation. Methods Twenty-four novices without experiences of intravascular manipulation were divided into 2 groups (VR group or control group)with random pair method concerning the age,gender and subjects. The par-ticipants in control group were trained in routine manners while those in VR group practiced on a simulator and subsequently participated in real angiography once as assistants. Real angiography tests were performed for all participants after the training session and additional angiography tests were per-formed for VR group just after the stimulation session on the simulator. Real angiography tests were supervised and scored according to a modified rating scale by neuroradiological experts who were blinded to the novices' training procedures. Difference between the real test performance of the two groups were compared by pared-samples t test,while the correlation between the performance of the real tests and simulator tests of VR group was proved by Pearson correlation analysis. P<0.05 was con-sidered statistically significant. Results The mean scores of VR group were (27.6±3.6)and (26.4± 3.8)in the tests on simulator and real angiography tests respectively,while score of control group was (21.2±3.4)in the real angiography tests. A positive correlation was revealed in VR group between performance on the simulator and that on real patients (r=0.825,P=0.001). Real performance of the VR group was significantly better than that of control group (P=0.010). Conclusions Virtual reality could ensure transfer of acquired endovascular skills from simulators to patients so as to become a valid tool for novices to improve the interventional techniques in tranfemoral cerebral angiography.

Abstract Social withdrawal is a kind of behavioral inhibition in social situations, which may increase the risk for maladjustment, internalizing and externalizing problems, interfering with psychological development and healthy growth. With the deepening understanding in sociology of development, child social withdrawal has gradually received extensive attention from scholars across the world. Understanding the phenomenon of child social withdrawal is important for in depth follow up research. Based on the literature review, the paper aims to summarize the types, mechanisms and influencing factors of social withdrawal in children, in order to provide scientific basis for formulating prevention strategies and early intervention programs in the future.