Objective To study the relationship between the exposure time of puncture needle of infusion bottle stopper and microbial contamination during clinical intravenous transfusion. Methods A total of 600 cases from November 1, 2014 to January 31, 2015 who have received the clinical intravenous transfusion for investigation were selected.When replacing the infusion bottle (bag), inserting the puncture needle slowly across the bottle stopper and making the needle tip be canted to the transfusion bottle mouth (bag) of the rubber plug, gently squeezing the Murphy's tube until solution was not dripping, recording down the exposure time in the air of the needle tip from medicine droplet to the end. To dip the lower part with sterile swabs and culture the swabs in nutrient broth medium. Meanwhile, to replace the next bottle of medicine and get the remaining 2 ml of liquids into the culture broth medium, after 48 h, both of which medium were switched to blood plate culture cultivation for observing the general situation of the bacteria growth. Results Among the 600 cases of clinical transfusion, 24 cases were positive for sterile swabs microorganisms culture, positive rate was 4.0%, among which microorganisms, 15 cases were gram-positive coccus, 3 cases were gram-negative bacillus, 3 cases were gram-positive bacillus and 3 cases were fungi. Correspondingly, 3 cases were positive for liquid broth culture, positive rate was 0.5%as the gram-positive coccus. The exposure time and broth microbial culture result was statistically significant, while the exposure time and medicinal broth microorganisms culture result possesses had no statistical significance. Conclusions Inserting the puncture needle across the bottle stopper could successfully reduce the liquid drug residues in the infusion bottle (bag), however, which might also cause time-dependent microbial contamination during the exposure process in the air.

Objective To develop a curriculum system for social communication disorders rehabilitation in children with autism based on humanoid robot. Methods The curriculum was developed through the robot programming and the structure hierarchy of the curriculum. It was applied in three children with autism. Results and Conclusion The curriculum has been developed. All the children concentrated in the class, with few emotive disorders.

Objective To investigate the effect of ketamine on depression-like behaviors at different developmental stages of offspring rat exposed to prenatal restraint stress (PRS).MethodsPregnant SD rats were randomly divided into control group (n=6) and PRS group (n=8).The dams of PRS group received three times(45 minutes/time)restraint stress every day.The anxiety-like and depression-like behaviors of the offsprings of the two groups were tested in the stage of juvenile,adolescence and early adulthood.Then the antidepressant effect of ketamine on prenatal stress rats at different developmental stages was observed.ResultsIn the open-field test,the time in the central area of the offspring rats in PRS group at different developmental stages (juvenile(2.50±0.43)s,adolescence(9.17±1.05)s,early adulthood(8.33±0.92)s) were significantly lower than those of the control group((8.33±1.05)s,(19.17±1.06)s,(18.83±1.30)s,all P<0.05).In the forced swimming test,the immobility time in the offspring rats of PRS group at the different developmental stages (juvenile(192.50±10.82)s,adolescence(182.75±10.12)s,early adulthood(199.88±9.20) s)were significantly higher than those of control group((76.00±19.00)s,(96.30±12.91)s,(108.30±10.98)s,all P<0.05).Ketamine could quickly and strongly reduce the immobility time of the offsprings exposed to PRS in the stage of adolescence and early adulthood (P<0.01),but the effect was weaker in the juvenile offsprings (P<0.05).ConclusionPRS leads to persistent anxiety-like and depression-like behavior in offsprings and ketamine exerts a good antidepressant effect on the offspring rats in the stage of adolescence and early adulthood.

Objective To identify the risk factors for positive resection residues after endoscopic submucosal dissection ( ESD ) of early esophageal squamous carcinomas and precancerous lesions. Methods A retrospective analysis was performed in 315 patients with early esophageal squamous cancer and precancerous lesion who underwent ESD. The pathological features of all resection margins in the specimen and the follow?up outcome of the patients with positive resection margin were evaluated. Univariate and multi?variate analysis were used to determine the risk factors for resection margin residues after ESD. Results In 315 lesions,there were 290 lesions with negative resection margins and 25 with positive resection margins.The number of lesions with positive lateral, basal, or both resection margins was 13, 8, and 4, respectively. Multivariate analysis showed that the depth of invasion( submucosal layer invasion, P=0?048) was the only independent risk factor for positive basal resection margin. The proportion of circumferential extension (≥3/4,P=0?014) and the depth of invasion( exceeding muscularis mucosa, P=0?007) were independent risk factors for positive lateral resection margin. Conclusion The diameter of the lesions and the depth of tumor invasion are independent risk factors for esophageal ESD positive resection margins. Accurate evaluation of lesion extension and invasive depth is critical to avoid residual or recurrent tumor after esophageal ESD.

Objective To study the risk factors for pathological upgrading after diagnosis of esophageal low?grade intra?epithelial neoplasia with ESD preoperative biopsy. Methods The endoscopic and pathological data of 85 lesions with ESD preoperative biopsy were analyzed, and grouped based on pathological upgrading after ESD. The risk factors for pathological upgrading after ESD was studied through single and multiple factor analysis. Results Pathological upgrading occurred in 45(52?94%) lesions after ESD, among whom 38 lesions developed up to high?grade intra?epithelial neoplasia and 7 lesions developed to esophageal early cancer. NBI?ME was performed on 37 patients and the accuracy of detecting the pathological invasion was 83?8%(31/37).Multi?factor analysis showed that reddish surface(OR=9?478, 95%CI:2?775?32?368, P = 0?000 3 ) and nodular lesion ( OR = 15?628, 95%CI:1?475?165?617, P =0?022 5) were independent factors for pathological upgrading after ESD. Conclusion Pathological upgrading of low?grade intra?epithelial neoplasia was common, especially esophageal mucosa with red surface and nodular lesion.Biopsy combined with NBI?ME is of significant importance to improve diagnostic accuracy.

Objective: To understand the prevalence of anemia among children aged 6 months to 5 years old in Guizhou Province, providing a scientific basis for anemia intervention. Methods: A total of 853 children aged 6 months to 5 years old and their families were chosen through a multi-stage stratified cluster sampling method. All the participants were surveyed with relevant questionnaires and hemoglobin testing. Unconditional logistic regression analysis was used to explore the associated factors. Results: The anemia rate among 853 children aged 6 months to 5 years old in Guizhou was 14.9%, among which mild, moderate and severe anemia accounted for 70.08%, 29.13% and 0.79%, respectively, and the detection rate of anemia decreased with the growth of age(χ2=27.87,P<0.01). Logistic regression analysis showed that anemia was negatively correlated with regular growth monitoring. Children with complementary food supplements after 6 months old were less likely to develop anemia than children with complementary food supplements younger than 4 months; Compared with 6-12-month-old group, older children were less likely to develop anemia; Delayed weaning increased the risk for childhood anemia. Conclusion The prevalence of anemia among children aged 6 months to 5 years old in monitoring area of Guizhou province is still alerting. Introducing scientific feeding practice to parents, regular growth monitoring, deep cooperation among the government, medical institutions and the family, are vital parts in effectively reducing childhood anemia.

Objective:To evaluate the application value of small IT knife pre-cut in assistance to duodenal papillary cannulation compared with conventional guidewire cannulation.Methods:A retrospective analysis was performed on the data of 90 patients with choledocholithiasis including 52 patients with small IT knife pre-cut assisted intubation (small IT knife group) and 38 patients with conventional guidewire intubation (conventional group) in endoscopic retrograde cholangiopancreatography (ERCP) from May 2016 to July 2019 in the digestive endoscopy center of Nanjing Drum Tower Hospital. The basic data, curative effect and complications of the two groups were collected and compared.Results:There was statistically significant difference in gender composition between the small IT knife group and the conventional group ( χ2=5.679, P=0.017), but no significant difference in other baseline data between the two groups (all P>0.05). The median intubation time of the small IT knife group was significantly shorter than that of the conventional group (141.5 s VS 270.0 s, Z=1 268.0, P=0.022). There were no significant differences in the success rate of intubation [98.1% (51/52) VS 94.7% (36/38), χ2=0.760, P=0.571], the incidence of intraoperative bleeding [15.4% (8/52) VS 7.9% (3/38), χ2=1.148, P=0.345], postoperative pancreatitis [5.8% (3/52) VS 7.9% (3/38), χ2=0.159, P=0.694], and postoperative cholangitis [1.9% (1/52) VS 5.3% (2/38), χ2=0.760, P=0.571] between the two groups. No perforation occurred in the two groups. After stratifying according to the operator′s proficiency, the median intubation time was significantly different between the small IT knife expert group and the conventional expert group (116.0 s VS 258.0 s, Z=276.0, P=0.038), while there was no significant difference in the intubation time among other groups (all P>0.05). Conclusion:The small IT knife is safe and effective to pre-cut and assist intubation in ERCP, and it may shorten the intubation time.

At present, the passive simulated lung including the splint lung is an important device for hospitals and manufacturers in testing the functions of a respirator. However, the human respiration simulated by this passive simulated lung is quite different from the actual respiration. And it is not able to simulate the spontaneous breathing. Therefore, including" the device simulating respiratory muscle work "," the simulated thorax" and" the simulated airway", an active mechanical lung to simulate human pulmonary ventilation was designed:3D printed human respiratory tract was developed and connected the left and right air bags at the end of the respiratory tract to simulate the left and right lungs of the human body. By controlling a motor running to drive the crank and rod to move a piston back and forth, and to deliver an alternating pressure in the simulated pleural, and so as to generate an active respiratory airflow in airway. The experimental respiratory airflow and pressure from the active mechanical lung developed in this study are consistent with the target airflow and pressure which collected from the normal adult. The developed active mechanical lung function will be conducive to improve the quality of the respirator.
Adult ; Humans ; Lung/physiology* ; Respiration ; Pulmonary Ventilation ; Respiration, Artificial ; Ventilators, Mechanical

Thoracentesis is common in daily medical practice. During the operation, it is easy to cause complications such as re-expansion pulmonary edema, pulmonary hypotension, liver and spleen injury, pleural reaction, intercostal artery injury, pneumothorax, and so on. If the operator does not master procedures properly, it is easy to damage the thoracic organs. Therefore, the department of the general practice of the First Hospital of Jiaxing improved the puncture needle device based on thoracic puncture cannula, developed a new type of disposable thoracic puncture cannula, and obtained the National Utility Model Patent of China (patent number: ZL 2019 2 2112955.7). New type of disposable thoracic puncture cannula comprises a flexible puncture cannula, a steel needle, a limit structure, and a second bolt. In the process of puncture, the length of the puncture is limited by the limit structure. If the puncture force is too strong, the limit structure will prevent further penetration of the needle. The device is easy to use, flexible to operate, easy to master, and can reduce the risk of thoracentesis, which is worth of clinical promotion.

Objective To assess the clinical effects of simethicone emulsion combined with polyethylene glycol on bowel preparation for colonoscopy. Methods Two hundred out-patients, who underwent colonoscopy,were randomly divided into the study group and the control group. The study group was given simethicone in addition with polyethylene glycol, and the control group was given polyethylene glycol only. The differences on bowel preparation scores, air bubble reduction rate, colon lens sharpness, ileocecal region arrival time, colon polyp detection rate, the number of colon poly detection, and adverse event rate between the two groups were compared. Results The air bubble reduction rate, colon lens sharpness score and ileocecal region arrival time of the study group was 1(0-3)score,1.0(0-2)score,and 9(5-21)min,respectively,which was 2(1-3)score,1.5(0-2)score and 12(6-22)min, respectively in the control group. Differences between the two groups were statistically significant(Z=-9.490,P=0.000;Z=-6.768,P=0.000;Z=-5.521,P=0.000). For the bowel preparation score, colonoscopy polyp detection rate,the detection rate of colon polyp of diameter less than 5 mm, and number of colonoscopy polyp detection,there was no statistical difference between the two groups(P>0.05). No adverse events were observed in the both two groups. Conclusion The bowel preparation using simethicone combined with polyethylene glycol could effectively decrease the number of air bubble, enhance colon lens sharpness and shorten operation time,which contributes significant improvement for colonoscopy quality.