Objective To investigate the surgical outcome of cervical spondylotic myelopathy. Methods Twenty -five patients (14 males and 11 females) with cervical spondylotic myelopathy who underwent operative treatment between 2004 and 2007 in our hospital were included in this study. The mean duration of symptoms was 31 months (ranging from 8 days to 10 years) . The follow - up period ranged from 18 months to 4 years (mean 30 months). The study comprised 6 posterior decompression (laminoplasty) and 17 anterior cervical discectomy with fusion and anterior locking plate systems. 2 patients with severe cervical spondylotic myelopathy were treated by operation of the combining anterior and posterior. Results According to COA, the recovery (improving) rate among the tolal patients was classified as exellent in 20 cases, good in 3 cases, fair in 2 cases. The excellend and good rate was 92% . Conculusion Both anterior and posterior surgery were effective for cervical spondylotic myelopathy with effective decompression according to the location of abnormality.

Objective To explore the application effect of quality control circle(QCC)in the construction of a new model for abdominal pain centers in county-level comprehensive hospitals.Methods A total of 160 patients with non-traumatic abdominal pain admitted to the department of emergency of Baiyin Central Hospital from June 2021 to October 2022 were selected as research objects.Divided by March 2022,from June 2021 to February 2022,and 80 patients with non-traumatic abdominal pain admitted to the department of emergency before the establishment of QCC management mode from June 2021 to February 2022 were given routine treatment and nursing care.After establishing the QCC theme,the targets were set according to the 10 steps of QCC activities,the circle members drew up the strategies and carried out the second development of the strategies one by one,evaluated the feasibility,economy,urgency and circle ability,formulated the treatment plan for the patients with abdominal pain,carried out the standardized treatment,selected the most suitable method to carry out and review,and finally evaluated the effect.The difference of tangible outcomes(the average response time for pre hospital emergency treatment,average response time for in-hospital emergency treatment,waiting time for abdominal special examination,consultation waiting time,emergency department retention time,and emergency surgery entry time,triage accuracy,incidence of adverse events)and non-tangible outcomes(problem-solving ability,personal qualities,sense of responsibility,communication and coordination ability,self-confidence,teamwork ability,enthusiasm,and mastery of QCC)between pre-and post-QCC patients were compared.Results ①Tangible results:after QCC,the average response time for pre hospital emergency treatment,average response time for in-hospital emergency treatment,waiting time for abdominal special examination,consultation waiting time,emergency department retention time,and emergency surgery entry time were significantly shortened compared to before QCC[pre hospital emergency response time(minutes):2.15±0.05 vs.4.25±0.25,average response time for in-hospital emergency treatment(minutes):58.32±10.25 vs.100.22±25.25,waiting time for abdominal special examination(minutes):29.78±6.44 vs.40.22±8.59,consultation waiting time(minutes):9.05±2.12 vs.13.15±3.12,emergency department retention time(minutes):58.60±9.25 vs.76.00±12.02,emergency surgery time(minutes):115.25±20.25 vs.153.22±25.32,all P<0.05],triage accuracy significantly improved compared to before QCC[98.75%(79/80)vs.87.50%(70/80),P<0.05],incidence of adverse events significantly decreased compared to before QCC[16.25%(13/80)vs.35.00%(28/80),P<0.05].Intangible achievements:after the implementation of QCC,circle members had significantly improved their problem-solving ability scores,personal qualities scores,sense of responsibility scores,communication and coordination ability scores,self-confidence scores,teamwork ability scores,enthusiasm scores,and mastery of QCC scores compared to before QCC(problem-solving ability scores:3.75±0.26 vs.2.89±0.19,personal qualities scores:3.76±0.24 vs.2.92±0.28,sense of responsibility scores:3.63±0.22 vs.3.20±0.33,communication and coordination ability scores:4.25±0.30 vs.3.20±0.33,self-confidence scores:3.52±0.30 vs.2.90±0.19,teamwork ability scores:3.63±0.29 vs.3.00±0.18,enthusiasm scores:3.63±0.27 vs.2.97±0.22,mastery of QCC scores:3.38±0.22 vs.2.91±0.27,all P<0.01),with significant intangible achievements.Conclusion Conducting QCC activities can improve the management level of abdominal pain patients and enhance the quality of medical care.

Objective: To investigate the current application status of continuous blood purification (CBP) technology and equipment in pediatric intensive care unit (PICU) in China. Methods: A cross-sectional survey was conducted to understand the current popularization of CBP technology and equipment, the management of CBP equipment and consumables, and the application of CBP in different diseases. A questionnaire named Application Status of Continuous Blood Purification Technology was applied. Children's hospitals and polyclinic hospitals with the pediatric qualification (pediatric emergency or critical care unit members of Chinese Medical Association and Chinese Medical Doctor Association) were selected. Results: From December 2016 to February 2017, 53 hospitals completed the questionnaire, including 7 in northeast, 6 in north China, 16 in east China, 9 in south China, 5 in central China, 4 in the northwest, and 6 in the southwest region. Continuous renal replacement therapy (CRRT), the most widely used technology, was carried out in 51 hospitals. Other technologies were peritoneal dialysis (IPD) (n=37), artificial liver support (ALSS) (n=26) and blood adsorption (PA) (n=13). There were 107 CBP machines in the 51 hospitals used CBP technology, with an average of 2.10/hospital. In 36 hospitals CBP machines were managed independently by PICU (70%). Hospitals made their own displacement liquid (n=40, 78%), or purchased displacement liquid (n=11, 22%). Hospitals prepared dialysate on their own (n=38, 75%), or purchased dialysate (n=13 hospitals, 25%). In 46 (90%) hospitals, hemodialysis catheter was placed independently by PICU doctors. The routine operation and maintenance of CBP were mainly completed by the PICU nurses in 36 hospitals (71%). There were 39 hospitals (76%) where professional nurses manage and maintain CBP. Puncture sites were femoral vein (n=26, 51%), internal jugular vein (n=21, 41%) and venae subclavia (n=4, 8%). Forty-two hospitals (82%) selected B-mode ultrasound positioning and guidance when performing internal jugular vein puncture. A total of 40 (78%) hospitals have developed post dilution and combined dilution techniques during the implementation of CBP. The most common indications of CBP technology were different in different regions. They were sepsis in northeast (24.0%, 243/1 011) and east China region (32.0%, 982/3 069), multiple organ dysfunction syndrome in south China (29.2%, 444/1 520), north China (15.8%, 126/796), and southwest region (30.1%, 460/1 526), drug poisoning in central China region (21.6%, 325/1 506), and renal failure in northwest region (53.0%, 44/83). Conclusions CBP technology is widely used in the field of pediatric severe diseases in China. The eastern regions possess more CBP equipment than the western regions. CBP is widely used in the treatment of sepsis.

Objective:To analyze the difference of clinical characteristics and outcomes of infants with moderate and severe pediatric acute respiratory distress syndrome(PARDS)diagnosed according to baseline oxygenation index(OI) in pediatric intensive care unit(PICU).Methods:Second analysis of the data collected from the "Efficacy of pulmonary surfactant (PS) in the treatment of children with moderate and severe ARDS" program.Retrospectively compare of the differences in clinical data such as general condition, underlying diseases, OI, mechanical ventilation, PS administration and outcomes among infants with moderate and severe PARDS divided by baseline OI who admitted to PICUs at 14 participating tertiary hospitals from 2016 to December 2021.Results:Among the 101 cases, 55 cases (54.5%) were moderate and 46 cases (45.5%) were severe PARDS.The proportion of male in the severe group (50.0% vs.72.7%, P=0.019) and the pediatric critical illness score(PCIS)[72 (68, 78) vs.76 (70, 80), P=0.019] were significantly lower than those in the moderate group, while there was no significant difference regarding age, body weight, etiology of PARDS and underlying diseases.The utilization rate of high-frequency ventilator in the severe group was significantly higher than that in the moderate group (34.8% vs.10.9%, P=0.004), but there was no significant difference in PS use, fluid load and pulmonary complications.The 24 h OI improvement (0.26±0.33 vs.0.04±0.34, P=0.001) and the 72 h OI improvement[0.34 (-0.04, 0.62) vs.0.15 (-0.14, 0.42), P=0.029)]in the severe group were significantly better than those in the moderate group, but there was no significant difference regarding mortality, length of hospital stay and intubation duration after diagnosis of PARDS between the two groups. Conclusion:In moderate and severe(divided by baseline OI) PARDS infants with invasive mechanical ventilation, children in severe group have better oxygenation improvement in the early stage after PARDS identified and are more likely to receive high frequency ventilation compared to those in moderate group.Baseline OI can not sensitively distinguish the outcomes and is not an ideal index for PARDS grading of this kind of patient.