Objective To evaluate the accuracy of ultrasonographic measurement of the transverse diameter of the cricoid cartilage in selecting the cuffed endotracheal tube (ETT) size for pediatric patients.Methods A total of 120 pediatric patients of both sexes,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 1 month-6 yr,with body mass index of 10.9-31.2 kg/m2,undergoing endotracheal intubation and general anesthesia,were divided into group A and group B,with 60 pediatric patients in each group.The pediatric patients were intubated with a cuffed ETT in two groups.The ETT size was selected based on the transverse diameter of the cricoid cartilage measured by ultrasonography in group A.The ETT size was selected according to the age-based formula in group B.A tracheal leak was detected after intubation to determine whether or not the ETT size selected was appropriate.ETTs were replaced when the actually selected ones were not appropriate,and the number of replacement was recorded.The development of intubation-related complications was also recorded.Results The accurate rate of cuffed ETT size selected at the first time was 95％ in group A,and it was significantly higher than that in group B (60％) (P＜ 0.05).There was no significant difference in the incidence of intubation-related complications between the two groups (P＞0.05).Conclusion Uhrasonographic measurement of the transverse diameter of the cricoid cartilage produces higher accuracy in selecting the cuffed ETT size for pediatric patients and is worthy of clinical application.

Objective To determine the value of ischemia modified albumin,heart-type fatty acid-binding protein,B-type natri-uretic peptide and homocysteine in the risk stratification of patients with unstable angina pectoris;thus to provide an assessment for the condition of patients in clinic.Methods 135 patients with unstable angina were included in the disease group and subjected to risk stratification according to GRACE risk score software,70 cases of low-risk group,60 cases in the middle-risk group and 5 cases in the high-risk group.Another 145 healthy people were in the control group.The levels of ischemia modified albumin,heart-type fatty acid-binding protein,B-type natriuretic peptide and homocysteine were detected and compared.Results Between the control group and the disease group,significant difference of heart-type fatty acid-binding protein,B-type natriuretic peptide and homocys-teine was found (P <0.05),but the difference of ischemia modified albumin was not statistically significant(P >0.05).In the dis-ease group,the levels of ischemia modified albumin,heart-type fatty acid-binding protein and homocysteine in each risk stratification showed no significant difference(P >0.05).The level of B-type natriuretic peptide in high-risk group was higher than that in the low-risk group and in the middle-risk group and the difference was statistically significant (P <0.05),while there was no statisti-cally significant difference between the low-risk group and the middle-risk group(P >0.05 ).Conclusion The detection of heart-type fatty acid-binding protein,B-type natriuretic peptide and homocysteine possesses certain meaning in diagnosing unstable angi-na,and the level of B-type natriuretic peptide indicates the risk degree of the disease.

Objective The number of awarded provincial-level research projects and their budget had been declining year by year.We analyzed the data of provincial-level research projects in a general hospital in last ten years to be able to describe the distribution of research projects,the subject crossing situation,the distributions of subject and age structure,degree,title of the project leaders.We tried to find out the problems of them and to provide evidence for policy making.Methods Based on the scientific research management software,the data of the provincial-level research projects can be collected from 2005 to 2014.To Analyze the distributions of subject and structure of age,degree,professional title of the projects leaders by SPSS software.Results In general,the number and funds of provincial-level projects were unstable in the nearly ten years.Many of them focused mainly on basic departments and key subject.Young and middle-aged professionals were the backbone of the hospital team and talents with a high degree and title were the main force in the successful provincial-level projects.Conclusions According to the distribution trend of the projects,the hospital should deliver a carefully targeted set of actions.According to the distribution trend of the subject departments,the hospital should strengthen cooperation among departments and promote the integration of subjects.Strengthen the construction of talent team,pay attention to the cultivation of young talents.Strengthen scientific research management,To provide services for provincial level projects management.

A group of SARS-Iike coronaviruses(SL-CoV)have been identified in horseshoe bats.Despite SL-CoVs and SARS-CoV share identical genome structure and high-level sequence similarity,SL-CoV does not bind to the same cellular receptor as for SARS-CoV and the N-terminus of the S proteins only share 64% amino acid identity,suggesting there are fundamental differences between these two groups of coronaviruses.To gain insight into the basis of this difference,we established a recombinant adenovirus system expressing the S protein from SL-CoV(rAd-Rp3-S)to investigate its immune characterization.Our results showed that immunized mice generated strong humoral immune responses against the SL-CoV S protein.Moreover,a strong cellular immune response demonstrated by elevated IFN-γ and IL-6 levels was also observed in these mice.However,the induced antibody from these mice had weaker cross-reaction with the SARS-CoV S protein,and did not neutralize HIV pseudotyped with SARS-CoV S protein.These results demonstrated that the immunogenicity of the SL-CoV S protein is distinct from that of SARS-CoV,which may cause the immunological differences between human SARS-CoV and bat SL-CoV.Furthermore,the recombinant virus could serve as a potential vaccine candidate against bat SL-CoV infection.

Objective Investigating and analyzing problems and influencing factors in the process of hospital-level research project management,proposing effective and feasible recommendations,and to prove a reference for hospitals administrative management development.Methods The research analyzed factors including researchers,the departments and implementation.Results Since 2005,the total funding to support research projects in the hospital-level project reached 6.345 million yuan,the pass rate in middle-term examination was 84.94％ and was 71.81％ in final examination,with the majority of them were senior researchers.Conclusions Problems founded in this study includes the participate rate was low inyoung and middle-aged researchers,the quality of hospital-level research is also low,lack of research time,and the research outcome is not satisfied.We suggest strengthen the management of the research process,improve the mechanism of scientific rewards and punishments,integrate the disciplines resources,and improve the quality of hospital-level research project.

Objective To evaluate the value of urinary normal and modified nucleosides in the diagnosis of primary gallbladder carcinoma.Methods Between March 2011 to September 2012,28 patients with primary carcinoma of the gallbladder (PCG) were included in this study.Spontaneous urine samples were collected and 10 kinds of urinary nucleosides in the sample were determined by reversed-phase high performance liquid chromatography method.Another 62 patients with benign gallbladder disease and 70 healthy volunteers were enrolled as controls.Routine clinical tumor markers,including serum CA19-9 and CA125 levels of the PCG patients were also evaluated.Results 10 kinds of nucleoside had a good linear correlation (r＞0.99),and the recovery rate was between 87.4％ ～121.5％ range,and the accuracy rate was between 87.7％ ～121.3％,and the RSD of precision was between 1.5％～10.5％ range.In addition to adenosine and cytidine,the mean levels of the rest of the urinary nucleosides in the PCG group were much higher than those of the controls (P＜0.01).Based on principal component analysis,89.3％ of the PCG patients were correctly identified,which was much higher than those detected by CA19-9 (60.7％) and CA125 (67.9％) (P＜0.01).Conclusion Urinary nucleosides may become additional tumor markers which when combined with other clinical methods may help in the screening and early diagnosis of primary gallbladder cancer.

Objective To explore the surgical techniques in laparoscopic distal pancreatectomy for benign and low malignant tumors in the body or tail of the pancreas.Methods The clinical data of 21 cases of benign and low-malignant tumors in the body or tail of the pancreas undergoing LDP from Jan 2015 to Mar 2017 in the First Hospital of Shanxi Medical University were analyzed retrospectively.Results One patient was converted to open surgery(4.76％),13 patients underwent laparoscopic spleen-preserving distal pancreatectomy (Kimura procedure).The other 7 patients underwent LDP with splenectomy.The average size of the tumor was (6.0 ±3.1)cm;the operation time was 190 to 421 mins with mean time of (288.4 ± 56.9)min;the intraoperative blood loss was 30 to 800 ml with the mean volume of(235.7 ± 202.6)ml;Postoperative hospital stay was 6 to 17 days with the mean time of (8.9 ± 3.1) days.Six patients suffered from type A pancreatic fistula,and were cured by conservative treatment.Conclusions Laparoscopic spleen-preserving pancreatectomy for benign or low-grade malignant body and tail pancreatic tumors is feasible and safe.

Urothelial carcinoma (UC) is one of the most common malignant tumors. The development of omics technologies has provided new perspectives for the diagnosis and treatment of UC. Genomics, transcriptomics, and proteomics have unveiled the molecular mechanisms and biological characteristics of UC, which are conducive to the discovery of new therapeutic targets and biomarkers. Single-cell omics and spatial transcriptomics have further deepened the understanding of cellular heterogeneity and the tumor microenvironment. These technologies show great potential in molecular typing, non-invasive diagnosis, early screening, and personalized treatment of UC. This article, in response to the national key strategy, will delve into how omics technologies can drive new developments in the diagnosis and treatment of UC, as well as the application and translation prospects of these technologies in UC.

Urothelial carcinoma (UC) is one of the most common malignant tumors. The development of omics technologies has provided new perspectives for the diagnosis and treatment of UC. Genomics, transcriptomics, and proteomics have unveiled the molecular mechanisms and biological characteristics of UC, which are conducive to the discovery of new therapeutic targets and biomarkers. Single-cell omics and spatial transcriptomics have further deepened the understanding of cellular heterogeneity and the tumor microenvironment. These technologies show great potential in molecular typing, non-invasive diagnosis, early screening, and personalized treatment of UC. This article, in response to the national key strategy, will delve into how omics technologies can drive new developments in the diagnosis and treatment of UC, as well as the application and translation prospects of these technologies in UC.