Objective:To study the experience of frontline medical workers in COVID-19 quarantine points.Methods:Purposive sampling method was employed and 12 frontline medical workers in COVID-19 points of Zhaoyuan City were selected for semi-structured and in-depth interview. Colaizzi′s seven-step analysis method was adopted to analyze and categorize the data.Results:The real experience of frontline medical workers in quarantine points were classified into five themes: professional mission and pride, inadequate initial response in dealing with public health emergencies (shortage of personal protective equipment,inadequate preparation of medical workers and imperfect settings of quarantine points), having some negative emotions (worrying about being infected and feeling fearful for family members), facing complex and diverse working difficulties (repugnance and diversified demands of people quarantined, heavy workload, discomfort from personal protective equipment and occupational exposure), and gaining support and appreciation (getting support from epidemic control and prevention departments as well as medical systems and winning appreciation from people quarantined).Conclusions:The frontline medical workers are lack of experience in dealing with public health emergencies and have some psychological and working pressure. Administrative department should further complete the emergency plan of centralized isolation medical observation, strengthen the contingency management of public health emergencies, attach importance to the mental health of medical workers, optimize management methods and establish flexible work schedules.

Malnutrition in patients with acute stroke is quite common. It is an independent risk factor affecting stroke prognosis. Early enteral nutrition can improve the nutritional status of the stroke patients, lower infection rate and mortality, promote recovery of neurological function, and improve the quality of life. Therefore, under the premise of the gastrointestinal tolerance, the patients with severe stroke should select early enteral nutrition as early as possible.

Objective To find a indicator in urine to assist diagnosis of cerebral infarction,we investigated the changes of urine ferritin in patients with cerebral infarction.Methods Collected serum from 30 healthy volunteers and 53 patients with cerebral infarction(CI),with ratio of males to females 19∶11 vs.30∶ 23,and average age was (56 ± 11) vs.(63 ± 11) respectively.Collected urine from 39 heathy volunteers and 33 patients with CI,with ratio of males to females 25∶14 vs.20∶ 13,and average age was (57 ± 10) vs.(64 ± 11) respectively.Ferritin concentration in all samples was detected with the chemical luminescence method,and the urine ferritin/urine cretinin (uFer/uCr) ratio was calculated.Differences of serum ferritin and uFer/uCr between healthy volunteers and CI patients were analyzed with the statistical software under Wilcoxon test.Urinary proteins were extracted with absolute ethanol.The extracted ferritin was displayed with Western blot for light chains and heavy chains to investigate the difference between healthy volunteers and CI patients.Results uFer/uCr was higher than that from healthy volunteers (U =292.00,P ＜0.05),and the median was (14.86 vs.6.22) μg/g.Moreover,after extraction of urinary proteins with alcohol,both light chains and heavy chains of ferritin in urine from CI patients were much more obvious than that from healthy volunteers.Conclusion The uFer/uCr ratio could provide a new proof to assist the diagnosis of cerebral infarction.

Facing the new problems under the background of new era,with the establishment of the market economy of our country and the improvment of the medical health system,how to solve medical health problems,how to strengthen the modernization management of state-owned hospital,and how to improve their comprehensive strength become the focus of the health research.With the internal and external environment analysis and the strategic management theory,this paper puts forward the development strategy and the support system of the children's hospital of Chongqing Medical University.

Objective To eliminate the interference of CEA-related substances in CEA measurement and increase the specificity of CEA in the detection of malignant digestive diseases.Methods CEA level of peripheral blood and digestive juice(bile,gastric juice) from patients with benign or malignant digestive diseases was measured by ELISA,and semi-dry electrophoretic transfer method of Western blot technique to distinguish CEA and CEA-related substances.Results In malignant diseases,the CEA level of digestive juice was significantly higher than that in the blood,and there was no difference of CEA level in digestive juice and blood in benign diseases.Meanwhile,the CEA level of digestive juice and blood in malignant diseases were significantly higher than that in benign diseases.A specific band(molecular weight about 210?10~3) was detected in all malignant diseases except four cases whose CEA level was too low(less than 5 ?g/L),whereas no one of benign diseases had this specific band no matter how high or low the CEA level was.Conclusion The specificity of CEA detection in malignant digestive diseases can be improved by using digestive juice as sample and combining with Western blot technique.

Objective To research the electrocardiogram (ECG) manifestations of common electrolyte disturbance and to discuss the accuracy of ECG diagnosis. Methods One hundred and sixty-nine hospitalized patients with hyperkalemia and 170 patients with hypokalemia were selected and the results of ECG were analyzed. Results In mild hyperkalemia patients (serum potassium concentration 5.5- 6.5 mmol/L), the ECG abnormal rate was 91.4% (64/70). In mild hypokalemia patients (serum potassium concentration 3.0-3.5 mmol/L), the ECG abnormal rate was 56.9% (41/72). There was significant difference (P < 0.05). The greater the deviation of serum potassium concentration, the more obvious the characteristic changes of ECG. Conclusions In addition to the blood biochemical test, ECG is also a kind of check tool that can help to diagnose abnormal blood potassium.

Objective To explore the relationship between severity of symptom and immune function in left-to-right shunt congenital heart disease (CHD) infants combined with pneumonia. Methods The clinical data of 45 left-to-right shunt CHD combined with pneumonia infants were retrospectively analyzed. The infants were divided into 2 groups according to the modified Ross score:mild group (0-6 scores, 28 cases) and severe group (7-12 scores, 17 cases);then, the infants were divided into 2 groups according to deformities:single deformity group (the infants had a kind of deformity such as ventricular septal defect, atrial septal defect and patent ductus arteriosus, 21 cases) and composite/complex deformity group (the infants combined 2 or more deformities or other malformations, 24 cases). Twelve cases of healthy check-up infants were selected as control group. The levels of lymphocyte subsets (including CD3+, CD4+, CD8+, CD4+/CD8+, NK cell and B lymphocyte) and IgG, IgA, IgM were detected in every group. Results There were no statistical differences in IgG, IgA, IgM, CD8 +, CD4 +/CD8 +, NK cell and B lymphocyte among mild group, severe group and control group or single deformity group, composite/ complex deformity group and control groups (P>0.05). The CD3+ in severe group was significantly lower than that in mild group and control group (0.59 ± 0.10 vs. 0.69 ± 0.13 and 0.69 ± 0.12), the CD4+was significantly lower than that in control group (0.34 ± 0.07 vs. 0.45 ± 0.09), and there were statistical differences (P<0.05). For CD4+, though there was statistically difference among single deformity group, composite/complex deformity group and control groups (P<0.05), no statistically significant difference was in multiple comparison among the 3 groups (P>0.05). The CD4 + in the composite/ complex deformity group was significantly lower than that in the single deformity group and the control group (0.34 ± 0.07 vs. 0.45 ± 0.15 and 0.45 ± 0.09), and there was statistical difference (P<0.05). Conclusions In left-to-right shunt CHD infants combined with pneumonia, the reduction of CD3+and CD4+may be one of the causes of serious illness.

Objective To explore the clinical and imaging features of reversible posterior leukoencephalopathy syndrome(RPLES).Methods The data of clinic five cases with RPLES were analyzed retrospectively.Results The primary diseases in this group were hypertension for one case,uraemia for three cases and lupus nephropathy for another.Clinical features of five patients include acute onset of hypertension,headache with vomiting.Neurological symptoms were conscious disturbance,seizures(in 5 cases)and visual disorder(in 3 cases).The movement of limbs were normal.The abnormal laboratery data was renal inadequacy in 5 cases.The findings of imaging of all cases included bilateral white matter of parietal and occipital lobe abnormalities,which appeared as large areas of low density on CT scan,hypo-intense in T1 and hyper-intense in T2 on MRI scan.Four cases presented clinical symptoms improvement in a short time and radiological recovery obviously after anti-hypertensive and anhydration therapy.One patient died caused on brain herniation.Conclusions Clinical features of RPLES is brain damage associated with malignant hypertension or the use of immunosuppressive agents.The most important pathogenesis is considered to be failure of the self regulation of cerebral vascular circulation.The imaging findings are bilateral symmetry cortical and subcortical edema in the posterior areas of the brain.Most patients can be recovery by timely therapy,otherwise the irreversible neuronal injury even death can be also found in very few serious cases.

Objective To discuss the application of minimally invasive surgery in the treatment of esophageal leiomyoma. Methods Clinical data of 26 patients with esophageal leiomyoma from September 1996 to October 2002 treated by minimally invasive surgery were reviewed retrospectively. Results Video-assisted thoracoscopic leiomyoma enucleations were performed in 23 patients, and a conversion to mini-thoracotomy was required in 3 of them because of dense pleural adhesion (2 patients) or location failure of tumor (1 patient). The remaining 3 patients underwent transjugular leiomyoma enucleation (2 patients) or esophagoscopic resection of leiomyoma (1 patient), respectively. All the procedures were completed smoothly and the postoperative recovery was uneventful, without mortality or severe complications. All the patients were pathologically diagnosed as leiomyoma after surgery. Follow-up for 2 ～ 73 months (mean,32.3months) found no recurrence. Conclusions Video-assisted thoracoscopic enucleation can be the first choice for the esophageal leiomyomas that derived from lamina propria, while esophagoscopic removal may be considered for those from muscularis mucosa.