Objective To study the current situation of pediatric emergency department of primary hospitals in Guangdong province,in order to provide evidence for the development of appropriate pediatric emergency skill.Methods A questionnaire survey was conducted in primary hospitals of Guangdong province by face to face and mail.The questionnaire was self-designed,including the hospital area and level set,the key equipment in pediatric emergency,common symptoms and diseases,the need for pediatric specialty in local medical colleges.Results60 questionnaires were released and 38(63.3％) were available,which were from 14 different cities of Guangdong province.Among the 38 hospitals,16 hospitals(42.1％) had no independent pediatric emergency;24 hospitals(63.2％) had no blood gas analyzer;23 hospitals(60.5％) without a defibrillator;22 hospitals(57.9％) had no bedside ultrasound,neonatal warm or warm box;17 hospitals(44.7％) had no bedside X-ray,infusion pump;13 hospitals(34.2％) without gastric lavage machine;12 hospitals(31.6％) without ventilator;8 hospitals(21.1％) without the monitor.Top five symptoms were fever,cough,vomiting,diarrhea,convulsion.The top five diseases were pneumonia,fever of unknown,acute gastroenteritis,hand-foot-mouth disease,convulsion of unknown.Only 5 hospitals (13.2％) thought there was no need for pediatric specialty in local medical colleges.Conclusion Shortages of the pediatric emergency equipments and specialists are very severe in primary hospitals,in order to improve the status of pediatric emergency,some ways can be explored:the construction of grassroots pediatric emergency should be speeded up;a grades regional system for child emergency transport should be improved as soon as possible;the appropriate pediatric emergency skills and training for primary hospitals should be explored and compiled into instructions;pediatric emergency health education could be implemented in child health care.

Objective To study the effects of Compound Di Gui Capsule (CDGC) on the levels of glucose and lipid in diabetic rats.Methods Rats models with diabetes mellitus were induced by intraperitoneal injection of streptozotocin (50mg?kg-1).Then the diabetic rats were divided into different groups at random.CDGC groups were given CDGC in the dosages of 2.4,1.2,0.6 g?kg-1?d-1 respectively by gastric gavage for 90 d.Levels of whole blood glucose,glycosylated hemoglobin,total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),nitric oxide (NO),total antioxidation capacity (T-AOC) were determined.The insulin level and the pathological changes of pancreatic tissues were also observed.Results The glucose level of diabetic rat was decreased 2h after administration.After administration of CDGC for 90d,the glycosylated hemoglobin,TG,LDL-C and NO were markedly decreased,islet ?cells were protected and restored,and the insulin level and T-AOC were increased.Conclusion CDGC can regulate the metabolism of glucose and lipid in diabetic rats,and can protect and restore the pancreatic islet cells.

OBJECTIVE: To study the effect of hypertonic seawater and isotonic seawater for nasal mucosa of allergic rhinitis mice model, and explore the possible mechanism of nasal irrigation with seawater in treatment of allergic rhinitis. METHOD: We used Der pl to make allergic rhinitis model of BALB/c mice, and divided them into three groups randomly. Nasal irrigation with hypertonic seawater (HS) or isotonic seawater (IS) in the treatment group 1-14 days after modeling, and black control (BC) group was given no treatment after modeling. Normal control (NC) group was given no treatment, the number of rubs and sneezings in each group were counted in 30 min after the last nasal irrigation. Mice were then killed 24 h after the last therapy. The noses of mice from each group were removed and fixed, then the slices were stained with hematoxylin and eosin, the others were observed by transmission electron microscope. RESULT: Mice with hypertonic seawater and isotonic seawater were significantly improved in rubs and sneezings compared to the black control group (P<0. 05); The number of eosinophiles in mucosal tissues of HS group and IS group had no significant difference with that of the black control group (P> 0. 05); Ciliated columnar epithelium cells in mucosal tissues of HS group and IS group were arranged trimly, better than that in the black control group. Morphology and microstructure in nasal mucosal of HS group was closer to the normal group than in IS group. CONCLUSION The injury of nasal mucosa ciliated epithelium was significantly improved by nasal irrigation with hypertonic seawater and isotonic seawater, and the former is better than the latter, the mechanism of nasal irrigation with seawater in treatment of allergic rhinitis may rely on repairing the injured nasal mucosa ciliated epithelium, thereby the symptoms of nasal was reduced.
Animals ; Disease Models, Animal ; Mice ; Mice, Inbred BALB C ; Nasal Lavage ; Nasal Mucosa ; Nose ; Rhinitis, Allergic ; therapy ; Seawater

Objective To observe the effect and safety of the endovascular hypothermia through hypothermic intravenous infusion device in the treatment of patients with severe craniocerebral injury compared with conventional surface cooling. Methods A total of 66 cases of patients with severe cranio-cerebral injury were randomly divided into the observation group and the control group with 33 cases in each group according to envelop randomization. The control group received surface cooling, and the observation group was given surface cooling plus endovascular hypothermia through hypothermic intravenous infusion device. The target temperature was 35 ℃maintained for 3-5 days, and natural rewarming was applied at the speed of 0.1-0.5℃/h to 36.0-37.3℃. The time to reach target temperature, the constant stability, the incidence rate and severity of complication such as shiver, arrhythmia, skin injury and agitation were recorded and compared between two groups, as well as the heart rate, breathing rate, pulse rate, blood pressure and Glasgow Coma Scale (GCS) scores after 72 h of treatment. Glasgow Outcome Scale scores 30 days after treatment and nursing workload were also calculated and compared. Results The cooling speed, time to reach target temperature and the ability to maintain at 35℃were (1.3±0.2)℃/h, (2.3±0.2) h and (6.5± 1.8)%in the observation group, respectively, compared with (0.5±0.1)℃/h, (3.6±0.6) h and (11.3±2.2)%in the control group, which had significant differences (t=1.862, 2.112, 2.408,P < 0.05). The occurrence rates of shiver, arrhythmia, skin damage and dysphoria and restlessness in the observation group were 33.33%(11/33), 9.09%(3/33), 6.06%(2/33) and 27.27%(9/33), respectively, which were much lower than those in the control group 84.85%(28/33), 15.15%(5/33), 33.33%(11/33), 54.55%(18/33),χ2=1.764-2.733,P<0.05. The heart rate, breathing rate, pulse rate, systolic blood pressure and GCS score after 72 h of treatment were(68.31 ± 3.73)times/min,(16.60 ± 1.52)times/min,(136.35 ± 3.71)mmHg(1 mmHg=0.133 kPa),(34.61 ± 1.05)℃, (9.91±4.05)points in the observation group, while(58.31±3.62)times/min,(19.81±1.83)times/min,(150.66± 2.70)mmHg,(35.65 ± 1.36)℃,(7.63 ± 3.17)points in the control group, and there were significant differences between two groups(t=2.275-3.035, P < 0.05).Besides, the ice-changing ice and turning-over time in the observation group were both remarkably reduced compared with control group, (14.03±3.11) min/h vs (38.12± 2.70) min/h (t=3.356, P<0.05) , (15.08±3.07) min/h vs (26.16±2.54) min/h ( t=3.021, P<0.05). Patients with good recovery, mild disability, severe disability, death in the observation group were 16, 13, 3 and 1 case, while 6, 11, 9, 7 cases in the control group (χ2=2.351,P < 0.05). Conclusions The endovascular hypothermia through hypothermic intravenous infusion device can rapidly reduce and effectively maintain target temperature, reduce the incidence rate of complication, improve the vital signs and decrease the nursing workload in order to improve neurological outcome in the treatment of patients with severe craniocerebral injury.

Objective To evaluate the efficacy and safety of proton pump inhibitor (PPI)plus prokinetic drug on the treatment of laryngopharyngeal reflex .Methods According to predetermined criteria of inclusion and exclu-sion ,Cochrane Central Register of Controlled Trails(CENTRAL) ,Embase ,Elsevier ,Pubmed ,VIP ,Wanfang Data , CNKI and CBM were searched for the randomized controlled trails of proton pump inhibitor and prokinetic drug on the treatment of laryngopharyngeal reflex diseases from the date of establishment of the datebases to November 2012 .Revman 5 .1 software and GRAED profiler 3 .6 software were applied to analysis the data ,which was extrac-ted by three independent evaluators .Results A total of 346 related articles were obtained ,7 trails were included , 614 patients in total .The results of Meta -analysis showed that :the overall effictive rate of combination therapy with proton pump inhibitors plus prokinetic drug in patients with laryngopharyngeal reflex was higher than those in the control group [RR=1 .18 ,95% CI(1 .10 ,1 .28) ,P<0 .0001] .The rate of improvement of laryngeal signs exam-ined by fiberoptic laryngoscope was higher than those in the control group [RR= 1 .38 ,95% CI(1 .16 ,1 .65) ,P<0 .001] .The average relief time of dysphonia symptoms was shorter than those in the control group [MD = -1 .70 , 95 CI (-2 .95 ,-0 .45) ,P<0 .001] .Conclusion The effect of proton pump inhibitor plus prokinetic drug on the treatment of laryngopharyngeal reflex is superior to those of proton pump inhibitors or prokinetic drug only ,but in terms of safety ,more large-sample ,high-quality randomized controlled trails are required .

Objective To assess the role of Matrix Metalloproteinase-9 (MMP-9)in rheumatoid arthritis (RA).Methods Peripheral blood from 45 RA patients and 28 healthy individuals (HV)were collected to detect RF and hs-CRP by immuno-turbidimetry,ESR by westergren method and MMP-9 by ELISA.The correlation was analysed between MMP-9 and RF, ESR or hs-CRP,respectively,by pearson correlation analysis.Results Levels of RF,ESR,hs-CRP and MMP-9 were signifi-cantly higher in RA patients than HV group (t=3.93~5.96,P<0.001),respectively.RF high titer patients or patients with a high inflammation response showed a higher MMP-9 levels than the RF low titer or slight inflammation patients (P<0.05).MMP-9 was positively correlated to RF,ESR and hs-CRP in RA patients(P<0.05),respectively.Conclusion MMP-9 maybe a sensitive tool in the diagnosis and management of RA patients.