Objective To establish a method for determination of aluminum in water by graphite furnace atomic absorption spectrometry (GFAAS). Methods Aluminum in water was directly determined by GFAAS at wavelength of 394.4 nm without any matrix modifiers. Results A good linearity (r=0.999 5) was obtained, the linear range was 0-0.600 mg/L. RSD of samples ranged from 2.1% to 6.4%, the average rates of recovery were between 91.0%-108.0%. The detection limit of the method was 0.6 ?g/L, the quantitative limit was 1.9 ?g/L. There was no significant difference between the results determined at wavelength of 394.4 nm and 309.3 nm. Conclusion This method is simple, rapid, accurate and has a wide linear range. It can be applied in the determination of aluminum in drinking water.

Objective To explore the clinical features and gene diagnosis of the distal renal tubular acidosis (dRTA). Methods The clinical data and gene detection results of one child with dRTA were retrospectively analyzed. The related literatures were reviewed. Results Four-month-old female was admitted with frequent vomiting and hearing impairment. The laboratory examination showed refractory hypokalemia and it was difficult to correct metabolic acidosis. Gene detection found a new mutation on ATP6V1B1 gene. The diagnosis of dRTA was confirmed. Conclusions dRTA is a rare disease, ATP6V1B1 gene is the causative gene of the dRTA with sensorineural deafness.

Objective To explore the clinical features and gene mutation types of Cornelia de Lange syndrome (CdLS), an inherited metabolic disease. Methods The clinical data and gene detection results of one case of CdLS were retrospectively analyzed. Results Two-year-old male had special appearance, microcephaly, bushy eyebrows with both sides meeting in the midline, long curly eyelashes, low body mass, and motor and mental retardation. NIPBL gene detection found the variation of the nucleotide in c.7176T>A (nucleotide 7176 in coding region changed from T to A). Conclusions CdLS is a rare congenital inherited metabolic disease. The clinical manifestations were special appearance and signs. The c.7176T>A mutation in NIPBL gene has not been reported at home and abroad.

Extracorporeal membrane oxygenation(ECMO)is more and more widely used in children as a supporting technology for cardiopulmonary organ failure, but bleeding and thrombus are still the most common and serious complications during the use of ECMO.Heparin is the most commonly used anticoagulant in children with ECMO.Activated clotting time, activated partial thromboplastin time, and anti-Ⅹa activity are often monitored to guide the dosage of heparin.However, the optimal dosage of heparin and the appropriate monitoring method are still unclear.This study aimed to summarize the research progress of anticoagulation and monitoring methods in children′s ECMO.

Objective To investigate the effect of acupuncture on gap junction protein Cx43 expression in the hippocampal region in ischemia/reperfusion rats.Methods Wistar rats were randomized into normal, model, non-point acupuncture and acupuncture groups. A rat model of focal cerebral ischemia/reperfusion was made by modified middle cerebral artery thread occlusion. The model, non-point acupuncture and acupuncture groups were separately divide into four subgroups: 30, 60, 180 and 360 min ischemia/reperfusion, 10 rats each. The middle and lateral lines of vertex were given electroacupuncture in the acupuncture group of rats. A subcostal fixed point 10 mm above the iliac crest on the affect side was selected as an acupuncture point in the non-point acupuncture group. The model group was not treated. Cx43 protein expression was determined by an immunohistochemical method.Results There was a statistically significant difference in the behavior disorder (Bederson’s) score between the acupuncture group and the non-point acupuncture or model group after different times of cerebral ischemia/ reperfusion (P<0.05). There was a statistically significant difference in hippocampal Cx43 content between model, acupuncture or non-point acupuncture group and the normal group and between the acupuncture group and the model or non-point acupuncture group after different times of cerebral ischemia/reperfusion (P<0.05).Conclusions Acupuncture can inhibit the overexpression of Cx43, intervene in cerebral ischemia-reperfusion injury and produce a neuroprotective effect in ischemic brain injury.

Objectives To analyze the relationship between the different dosage of vancomycin and its blood concentration in children in pediatric intensive care unit (PICU), the relationship between different valley concentrations and therapeutic efficacy and the adverse reactions. Methods The clinical data of 72 children admitted to PICU and treated with vancomycin from January 2013 to June 2016 were retrospectively reviewed. The vancomycin doses in 58 cases was 40 mg/(kg·d) and were 60 mg/(kg·d) 14 patients. In the subjects treated at 40 mg/(kg·d), administration by q12h were in 19 cases, q8h in 22 cases and q6h in 17 cases. After vancomycin was administered at least 4 doses, blood samples were collected, and the valley concentration was determined within 30 min before administration of vancomycin and peak concentration was determined within 30-60 min after administration of vancomycin. The concentration of vancomycin in plasma was detected by high performance liquid chromatography (HPLC). Results When vancomycin was administrated at 40 mg/(kg·d), there were no difference in valley concentration and peak concentration among the three groups of q12h, q8h, and q6h (P>0.05). The effective rate was not different between valley concentration ≤5 μg/mL and >5 μg/mL of vancomycin (81.8% vs. 84.0%, P>0.05). Compared with vancomycin 40 mg/(kg·d) group (q8h), the valley concentration and peak concentration in 60 mg/(kg·d) group were significantly increased (P<0.05). Conclusion It was difficult to reach a valley concentration of 10 μg/mL by using conventional doses of vancomycin. Thus, in order to achieve effective concentration and reduce adverse reactions, the dosage of vancomycin can be increased, and the times of administration can also be increased.

Objective To investigate the effects of three-dimensional titanium mesh repair on cerebral perfusion,intracranial pressure and nerve function after decompression with bone flap.Methods From October 2015 to October 2018,132 hypertensive cerebral hemorrhage patients of bone disc decompression in the Fifth People's Hospital of Jinan were selected and divided into observation group (66 cases) and control group(66 cases) by double blind random method.The observation group received three-dimensional titanium mesh repair at 24 ～ 42 d after bone disc decompression surgery.The control group received three-dimensional titanium mesh repair at 90 ～ 150 d(3 ～ 5 months) after surgery.The changes of operation,cerebral perfusion,intracranial pressure and nerve function were compared between the two groups.Results The operative time,blood loss and free time of the flap in the observation group were (92.5 ± 12.4) min,(354.3 ± 17.5) mL and (13.2 ± 3.1) min,respectively,which were shorter or less than those in the control group [(142.8 ± 15.3) min,(518.3 ± 22.3) mL and (38.3 ± 4.3) min],the differences between the two groups were statistically significant (t=4.745,6.831,4.963,all P ＜ 0.05).After treatment,the abnormal indices of intracranial pressure and cerebral perfusion in the observation group were (0.1 ±0.0) and(0.2 ± 0.1),respectively,which were lower than those in the control group [(0.2 ± 0.1),(0.3 ± 0.1)] (t =3.657,2.579,all P ＜0.05).There were statistically significant differences in neurological deficit scores between the two groups at different time points(all P ＜0.05).The incidence of treatment complications in the observation group was 10.94％ (7/64),which was significantly lower than that in the control group [38.7％ (24/62)] (x2 =14.094,P ＜ 0.05).Conclusion Three-dimensional titanium mesh repair is helpful to shorten the operation time,restore the intracranial pressure on the affected side,improve the abnormal cerebral perfusion,and reduce the neurological damage in patients with hypertensive cerebral hemorrhage.

Objective:To analyze the clinical characteristics of novel coronavirus (COVID-19) infection in liver transplant recipients.Methods:Clinical data of 130 liver transplant recipients with COVID-19 infection followed in Hebei Medical University Third Hospital from November 2022 to January 2023 were retrospectively collected, including 103 males and 27 females, aged (53.6±11.4) years. The severity of COVID-19 infection, its clinical symptoms, and negative conversion time for each recipient were analyzed and compared.Results:For the disease severity, 121 (93.1%) were mild, 5 (3.8%) were moderate, 3 (2.3%) were severe, and 1 (0.8%) was critically severe. The most common symptoms in the 126 patients with mild to moderate COVID-19 infection were successively fever, fatigue, cough and myalgia, with a negative conversion time of (10.1±4.5) (3.0-29.0)d. In those who underwent transplantation less than 12 months ( n=28), those who were taking mycophenolate mofetil ( n=53) and those who were taking methylprednisolone ( n=10), the negative conversion time was (11.6±5.1) d, (11.4±5.4) d, and (13.4±6.4) d, respectively, longer compared to those who underwent transplantation more than 12 months (9.7±4.2 d, n=98), and who were not taking mycophenolate mofetil (9.2±3.4 d, n=73) or methylprednisolone (9.8±4.2 d, n=116, all P<0.05). The negative conversion times were longer in recipients with symptoms (eg. fatigue and cough) than those in asymptomatic recipients (11.0±5.1 d vs. 9.0±3.3 d, t=2.64, P=0.009, and 11.4±5.2 d vs. 9.0±3.4 d, t=2.92, P=0.004). Conclusion:The COVID-19 infection in liver transplant recipients was mainly mild and moderate. The most common symptoms are fever, fatigue, cough and myalgia. The short time (less than 12 months) after liver transplantation, oral mycophenolate mofetil and methylprednisolone, with symptoms (fatigue and cough) could be associated with a prolonged negative conversion time.