Objective To investigate the relationship between coagulation function and pediatric critical illness scores (PCIS) in children with severe pneumonia.Methods The PCIS were collected in 152 children with severe pneumonia (pneumonia group) admitted in our pediatric intensive care unit from Jan 2010 to Jul 2011,and 20 healthy children in the same period were selected as the healthy control group.The coagulation indicators of children in both groups were detected and the relationship between coagulation markers and severity of pneumonia was analyzed.Results There were significant differences in platelet count,fibrinogen,D-Dimer,soluble P-selectin between pneumonia group and healthy control goup [(185.74 ±116.26) × 109/L vs (287.10 ±90.01) × 109/L,(3.51 ±0.50) g/L vs (3.15 ±0.15) g/L,(1.39 ±2.18) μg/ml vs (0.36 ± 0.07) μ g/ml,(110.07 ± 83.47) ng/ml vs (33.74 ± 9.47) ng/ml,P ＜ 0.05].There were positive correlation between soluble P-selectin,D-Dimer and severity of disease and negative correlation between platelet count and severity of disease in children with severe pneumonia.Regression equation:y =1.154 +0.003 × soluble P-selectin + 0.089 × D-Dimer-0.001 × platelet count (P ＜ 0.05).As the children's critical condition getting worse,soluble P-selectin and D-Dimer levels increased (P ＜ 0.05).Hatelet count showed no significant difference between critical group and extremely critical group,which was significantly lower than that in non-critical group (P ＜ 0.05).Conclusion Soluble P-selectin,D-Dimer,and platelet count are associated with the severity of pneumonia.The children with severe pneumonia are easy to have coagulation disturbance.

Objective To investigate the clinical characteristics of tuberculous pleurisy(TP) in children in order to provide a good solution to the diagnosis and treatment of this disease.Methods Retrospective analysis was performed on the clinical data of 113 cases confirmed with TP who were admitted to Children's Hospital of Chongqing Medical University from January 2009 to December 2014.Results Among the 113 pediatric inpatients with TP,85 cases (75.2％) were sick for less than 1 month;92.9％ (105/113 cases) age ≥≥5 years old by onset;and 21.2％ (24/113 cases) patients demonstrated the contact with tuberculosis ,among whom 70.8％ (17/24 cases) attributed to linear relatives.The primary clinical manifestations included fever[96.5％ (109/113 cases)], cough [76.1％ (86/113 cases)] and chest pain[38.9％ (44/113 cases)] ,with as high as 89.0％ (87/109 cases) of the patients experiencing moderate or ardent fever.The positive rates of acid-fast bacilli smear and mycobacterium tuberculosis culture were 12.2％ (17/139 cases) and 22.7％ (15/66 cases), respectively;among the 41 patients who received pleural biopsy,40 cases (97.6％) were identified with the typical pathological changes in tuberculosis;and all 11 patients who received acid fast stain test on pleural tissues were positive to the test.Pulmonary parenchymatous lesions were revealed on CT examination in 89.1％ patients(98/113 cases),82.4％ (90/109 cases) of the patients had normal body temperature within a short period,and reduced effusion was revealed in 86 out of 98 patients who received repeated chest imaging examinations.Conclusions TP in children has acute onset typically, and the diagnosis of TP in children is more difficult than in adults,requiring considering multiple factors.Contact history with tubercular patients, etiological examination, pleural biopsy and chest CT are essential for the diagnosis of this disease.

CT laser simulation positioning system is a necessary auxiliary device for radiotherapy. Its main purpose is to position patients by simulating different kinds of treatment machine. In order to demarcate the mark of the iso-center, it is common to use the laser positioning device to indicate the iso-center. The kernel technology of the laser positioning system is the controlling of the step progress motor by using the MCS, which is to control the movement of step progress motor using the wheel of the motor. This design uses MCS-51 to control step progress motor by the way of exporting the rectangle wave form through I/O port of 8255 chip. The system configuration is simple, the operation is convenient and the positioning is precise.

Objective To study the relationships between the standing balance and walking ability of hemiplegic stroke survivors.Methods Eighty-eight post-stroke hemiplegic patients who could walk independently for more than 10 metres were selected into a patient group,while 88 healthy counterparts were recruited into a control group.Descriptors of the gait and balance function of both groups were collected using a gait and balance training and evahuation apparatus (Model:AL-600).The gait parameters were step width,walking speed,step length asymmetry (SLA),swing time asymmetry (SWTA) and stand time asymmetry (STA).The balance parameters studied were total trajectory length of the center of plantar pressure (COPD),the average left and right deviation of the center of plantar pressure (COPD-X) and the average anterio-posterior deviation of the center of plantar pressure (COPD-Y).Differences in indexes of gait and balance function between the two groups were analyzed using t-tests,and the relationships between the gait and balance indicators were analyzed using Pearson correlation coefficients.Results The walking speed,step width,COPD,COPD-X,COPD-Y,SLA,SWTA and STA of the patient group [(37.64± 18.29)cm/s,(14.45±4.17)cm,(66.75±29.04)cm,(2.04±1.41)cm,(2.48±1.28)cm,(1.30±0.46),(1.65±0.67) and (1.18±0.16),respectively] all increased significantly more compared to the control group [(90.76±14.72)cm/s,(8.70±2.62) cm,(27.84±6.54) cm,(1.30±0.53) cm,(1.68±0.40) cm,(1.07±0.06),(1.07±0.08) and (1.05±0.06),respectively],though the walking speed was significantly slower than that in the control group (P＜0.05).The patient group's average COPD-X showed slightly and moderately negative correlation with their walking speed,step width,SLA and SWTA (P＜0.05).COPD-Y was weakly related with step width (P＜0.05).Conclusion The standing balance of hemiplegic patients after stroke is related to their walking speed,step width and gait asymmetry.Especially significant correlation is observed between standing balance parameters such as COPD-X and gait parameters.

Objective:To observe factors influencing the risk of urinary tract infection (UTI) after cerebral hemorrhage (ICH).Methods:A total of 77 ICH patients undergoing rehabilitation between August 2015 and August 2017 were studied. Among them, 24 were diagnosed with a UTI according to clinical manifestations and urine routine tests and urine culture. They formed the UTI group. The other 53 were the non-UTI group. Complete clinical evaluations were available for all 77, and those data were used to identify risk factors for UTI using univariate and multivariate logistic regression analysis.Results:The univariate analysis showed that age, side of paralysis, consciousness dysfunction, Brunnstrom staging of the lower extremity, tracheotomy, indwelling catheter, lung infection, white blood cell count, neutrophil percentage, serum natrium, uric acid, D-dimer level and fibrinogen were all significant predictors of UTI. The multivariate analysis identified age, right side hemiplegia and D-dimer level as useful predictors.Conclusions:Advanced age and a high D-dimer level are independent risk factors for UTI after ICH, while hemiplegia on the right side is a protective factor.

This is the design of a mechanical systems for use in the balanceable system of ambulance, which can keep the medical service bed at the ambulance level, whatever the terrain is. A level detector will detect the level state of the bed and turn it to a signal. The central processing unit will use this signal to analyse and control the movement of the motor. By this design (which uses the rolling rail as a drive transmission and makes three supports of the bed go up and down), the bed will keep level. With the use of this design, the balanceable system of ambulance can counteract 35 degrees. The error is controlled within +/- 1 degree. And the response time is within 0.3 s. The method of registration can be effective for keeping the bed at the ambulance level, and for reducing the chance of making the patient get hurt on the way to hospital.
Ambulances ; Equipment Design ; Humans ; Robotics ; methods ; Transportation of Patients

Objective To observe any effect of pulmonary rehabilitation in preventing ventilator-associated pneumonia (VAP) among patients receiving invasive mechanical ventilation (MV). Methods A total of 117 a-dults who had be receiving mechanical ventilation for at least 48 hours were randomly divided into an observation group and a control group. Both groups were given routine drug treatment and nursing, but the observation group al-so received comprehensive and individualized pulmonary rehabilitation interventions including airway clearance, respiration training, electrical stimulation of the sacral nerve, lung expansion and early mobilization. The main indi-cators were the incidence of VAP, mortality, MV duration, ICU stay time, and total hospital stay. Results At the end of the treatment the average clinical pulmonary infection score, the acute physiology and chronic health e-valuation Ⅱ score, SpO2 level and oxygenation index of the observation group were all significantly better than those of the control group. The incidence of VAP within one month after leaving the ICU was 47. 5％ in the observation group and the mortality rate was 44.1％, both significantly lower than in the control group. The average MV dura-tion, total hospitalization time and the ICU stay of the observation group were also significantly shorter than those of the control group. Conclusion Early and comprehensive pulmonary rehabilitation can prevent VAP and shorten the length of hospital stays, ICU stays and time on a mechanical ventilator, improving patients' survival chances and prognoses.

Objective To explore the risk factors for deep vein thrombosis (DVT) of the lower extremity among patients hospitalized after a cerebral hemorrhage. Methods A total of 230 patients with cerebral hemorrhage admitted between August 2015 to August 2017 were retrospectively analyzed. At admission, each was were given a coagulogram, D-dimer and color Doppler ultrasound of the lower extremity. The patients were divided into a DVT group (31 cases) and a non-DVT group (199 cases) according to the color Doppler ultrasound results. The following clinical information was recorded: sex, age, disease course, paralysis side, consciousness, tracheotomy, complications (pulmonary infection, urinary tract infections and pressure sores), foreign matter implanting, history of venous catheterization, heart rate over 100 beats/ min or not, rehabilitation intervention after the onset, muscle tension in the lower extremity, activity and swelling on the paralysis side, and the serum levels of D-dimer and fibrinogen. Univariate and multivariate logistic regression was applied in search of useful risk factors. Results The univariate analysis showed that age, gender, disease course, tracheotomy, urinary tract infections, pressure sores, foreign matter implanting, and swelling and muscle tension in the lower extremity were all associated with the occurrence of DVT among these cerebral hemorrhage patients. According to the results of the multivariate logistic regression analysis, swelling and muscle tension in the lower extremity were related with the occurrence of DVT for those patients. Conclusion Swelling and muscle tension in a lower extremity are independent risk factors for the occurrence of DVT after a cerebral hemorrhage.__

Objective:To explore any changes with age in the center of plantar pressure among normal people after walking.Methods:Fifty healthy subjects were divided into a young group and an elderly group, each of 25. Gait descriptors were collected for each subject using a model AL-600 gait and balance training and evaluation apparatus. The gait descriptors were the center of pressure displacement (COPD), and the COPD in the medial-lateral (COPD-X) and anterior-posterior (COPD-Y) directions before and after 10 and 15 minutes of walking.Results:The average COPD, COPD-X and COPD-Y of the elderly group increased after both 10 and 15 minutes of walking, but among the young group increases were observed only after 15 minutes. The average COPD, COPD-X and COPD-Y of the elderly group were always significantly larger than the young group′s averages.Conclusions:Gait stability among the elderly decreases after as little as 10 minutes of walking, but among the young decreases are observed only after 15 minutes.

Objective:To observe risk factors for lung infection (LI) after cerebral hemorrhage (ICH).Methods:A total of 118 patients with ICH were retrospectively analyzed. Among them, 63 were diagnosed with an LI according to clinical manifestations and X-ray or CT on admission. They were selected into an LI group, while the rest formed the non-LI group. Gender, age, duration of disease, side of paralysis, position and type of ICH, complications, cognitive disorders, consciousness, dysphagia, motor function, and serum levels of albumin, sodium, potassium, calcium and magnesium were recorded on the second day after admission. The risk factors for LI were analyzed using univariate and multivariate logistic regression analysis.Results:Age, duration of disease, side of paralysis, position and type of ICH, tracheotomy, urinary tract infection, cognitive impairment, dysphagia, motor function, and serum levels of albumin, sodium, calcium, and magnesium were all significant predictors of LI after an ICH. Multivariate logistic regression analysis showed that right side hemiplegia, bilateral paralysis, subarachnoid hemorrhage, urinary tract infection, and serum magnesium are all significant predictors.Conclusions:Right or bilateral paralysis, subarachnoid hemorrhage and urinary tract infection are independent risk factors for LI after an ICH. High serum magnesium within the normal range can reduce the incidence of LI.