Objective:To study dynamic change of brain natriuretic peptide (BNP),left ventricular ejection fraction (LVEF)and prognosis improvement in patients with acute anterior myocardial infarction (AAMI)complicated hy-poxemia after noninvasive mechanical ventilation therapy.Methods:A total of 60 patients with AAMI complicated hypoxemia,who were hospitalized in our hospital from Mar 2011 to Oct 2013,were divided into noninvasive venti-lation group (n=28)and routine treatment group (n=32)according to number table.Dynamic change of BNP, LVEF and prognosis were observed and compared between two groups.Results:After treatment,BNP level and LVEF significantly improved in both groups (P<0.05 all),compared with routine treatment group,there was more significant reduction in BNP level [24h:(263.6±23.3)μmol/L vs.(126.2±21.9)μmol/L]and significant rise in LVEF [(40.6±13.1)% vs.(47.3±14.7)%]in noninvasive ventilation group after treatment (P<0.01 both);af-ter 30d follow-up,there were significant rise in 6min walking distance (percentage of 426~550m,59.3% vs. 75.0%),LVEF [(41.1±11.7)% vs.(49.4±12.5)%]and survival rate (90.6% vs.96.4%),and significant re-duction in rehospitalization rate (12.5% vs.7.1%)in noninvasive ventilation group,P<0.01 all.Conclusion:Ear-ly noninvasive mechanical ventilation therapy can significantly improve cardiac function,exercise tolerance and short-term prognosis in patients with acute anterior myocardial infarction complicated hypoxemia.

Objective:To investigate the efficacy of modified vaginal cervical cerclage in the treatment of cervical insufficiency during pregnancy.Methods:The clinical data of 18 women with cervical insufficiency during pregnancy who received treatment in Changzhi Maternal and Child Health Hospital from January 2018 to January 2020 (including nine cases receiving modified Shirodkar operation and nine cases receiving modified McDonald operation) were retrospectively analyzed.Results:The operation process was successful in all 18 women, and there were no postoperative complications. After modified Shirodkar operation, the average gestational weeks were prolonged by 14.7 weeks. Six cases had a smooth vaginal delivery [full-term delivery in five cases and preterm premature rupture of membranes (35 weeks + 1 day) in one case]. Three women had a cesarean delivery [cesarean delivery at full-term in two cases, including twin pregnancy in one case and previous cesarean delivery in one case; preterm premature rupture of membranes because of chorioamnionitis (32 weeks + 1 day) with poor prognosis in one case]. The rate of holding babies home was 88.9%. After modified McDonald operation, the average gestational weeks were prolonged by 11.5 weeks. Five cases had a smooth vaginal delivery [full-term delivery in three cases, preterm premature rupture of membranes in one case (35 weeks + 3 days) and in one case (31 weeks)]. Three women had a cesarean delivery at full-term [secondary cesarean delivery in one case, twin pregnancy in one case, and preterm premature rupture of membrane because of preeclampsia in one case]. One case had infectious abortion, and the rate of holding the baby home was 88.9%.Conclusion:Selection of different modified operations according to the length of cervical canal can prolong gestational weeks and increase the survival rate of newborns. The modified vaginal cervical cerclage is simple and easy to operate with minimal damage to pregnant women, which is suitable for clinical promotion.

Objective:To investigate the safety and outcomes of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in hepatocellular carcinoma (HCC).Methods:The clinical data of HCC patients who underwent hepatectomy at the University of Hongkong-Shenzhen Hospital from April 2014 to December 2020 were retrospectively analyzed. Of 57 HCC patients who were enrolled, there were 43 males and 14 females, aged (51±14) years old. According to the surgical method, the patients were divided into two groups: patients with pre-operative residual liver volume/standard liver volume <30% who underwent ALPPS procedure by anterior approach formed the study group ( n=20), and patients who underwent right hepatectomy with residual liver volume/standard liver volume ≥35% formed the control group ( n=37). Clinicopathological data and prognosis were reviewed and compared between the two groups. The patients were followed up via outpatient service and telephone. Results:There were more patients with well-moderately differentiated HCC in the study group than in the control group, and the difference was statistically significant ( P<0.05). All patients in the study group successfully completed two-step hepatectomy. Compared with the control group, the operative duration [644(535, 780) vs. 352 (269, 401) min], intraoperative blood loss [1 650 (1 338, 2 200) vs. 650 (500, 925) ml], and proportion of patients requiring blood transfusion (60.0% vs. 29.7%) were increased in the study group. The difference was statistically significant ( P<0.05). There was no significant difference in the incidence of grade III or higher complications between the study group and the control group [30.0% (6/20) vs. 18.9% (7/37), χ 2=0.91, P=0.341]. The 1-, 2- and 3-year overall survival rates were 90.0%, 63.8% and 46.4% respectively, and the corresponding tumor-free survival rates were 53.3%, 35.6%, and 35.6% respectively for the study group. The 1-, 2-, and 3-year overall survival rates were 71.4%, 63.4%, 51.7%, and tumor-free survival rates were 39.0%, 18.5%, 9.3% in the control group respectively. There was no significant difference in the postoperative survival rate and tumor-free survival rate between the two groups ( P>0.05). Conclusion:ALPPS was safe and feasible for treatment of right hepatocellular carcinoma with insufficient residual liver volume, and its survival outcomes was similar with one-stage right hepatectomy for HCC patients.

Objective To construct a core response competence index system for infectious disease emergencies,and to provide content framework for training program.Methods A draft of index system was developed based on literature review and theory study.Delphi technique was employed to revise the draft.Analytical Hierarchy Process and average distribution method were used to measure the weight of each index.Results Response rate of the two round consultations were 100％ and 77.8％,respectively.experts' authority coefficients were 0.88 and 0.87.Kendall's coefficients of concordance were 0.274 and 0.258,and both were statistically significant (P＜0.001).The final index system comprised 3 first-level indexes,11 second-level indexes,and 38 third-level indexes.Conclusion The index system could be used to evaluate response competence of medical staff towards infectious disease emergencies,and served as the content framework of future training program.

Objective:To develop a systematic and comprehensive training program focusing on infectious disease emergencies, which is suitable for continuing education of medical staff.Methods:The emergency competence index system constructed in previous study was used as the content framework. The training method was selected based on the core concept of "Lindeman's View of Adult Education". The training form was designed based on the results of the questionnaire survey. The expert group meeting was used to demonstrate and revise the concrete training items.Results:The finally formed Training Program on Infectious Diseases Emergencies for Medical Staff adopted a "small-group" training format and modular design, including a total of 3 modules and 9 items, and the training program database included portable training manuals, skills videos, scenario cases scripts, and assessment papers, etc.Conclusion:The developed training program could be applied to regular continuing education or intensive training of response team for certain infectious disease emergencies, so as to improve their response competence.