Objective:To design Disinfection device of Infant incubator to address the existing infant incubator terminally sterilized in the presence of ultraviolet light disinfectant wipe and disinfection effect is not complete. Methods:Using vaporized hydrogen peroxide to kill spores of principle, to design a PLC and touch screen technologies such as infant incubator terminal disinfection device, mainly by vaporized hydrogen peroxide generator to accommodate infant incubator stainless steel tanks, gas communication piping, etc., through clean and dry after the infant incubator, pushed into stainless steel tanks, a key parameter set to start after the end of the introduction of the incubator to disinfection, disinfection by chemical and biological indicator discoloration indicator kill situation to judge. Results:The disinfection device for gas distribution, no disinfection dead, low-temperature sterilization effect is good and easy to verify, infant incubator for material compatibility, safe, reliable, easy to operate, chemical indicator from green to yellow, biological indicator Bacillus stearothermophilus cultured for 7 days, sterile growth. Conclusion:The device is easy to verify the sterilization effect, material compatibility, safety and reliability, reduce labor intensity in clinical neonatology and critical sections infant incubator terminal disinfection areas have higher promotion and application value.

The article introduces the advances in the evaluation of transient ischemic stroke (TLA) and reviews them from four aspects, including identifying whether the symptoms accord with the diagnosis of TLA, which blood supply area the ischemia is located in, evaluating the pathogenesis of TIA, and predicting its prognosis.

Objeetive To investigate the risk of hemorrhagic transformation (HT) and the outcome as well as its influencing factors at 3 months after thrombolytic therapy in acute ischemic stroke patients with non-valvular atrial fibrillation (NVAF).Methods Consecutive acute ischemic stroke patients with NVAF were enrolled retrospectively.Their demography,vascular risk factors and other clinical data were collected.The modified Rankin Scale (mRS) was used to evaluate the outcome at 3 months after symptom onset.The mRS score ≤ 2 was defined as good outcome,and ＞ 2 was defined as poor outcome.Results A total of 119 acute ischemic stroke patients with NVAF were enrolled,including 63 males (52.9％) and 56 females (47.1％); their mean age was 72.1± 10.0; 45 (37.81％) were treated with recombinant tissue type plasminogen activator (rtPA),55 (46.2％) had a good outcome and 27 (22.7％) combined with HT.Compared with the poor outcome group,the mean age was younger in the good outcome group (P =0.028).The proportions of the patients with ischemic heart disease and the time from onset to treatment ＞ 4.5 h were lower (P ＜0.05).The baseline systolic blood pressure and diastolic blood pressure,as well as the National Institutes of Health Stroke Scale (NIHSS) score were lower (P ＜0.05),while the proportion of patients receiving intravenous thrombolysis with rtPA was higher (P =0.019).Multivariate logistic regression analysis showed that the patients with ischemic heart disease (odds ratio [OR] 4.572,95％ confidence interval [CI] 1.392-15.014; P =0.012),systolic blood pressure before treatment (OR 1.028,95％ CI 1.007-1.049; P =0.009),baseline NIHSS score (OR 1.058,95％ CI 1.002-1.117; P =0.042) were the independent risk factors for poor outcome,while intravenous thrombolysis with rtPA (CI 0.264,95％ CI 0.102-0.683; P =0.006) was an independent protective factor for poor outcome.The proportions of the baseline systolic blood pressure,fasting blood glucose and NIHSS score,as well as the patients with a history of previous stroke or transient ischemic attack (TIA) in the HT group were significantly higher than those in the non-HT group (all P ＜ 0.05).Multivariate logistic regression analysis showed that the baseline NIHSS score (OR 1.147,95％ CI 1.068-1.231; P＜0.001),baseline systolic blood pressure (OR 1.951,95％ CI 1.921-1.982; P =0.002),and blood glucose level (OR 1.191,95％ CI 1.095-1.294; P ＜ 0.001) were the independent risk factors for HT.Compared with the non-thrombolysis group,the mean age of the thrombolysis group was younger (P =0.021),the baseline systolic blood pressure,fasting glucose and NIHSS scores,as well as the proportions of patients with hyperlipidemia,previous stroke or TIA history,and using antihypertensive drugs before admission were higher (all P ＜ 0.05).The proportion of patients with ischemic heart disease were lower (P =0.035),but the proportion of the patients with a good outcome was higher (P =0.019).Conclusions Patients with ischemic heart disease,systolic blood pressure and higher baseline NIHSS score before treatment were the independent risk factors for poor outcome,while intravenous thrombolytic therapy with rtPA was an independent protective factor for poor outcome; the high baseline NIHSS score,baseline systolic blood pressure and glucose level were the independent risk factors for HT.For acute ischemic stroke patients with NVAF,such as no obvious contraindications for thrombolytic therapy,might benefit from intravenous thrombolytic therapy,and it could not increase the risk of HT,but the blood pressure and glucose level of the patients should be controlled appropriately.

ObjectiveTo characterize the gene expression in acute phase of irradiated oligodendrocytes (OL) in vitro.Methods The total RNA was extracted from irradiated OLs with 10 Gy by 6 MV X-rays at 1 and 4 h.The Affymetrix RAT 230 2.0 microarray were used to evaluate and screen the gene expression profile.The quantitative real-time RT-PCR was performed to validate the microarray results of selected myelin basic protein (MBP) and neural cell adhesion molecule 1 ( NCAM-1 ) genes.Results Compared with un-irradiated OLs,there were 1079 different expressed genes in irradiated cells.Those genes were classified in 79 categories based on the functional classification.Some familiar genes associated with OL cellular physiological process,apoptosis,cell cycle control,metabolism,cell communication and receptor binding were included.Compared with the microarray results,the coincidence rate of real-time RT-PCR was 91.7%.The down-regulation of MBP and up-regulation of NCAM 1 gene expression were confirmed.Conclusions Radiation-induced changes in gene expression in OLs took place in acute phase and influenced by time-course.The changes of MBP and NCAM1 gene expression may play a key role in the pathogenesis of radiation-induced demyelination.

Objective:To evaluate the diagnostic and therapeutic value of bedside severe ultrasound in children with shock.Methods:Children who were diagnosed shock in the PICU of Shengjing Hospital of China Medical University from May 1, 2019 to April 31, 2020 were included in this study.Rapid ultrasound in shock (RUSH) exam was used to evaluate the morphology and function of heart, lung and abdomen of children with shock, so as to assist the diagnosis and treatment of shock.Results:Twenty-six children with shock were evaluated immediately according to the RUSH exam when they were admitted to hospital.Eight cases were diagnosed as septic shock, six cases as cardiogenic shock, six cases as hypovolemic shock and six cases as mixed shock.The left ventricular ejection fraction (LVEF) of children with cardiogenic shock was (26.5±8.24)%, and the width of inferior vena cava was greater than 10 mm.After the shock was corrected, LVEF increased to (32.17±26.11)%.However, the LVEF of children with septic shock was (73.25±1.28)% at admission and (50.12±31.41)% at shock correction.Nine cases (34.6%) found more B-lines in the lungs after fluid resuscitation for one hour in 26 children with shock.Among them, about 50% of the children with cardiogenic shock found more B-lines in their lungs one hour after fluid resuscitation, and 11 cases(57.9%) of the surviving children showed more B-lines after shock correction, but only six children could hear blisters after physical examination.Conclusion:According to RUSH exam, we can evaluate the volume status, cardiac function, volume responsiveness and focus on infection in children with shock, distinguish the type of shock earlier and more accurately, assist in guiding fluid resuscitation, and facilitate accurate and individualized fluid management and treatment of patients.

BACKGROUND: Female hypertension has its own epidemicologic character and the chief interventions on it are various.OBJECTIVE: To investigate the risk factors of female hypertension and observe the effects on rehabilitative and preventive intervention in demonstrative community for comprehensive prevention and treatment of cardiac cerebral vascular disease in Guizhou.DESIGN: Group randomization was designed. The samples of certain percentage were randomized according to total population from each village of 13 administrative areas.SETTING: Guizhou Institute of Cardiovascular Disease, Renmin Hospital of Yunyan District in Guiyang, Guizhou Clinical Examination Center.PARTICIPANTS: Since 1996, a series of comprehensive prevention and treatment had been carried in the communities for cardiac cerebral vascular disease in Guizhou, involved 13 administrative areas and 112 villagecitizen groups, in which, 26 604 people were employed, living in the regions between town and country. Social natural condition and life behavior of majority citizen reflected the common state of people in town and country. Totally 3 934 people aged over 15 years were investigated in the communities, and were all in the known of investigation. The samples without complete data were excluded.METHODS: ① Base-line investigation was carried on for the groups over 15 years old according to the requirement for administrative region designed by Institute of Preventive Medicine of China Academy of Sciences from April 1st 2001 to May 15th . ② Health education and health promotion activity were carried on for the included groups. ③ Survey after intervention was given for females according to the survey items designed by Institute of Preventive Medicine of China Academy of Sciences from July 2002to June 2003. ④ Normal body-mass index (BMI) was 18.5-23.9 kg/m2,overweight was indicated if BMI was 24-27.9 kg/m2 and obesity was diagnosed if BMI ≥28 kg/m2. ⑤ Analysis was applied on comparison of BMI,waist to hip ratio (WHR), average blood pressure, the rates of incidence,awareness and treatment of hypertension and rate of high-salty and lipid diet. ⑥ t test was adopted for comparison of means between two samples and x2 test was used for rate comparison.MAIN OUTCOME MEASURES: ① Comparison of the rates of incidence, awareness, treatment and control of hypertension for females of different ages in community base-line investigation in Guizhou. ② Comparison of BMI, WHR and BP of females of various ages in baseline investigation.③ Comparison of incident rate of hypertension for females with various BMI in baseline investigation. ④ Comparison of BMI, WHR, BP, smoke, alcohol, rate of high-salty and lipid diet, the rates of incidence, awareness,treatment and control of hypertension for females between baseline investigation and post-intervention survey.RESULTS: In baseline investigation, 6 361 correct and complete forms were collected, with 99.84% qualified rate, of which, there were 3 934females. 1 141 data were qualified after intervention. It was indicated in community baseline investigation: ① Rates of incidence, awareness and treatment of hypertension for females were improved with increased age (P ＜ 0.05), and the control rate was decreased with increased age (P ＜ 0.05). ② BMI, WHR, SBP (systolic blood pressure) and DBP (diastolic blood pressure) and PP (pulse pressure) were improved significantly with in creased age (P ＜ 0.01). BMI for females was increased with ages, but was declined with age ≥60 years. ③ The incident rates of hypertension for groups of normal body mass, overweight and obesity were 15.05%, 23.87% and 39.37% successively, indicating that the hypertension inci dent rate was increased significantly with improved BMI (paired compari son, P ＜ 0.05). Comparison between post-intervention survey and base-line investigation: ① In the comparison, the results of BMI, WHR and BP means were reduced for most cases at same age and significant difference was displayed in majority (P ＜ 0.05). ② After intervention, smoke rate of females was increased significantly and rate of high-salty and lipid diet was decreased (P ＜ 0.05). ③ Incident rate after health intervention was decreased significantly compared with that before intervention (P ＜ 0.05),and the rates of awareness, treatment and control of hypertension were enhanced significantly (P ＜ 0.05).CONCLUSION: ① The rates of incidence, awareness, treatment and control of female hypertension are different in ages in community of Guizhou. ② The severity of risk factor of female hypertension is enhanced with increased age in community of Guizhou. ③ The increased body mass is the important factor of incident rate of hypertension. ④ Health education probably decreases the severity of risk factor of hypertension and increases the rates of awareness, treatment and control.

Objective To compare treatment response according to the PERCIST1.0,RECIST1.1,EORTC,and WHO criteria in patients with colorectal liver metastases (CLM) who received neoadjuvant chemotherapy.Methods A total of 41 CLM patients (27 males,average age 68.48 years;14 females,average age 62.43 years) from January 2010 to September 2013 were included in this retrospective study.PET/CT scan was performed before chemotherapy and after 4-6 cycles′ chemotherapy.The baseline and the sequential follow-up 18F-FDG PET/CT of each patient were evaluated according to the PERCIST1.0,RECIST1.1,EORTC,and WHO criteria.The response was categorized into 4 levels including CR,PR,SD,PD.PET/CT images were used for both metabolic and anatomic evaluation.The concurrent diagnostic CT or MRI images (performed within 1 week of PET/CT) were also utilized when needed.The agreements of criteria were analyzed using Kappa test.The response rate (RR) and disease control rate (DCR) were compared using χ2 test.Results The RR and DCR according to the PERCIST1.0,EORTC and RECIST1.1 criteria were 31.71％(13/41) and 63.41％(26/41),31.71％(13/41) and 60.98％(25/41),17.07％(7/41) and 68.29％(28/41),respectively.The general comparison of PERCIST1.0 and RECIST1.1,EORTC and RECIST1.1 criteria showed good agreements (κ values: 0.711,0.689).Significant difference was not found in the DCR(χ2=2.000,P>0.05) but found in the RR(χ2=6.000,P<0.05) between PERCIST1.0 and RECIST1.1.Difference of DCR between EORTC and RECIST1.1 was not significant(χ2=3.000,P>0.05),while the RR had significant difference(χ2=6.000,P<0.05).The RR and DCR according to WHO criterion were 12.20％(5/41) and 70.73％(29/41),which had a good consistency with those according to PERCIST1.0 criteria (κ=0.629).Significant statistical difference was not found in the DCR(χ2=3.000,P>0.05) but found in the RR(χ2=8.000,P<0.05) between PERCIST1.0 and WHO criteria.Conclusions In evaluating CLM treatment response,anatomical criteria and metabolic criteria have a good consistency.But metabolic criteria are more sensitive for RR evaluating.

Objective:To explore the effect of breathing exercises on motor, balance, respiration and ability in the activities of daily living (ADL) of patients with Parkinson′s disease.Methods:Sixty patients with idiopathic Parkinson′s disease who met the inclusion criteria were divided at random into a control group and a treatment group, each of 30. Both groups received routine drug therapy and 60 minute of rehabilitation training daily, including core muscle group control training, relaxation training, joint motion training, posture training, balance function training, gait training and facial muscle control training. There were 3 sessions a week for 24 weeks. The treatment group was also given breathing exercises, including training in abdominal breathing with the expiration time twice the inspiration time and inspiratory muscle training. The abdominal breathing training included 15 abdominal breaths, repeated twice after a 2-minute break; the inspiratory muscle training required 10 respirations and expirations at the maximum volume, repeated twice after an interval of 2 minutes. The training lasted 24 weeks, five times a week. The subjects′ motor functioning, balance, walking, respiration and daily living ability were evaluated before the treatment and after 12 and 24 weeks of treatment using the Parkinson′s Disease Rating Scale (part III) (UPDRS ⅲ), the Berg Balance Scale (BBS), the 6-minute walk test (6MWT), walking distance and the modified Barthel Index (MBI). Forced expiratory volume in the first second (FEV 1), forced vital capacity (FVC) and their ratio (FEV 1%) were also observed. Results:After 12 weeks of treatment, significant improvement was observed in the average UPDRS iii, BBS, 6MWT, MBI, FEV 1, FVC and FEV 1% results of both groups, but the improvement in the treatment group was significantly greater on average. After another twelve week the average UPDRS iii, BBS, 6MWT, MBI, FEV 1, FVC and FEV 1% results of the treatment group had improved significantly more than those of the control group. Conclusion:Breathing exercises can significantly improve the motor function, balance, walking, respiratory function and ADL ability of persons with Parkinson′s disease.

Objective:To explore the effect of subclinical hypothyroidism(SCH) on complications after coronary artery bypass grafting(CABG).Methods:The data of CABG patients hospitalized in TEDA International Cardiovascular Disease Hospital from January 2016 to December 2017 were retrospectively analyzed. According to the thyroid function after admission, the patients were divided into normal thyroid function group(NC group, 814 cases, 0.27 mIU/L≤TSH≤4.2 mIU/L) and subclinical hypothyroidism group(SCH group, 106 cases, TSH>4.2 mIU/L). The preoperative clinical data, surgical conditions, recent complications and one-year bridge stenosis rate were compared between the two groups in male or female.Results:Compared with NC group, SCH group had more female patients(53.8% vs 24.4%, P=0.000), lower smoking rate (38.7% vs 58.0%, P=0.000). There was no statistical difference in other baseline data and postoperative complications( P>0.05). Subgroup analysis depending on gender showed that the incidence of respiratory tract infection increased in female patients with SCH(10.5% vs 3.5%, P=0.034) compared with those in NC group, there was no significant difference in male. The TSH level was an independent risk factor for respiratory tract infection in female patients( OR=1.307, 95% CI=1.110-1.539, P=0.001). Compared with the male patients, the prevalence of hypertension(84.2% vs. 67.3%, P=0.041), diabetes mellitus(45.6% vs 16.3%, P=0.001), hospitalization time in ICU(44 h vs. 42 h, P=0.003), acute renal failure(10.5% vs 0, P=0.019) and massive blood transfusion(8.8% vs 0, P=0.034)increased. Conclusion:SCH appears to influence the postoperative outcome for female patients by increasing the development of postoperative respiratory tract infection.

ObjectiveTo conduct comprehensive assessment of internal and external cadmium exposure and health risks for Shanghai residents. MethodsCadmium levels in food samples were calculated by employing two dietary exposure assessment methods， total diet study （TDS） and food frequency questionnaire （FFQ）， to estimate the daily dietary cadmium exposure of Shanghai residents. The provisional tolerable monthly intake （PTMI） of cadmium set by joint food and agriculture organization/WHO expert committee on food additives （JECFA） was applied to evaluate the health risk. Differences in dietary and urinary cadmium were compared by rank-sum test among different regions， age， gender， smoking status， and BMI groups， and the association between internal and external cadmium exposure was investigated by correlation analysis. ResultsThe mean value of urinary cadmium for 1 300 respondents was 0.542 μg·L^-1. Urinary cadmium was higher in the population in central urban and urban-rural fringe areas than in the suburban area， higher in the older age group than in the younger age group， and higher in the smoking group than in the non-smoking group （all P<0.01）. The two assessment methods showed that the mean values of daily dietary cadmium exposure for Shanghai residents were 0.306 and 0.090 μg·kg^-1， with 3.69% and 0.85% of Shanghai residents exceeding the PTMI， respectively. Correlation analyses showed that dietary exposure to cadmium based on the FFQ method was positively correlated with the urinary cadmium level when smoking status， age， gender， and BMI were adjusted. ConclusionDietary exposure to cadmium of Shanghai residents is mainly derived from vegetables， aquatic products， cereals and potatoes， and is overall at a low-risk level. Dietary exposure assessment based on FFQ and risk monitoring data can effectively estimate long-term cadmium exposure.