Child ; Critical Illness ; classification ; Emergency Medical Services ; standards ; Humans ; Intensive Care Units, Pediatric ; standards ; Quality Assurance, Health Care ; Severity of Illness Index

Objective To establish chemiluminescent immunoassay(CLIA) for quantitative detection of Rabies virus antibody in human serum.Method The purified antigen was coated on the microplate,pairing with alkaline phosphatase(ALP)-labeled antigen and luminescence substrate CSPD,then the double antigen sandwich CLIA was established.Results The sensitivity of the assay was 0.2IU/ml.The linear range was from 0 IU/ml to 200 IU/ml.The precision was less than 10%.The analytical recovery rate was from 90% to 110%.Conclusion The CLIA is a simple,sensitive,special and repeatable method for detection of Rabies virus antibody.It was suitable for clinical application.

Objective To discuss the effectiveness of tracer methodology in the training of intern medical record writing. Methods Fifty interns who received medical record writing training in July 2012 were set as control group and were trained by traditional methods. Meanwhile, 58 interns who received medical record writing training in July 2013 were set as investigation group and were trained by tracer methodology. Pre-training questionnaire survey was conducted for interns in investigation group and targeted training was provided. After the training, interns in two groups were surveyed by questionnaire of basic norms of medical record writing. Excel software was used to do data entry and SPSS 21.0 statistical software was used to statistical analysis. P<0.05 signifies statistical differences. Results Final record writing exam after the training demonstrated that there were significant differ-ences in basic requirement of record writing, basic principle of record writing, history taking, record time limit, contents of record writing and correct rate of patients' answer to the document between in-vestigation group and control group with statistical differences(P<0.05). Conclusion Tracer method-ology has obvious effects in intern medical record writing training and is worth popularization and ap-plication in clinical teaching.

Objective To study the level of serum vascular endothelial growth factor(sVEGF)in advanced non-small cell lung cancer(NSCLC) and its clinical significance.Methods Serum level of VEGF was detected by ELISA method in 96 patients with advanced NSCLC.sVEGF level was analyzed after giving 2-4 cycles of cisplatin-based chemotherapy.At the same time,serum level of VEGF in 50 healthy controls was detected.Results The level of sVEGF was significantly higher in patient with lung cancer than in control group (P＜0.01).No statistical significant defference was observed between sVEGF level of stage Ⅲ and Ⅳ NSCLC patients,the patients with squamocellular lung cancer and adenocarcinoma(P＞0.05);Descended sVEGF level was found in the patients with response to chemotherapy(P＜0.05).Conclusion sVEGF can be used to evaluate chemotherapy response and diagnoses in the patients with advanced NSCLC.

Objective To study the role of serum C-reactive protein (CRP) ,supplement C3 and CA in sys-temic inflammatory response syndrome (SIRS) induced by acute cerebral infarction(ACI).Methods The levels of CRP,C3 and CA were measured by automatic immunoturbidimetry in 52 ACI cases accompanied with SIRS (SIRS group) ,50 cases of acute simple cerebral infarction(SACI group) and 46 normal cases (control group).Results The serum CRP, C3 ,and CA levels were significantly different among the three groups( F=720.6,580.8,94.1 ,P <0.01) ,the serum CRP levels in SIRS group were significantly higher than those in SACI group(P <0.01 ).The ser-um C3 and CA levels in SIRS were significantly lower than those in SACI group(P <0.01).With the diagnosis crite-rion items increasing, the serum CRP levels tended to be higher (t = 7.69 ,P < 0.01 ), and the serum C3, CA levels tended to be lower meeting SIRS diagnosis criterion numbers increasing respectively (t=10.68 and 10.53, P <0.01).Conclusion The serum ClIP levels are higher significantly and the serum levels of C3 and C4 are lower sig-nificantly when ACI progresses to SIRS.The serum CRP,C3,CA level changes can be used as an index for judging the progress of ACI progressed to SIRS.

Objective: To discuss the value in the differential diagnosis of benign and malignant in ulmonary ground-glass opacities with multislice spiral CT. Methods: Selected 31 patients in Beijing North hospital with spiral CT examination of the chest as the research object, the lungs differential diagnosis of ground-glass image analysis to pathological findings as diagnostic criteria, analysis Imaging features of benign and malignant grinding glass shadow. Results: Malignant lesions with pleural indentation, spiculation, lobulation, such as performance-based, clear boundary between the two groups in the pleural indentation, spiculation, points Ye Zheng, clear boundary comparing with statistical significance(x2=11.138, x2=6.482, x2=4.306, P<0.05). Meanwhile benign lesions showed a round or oval, and malignant lesions with irregular shape and multi-nodular-like performance-based fusion of the two groups in a round or oval, irregular and more fusion-like nodules difference was significant, the statistical significance (x2=11.138, x2=6.482, x2=4.306, P<0.05). Conclusion:Application of multislice spiral CT examination of the chest can be on the ground glass by special signs and morphological comprehensive analysis, benign and malignant, with a high value.

Objective:To comparative Research with MSCT and CAG in the myocardial bridge-wall diagnostic coronary. Methods: Selected 93 patients for the study in January 2011 to the end of December 2013,MB-MCA patients diagnosed in Beijing North Hospital, all patients underwent catheter coronary angiography (CAG) and 64-slice spiral CT (MSCT), comparison of the diagnostic accuracy of the two inspection methods, and the results of the correlation analysis, results processing and analysis using statistical software SPSS17.0. Results:MSCT and CAG were two examination methods in the diagnosis of superficial and deep type MB-MCA, with a high degree of consistency in the diagnosis of MB-MCA average length, average depth comparison with statistical significance(t=3.021, t=3.758;P<0.05), there was not statistically significant comparison in the narrow detection rate. Conclusion:MSCT as a novel, non-invasive means of MB-MCA examination, the diagnosis results are reliable, accurate and capable of providing a richer diagnostic information for clinicians, clinician and patient can be widely applied.

Objective To explore the mechanism of the acute cerebral infarction leading to systemic inflammatory response syndrome (SIRS) which causes multiple organ dysfunction syndrome (MODS), and to explore the role of tumor necrosis factor (TNF-?) and IL-1? in the mechanism from SIRS to MODS.Methods 68 cases of acute cerebral infarction (ACI) were divided into three groups. They were 36 cases of simple acute cerebral infarction (SACI group), 32 cases accompanied with SIRS (SIRS group) and 24 cases accompanied with MODS (MODS group). Enzyme linked immunosorbent assay (ELISA) method was used to measure serum TNF-? and IL-1? contents at different time after ACI and compared with 28 healthy persons.Results (1) 47.06% of the 68 cases were accompanied with SIRS, of whom 75.00% were accompanied with MODS.(2) The serum TNF-? and IL-1? levels were the highest in MODS group, next in SIRS group, then in SACI group, the lowest in control group. The differences were significant among 4 groups (all P

As a rapid prototyping technology,three-dimensional (3D) printing is widely used in diagnosis and treatment of cardiovascular diseases.There are variable methods of 3D printing,and different forming methods have their respective advantages and disadvantages.3D printing plays an important role in congenital heart disease,valvular heart disease,aorta disease and arrhythmia.The application and the research progresses of 3D printing based on medical imaging in diagnosis and treatment of cardiovascular diseases were reviewed in this article.

Objective To analyze cardiac function of patients with first onset acute myocardial infarction (AMI)by speckle tracking imaging (STI).With clinical data of long-term follow-up,to explored the prognostic value of left ventricular functional reservation and damage after AMI.Methods Seventy-eight patients with first onset AMI were enrolled in the study.Dynamic images were acquired before primary percutaneous coronary intervention for the analyses of longitudinal peak systolic strain (LPSS), radial peak systolic strain (RPSS)and circumferential peak systolic strain (CPSS).Clinical data of long-term follow-up,results of electrocardiogram and coronary angiography were used for the evaluation of the recurrence risk of cardiac events and cardiac death after AMI.All the baseline clinical data and parameters of echocardiography were compared between patients with and without cardiac events and cardiac death during follow-up.Results Baseline clinical data of electrocardiogram and coronary angiography didn't show significant differences for the comparison of AMI patients with and without cardiac events and cardiac death during long-term follow-up.Compared to patients without cardiac events during follow-up,LPSS and CPSS (P <0.001)of patients with cardiac events were relatively lower and the prognostic value of CPSS (HR=1 .4096)for the recurrence risk of cardiac events was better.For the risk prediction of cardiac death,LPSS ( P <0.001,HR=1.5735)was relatively better.Conclusions Left ventricular functional reservation and damage after AMI were accurately assessed by STI,which helped predicted the recurrence risk of cardiac events and cardiac death of AMI patients.CPSS and LPSS were optimal indicators for the prediction of cardiac events and cardiac death,respectively.