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

Combined Modality Therapy ; High-Frequency Ventilation ; Humans ; Liquid Ventilation ; Nitric Oxide ; therapeutic use ; Pulmonary Surfactants ; therapeutic use ; Respiration, Artificial ; Respiratory Insufficiency ; therapy

Objective To study the role of focal adhesion kinase in the breast carcinoma cell adhesion and migration mediated by coagulation factor Ⅶa combined with tissue factor to explore the mechanism of tissue factor promoting metastasis. Methods The count of adherent cells were detected by using colorimetric assay,cell migration was detected with modified Bodyen chamber,and the FAK and the tyrosine phosphorylation of FAK were detected by immunoprecipitation and Western blot.Results Factor Ⅶa combinaed with tissue factor induced the tyrosine phosphorylation of FAK,which took part in the cancer cell's migration.Conclusion FAK is an important message of the breast carcinoma's adhesion and migration mediated by TF.

Objective To study the Genotype of local clinical isolates of Enterobacteriaceae producing extended spectrum ? lactamases. Methods K B test, conjugative transfer test, plasmid profile analysis, PCR, PCR RFLP, and DNA sequencing were used to detect the phenotype and genotype of 33 isolates of Enterobacteriaceae producing ESBLs. Results Eighty five percent of 33 isolates was resistant to cefotaxime which was obviously higher than that to ceftazidime. blaCTX M ESBLs was detected in 28 isolates by PCR, blaTEM DNA in 24 isolates, and blaSHV DNA in 9 isolates. Mutation of E104K was only identified in one TEM ? lactamase produced by EC98A7 by PCR RFLP. No substitution of G238S occurred in 9 SHV ? lactamases. DNA sequencing and DNA alignment showed the blaCTX M DNA fragments from 4 clinical isolates of EC98A7,EB56,CFR78 and, KP9941 belonged to CTX M type 1, with highest identity to blaCTX M 3 or blaCTX M 12 respectively. Conclusions CTX M ESBLs is carried in 85% isolates of Enterobacteriaceae producing ESBLs in this city. Most of the isolates carry 2 or more ? lactamases. E. coli EC98A7 produces two ESBLs, a TEM ESBL and a CTX M ESBL.

The pediatric risk of mortality Ⅲ(PRISM Ⅲ) score and pediatric critical illness score(PCIS) are physiology-based scores for assessing the severity of illness and mortality risk in pediatric patients.The PRISM Ⅲscore was revised version of the PRISM and was first developed in 1996.It includes 17 physiologic variables subdivided into 26 ranges.It had been validated by numerous studies worldwide and is the most widely known and used at pediatrics intensive care unit(PICU).The PCIS was first developed in 1995 in China,which included 10 physiologic variables.It had been validated by numerous studies nationwide and was simple,effective and suitable to Chinese situations.The scoring systems also can be used for quality assessments,grading the severity of illness in clinical study,and(stu)-dies of ICU resource utilization and management.There were no such study for validating the PRISM Ⅲ at present,comparing the performance of the PRISM Ⅲ score and the PCIS in China.

Objective To investigate the effect of Roux-en-Y gastric bypass surgery on renal gluconeogenesis, and to explore the mechanism of improving glucose control and insulin sensitivity in obese rats.Methods Rats were randomly divided into the obese group (n=30) consumed high-fat diet (HFD) and control group (NC group, n=8).Top 24 of animals fed HFD by change in body mass were subdivided into three groups: obese control group (OB group, n=8), obese under RYGB group (RYGB group, n=8) or sham-operation (sham group, n=8).Intraperitoneal glucose tolerance tests (IPGTT) were performed meanwhile the AUC of blood glucose concentration-time after surgery.Fasting glucose, insulin and lipid were measured respectively and HOMA-IR were calculated.The mRNA level and protein level of the key enzymes (G6P and PEPCK) of renal gluconeogenesis were examined with RT-PCR and Western blot respectively.Results Compared with OB group and Sham group, the body mass, lipid, blood glucose, insulin, HOMA-IR and AUG were significantly decreased (P<0.05), the expression of G6P and PEPCK mRNA and protein were significantly reduced(P<0.05) in RYGBgroup.Conclusions Roux-en-Y gastric bypass surgery can improve glucose control and insulin resistance, which may be related to the decreased level of mRNA, protein of G6P and PEPCK, reduced gluconeogenesis and glucose output in renal cortex.

Based on the analysis of the status quo and development trends of disaster medicine system abroad along with a summary of the present conditions and inadequacies of the same system in China, this paper proposes to build such a system in Hainan Province. It studied, with reference to the specifics of Hainan Province, the characteristics of such a system in the province, involving such aspects as hospital setup, human resource development, construction of research centers, professional training,management of disease control centers, improvement of the hospital self-rescue system, reliable supply of drugs and medical devices, maintenance of disaster medicine information system, logistics support,improvement of assessment system, establishment of rescue-oriented culture, and psychology crisis intervention and promotions.

Astemizole is nitrasoted with sodium nitrite in 0.12 mo l/L HAc solution at boiling bath for 25 min. The nitrosation product of astemizo le shows a reduction peak by single-sweep oscillopolarography. The peak potenti al is -0.72V (vs.Ag/AgCl). The first-order derivative peak current is propo rtional to the concentration of astemizole in the range of 4.0×10-7～1.6 ×10-5 mol/L (r=0.9997), with detection limit of 2.0×10-7 mol/L . The proposed method has been applied to the determination of astemizole in pha rmaceutical tablets.