Objective To investigate the distribution and to analyze the immunological mechanism of HBV-infected serum-type in Kunming City,China.Methods We studied all the 98462 tests of the "HbsAg,anti-HBs,HbeAg,anti-Hbe,anti-HBc" in our lab since 2000,from which we selected 426 samples that contain all kinds of serum-types of the HBV infection and 50 health samples as a control group.The HBV-DNA levels of the 426 samples were detected by real-time quantitative PCR,and the activity of ALT and AST were also detected at the same time.Results Among the 98462 samples,we found 12 kinds of HBV-infected serum-types in all,4 of which were recently found and infrequent in Kunming City(the proportions were lower than the others,P

Objective: To assess the effectiveness in optimizing resources and shortening critical children′s waiting time in pediatric emergency department (PED) with five-level pediatric emergency triage system (PETS). Methods: This retrospective study was conducted in the First Affiliated Hospital of Xiamen University after PETS was applied. The data of patients who visited the pediatric emergency department from January 2015 to December 2017 were collected and analyzed, including age, sex, diseases, visiting time, triage rate and destination. Results: A total of 375 985 patients were included, among whom males were 225 308 (59.9%) and females were 150 677 (40.1%), all younger than 14 years of age. The number of critical cases (level Ⅰ, level Ⅱ and level Ⅲ) was increased from 4 719 (3.7%) in 2015, 12 209 (10.2%) in 2016 to 16 188 (12.7%) in 2017. The number of non-critical patients (level Ⅴ) decreased year by year, as from 98 213 (76.8%) in 2015 to 75 210 (62.6%) in 2016 and 78 857 (61.7%) in 2017. The patients who classified as level Ⅰ or levelⅡaccording to the PETS were seen immediately by physician (n=1855, 0.5%). Overall, 119 738 patients (98.3%) who were classified as level Ⅲ or level Ⅳ could be seen by physician in a timely manner according to triage guidelines, while 2 112 patients (1.7%) could not. The mean waiting time was 9.09 min in level Ⅲ, 17.7 min in level Ⅳ, and 55.76 min in level Ⅴ patients, respectively. The critical cases admitted to the intensive care units were 175 (36.2%) in 2015, 350 (62.8%) in 2016 and 374 (66.2%) in 2017. The etiologies were respiratory diseases (73.3%), gastrointestinal diseases (15.8%) and infectious diseases (3.1%). Conclusion The application of PETS could optimize emergency resources and shorten the waiting time of critically ill children.

Objective To investigate the therapeutic effect of damage control neurosurgery (DCNS) on patients with bilateral frontal contusion.Methods Thirty-three patients with bilateral frontal contusion,admitted to and accepted DCNS in our hospital from September 2017 to January 2019,were chosen in our study.According to DCNS rules,the disease condition changes of these patients were monitored,the internal environment disorders after trauma were adjusted,plasma osmotic pressure was increased,and blood oxygen saturation was maintained;once the patients grew worse,craniotomy and decompression should be undertaken immediately;the patients were followed up for 6 months after the injury and Glasgow outcome scale (GOS) was used to determine the prognoses of these patients.Results Among the 33 patients,25 (76％) received conservative treatment successfully,8 (24％) were converted to surgery during conservative treatment.Among the 8 patients,5 received unilateral craniotomy and three received bilateral craniotomy.The lower the Glasgow coma scale scores,the lower the proportion of conservative patients.GOS 6 months after injury showed good recovery in 11 patients,mild disability in 16 patients,severe disability in 4 patients,and plant survival in two patients;22 patients from the conservative treatment group and 5 from the surgery group had good recovery or mild disability.Conclusion DCNS can reduce the operation rate and its complications so as to make the patients recover earlier and better in the treatment of bilateral frontal contusion.

Objective:To investigate the effect of liaison nurse-led relocation program on the relocation stress in family members of neurosurgery patients after ICU transfer.Methods:A total of 90 neurosurgery patients and family members were randomly divided into study group (45 cases) and control group (45 cases) . Participants in the control group received routine nursing, while the study group carried out liaison nurse-led relocation program. Family relocation stress scale and family caregiver task inventory-Chinses version was used to assessed relocation stress, care ability of the families before and after intervention.Results:After intervention, the scores of separation anxiety, environmental changes, nursing model changes, the safety of transfer, self-efficacy of care ability and total relocation stress scores were 15.20±2.42, 7.14±1.63, 7.68±2.12, 7.10±1.73, 8.25±1.94 and 49.69±6.96 in the study group, those scores were 16.93±4.19, 9.42±2.31, 10.53±2.64, 8.06±2.12, 10.39±1.62 and 42.56±4.68 in the control group. The scores of separation anxiety, environmental changes, nursing model changes, the safety of transfer, self-efficacy of care ability and total relocation stress scores were lower in the study group compared to the control group ( t value was 2.400-5.678, P<0.05). After intervention, the scores of FCTI such as care role, strain and provide assistance, handle personal emotions, assess family and community resources and adjust life to meet care needs and total scores were 4.16±0.66, 5.28±0.73, 3.51±0.65, 3.99±0.83, 4.52±1.07 and 21.46±1.73 in the study group, those scores were 7.63±1.30, 6.82±1.08, 4.94±0.94, 5.08±1.09, 7.17±1.51 and 31.65±3.09 in the control group. The scores of care role, strain and provide assistance, handle personal emotions, assess family and community resources and total FCTI scores significantly decreased in the study group compared to the control group ( t value was 5.343-19.268, P<0.05). Conclusion:The liaison nurse-led relocation program can effectively prevent the level of relocation stress and improve the care ability of family members of neurosurgery patients after ICU transfer.

Objective:To investigate the causes of secondary glaucoma after vitrectomy for familial vitreous amyloidosis associated with transthyretin (TTR) gene Gly83Arg mutation.Methods:A retrospective case study. From January 2008 to January 2020, 13 cases (23 eyes) with hereditary vitreous amyloidosis and treated by vitrectomy in the Affiliated Hospital of Zunyi Medical University were collected. Among them, there were 7 males with 12 eyes and 6 females with 11 eyes. The average age was 43.0±4.8 years. All the affected eyes underwent standard three-channel vitrectomy through the flat part of the ciliary body. According to whether complete vitreous detachment (PVD) was formed during the operation, it was divided into complete PVD group and incomplete PVD group; according to the occurrence time of secondary glaucoma and vitreous amyloidosis after surgery, it was divided into 1-12 months group and 13-36 months group, >37 months group. The average follow-up time after surgery was 36.7±6.0 months. The incidence of secondary glaucoma and the recurrence rate of vitreous amyloidosis between groups were compared by χ2 test; the correlation between recurrence of vitreous amyloidosis and secondary glaucoma after surgery was analyzed by Spearman rank correlation analysis. Results:Among the 23 eyes, there were 8 eyes in the complete PVD group and 15 eyes in the incomplete PVD group, respectively. Vitreous amyloidosis recurred in 15 eyes (65.22%, 15/23) after surgery. There were 14 (93.30%, 14/15) and 1 (6.70%, 1/15) eyes in the incomplete PVD group and the complete PVD group, respectively; the comparison of the recurrence rate of vitreous amyloidosis between the two groups was statistically significant ( χ2=11.676, P<0.01). 1-12 months group, 13-36 months group, >37 months group included 1 (4.35%, 1/23), 12 (52.17%, 12/23), 2 (8.70%, 2/23) Only eye. The recurrence rate in the 13-36 months group was significantly higher than that in the 1-12 months group and >37 month group. Secondary glaucoma occurred in 11 eyes (47.80%, 11/23) after surgery. 1-12 months group, 13-36 months group, above 37 months group were 1 (4.35%, 1/23), 8 (34.78%, 8/23), 2 (8.70%, 2/23) eyes. The incidence of secondary glaucoma in the 13-36 months group was higher than that in the 1-12 months group and >37 months group. Among 11 eyes with secondary glaucoma, 10 eyes had recurrence of vitreous amyloidosis after surgery, and 1 eye had no recurrence. The results of Spearman rank correlation analysis showed that there was a positive correlation between the recurrence of vitreous amyloidosis and the occurrence of secondary glaucoma ( rs=0.516, P=0.012). Conclusion:The incidence of secondary glaucoma after vitrectomy in a family with vitreous amyloidosis caused by the Gly83Arg mutation of TTR gene is higher, and its occurrence is significantly positively correlated with the recurrence of vitreous amyloidosis.