Point-of-care testing technology has been widely used in clinical practice, especially in the emergency department of intensive care unit, operating room, and so on.Clinicians should correctly select patients, standardize specimen collection and strict operation according to the indications of different POCT items, and correctly interpret the results of POCT based on the clinical characteristics of children and other auxiliary examination results, so as to guide clinical diagnosis and treatment.From the perspective of pediatric emergency, this review analyzed the application of POCT technology in infection-related indicators, etiology, coagulation indicators, myocardial injury, and so on.

OBJECTIVE:To optimize the formulation of azithromycin sustained-release vaginal suppository(ASVS).METHODS:The ASVS was prepared using S-40 as suppository base,HPMC as sustained-release material and glycerine as humectant.The formulation of ASVS was optimized by orthogonal design with accumulated release percentage and hardness as indexes and the amount of 8% HPMC and glycerol as factors;meanwhile,a verification test and the fitting of in vitro drug release model were performed.RESULTS:The optimized formulation ASVS was as follows:azithromycin 6 g,8% HPMC 23.52 g,glycerol 29.40 g,ethanol absolute 3 g,ethylparaben 0.59 g,and S-40 294 g.Three batches of suppositories prepared under the optimized formulation reached a mean content of 99.5%,with hardness up to the standard,showing good reproducibility and homogenicity in drug release in vitro.The accumulative release rates of all samples were greater than 98% at 180 min,and the release dynamics in vitro were in line with Higuchi equations.CONCLUSION:The optimized ASVS is feasible in formulation,stable and reproducible in preparation technology and up to the standard for sustained-release preparation.

OBJECTIVETo explore the clinical application of mandibular-driven simultaneous maxillo-mandihular distraction to correct hemifacial microsomia with rapid prototyping technology.

METHODSThe patient' s skull resin model was manufactured with rapid prototyping technology. The osteotomy was designed on skull resin model. According to the preoperative design, the patients underwent Le Fort I osteotomy and mandibular ramus osteotomy. The internal mandible distractor was embedded onto the osteotomy position. The occlusal titanium pin was implanted. Distraction were carried out by mandibular-driven simultaneous maxillo-mandihular distraction 5 days after operation.

RESULTSThe distraction in five patients was complete as designed. No infection and dysosteogenesis happened. The longest distance of distraction was 28 mm, and the shortest distance was 16 mm. The facial asymmetry deformity was significantly improved at the end of distraction. The ocelusal plane of patients obviously improved.

CONCLUSIONSRapid prototyping technology is helpful to design precisely osteotomy before operation. Mandibular-driven simultaneous maxillo-mandibular distraction can correct hemifacial microsomia. It is worth to clinical application.

Face ; abnormalities ; surgery ; Facial Asymmetry ; congenital ; surgery ; Goldenhar Syndrome ; surgery ; Humans ; Hyperplasia ; surgery ; Mandible ; surgery ; Maxilla ; surgery ; Osteogenesis, Distraction ; methods ; Osteotomy ; methods ; Osteotomy, Le Fort

Objective To compare the value of contrast-enhanced ultrasound(CEUS) and contrastenhanced CT(CECT) for the differential diagnosis of the benign and malignant hepatic nodules in BuddChiari syndrome(BCS).Methods Thirty-nine BCS patients with hepatic nodules underwent CEUS and CECT examination separately,through which the perfusion characters of the nodules in different phases were observed.With the pathological result as the golden standard,the sensitivity,specificity and accuracy of CEUS and CECT were compared on diagnosing benign regenerative nodules and hepatocellular carcinoma (HCC) in BCS.Results Of the 66 hepatic lesions in 39 patients,21 were hepatocellular carcinoma(HCC),and the other 45 were regenerative nodules.The sensitivity,specificity and accuracy of CEUS and CECT were 81％,91％,88％ and 71％,84％,80％ respectively.Thus the diagnostic efficiency difference between CEUS and CECT had no statistic significance(P ＞0.05).Conclusions The differential diagnoses of the benign and malignant hepatic nodules in BCS on CEUS and CECT have high consistency.Due to the convenience and safety of CEUS,it can be used as first-line method.

OBJECTIVETo investigate and establish a risk assessment indicator system of infectious disease event for 2008 Beijing Olympic Games and to assess the risk of infectious disease epidemic on 2008 Beijing Olympic Games, as to offering scientific bases for security public health of Olympic Games.

METHODSRisk assessment subject discussion group was constituted to collect all sorts of data of infectious disease and the risk assessment and synthesis were analyzed. Then the expert's opinions were consulted to confirm the entered indicators and the judged content of indicators.

RESULTSA preliminary risk assessment indicator system of infectious disease events of 2008 Beijing Olympic Games was established. The system mainly include six first level indicators and twenty judge indicators altogether.

CONCLUSIONSThe risk assessment indicators system of infectious disease event for 2008 Beijing Olympic Games should be considered as all the risk factors and general application characteristics. It might be used in any security procedure of important function and risk management.

Anniversaries and Special Events ; China ; Communicable Disease Control ; Humans ; Public Health ; Public Health Administration ; Risk Assessment ; Sports

OBJECTIVETo investigate the diagnostic methods and reasonable treatment of Peutz-Jeghers syndrome (PJS).

METHODSClinical data of six patients with PJS were reviewed.

RESULTSRepeated abdominal pain, intussusception and intestinal polyp with bleeding were main manifestations. Four patients father,three patients grandfather and one patients mother were diagnosed with PJS. Three patients had family history of cancer. Case 4 and case 5 underwent laparotomy for many times because of intussusceptions caused by polyps or recurrent abdominal pain. Case 1 and case 4 had polyps synchronous with adenoma, and case 2 had polyp with gastric cancer. Main treatment included polyp resection and partial small intestinal and colon resection.

CONCLUSIONSPatients with PJS have family history of cancer and a high incidence of polyp recurrence of small intestine. Surgical intervention is the first choice regimen. Surveillance should be emphasized on gastrointestinal tract and other potential malignant organs in PJS patients.

Adolescent ; Adult ; Female ; Humans ; Intestine, Small ; surgery ; Male ; Pedigree ; Peutz-Jeghers Syndrome ; diagnosis ; genetics ; surgery

OBJECTIVETo explore factors related to pandemic influenza A (H1N1) virus infection among healthcare workers.

METHODSH1N1 influenza confirmed cases of health workers in hospital of Beijing from Aug 30th 2009 to Jan 31st 2010 were included. A 1:4 matched case-control study was conducted with 54 healthcare workers who were infected by influenza A(H1N1) virus and 216 matched controls who were not infected. Face-to-face interview with questionnaires was used to collect information of work and family aspects of the study participants. Conditional logistic regression was used to analyze the H1N1 infection factors.

RESULTSThe age was 29.6 ± 7.4 years old and male subjects accounted for 17.4% (47/270). There were 5.6% (3/54) and 34.4% (74/216) of the cases get the influenza A (H1N1) vaccine immunization separately in the case group and control group. Among 18.5% (10/54) and 40.1% (88/216) of the cases and controls used high protection level masks during the epidemic. Besides, 33 (61.1%)and 161 (74.5%) cases lengthening the time of mask wearing separately. There were 13 (24.1%) and 85 (39.4%) cases using disposable tissue to clean hands in the case group and control group, 24 (44.4%) and 46 (21.3%) cases feel they were much easier to get infected in respiratory disease than others based on experience in the case and control group. Univariate analysis showed that factors such as using disposable tissue to clean hands (OR = 0.15, 95%CI = 0.04 - 0.57), lengthening the time of mask wearing (OR = 0.43, 95%CI = 0.20 - 0.92), using high protection level masks (OR = 0.26, 95%CI = 0.11 - 0.58), getting influenza A (H1N1) vaccine immunization (OR = 0.04, 95%CI = 0.01 - 0.32), much easier to get infected in respiratory disease than others based on experience (OR = 2.85, 95%CI = 1.44 - 5.62), were all associated with influenza A (H1N1) infection. Results of multivariate logistic regression analysis showed that variables such as history of influenza A (H1N1) virus immunization (OR = 0.18, 95%CI = 0.06 - 0.51), using high protection level masks (OR = 0.05, 95%CI = 0.01 - 0.35), much easier to get infected in respiratory disease than others based on experience (OR = 3.69, 95%CI = 1.58 - 8.63) were all correlated to influenza A (H1N1) infection.

CONCLUSIONSFactors such as history of influenza A (H1N1) vaccine immunization, using high protection level masks and improving respiratory health can protect healthcare workers from infection of influenza A (H1N1).

Adult ; Case-Control Studies ; China ; epidemiology ; Female ; Health Personnel ; statistics & numerical data ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza Vaccines ; Influenza, Human ; epidemiology ; prevention & control ; virology ; Male ; Occupational Health ; Pandemics ; Young Adult

OBJECTIVETo evaluate the clinical efficacy and safety of hand-assisted laparoscopic surgery (HALS) vs. open surgery (OS) for portal hypertension.

METHODSRelevant literature was retrieved from databases including PubMed, EMBASE, Cochrane Library, Chinese Biomedical Literature Database, Chinese Journal Full Text Database, Chinese Vip Datebase, and Chinese Wanfang. All the relevant trials were collected and then we performed the literature screening. The quality of the included trials was assessed by Cochrane Systematic Review Handbook 5.1. Meta-analyses were conducted by RevMan 5.1 software.

RESULTSEight studies were involved and 435 patients were included. Meta-analysis showed that there was significant difference in intraoperative blood loss [MD = -140.95, 95% CI = (-233.58--48.32), P=0.003], total abdominal drainage volume [MD = -544.32, 95% CI= (-789.97--298.67), P<0.0001], postoperative exhaust time [MD = -28.30, 95% CI= (-41.90--14.69), P<0.0001], length of postoperative hospital stay [MD =-3.61, 95% CI= (-4.16--3.07), P<0.00001], postoperative complication [OR=0.35, 95% CI= (0.15-0.82), P=0.02] between HALS group and OS group. However, the operative time was not significantly different between these two groups [MD = -7.44, 95% CI = (-36.00 -21.12), P=0.61].

CONCLUSIONSCompared with the traditional OS, HALS can reduce intraoperative bleeding, postoperative exhaust time, hospitalization time, surgical trauma, and postoperative complications.The patients often recover more quickly from the HALS. However, its long-term effictiveness and safety still needs to be further verified by randomized controlled trials.

Hand-Assisted Laparoscopy ; Humans ; Hypertension, Portal ; surgery ; Laparotomy ; Postoperative Complications ; epidemiology

OBJECTIVETo study the immunoglobulin gene rearrangement patterns in Hashimoto's thyroiditis (HT) and primary thyroid lymphoma (PTL), and to analyze the relationship between the two diseases.

METHODSFormalin-fixed and paraffin-embedded tissues of 11 cases of PTL and 38 cases of HT as well as their clinical data, were retrieved. The latter group was further subcategorized into classic HT and suspicious PTL. Gene rearrangement studies for immunoglobulin heavy chains and light chains were carried out by polymerase chain reaction (PCR) using VH, FR3A and FR3kappa primers.

RESULTSThere was an increasing trend in immunoglobulin gene rearrangement rate for classic HT (10.7%), suspicious PTL (40.0%) and PTL (72.7%) groups. In general, a female predilection was observed. This sex predilection however was less obvious in the PTL group. There was no relationship between serum antibody (both thyroglobulin and thyroid peroxidase) titers and gene rearrangement patterns.

CONCLUSIONSHT and PTL show morphologic overlaps and may not be clearly distinguished on the basis of light microscopy alone. PCR-based immunoglobulin gene rearrangement study may be helpful in the detection of cases with early lymphomatous transformation of HT.

Female ; Gender Identity ; Gene Rearrangement ; Hashimoto Disease ; genetics ; Humans ; Lymphoma ; genetics ; pathology ; Male ; Middle Aged ; Sex Characteristics ; Thyroid Neoplasms ; genetics ; pathology ; Thyroiditis, Autoimmune ; genetics

Objective:To evaluate the influence of different CO2 pneumoperitoneum pressure on intestinal mucosal injury and intestinal function recovery in patients undergoing laparoscopic radical gastrectomy.Methods:A total of 120 patients undergoing laparoscopic radical gastrectomy were randomly divided into group A,B and C.Each group included 40 patients.CO2 pneumoperitoneum pressure ingroup A,B and C were 8～10 mmHg,11～13 mmHg and 14～16 mmHg,respectively.The degree of intestinal mucosa damage,plasma D-lactate(2,24 and 48 hours after the treat-ment),intestinal function recovery and complication ration were compared between the three groups.Results:Damage degree of intestinal mucosa after operation in A,B and C groups were 0～1,1～2 and 2～3 respectively.There was significant change in intestinal mucosa injury after operation in both B and C groups.The level of D-lactic acid in group C (2,24 and 48 hours after the treat-ment) were significantly higher those in group A and group B (P＜0.05).The bowel sounds appeared time,exhaust time and intake time in group C were significantly longer than group A and group B (P＜0.05).The incidence of complications were not significantly difference during the three groups.Conclusion:The high pressure of CO2 pneumoperitoneum will cause intestinal mucosa damaged,and not conducive to the patients' intestinal rehabilitation.We suggest that the CO2 pneumoperitoneum pressure should be as low as possible under clear visualization during operation.