Background and purpose:Endoscopic treatment is a promising therapeutic option for superifcial lesions throughout the gastrointestinal tract, this study was aimed to evaluate the efficacy of endoscopic resection (ER) using the new Duette multiband mucosectomy kit (DT-6) on treating esophageal disease. Methods:Since Jun. 2011, ER using DT-6 has been performed on 100 patients in a tertiary medical center. Data from those who have been followed up for over 6 months was analyzed. ER and esophagectomy were compared on treating high grade dysplasia (HGD) lesions and early esophageal cancer. Results:From Jun. 2011 to Jan. 2012, a total of 32 patients with esophageal lesions underwent 34 ER using DT-6 (22 male and 10 female, mean age 59.0 years, range 25 to 83 years). There were (3.4±1.0) specimen resected per operation, and the average greatest diameter was (11.8±2.7)mm. Intraoperative blood loss was (5.45±1.47)mL. The median follow-up period was 8.2 months with a 100%half-year-follow-up rate. Except one pneumothorax occurred during one endoscopic submucosal dissection (ESD), no other complications happened. When Comparing ER and esophagectomy on treating HGD and early esophageal cancer, ER showed advantages in terms of operation time, intraoperative blood loss, hospital stay and complications. Conclusion:ER using DT-6 is safe, simple, minimally invasive and effective for esophageal disease. Prospective study and long follow-up are needed to compare endoscopic resection and esophagectomy for HGD and early esophagus cancer.

OBJECTIVETo investigate the biomechanical effect of anterior screw fixation on the type II fractured odontoid process.

METHODSTwenty fresh human C1-C2 vertebrae specimens were harvested and randomly divided into three groups. The angle of type II fracture line was 0 degree in group I (n=6), 17 degrees in group II (n=8) and 25 degrees in group III (n=6). The fractures were treated by anterior screw fixation. Insertion torque,maximal axial pullout force and stiffness of the bone-screw were tested.

RESULTSThere was no significant difference of screw insertion torque and the pull-out strength between each group. The displacement of the odontoid fragment had an association to the angle of the fracture line,the displacement of the small angle was significantly higher than that of the large one (P < 0.5). No significant difference of structure stiffness of the bone-screw was found between each group.

CONCLUSIONAnterior screw fixation is feasible for type II odontoid fracture with certain fracture line extends from anteroinferior to posterosuperior.

Biomechanical Phenomena ; Bone Screws ; Cervical Vertebrae ; injuries ; Fracture Fixation, Internal ; methods ; Humans ; Spinal Fractures ; physiopathology ; surgery

Objective: To explore the effects of delayed umbilical cord clamping on full-term newborns and maternal outcomes. Methods: From January 2017 to April 2018, 287 normal full-term newborns delivered by vagina in the First People's Hospital of Xiaoshan District were selected in the research, and randomly divided into the control group (141 cases) and observation group (146 cases) according to the order of entering the delivery room.The control group was ligated the umbilical cord 15-20 s after delivery, while the observation group was ligated the umbilical cord 60 s after delivery.The level of hemoglobin, hematocrit, the incidence of anemia, polycythemia, hyperbilirubinemia and phototherapy time of full-term newborns were compared between the two groups 3 days after birth.The third stage of labor, the amount of postpartum hemorrhage and the incidence of postpartum hemorrhage were compared between the two groups. Results: The hemoglobin[(181.49±16.84) g/L] and hematocrit (0.545±0.055) in the observation group were significantly higher than those in the control group[(175.90±17.49 )g/L, (0.515±0.062)] at the third day after birth (t=2.748, 3.409, all P<0.05). The incidence of neonatal anemia in the observation group was 0.68% (1/146), which was significantly lower than that in the control group [4.96% (7/141)], and the difference was statistically significant (χ²=4.848, P<0.05). The incidence rates of neonatal polycythemia, hyperbilirubinemia and phototherapy time in the observation group were 2.05% (3/146), 24.66% (36/146), (65.50 ±14.63)h, respectively, which in the control group were 0.17% (1/141), 22.70% (32/141) and (62.09±14.40)h, respectively, there were no statistically significant differences between the two groups (χ²=0.945, 0.153, t=0.953, all P>0.05). The third stage of labor time, postpartum hemorrhage volume, incidence of postpartum hemorrhage in the observation group were (5.97 ±4.17)min, (239.04±69.15)mL, 2.05% (3/146), respectively, which in the control group were (5.84±3.62)min, (227.73±56.99)mL, 0.71% (1/141), respectively, there were no statistically significant differences between the two groups (t=0.281, 1.504, χ²=0.945, all P>0.05). Conclusion Delayed umbilical cord clamping can increase the level of hemoglobin and hematocrit in newborns, reduce the incidence of anemia in newborns, and without increasing postpartum hemorrhage.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases. Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic. Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection. This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities. The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period.