Objective The experimental condition of PEG precipitation pre-treatment method associated with electrochemiluminescence was optimized to gain a coincident result compared with gel chromatography method.Methods A fixed centrifuge time,optimized centrifuge speed,temperature and iron intensity were used to achieve a best experimental condition.Results The detection concentration of micromolecular PRL was approximate to gel chromatography method under the experimental condition of being centrifuged 10 minutes at 18℃ and pretreated with 25%PEG 6000 1M PBS.Conclusions The optimized PEG precipitation test united with the electrochemillumescence immunoassy was a good method for screening macroprolactinemia in clinical diagnosis.

OBJECTIVE To understand the distribution of pathogen in very-low-birth-weight or preterm infants septicemia in early-onset and late-onset and drug sensitivity.METHODS Bacterial isolates from inpatients of very-low-birth-weight or preterm infants septicemia over a period of 3 years were retrospectively analyzed,and classified as when septicemia was happened.RESULTS The positive rate of isolates was 43.2% in 970 samples of very-low-birth-weight or preterm infants septicemia.Most of the sepsis detected by blood culture was late-onset neonatal sepsis(58.6%).Pathogen of late-onset neonatal sepsis mostly was Gram-positive cocci,Staphylococcus were found to be the most common isolates(80.5%).In early-onset sepsis group,the isolates rates of Gram-negative and Gram-positive bacteria were mostly in proportion,there were 52.4% and 47.6%,respeitively.The resistance rate of late-onset sepsis group was higher than that of early-onset one.CONCLUSIONS The key of curing infants septicemia is that we should master the distribution of pathogen of very-low-birth-weight or preterm infants septicemia in early-onset and late-onset and drug sensitivity.Antimicrobial therapy should be initiated under the guidance of anti-microbial sensitivity test,in order to avoid abuse of antimicrobial.

Objective:To analyze the foreign research status and hotspots of transitional care for adolescents with chronic diseases.Methods:On December 31, 2021, Web of Science TM was searched for articles concerning transitional care for adolescents with chronic disease published between 2000 and 2021. Knowledge maps were used to analyze the included articles in terms of number, distribution of prolific authors and institutions, journals, research hotspots, frontiers and trends. Results:A total of 692 articles were included, the number of articles was increased from 2000 to 2021, with the largest in 2021 (76 articles). The most prolific country was the United States (358 articles). University of Toronto, University of North Carolina, Children′s Hospital of Philadelphia and Harvard University were the most prolific institution with high centrality (>0.1). Journals such as Pediatrics, J Adolescent Health, and J Pediatr Nurs published the largest number of articles, and Arch Pediat Adol Med had a total citation frequency>100 and high centrality (>0.1). In addition to the subject terms used in the search process of this study, the high-frequency keywords (>50 times) were “health care” “service” “health care transition” “quality of life” “experience” “need” “outcome” “transition readiness” and “adherence”. In keywords cluster analysis, the cluster whose time line extended to the recent two years were “quality of life” “program” “transition clinic” “adolescent health services” and “adherence”. Conclusions:In the field of transitional care for adolescents with chronic disease, studies mainly focus on patient needs, transitional experience, adherence, self-management, quality of life, etc. The research frontiers are transitional health management, disease care, construction and implementation of health care service program for adolescents with chronic disease.

Objective To study the effects of preoperative autologous blood donation on involution of uterus of puerpera under cesarean section after delivery. Methods Non-autologous blood donation was applied as control group. Height of uterus declining, pain of uterine contraction, amount of lochia, ending time of lochia and involution of uterus under ul-trasound B after delivery were compared between both groups. Results Heigh of uterus, score of uterine contraction pain, mean ending time of lochia, the sum of three dimensions of uterus in the third day and the seventh day and inci-dence of endometrial cavity fluid in the preoperative autologous blood donation group were lower than those in the non-autologous blood donation group. Mean good rate of involution of uterus in 42 days after delivery was higher than that in the non-autologous blood donation group. All the differences were statistically significant (P<0.05). Conclusion Pre-operative autologous blood donation is able to promote the involution of uterus after delivery, alleviate postpartum con-traction pain and significantly shorten lochia time, which is worthy of promotion.

Objective:To conduct a survey and study on thyroid hormone levels in Tibetan adults in Baingoin County, Nagqu City, analyse reference range of thyroid hormones, and provide a basis for subsequent diagnosis of thyroid diseases.Methods:According to the screening requirements of the National Academy of Clinical Biochemistry (NACB) Laboratory Medicine Application Guidelines, 193 local Tibetan adults in Baingoin County were selected as the survey subjects. Among them, 112 adults underwent physical examinations at the outpatient department of Baingoin County People's Hospital from May 2021 to August 2022, and 81 adults participated in rural physical examinations from June to August 2022. Using the Abbott i2000SR chemiluminescence immunoassay analyzer, the levels of thyroid stimulating hormone (TSH), total thyroxine (TT 4), total triiodothyronine (TT 3), free thyroxine (FT 4), and free triiodothyronine (FT 3) were determined. The reference range of thyroid hormones for local residents was established, and the correlation between thyroid hormone levels and age, as well as the differences between different townships were analyzed. Results:A reference range for thyroid hormones in Tibetan adults in Baingoin County, Nagqu City had been established (TSH: 0.53 - 6.16 μU/ml, TT 3: 1.07 - 2.28 nmol/L, FT 3: 3.30 - 5.86 pmol/L, TT 4: 60.68 - 129.96 nmol/L, and FT 4: 9.74 - 16.29 pmol/L). TSH level was positively correlated with age ( r = 0.16, P = 0.026), while TT 3, FT 3, TT 4, and FT 4 levels were negatively correlated with age ( r = - 0.21, - 0.23, - 0.16, - 0.26, P < 0.05). The comparison of TT 3, FT 3, TT 4 levels among 5 townships in Baingoin County showed statistically significant differences ( P < 0.05). Among them, Baoji Township was lower than the other four townships in the TT 4 level, and Deqing Township was higher than the other four townships in the FT 3 level ( P < 0.05). Conclusions:Successfully established a reference range for thyroid hormones in Tibetan adults in Baingoin County, Nagqu City. It is recommended to establish a reference range for thyroid hormones based on age groups and conduct more in depth investigations and studies on iodine nutrition and thyroid function in different townships.

Objective:To explore the feasibility of bedside ultrasound in monitoring gastric residual volume and predicting feeding intolerance during enteral nutrition in critically ill patients in intensive care unit.Methods:The data of critically ill patients admitted to emergency intensive care unit of the Second Affiliated Hospital of Zhejiang University School of Medicine from April 2018 to September 2018 were retrospectively analyzed. The following patients were finally included in this study: (1) abdominal computed tomography during the stay of emergency intensive care unit was performed due to the requirement of disease evaluation and management; (2) bedside ultrasound was performed to measure the gastric antrum cross-sectional area at 30 min prior to or after abdominal computed tomography. The outline of stomach wall in the imaging of abdominal computed tomography was traced with the help of VOLUME-Work Flow medical imaging software to calculate the value of gastric residual volume. The relationship between gastric antrum cross-sectional area under semi-sitting, horizontal and right-lateral positions and gastric residual volume was evaluated by Pearson correlation analysis. The difference of gastric antrum cross-sectional area between those critically ill patients with or without feeding intolerance was compared by independent-sample t test. The predictive value of gastric antrum cross-sectional area under different body positions on feeding intolerance during enteral nutrition was analyzed by ROC curve. Results:Totally, forty-two patients were enrolled and analyzed in this study, in which the mean age was (53±13) y, mean body mass index was (21.5±2.8) kg/m 2 and mean acute physiology and chronic health evaluation was 17.0±6.9. The value of gastric residual volume was (314.5±126.6) mL, and the values of gastric antrum cross-sectional area under semi-sitting, horizontal and right-lateral positions were (7.11±4.13) cm 2, (4.22±2.66) cm 2, (8.36±4.58) cm 2, respectively. The correlation analysis indicated that gastric residual volume was positively associated with gastric antrum cross-sectional area under semi-sitting, horizontal and right-lateral positions ( r=0.543, 0.604 and 0.618, respectively; all P<0.001). During enteral nutrition, 15 patients experienced feeding intolerance while 27 patients hadn’t feeding intolerance, in which the gastric antrum cross-sectional areas under semi-sitting, horizontal and right-lateral positions were significantly increased in those patients with feeding intolerance than those patients without feeding intolerance [semi-sitting: (8.53±4.07) cm 2vs (4.60±2.76) cm 2; horizontal position: (5.15±2.75) cm 2vs (2.61±1.32) cm 2; right-lateral position: (10.32±4.06) cm 2vs (4.95±3.20) cm 2, all P<0.005] . ROC curve analysis showed that the area under ROC curves of gastric antrum cross-sectional area under semi-sitting, horizontal and right-lateral positions for predicting feeding intolerance during enteral nutrition were 0.815, 0.833 and 0.849, respectively; when its values≥3.917 cm 2, 3.395 cm 2 and 4.402 cm 2 were used as the cut-off points, the sensitivities were 92.0%, 69.6% and 92.3%, and the corresponding specificities were 69.2%, 92.3% and 71.4%, respectively. Conclusions:Bedside gastric ultrasound could accurately evaluate the status of gastric residual volume in critically ill patients, and effectively predict their occurrence of feeding intolerance during enteral nutrition.

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.