With the changes in the social structure of China, medical aid to the poor has become a hot issue in our society. The authors analyze the current state of medical aid to the poor in China, disenss the difficulties in providing medical aid to the poor at present, and put forward the idea of providing medical aid to the poor through specifying aid funds, conducting fundraising in every way, establishing foundations, adopting a variety of aid patterns, obtaining the active cooperation of local hospitals, and coordinating aid organizations.

Objective:To study the distributing characteristics of digestive malignancy in patients with type 2 diabetes mellitus.Methods:We reviewed the complete data of 201 dead patients with type 2 diabetes mellitus from 2000 to 2005,sifted those complicated by cancer and those by digestive malignancy,and then analyzed the distributing characteristics and morbidity of the tumor.Results:The patients(126 males and 75 females) died at the average age of(73.53?9.03) years.Of the total number,57 cases(44 males and 13 females) were complicated by cancer and 25(22 males and 3 females) by digestive malignancy,the latter constituting the largest proportion of the diabetic patients(12.44%),followed by malignancy of the blood system,the lung and the urinary system.The pancreas was involved in 4.48% of the cases,while the stomach,esophagus,gallbladder and other digestive organs in only 0.498% of them.Of all the patients,those complicated by pancreatic cancer ran a shortest disease course of about 3 years,while those with the colon involved a longest course of about 11 years.Conclusion:Patients with type 2 diabetes mellitus are liable to cancer,particularly to digestive malignancy,and males are more susceptible than females.The cancerous characteristics,including morbidity and disease course,vary in different digestive organs.

Aim To investigate the anti-angiogenesis and anti-xenograftes of UA in zebrafish larvaes. Meth-ods 24 hour post-fertilization ( hpf ) TG zebrafish was treated with different concentration of UA for 24h, and the number of intersegmental vessels( IVS) were detec-ted under fluorescent microscope respectively;then the models of AB/TG zebrafish xenografts were established by be micro-injected with SMMC-7721 or HT-29 cell at 48hpf respectively, and after cocultured with UA for 48h, optical density (OD) of the SMMC-7721 cell and subintestinal veins ( SIVs) induced by HT-29 were e-valuated under confocal microscope. Results ISV as-say showed that UA could cause IVS missing or disap-perance, inhibition ratio reaching 20. 25% and 26. 65%. UA blocked the spread of SMMC-7721 cells in zebrafish and OD value,and inhibition ratios at three concentrations were 38. 01%, 54. 69%, 61. 88%, re-spectively; in another SIVs assay induced by xeno-grafts, UA at concentration 10 and 15mg·L-1 showed that SIVs were inhibited (P<0. 01) obviously. Con-clusion UA could inhibit the angiogenesis and the growth of SMMC-7721/HT-29 xenografts,and the anti-tumor mechanism may be related with VEGFR2 expres-sion.

Objective:To search, evaluate and summarize the best research evidence of perioperative intestinal management in patients with cervical spinal cord injury, so as to provide evidence-based basis for clinical nursing practice.Methods:Literature on perioperative intestinal management of cervical spinal cord injury were systematically searched in databases, domestic and foreign relevant guidlines network and professional associations, such as UpToDate, Cochrane Library, PubMed, China National Knowledge Infrastructure, Wanfang Database, etc. The search period was from the establishment of the databases to October 1, 2023. The quality of the included literature was evaluated and the evidence was extracted and summarized.Results:Finally, 9 articles were included, including 2 guidelines, 2 expert consensuses, 1 randomized controlled trials, and 4 observational studies. Twenty-five pieces of evidence were summarized across six aspects: assessment, diet management, physical activity, physical therapy, drug therapy, prevention and management of intestinal complications.Conclusions:The best evidence of perioperative intestinal management in patients with cervical spinal cord injury summarized in this study can provide reference for clinical nursing practice.

Objective To investigate the prognostic factors of pediatric acute respiratory distress syndrome(pARDS),according to pARDS criteria from the 2015 Pediatric Acute Lung Injury Consensus Con-ference.Methods Clinical data of 69 cases with pARDS in PICU of Beijing Children′s Hospital affiliated to Capital Medical University from January 2009 to December 2015 were retrospectively analyzed. Results Among the 69 cases of pARDS,there were 13 cases with mild ARDS,19 cases with moderate ARDS and 37 cases with severe ARDS. Seventeen pARDS were dead in PICU,including 2 mild pARDS,3 moderate pARDS and 12 severe pARDS,and 14 pARDS of them were female,3 pARDS were male.Gender and chron-ic complication were related to the outcomes of pARDS,and the difference was significant(P<0.05).The mortality of pARDS with chronic complication was up to 69.23%.Duration of mechanical ventilation was related to PICU hospital stay and total length of hospital stay(correlation:0.324,0.181,P<0.01).Duration of mechanical ventilation was also related to weight(correlation 0.491,P<0.01),and weight was a protec-tive factor.Conclusion pARDS is one of the most critical diseases in PICU with low morbidity and high mortality,the mortality of pARDS in this study is 24.64%.Female or chronic co-morbidities pARDS may have poor prognosis.Duration of mechanical ventilation determines the PICU length of stay and total hospital length of stay,and weight is the protective factor of the duration of mechanical ventilation.

Objective:To summarize the clinical characteristics and prognosis of severe infant botulism and evaluate the therapeutic effect of botulinum antitoxin in the pediatric intensive care unit (PICU).Methods:The clinical data of 8 cases diagnosed with infantile botulism were retrospectively analyzed in the PICU of Beijing Children′s Hospital from October 2019 to August 2023. Data of basic demographic information, clinical manifestations, laboratory tests, treatment and prognosis of each child were collected and analyzed using descriptive statistical methods.Results:Eight laboratory-confirmed cases of infant botulism were included in this study, all of which were male infants with an age of 6.0 (3.3,6.8) months. Three of the children were from Inner Mongolia Autonomous Region, 2 of them were from Hebei, and the other 3 were from Beijing, Shandong and Xinjiang Uyghur Autonomous Region, respectively. All the patients were previously healthy. In 4 of these cases, the possible cause was the ingestion of either honey and its products or sealed pickled food by the mother or child before the onset of the disease. The first symptom was poor milk intake (4 cases), followed by shallow shortness of breath (7 cases), limb weakness (7 cases) and so on. The typical signs were bilateral dilated pupils (8 cases) and decreased limb muscle strength (8 cases). The main subtype was type B (7 cases), and only 1 case was classified as type A. Six of the children were treated with antitoxin therapy for a duration of 24 (19, 49) d. Seven of them had invasive mechanical ventilation. All the patients survived upon discharge with a follow-up period of 29 d to 3 years and 8 months. Six patients had fully recovered, and 2 recently discharged patients were gradually recovering.Conclusions:For infants with suspected contact or ingestion of botulinum and presented with bilateral pupillary paralysis, muscle weakness and clear consciousness, the stool should be collected for diagnostic testing using a mouse bioassay as soon as possible. Type B was the most common type. The antitoxin treatment was effectiveness and the prognosis was well.

Acute necrotizing encephalopathy (ANE) is a rare but distinctive acute encephalopathy with global distribution.It usually begins with a virus-associated febrile illness, which deteriorates rapidly, and leading to convulsion, unconsciousness and even coma.The neuroradiologic features of ANE are multi-focal and symmetrical brain lesions, involving bilateral thalamus.ANE has no specific treatment method at present.The majority of ANE patients are accompanied with varying degrees of neurological sequelae, and even death.In this review, we summarized the epidemiology, diagnosis and prognosis of this rare but fatal disease in children.

To analyze and research the number and size of public hospitals of our country at the present stage, and explore the regional health planning of public hospitals under the background of China's new medical reform, provide the scientific basis for our further layout of regional health planning for public hospitals of our country. Methods Mainly use the method of the document analysis, by collecting and analyzing the literature related to the regional health planning of public hospitals under the new health reform. And relevant data on China Health Statistics Yearbook 2011 were analyzed. Results The irrational regional health planning and layout design of public hospitals not only seriously affect the efficiency of health care resources, but also exacerbate the difficulty and high cost of people getting medical service. Conclusion Under the new health care reform, the definition of public hospitals and the positioning and functionality of public hospitals need to be re-examined. The following three aspects will solve the problem of regional health planning of public hospitals. First, to moderately reduce the number and size of public hospitals; second, to determine and adjust the number of public hospitals at all levels; Third, to reasonably lay out urban and rural public hospital.

Objective:To analyze the prognosis and influencing factors of acute necrotizing encephalopathy (ANE) in children.Methods:Clinical data of ANE patients admitted to Pediatric Intensive Care Unit, Beijing Children′s Hospital, Capital Medical University from March 2012 to February 2019 were retrospectively analyzed.Survivors were followed up by telephone or outpatient department, and the quality of life was evaluated by pediatric overall performance category scale.The t-test or rank sum test was used for comparison between groups, and the COX risk regression was used to analyze the influencing factors of prognosis. Results:A total of 38 patients were enrolled in this study with the male-to-female ratio of 1.24∶1.00, and median age of 29.5(10.0-130.0) months.They were followed up for the median of 27(15-96) months.The overall survival rate at 7 days, 14 days and 2 months after disease onset were 57.9%, 42.1%, and 34.2%, respectively.The mortality rate at discharge was 34.2%(13/38 cases), and the cumulative mortality rate at the 1 st, 3 rd and 12 th months after discharge was all 68.4%(26/38 cases). The complete reco-very rate was 10.5%(4/38 cases) after one-year follow-up.The univariate analysis indicated that cardiopulmonary resuscitation before admission, Glasgow coma score < 5 at admission, complication with shock/cerebral hernia/multiple organ dysfunction syndrome, creatine kinase isoenzyme> 100 U/L, lactate dehydrogenase>1 000 U/L, hypoalbuminemia, hyperglycemia, hyperurea, prolonged prothrombin time and elevated international standardized ratio were risk factors for the prognosis of ANE in children ( β=3.519, 6.967, 6.803, 3.000, 6.389, 3.471, 2.252, 1.616, 2.377, 3.092, 2.713, and 4.510, respectively, all P<0.05). Meanwhile, high-dose Methylprednisolone[20-30 mg/(kg·d)] and immunoglobulin (2 g/kg, divided into 2-5 days intravenous drip) treatment were protective factors ( β=0.625, 0.405, respectively, all P<0.05). The COX multivariate analysis showed that high-dose Methylprednisolone treatment [20-30 mg/(kg·d)] was an independent protective factor for the prognosis of children with ANE [95% CI: 0.449(0.213-0.944), P=0.035]. Conclusions:Early application of high-dose Methylprednisolone and immunoglobulin may contribute to the good clinical outcome.Children with neurological sequelae should be actively treated with rehabilitation, and the quality of life may be gradually improved.

Pneumonia is the most common cause of pediatric acute respiratory distress syndrome.Pneumonia combined with pediatric acute respiratory distress syndrome due to different pathogens has certain characteristics, and clinicians should pay attention to individualized anti-infective, anti-inflammatory and respiratory support therapy in the diagnosis and treatment.