Objectives To observe anatomical location of the top branch of plantaris arch which extends from the superficial branch of the medial plantar artery,design and apply flap base on it. Methods On the basis of the anatomical data from 8 feet of 4 fresh cadavers and probed of the Doppler from 50 feet of normal person,defined the anatomic location and body surface projection of the top branch of plantaris arch,a type of new flap design were introduced in the paper. Results The flaps have been used in six cases clinically to treat skin defect of the hand meanwhile,sensation of the flap was regained by suturing nerve.All flaps survived,the appearance of the flaps were excellent,the function of the injured hands were recovered well. Conclusions The design of the flap is reasonable,it is suitable that the free medialis pedis flap of the top branch of plantaris arch is used to repair a small skin defect of the hand.

Objective To study the feature of the etiology of pediatric syncope by cases study,and to discuss the feasibility on identification between the cardiac and neurally-mediated syncope with its inducements and symptoms.Methods One hundred and eleven patients were etiologically classified by standard diagnostic procedure to summarize the inducements,presymptoms and symptoms.The data about cardiac and neurally-mediated syncope were statistically treated to find their characteristic manifestation.Results Among these,60.4% was non-cardiovascular syncope,18.9% was postural hypotension,18.0% was vasovagal syncope and 9% was cardiac syncope.Most of them were non-cardiac syncope and neurally-mediated syncope was on the top,while cardiac syncope was rare in children.Prolonged standing and nausea was the feature of the neurally-mediated syncope,and the cardiac syncope is associated with physical exercise.Conclusions Most pediatric inpatients were non-cardiovascular syncope in which neurally-mediated syncope is first on the list.The movement-related syncope is the feature of the cardiac syncope.The prolonged standing and nausea are due to neurally-mediated syncope.

Objective To analyze the risk factors of early renal damage in children with Henoch Schonlein purpura(HSP).Methods The clinical data of 196 children with HSP admitted to our hospital from April 2012 to January 2016 were analyzed retrospectively.They were divided into the renal damage group and non-renal damage group within 90 d after confirmed diagnosis.The related clinical data such as serum immunoglobulin and urinary microalbumin were compared between the two groups,and the risk factors of early renal damage in children with HSP were screened.Results There were significant differences between the two groups on age,joint symptoms,recurrent purpura,persistent rash,gastrointestinal bleeding and abdominal pain(with χ2 or t of 11.345,16.223,11.275,43.211,12.592,17.771,P<0.05).The white blood cell count,platelet count,immunoglobulin A(IgA) level and urinary albumin level also showed significant differences between the two groups(t=33.750,60.442,9.451,8.458,P<0.05).The multivariate regression analysis showed that the independent risk factors for early renal damage in children with HSP included age(OR=2.703),recurrent purpura(OR=2.721),persistent skin rash(OR=1.782),gastrointestinal bleeding(OR=11.472),abdominal pain(OR=2.046),IgA level(OR=1.221) and urine microalbumin(OR=3.214).Conclusion Age,recurrent purpura,persistent skin rash,gastrointestinal bleeding,abdominal pain,IgA level and urine microalbumin are closely related to early renal damage in children with HSP.

Objective To understand the effects of environmental pollution on blood lead levels of children.Methods The blood lead levels of605children aged2-7in6urban districts of Harbin and307children aged2-7in Jixi were deter-mined by graphite furnace atom absorption spectrophotometry during the period from April to June in1999.Results The data on blood lead levels of children in two cities showed both positive skewness distribution.The geometric means of blood lead lev-els of children were0.354?mol/L in Harbin and0.441?mol/L in Jixi,the medians were0.369?mol/L in Harbin and0.440?mol/L in Jixi,the values of P 95 were1.575?mol/L in Harbin and1.304?mol/L in Jixi.The children with blood lead levels of≥0.483?mol/L accounted for44.5%of total observed in Harbin and44.9%in Jixi.Conclusion Environmental lead pollution had coused potential adverse effects on preschool children health.

Objective To understand the influential factors for blood lead level of children in Harbin.Methods The lead level in the air,dust,vegetables and the blood of 605 children aged 2-7 years were determineded and family fitment,fuel combustion,the food consumption were investigated.Results The lead contents of air,dust in pollutant areas [(2.037?0.455)?g/m3,(84.000?0.015)mg/kg] were higher compared with the control areas[(1.017?0.595)?g/m3,(72.000?0.025)mg/kg],the differences were significant(P

Objective To investigate the effects of different head positions during operation on wake-up time and quality among ankylosing spondylitis (AS) patients with thoracolumbar kyphosis following pedicle subtraction osteotomy (PSO).Methods Sixty patients were included in this study.All of them,treated with intravenous anesthesia,took the bow-prone position.The patients were randomly divided into two groups:the experiment group where the head was elevated by 10° and the control group where the head was not elevated.The two groups were compared in respect of wake-up time and quality of wake-up test.Results The wake-up time in the experiment group was significantly shorter as compared to that of the control group (1 3.7±2.0 min vs.24.2±2.7min,P＜0.05).The wake-up quality was better as well.Conclusion Elevation of the head by 10° can shorten wake-up time and improve the quality of wake-up test during the procedure of PSO for AS patients with thoracolumbar kyphosis.

Objective To investigate the feasibility of self-made quality control materials on chemiluminescence analyzer .Meth-ods Residual serum in blood bags were collected and served as matrixes .Complex quality control materials of tumor markers [car-cinoembryonic antigen ,alpha-fetoprotein ,carbohydrate antigen 125(CA125) ,CA199 ,CA153 ,human chorionic gonadotrophin and total prostate specific antigen ] and hormonal markers (luteinizing hormone ,follicle-stimulating hormone ,estradiol ,testosterone , progesterone and prolactin) were prepared .The monthly average value ,coefficient of variation(CV)% value ,cumulative average value and the number of out-of-control of each marker during the 12 months were calculated .Results All self-made quality control serum which stored and packaged separately showed appearance of clear and transparent after freezing and thawing ,without turbidi-ty and sedimentation .Difference of monthly average value and cumulative average value of each marker had no statistical significance (P>0 .05) .Compared with monthly average value and cumulative average value of each marker ,no obvious drift and trends were found .Monthly indoor imprecision of each hormonal marker were controlled within the allowable range .36 times of out-of-control alarm were monitored during a year ,among them ,25 for system error and 11 for random error .Conclusion Self-made quality con-trol materials has good stability and may find the instability factors of detection system timely to guarantee the reliability of test re-sults of chemiluminescence analyzer .

Aneurysm ; complications ; diagnostic imaging ; Child ; Coronary Aneurysm ; complications ; diagnostic imaging ; Humans ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnostic imaging ; Ultrasonography

Burnout, Professional ; psychology ; Faculty ; Female ; Humans ; Male ; Mental Health

OBJECTIVE:To provide reference for clinical rational drug use. METHODS:Medication error(ME)cases report-ed from outpatient department from Oct. 2014 to Sept. 2015 in our hospital were analyzed,including ME category,classification, cause and proportion of persons who triggered or detected ME. RESULTS:Among 207 reports,there was no case of category A, 199 cases of category B,8 cases of category C,no of categories D-I. Among them,162 cases occurred in the links of prescrip-tions by doctors (78.26%),45 cases (21.74%) occurred in the links of dispensing prescriptions by pharmacists,the top 3 ME were improper usage(42.59%),improper administration route(40.74%)and inappropriate solvent(5.56%);the top 3 dispensing errors were variety error(40.00%),specification error(28.89%)and number errors(24.44%). The main causes for prescription errors were incomplete information system(56.17%)and drug information missing of doctors(43.83%);the main causes for dis-pensing errors were double specifications of drugs(35.56%),similar drug name(28.89%)and staffsntired(26.67%). In terms of the persons who triggered ME,the proportions of pharmacists,nurses,patients or their families were 97.58%,1.45% and 0.97%, respectively. CONCLUSIONS:Further strengthening information system and the on-the-job training for physicians and pharmacists can reduce the ME to some extent.