Objective To evaluate the effect and safety of anticoagulant citrate dextrose solution A (ACD-A ) in continuous blood purification (CBP) for patients at high risk of bleeding with ARF. Methods Twelve patients at high risk of bleeding, treated with continuous venovenous hemofiltration(CVVH), were divided into regional citrate anticoagulant (RCA) group and control group. In the former, ACD-A solution was delivered, pre-filter , with the rate adjusted to maintain a postfilter ionized calcium (iCa2+) level between 0.30-0.40 mmol/L. Before the extracorporeal blood returned to the patient, 10% calcium gluconate was infused to maintain a systemic iCa2+ level between 0.90-1.20 mmol/L. In control group, CVVH were performed either with low dose of heparin LMW sodium (1700-2500 IU/12 h-24 h)or without anticoagulant. The life span of each hemofilter was recorded. In RCA group, prothrombin time (PT), activated partial thromboplastin time (APTT) , acid-base changes, serum sodium and iCa2+ were monitored pre- and during CVVH. Result In the whole duration 1192.5 hours of CVVH in RCA group and 596 hours in control group, 62 and 42 hemofilters were used, respectively. Filter survival was 65.3% at 24 h and 24.5% at 48 h in RCA group,while 14.5% and 0 in control group. The mean life span of filter in RCA group was significantly longer than that in control group[(29.4?21.0) (1.5-71.5)h vs( 14.2?8.2) (4.5-40)h, P

Purpose To investigate the diagnostic value of the arrhythmogenic right ventricular dysplasia (ARVD) using multi-slice spiral CT (MSCT). Materials and Methods Thirty-four patients who were suspected as ARVD received right ventricular radiography, including 16 ARVD patients and 15 non-ARVD patients regarded as control group. The structural and shaped change of heart on reconstructed images of long axis, short axis and four cavity surface and analyze were observed, and MSCT features of right ventricular radiography characteristics were analyzed for ARVD patients. Results Sixteen cases of ARVD were correctly diagnosed by MSCT, and 14 cases had fatty infiltration including 11 cases of apex of heart, 8 cases of inferior wall, 5 cases of anterior wall, 5 cases of anterior wall of funnel area, 3 cases of diagram, 4 cases of papillary muscle, 6 cases of muscular trabecula and moderator band and 1 case of whole right ventricular free wall. Five cases showed scallop sign, 16 cases excessive trabecular change, 11 cases thinned changes, and 16 cases enlarged changes of right ventricular wall. Conclusion MSCT features of right ventricular for ARVD have relative diagnostic characteristics, and the scallop sign and excessive trabecular change of right ventricular wall are its specific imaging characteristics.

Objective To investigate the effect of elispheric motion on balance and walking ability of hemiplegic patients after stroke. Methods From September to December, 2016, 40 hemiplegic patients after stroke were randomly divided into control group (n=20) and ob-servation group (n=20). Both groups received conventional rehabilitation, additionally, the control group received juggling ball training, and the observation group received elispheric motion combined with juggling ball training, 20 minutes a day, six days a week for six weeks. They were assessed with the Fugl-Meyer Assessment-Sensory (FMA-S), Fugl-Meyer Assessment-Lower Extremity (FMA-LE), Berg Bal-ance Scale (BBS) and TimedUp and GoTest (TUGT) before and six weeks after training. Results After training, the scores of FMA-S, FMA-LE, BBS significantly increased (t>10.012, P<0.05) in both groups, and were higher in the observation group than in the control group (t>2.129, P<0.05);the time of TUGT significantly shortened (t>10.001, P<0.001) in both groups, and were shorter in the observation group than in the control group (t>4.669, P<0.05). Conclusion Elispheric motion can facilitate to improve the balance and walking ability of hemi-plegic patients after stroke.

Objective To assess the diagnostic performance of CT for detecting anastomotic leak after esophagectomy.Methods A total of 50 patients who underwent both CT and fluoroscopy after esophagectomy in our hospital from September 2013 to December 2015 were enrolled in this study.The fluoroscopy features and CT findings were analyzed retrospectively.Results The sensitivity,specificity,positive and negative predictive values were 100%,86.67%,83.33%,100%,respectively,for CT,and 85%,100%,100%,90.91%,respectively,for fluoroscopy.The differences in CT features,including leak of contrast,wall discontinuity and air-fluid collection in the mediastinum were statistically significant between leak and no leak(P=0.000,P=0.000,P=0.005,retrospectively),while no statistically significant in air collection in the mediastinum,hydropneumothorax,pleural effusion and pneumatosis.The maximum diameter of air collection in leak was(1.54±0.97)cm,while the maximum diameter of air collection in no leak was (0.56±0.20)cm,the difference in the maximum diameter of air collection between leak and no leak was statistically significant(P=0.007).Conclusion CT is more sensitive but less specific than fluoroscopy for detecting anastomotic leak.CT can be a better choice for the patients who can not tolerate the fluoroscopy or the fluoroscopy results is negative but anastomotic leak is still suspected.

Child ; Child Welfare ; China ; Health Services, Indigenous ; Humans

Bone Screws ; utilization ; Female ; Foot Diseases ; surgery ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Internal Fixators ; utilization ; Metatarsus ; abnormalities ; surgery ; Osteochondritis ; congenital ; surgery ; Young Adult

To explore the nyopic shift after cataract extrac tion(ECCE ) with intraocular lens implantation (IOL． ) during childhood．2l children (24 eyes) with ECCE+0L are retrospectively analyzed,and were divided into two groups according to the age． The initial and last postoperative refractive errors were compared． The mean myopic shift was -0.89±0.40 (3～5 years group ) and -0.97± 0.l8 (6～ l0 years N) The difference between two groups was not significantly different(t=0.2l, P>0.05 ) ．The myopic shift was less than l.5re in 91.6W of the w． 83.32 of the eyes achieved a visual acuity of 0.5 or better in their pseudosphakic eyes． Undercorrecting most children 3 to 10 years of ag e by 1.00D from the IOL power predicted to achieve emmtropia．

The effects of astragalus polysaccharide (APS) on type 1 diabetes mellitus were investigated. The mRNA expressions of Th1/Th2 cytokines of pancrease and ultrastructure of islet were studied.Ultrastructure of islets was well protected in APS group;the mRNA expressions of Th1 cytokines were downregulated and those of Th2 cytokines were upregulated in APS group.APS may correct the imbalance of Th1/Th2 cytokines.

Objective: To investigate the implementation of sex education and its influencing factors among preschool teachers in Luzhou City, Sichuan Province, so as to provide insights into promoting the development of sex education, physical and mental health for preschool children. Methods: In January 2022, preschool teachers were sampled in 24 kindergartens in Longmatan District, Naxi District and Hejiang County of Luzhou City using the stratified random cluster sampling method. Demographic information, knowledge, attitudes, implementation of sex education, as well as difficulties, support, and needs in implementing sex education among preschool teachers were collected through questionnaire surveys. Factors affecting practice of sex education by preschool teachers were analyzed using a multivariable logistic regression model. Results: A total of 461 preschool teachers were included, including 456 females (98.92%), and had a median age of 28.00 (interquartile range, 9.50) years. The proportions of preschool teachers with good and pass of knowledge about sex education for preschool children were 10.20% and 57.48%, respectively. The proportions of preschool teachers with positive and general attitudes towards sex education were 28.20% and 36.44%, respectively. A total of 343 preschool teachers had implemented sex education (74.40%). A lack of a relaxed social environment was the main difficulty in carrying out sex education for preschool children (76.14%), while support from parents of preschool children was the primary need for conducting sex education activities (75.27%). Multivariable logistic regression analysis showed that age (>30 years, OR=2.218, 95%CI: 1.256-3.917), kindergarten type (public, OR=2.101, 95%CI: 1.253-3.524), attitude towards sex education (positive, OR=2.083, 95%CI: 1.036-4.187), participation in activities related to sex education (OR=6.355, 95%CI: 3.362-12.015), and communication with parents about sex education (OR=5.399, 95%CI: 3.152-9.248) were influencing factors for practice of sex education by preschool teachers. Conclusions The main difficulty in the practice of sex education for preschool children by preschool teachers in Luzhou City is a lack of a relaxed social environment, and there is a high demand for support from parents. Age, kindergarten type, attitude towards sex education, participation in activities related to sex education, and communication with parents about sex education are associated factors.

Objective To investigate the influence of parental compliance on the therapeutic effect of children with epilepsy.Methods Two hundred and sixty children with epilepsy and their parents admitted to the First People's Hospital of Wenling from December 2013 to June 2016 were enrolled,and the classical Morisky medication adherence questionnaire (MMAS-8) was applied to evaluate the compliance of parents for treatment of their children with epilepsy;after the patient taking drug for 3 days,fasting venous blood was collected in the morning,the concentration of the blood drug was tested and the influence of parent compliance on the blood drug concentration of the child with epilepsy was evaluated.Results In 260 patients,122 cases took karma form,and 138 cases took valproate orally.There were parents with good medication compliance in 130 cases (50％),medium medication compliance 80 cases (30.76％) and poor adherence to the doctor order in 50 cases (19.23％).In cases using medication irregularly,there were 26 cases sometimes without taking any drug (10.0％),17 patients' medication being interrupted (6.54％) and 10 cases having excessive medication (3.85％);no relationships were found between parental compliance and each of the following items,family role,occupation and age (all P ＞ 0.05);and the compliance was related to gender,indicating that women's good compliance level was higher than that of males';the education level was positively proportional to the compliance,and the compliance of parents with senior high school or above degree was higher than those with primary school and junior secondary school levels (83 cases vs.9 cases,38 cases,both P ＜ 0.01).Under situation of parents with poor compliance,their children had blood drug concentration higher or lower than proper range of drug level (high in 22 cases,low in 41 cases,higher than the result in good compliance 0 cases and 17 cases respectively),thus seriously affected the safety and efficacy of the treatment;the patients' frequency of irregular medication in parents' good compliance group was significantly lower than that in parents' poor compliance group [3.08％ (4/130) vs.72.0％ (36/50),P ＜ 0.05].Conclusion To improve the therapeutic effect of epileptic children,their parental good cooperation is necessary.