Sepsis is defined as the systemic inflammatory response to infection,with high morbidity, high mortality and high cost, which is the most common cause of death in ICU.The morbidity of sepsis-induced myocardial depression is about 37%~50%, and the mortality is 20% higher than simple sepsis. Although the research in sepsis-induced myocardial depression is deeper than ever before, the diagnostic standard of sepsis-induced myocardial depression is still unclear,the early diagnosis of sepsis-induced myocra-diald eprse sion seems patr icularly important.Nowd ays,ht e diga nostci ways include ce hocardiography,ivn asive andn oninvasive hemodynamic monitoring, electrocra diogram andb iological markers are the most common diang ostic methosd .This review discussed the diagnostic methdo s used in sepsis-induced myocardial deper ssion.

ObjectiveTo investigate the clinical efficacy of Yaotongxue(Ex-UE7)finger manipulation plus ultrashort waves in treating acute lumbar sprain.MethodForty-two patients with acute lumbar sprain were enrolled and randomized into groups. The control group received lumbar ultrashort waves treatment and the observation group, Yaotongxue finger manipulation in addition. Pain relief and activities of daily living were assessed using the Visual Analogue Scale (VAS) and the Barthel Index before and after one and five sessions of treatment.ResultThere was no statistically significant pre-treatment difference in the VAS score between the two groups (P>0.05). After one and five sessions of treatment, the VAS score was significantly lower in the observation group than in the control group and there was a statistically significant difference (P<0.05); the Barthel Index score was significantly higher in the observation group than in the control group and there was a statistically significant difference (P<0.05). at three months of follow-up, the VAS score and the Barthel Index score were basically normal; there were no statistically significant differences between the two groups (P>0.05). No adverse events occurred during the study.ConclusionYaotongxue finger manipulation plus ultrashort waves is safe and highly effective in treating acute lumbar sprain.

Acute pancreatitis with high decomposition and metabolic state, is one of the common acute abdominal pain in children. The patients are vulnerable to malnutrition during the illness. Reasonable nutrition therapy has an important role in pancreatitis management. Compared with parenteral nutrition,enteral nutrition,especially early enteral nutrition within 48 hours,can maintain the gut barrier function,reduce the incidence of enterogenic infection and multiple organ function failure,shorten length of hospital stay and re-duce the hospitalization expenses. Enteral nutrition should be initiated first,if feasible. Enteral nutrition,either by nasojejunal tube or via nasogastric tube,is believed to be safe and effective.

Histone deacetylase (HDAC) is a protease which regulates gene expression and modify the structure of chromosome. The balance between acetylation and deacetylation of histone plays an important role in maintaining cellular function and the process of genes expression. Overexpression of HDAC and recruitment by transcription factors inhibit the expression of certain genes, leading to tumorigenesis and other diseases. Recently, with the further research on cancer epigenetics, HDAC inhibitors have increasingly caught attention. As a novel class of antitumor agents, HDAC inhibitors are widely explored in hematological malignancies. There are several kinds of HDAC inhibitors for the treatment and clinical research of non-Hodgkin lymphoma (NHL), such as vorinostat, belinostat, chidamide, CUDC-907. This article mainly describes the development of the HDAC inhibitors in NHL.

In the review,we analyzed the status of triage in pediatric emergency both at home and abroad,stated the importance of the correct implementation of emergency triage in the emergency medical services,and maked recommendations for pediatric emergency triage.

The current situation of pediatric emergency medicine and the pediatric emergency medical service systems were analyzed.The equipment configuration,personnel allocation and the requirement of professional knowledge and technology in pediatric emergency setting,the triage system,the process of medical services for patients with acute illness or trauma,and the optimizing process of diagnosis and treatment for emergency cases and critical cases were discussed.The nationwide development model of pediatric emergency service systems were reviewed.

Malnutrition is common in critically ill children.Nutrition prescription is hampered by various factors,and the nutritional status of these children often deteriorates during hospitalization.Nutrition therapy for critically ill children must be based on proper nutrition screening and nutritional assessment.Adopting dynamic nutritional assessment is an effective method to monitor patients under nutrition therapy and inform the prescription and administration of nutrition therapy.This article reviews the recent advances in nutrition screening and nutritional assessment in critically ill children.

ObjectiveTo investigate osteopontin (OPN) level in pulmonary tuberculosis and its clinical significance.MethodsThe level of serum OPN was determined in 80 pulmonary tuberculosis patients before anti-tuberculosis treatment[patients group,simple pulmonary tuberculosis with 60 cases (simple pulmonary tuberculosis group),pulmonary tuberculosis combined with tuberculous pleurisy with 20cases (pulmonary tuberculosis combined with tuberculous pleurisy group)],and compared with that of 30healthy persons (healthy control group) and 20 patients having received effective anti-tuberculosis treatment and followed-up for 6 months (followed-up group).At the same time,the clinical significance of OPN was studied by other commonly used clinical indicators of tuberculosis.ResultsThe level of serum OPN in patients group [(843.49 ±569.23) ng/L] was significantly higher than that in healthy control group [(352.50 ± 185.02) ng/L,P ＜0.05].The level of serum OPN after treatment in followed-up group were significantly decreased compared with those before treatment [(494.11 ±352.40) ng/L vs.(1106.60 ± 628.39) ng/L,P＜ 0.05 ] and there was no significant difference compared with those in healthy control group (P ＞ 0.05 ).The level of serum OPN in pulmonary tuberculosis combined with tuberculous pleurisy group [(1179.80 ±606.33) ng/L] was significantly higher than those in simple pulmonary tuberculosis group [(727.53 ±511.66) ng/L,P ＜0.05],and they were both higher than those in healthy control group [ ( 352.50 ± 185.02 ) ng/L,P ＜ 0.05 ].Therefore,for further additional subgroup analysis in simple pulmonary tuberculosis group,the level of serum OPN in patients with cavity[ ( 836.51 ± 549.80) ng/L ] was significantly higher than that without cavity [ (535.52 ± 375.95 ) ng/L,P ＜ 0.05 ],while the levels of serum OPN had no statistical difference between pulmonary lesion involved ＜ 3 leaf patients and ≥ 3 leaf patients,sputum mycobacterium tuberculosis positive patients and negative patients,mycoDot test results positive patients and negative patients,erythrocyte sedimentation rate elevated patients and normal patients,PPD strongly positive patients and non-strongly positive patients (P＞0.05).ConclusionsOPN activity is closely related with pulmonary tuberculosis.OPN can serve as a judge of pulmonary tuberculosis and the clinical indicators of disease outcome.The level of serum OPN and the severity of pulmonary tuberculosis have some correlations.

Objective Analysis of roadblocks found in the reform of performance-based salary mechanism in public hospitals, along with recommendations for the implementation strategies. Methods Both the historical document method and qualitative method are called into play to identify the characteristics and measures for performance-based salary mechanism in public hospitals. Results Such roadblocks are mostly found in value measurement of the hospital services of welfare nature, criteria of appraisal and establishment of the indicator system, job evaluation and the extent of incentives to use. The authors hold that such reforms should go in parallel with the reform, development, management level upgrading, and cultural building of the hospitals, and should call into play roles of intermediacies. Conclusion Reform for performance-based salary mechanism will be inevitable in public hospitals, as it has a direct bearing on the mission and functionality of public hospitals. In spite of the difficulties met, appropriate strategies may powerfully push forward reforms and development of such hospitals.

Objective The separation of various proteins in urine was used to differentiate the types of urinary protein to determine the site of diabetic kidney damage and lesions. Methods We used sodium dodeeyl sulfonate - agarosegel electrophoresis(SDS - AGE) to detect the unconccntrated urine on 108 cases patients with diabetic nephropathy urine specimens analysis. Results The results of urinary protein electrophoretic of 108 patients displayed: 4 eases for renal tubular proteinuria, 10 eases for physiological proteinuria, 22 eases for glomerular proteinuria, 72 cases for mixed proteinuria. Conclusion Urine protein electrophoresis for diabetic nephropathy patients with positive can distinguish the various components, and to understand the degree of kidney damage and lesions. This method is low -cost, non - invasive and highly sensitive. The film can be stored. It is worthy to be popularized.