OBJECTIVE To investigate the risk factors of nosocomial infection among child tumor patients with post-surgery chemotherapy.METHODS A total of 312 child tumor cases with post-surgery chemotherapy in the pediatric ward during from Dec 2004 to Dec 2008 were retrospectively reviewed.And 16 variables such as age,diagnosis,white blood cell count and nosocomial infections were studied.The data were analyzed with the single factorial ?2 test and multifactorial Logistic-regression analysis.RESULTS The incidence of nosocomial infection was 27.56%.The length of hospitalization,the white blood cell count,the neutrophil cell count and the invasive operation were found as independent risk factors of the nosocomial infection.CONCLUSIONS Shortening the hospitalization length,increasing the white blood cell and the neutrophil cell count and avoiding the unnecessary invasive operation will decrease the nosocomial infection.

Objective To investigate the effects of citric acid on the related indexes of salivary secretion under acid loading in or‐der to optimize the citric acid load method .Methods The saliva samples were collected from 10 young healthy volunteers at 1-90 s before ,at 91-120 s during and at 121-210 s after citric acid loading .The indexes were detected in saliva with mixed loading and after loading .The salivary alpha‐amylase(sAA ) activity ,pH value ,saliva flow rate ,total protein concentration in various groups were detected .The ratio values before and after the acid loading were compared among the groups .Results (1)The sAA activity , saliva pH value and total protein concentrations after acid loading were significantly increased compared before loading (P<0 .05) , moreover the ratio of after loading and before loading was greater than 1(P<0 .05);(2) however in the citric acid mixing ,the sAA activity ,saliva pH value and total protein concentration were decreased compared with before acid loading ,its ratio was less than 1 (P<0 .05) .Conclusion Citric acid affects the secretion result of acid loading saliva secretion ,it is suggested that the saliva under acid loading is separated treated and analyzed .

To investigate the prognostic effects of integrated traditional Chinese and Western medicine therapy without antibiotics in treatment of patients with severe acute pancreatitis (SAP).

Objective To evaluate the changes of the right atrium,right ventriculum,left atrium and left ventriculum after transcatheter closure of atrial septal defect(ASD) during a short to mid-term follow-up.Methods The right ventricular end-diastolic anterior-posterior diameter(RVEDD),right atrial long diameter(RADl),right atrial transverse diameter(RADt),left ventricular end-diastolic ante-posterior diameter(LVEDD),left ventricular end-diastolic volume(LVEDV) and left atrial anterior-posterior diameter(LAD) in 36 patients with secundum ASD were measured before ASD closure,after 3 days,3 months and 6 months of ASD closure with transthoracic echocardiography(TTE).Results RVEDD,RADl and RADt were significantly decreased,while LVEDD,LVEDV and LAD significantly increased 3 days after ASD closure.During 3 months follow-up,RVEDD,RADl and RADt continuously became smaller;LVEDD,LVEDV and LAD continuously became larger.At 6 months,RVEDD was significantly smaller and LVEDD,LVEDV were significantly larger than those at 3 months.No remarkable difference of RADl,RADt and LAD was found between 6 months and 3months follow-up.Conclusion Transcatheter closure of ASD not only decreases the preload of right heart and causes right atrium and right ventriculum become smaller,but also improves the geometry of left heart and causes the narrowed left atrium and left ventriculum gradually return to almost normal status.

OBJECTIVE: To evaluate the anesthesia effect of etomidate and propofol on painless abortion surgery. 
 METHODS: After screening the Cochrane Library, Pubmed, China National Knowledge Infrastructure (CNKI), WANFANG, VIP database, the literatures regarding the anesthesia effect of etomidate and propofol on painless abortion surgery were collected from 1995 to 2014. The randomized controlled trials (RCTs) were selected, the quality evaluation was performed and the data was analyzed by using RevMan5.3 software.
 RESULTS: A total of 1 130 patients were included in 9 RCTs. The results of Meta analysis were as follows: the anesthesia induction time in the etomidate group was less than that in propofol group (MD=-0.14, 95% CI -0.24 to -0.04, P=0.004); there were more adverse reactions, such as myoclonus, nausea and vomiting, in the etomidate group compared with the propofol group (P<0.001); the incidence of pain in the etomidate group was less than that in the propofol group (P<0.001); there was no significant difference in the incidence of respiratory depression between the 2 groups (P>0.05); the surgery time, analgesia and duration from withdrawal to the wake-up was not significantly different between the 2 groups (P>0.05). 
 CONCLUSION Etomidate had a shorter anesthesia induction time than propofol in the painless abortion surgery. The incidence of reverse reactions such as myoclonus, nausea and vomiting, was more common in application of etomidate, whereas the incidence of injection pain was more common in the use of propofol group. There was no significant difference in respiratory depression between the 2 drugs. The comprehensive efficacy of propofol is better than etomidate.
Abortion, Induced ; Anesthesia ; Anesthetics, Intravenous ; China ; Etomidate ; therapeutic use ; Female ; Humans ; Pain ; prevention & control ; Pregnancy ; Propofol ; therapeutic use ; Randomized Controlled Trials as Topic

OBJECTIVE To evaluate the cost-effectiveness of tislelizumab monotherapy in the second-line treatment of advanced or metastatic esophageal squamous cell carcinoma （ESCC），so as to provide reference for rational use of drug in clinic. METHODS A three-state partitioned survival model was constructed from the perspective of China’s health system， based on the data of RATIONALE-302 study，with simulation time limit of 10 years， cycle period of 1 month. The incremental cost-effectiveness ratio （ICER） was calculated with quality-adjusted life year （QALY） as utility index. The cost-effectiveness of tislelizumab monotherapy was compared with that of chemotherapy for second-line treatment of advanced or metastatic ESCC by cost-utility analysis. The stability of basic analysis results was validated through sensitivity analysis and scenario analysis. RESULTS The results of basic analysis showed that compared with chemotherapy group， incremental cost per capita of tislelizumab group was 35 025.32 yuan，and incremental utility per capita was 2.71 QALYs； ICER was 12 892.31 yuan/QALY， which was far lower than the willingness-to-pay （WTP） threshold of 3 times of China’s per capita gross domestic product （GDP） 242 928 yuan in 2021. The results of univariate sensitivity analysis showed that parameters such as the cost of apatinib， the utility value of disease progression status and the cost of adverse reactions in the chemotherapy group had a great impact on the ICER value， but these parameters could not cause the reversal of the basic analysis results. Probabilistic sensitivity analysis showed that WTP threshold was higher than 80 000 yuan/QALY，the probability of tislelizumab monotherapy possessed cost-effectiveness was 100%. Results of scenario analysis showed that in which model simulation time lasted for 5 or 20 years，ICER of tislelizumab was 8 331.00 yuan/QALY and 12 981.00 yuan/QALY， which were less than 3 times of China’s per capita GDP in 2021 as WTP threshold. CONCLUSIONS When three times of China’s GDP per capita in 2021 is taken as the WTP threshold， the second-line treatment of tirelizumab monotherapy for advanced or metastatic ESCC is more cost-effective than chemotherapy.

【Objective】 To analyze the effect of fisetin against venous thrombosis in rats. 【Methods】 Seventy SD rats were randomly divided into the following groups: sham-operation group, model group, fisetin 45 mg/kg, 15 mg/kg, 5 mg/kg groups, and aspirin group (47 mg/kg). The corresponding medication was administered by gavage once a day consecutively (the sham-operation group and the model group were given 0.5% carboxymethyl cellulose sodium solution with 10 mL/kg, respectively) for 7 consecutive days. One hour after the last administration, the rats were anesthetized, the lower part of the intersection of inferior vena cava and left renal vein was ligated with silk thread (no ligation in the sham-operation group), and the abdominal wall was sutured. Two hours later, the abdominal cavity was reopened, the other venous branches 1.5 cm away from the ligation site were closed with the artery clamp, and blood was collected from the abdominal aorta. The anticoagulant ratio of 3.8% sodium citrate∶whole blood was 1∶9.The venous thrombus 1 cm down from the ligation point of the intersection of inferior vena cava and left renal vein was cut and the thrombus was separated. The residual blood was dried with filter paper, weighed and recorded. Plasma was taken after anticoagulant blood centrifugation. The levels of plasma antithrombin-Ⅲ (AT-Ⅲ), protease C (PC), plasminogen (PLG), and plasminogen activator inhibitor (PAI-1) were detected by ELISA kits. 【Results】 Compared with the model group, the weight of thrombus in fisetin 45 mg/kg group and aspirin 47 mg/kg group decreased (P<0.01). The content of AT-Ⅲ in three fisetin groups increased (all P<0.05). The content of PC in fisetin 45 mg/kg increased (P<0.05). The content of PLG and PAI-1 in fisetin 45 mg/kg group decreased (both P<0.05). 【Conclusion】 Fisetin has the effect against venous thrombosis in vivo, and the effect is related to the upregulation of AT-Ⅲ and PC and the downregulation of PLG and PAI-1.