Objective To compare the clinical effect of intraosseous versus traditional infusion in critical pediatric patients under resuscitation.Methods 56 critical pediatric patients under resuscitation,who were difficult to establish a venous access,were divided into two groups:intraosseous infusion group (IOI group)and traditional group.The clinical characteristics,lab tests,clinical efficacy and complications of all patients were recorded in detail. Results The general characteristics of two groups were comparable.The mean operation time to establish an emergency infusion access in the IOI group was (1.01 ±0.53)min,which was significantly shorter than (8.97 ±2.36)min of the traditional group(t =4.856,P <0.01).The IOI group had a greater efficacy over the traditional group (50.0% vs 36.7%),in the IOI group,the patients showed obvious positive effect and less patients had no efficacy(χ2 =18.476, P <0.05 ).In addition,lower complication rate and mortality were observed in the IOI group.Conclusion For critical pediatric patients under resuscitation whose intravascular access cannot be achieved through peripheral venous,intraosseous infusion is prior to traditional infusion.

Objective To investigate the change of blood lactate level in children with severe sepsis,and its relationship with clinical prognosis.Methods 90 children with severe sepsis who treated in our hospital from February 201 3 to May 201 4 were selected as the study subjects.According to the prognosis of children,they were divided into survival group and death group,45 cases in each group.The blood lactate levels at different time points, blood lactate clearance rates between the two groups at different time points as well as fibrin,oxygenation index and D -dimer levels were compared after admission.Results After treatment,the fibrin,oxygenation index and D -dimer levels in the two groups were improved.The fibrin and D -dimer levels in the survival group[(2.71 ±0.31 )ng/mL, (0.89 ±0.1 0)mg/L)]were lower than those in the death group[(2.89 ±0.21 )ng/mL,(1 .26 ±0.1 8)mg/L)],the differences were significant(t =3.224,P =0.001 ;t =1 2.053,P =0.000).The oxygenation index of the survival group[(1 96.23 ±1 4.69)mmHg)]was higher than that of the death group [(1 80.23 ±21 .03 )mmHg)],the difference was significant(t =4.1 84,P =0.000).The EGOT compliance rate,APACHE Ⅱscore and MODS incidence rate of survival group were significantly lower than those of the death group,the differences were significant(t =7.200,P =0.007;t =9.1 49,P =0.000;t =29.298,P =0.000).The blood lactate levels at each time points in the survival group were significantly lower than the death group,the differences were statistically significant(t =50.543, P =0.000;t =33.932,P =0.000;t =1 7.91 5,P =0.000;t =28.703,P =0.000).The 6 h,24 h blood lactate clearance rates≥1 0% of the survival group (73.33%,80.00%)were significantly higher than those of the death group(37.78%,44.44%),the differences were significant(χ2 =1 1 .520,P =0.000;χ2 =1 2.1 00,P =0.000). Conclusion Lactate level in children with sepsis is an important indicator of prognosis in children with severe sepsis,with guidance for the treatment of children with sepsis.

Objective To investigate the relationship between the onset of lower extremity venous thrombotic disease and seasons.Methods A retrospective study was conducted, 300 patients with lower extremity venous thrombotic disease admitted to HandanCity Hospital of Traditional Chinese Medicine (TCM) from August 2012 to February 2014 were enrolled, the incidences and TCM syndromes of patients with lower extremity venous thrombotic disease in different seasons were observed, and the pathogenesis and relationships between the types of TCM syndrome and seasons were analyzed.Results There were 142 patients with lower extremity superficial thrombophlebitis, and 158 cases with lower extremity deep venous thrombosis, the incidence of lower extremity venous thrombotic disease in spring was significantly higher than that in summer and autumn [32.8% (86/262) vs. 21.3% (54/254), 18.4% (50/272), bothP < 0.01], but lower than that in winter [32.8% (86/262) vs. 37.2% (110/296)], the difference was not statistically significant (P > 0.01); while the incidence of lower extremity venous thrombotic disease in winter was significant higher than those in summer and autumn (allP < 0.01). The incidences of damp and heat downward flow type in autumn and summer were increased compared with those in winter and spring [55.6% (30/54), 60.0% (30/50) vs. 20.0% (22/110), 23.3% (20/86), allP < 0.01], while the incidences of lower extremity venous thrombotic disease with damp heat and stasis syndrome in winter and spring were increased compared with those in summer and autumn seasons [80.0% (88/110), 76.7% (66/86) vs. 44.4% (24/54), 40.0% (20/50)].Conclusions The incidence of lower extremity venous thrombotic disease is related to seasons, and the onset is high in winter and spring, damp heat and stasis syndrome being the main type; according to different seasons, clinical treatment can direct to different pathogenic factors to adopt different preventive measures interfering with the patient's constitution in order to eliminate or reduce the risk factors, achieving the effect of the disease prevention.

To establish a method to detect cardiac troponin I by using time-resolved fluoroimmunoassay ( TRFIA) and apply to the clinic.Methods:The assay were measured by TRIFA and double antibody sandwich method .Standard protocols were evaluated with the standard curve , the limit of detection , stability, precision and cross reaction .Healthy reference populations and clinical serum specimens were measured to established the reference interval and evaluated the perspective of the clinical application . Results:The standard curve was Y=7485 .878+1400.924 X with a correlation coefficient of 0.999.The limit of detection was 0.052 ng/ml.The intra-and inter-assay coefficients of variation ( CV) were all <10%.Reference values was <0.14 μg/L.The AUC of ROC curve was 0.971 while the sensitivity was 96.45%,the specificity was 91.43% and the accuracy was 95.69%, with 98.45% of positive predictive value and 82.05%of negative predictive value.The correlation coefficient was 0.993 between our proposed method and the commercially available CLIA kits.There was no significant difference in statistics compared with ECG , CK-MB and cTnT ( P>0.05 ).There was significant difference in statistics compared before and after treatment with AMI ( P<0.001 ) .Conclusion: The TRFIA method for detecting cTnI achieves clinical application standards and may be used for the diagnosis and serosurveillance of acute myocardial infarction patients.

Objective To strengthen the voluntary blood donation publicity through the analysis of the voluntary blood donation.Methods The ratio of voluntary blood donation was statistically analyzed between staffs in some Medical institutions in Hangzhou and Ordinary people.Results The ratio of voluntary blood donation in ordinary people is 1.82％,which is higher than the national data (1.05％).The ratio of medical institutions in Hangzhou is 9.54％,which is far higher than ordinary people.The data of provincial,civic and private medical institutions are 10.20％,6.11％ and 15.42％,respectively.Conclusion The ratio of voluntary blood donation is different between different level hospitals,and the staffs in medical institutions are more willing to donate blood than ordinary people.

Objective To standardize the job training and improve the basic professional quality and induction ability of practitioners in Blood Services by setting up job training assessment standardized model.Methods Using the standardize model to carry out the application of standardized model of job training assessment for the practitioners in Blood Services.July 2016-June 2017,focusing on the standardize training materials and training standards to carry out the centralized training,establishing a unified teacher library of the province and the centralized training will be taught by those teachers,evaluating result by standardize theoretical test and the conformity standard,then evaluating and supervising the assessment results.Results 356 practitioners participated in centralized training,379 practitioners participated in the theoretical test,and 339 practitioners were qualified of the actual operation during these two years.The total qualified rate is 89.4％.There was no significant difference in the qualified rate between two years (P＞0.05).Among them,the qualified rate of category Ⅰ personnel was 85.1％,category Ⅱ personnel was 98.7％,category Ⅲ personnel was 94.8％,and the qualified rate of category Ⅱand Ⅲ was higher than that of category Ⅰ (P＜0.05).Conclusion Through the application of the standardized model to promote the standardization of education and training resource standard,and carry on standardized training evaluation as well as strictly grasp the examination and evaluation standards,it will be conducive to improving the quality of education and training,will also be conducive to improving the professional quality of employees and supply institutions.

Objective:To analyze the effects of protein intake of varied dietaries on the pregnancy of pregnant women.Methods:The pregnant women who had their medical records in our hospital were included in this study.Their dietary were collected based on the respective review of their food during 24 hours when they visited the Nutrition Clinics between 24 weeks and 28 weeks.The subjects were divided into six groups according to the dietary calories and protein intake:group A (normal calorie and normal protein),group B (normal calorie and low protein),group C (normal calorie and high protein),group D (high calorie and normal protein),group E (high calorie and high protein) and group F (low calorie and low protein).The gestational diabetes mellitus incidence rates,levels of fasting blood glucose (FBG),blood glucose (BG),hemoglobin Alc (HbAlc),and blood lipids,and bone mineral density were compared among six groups.Results:The gestational diabetes mellitus incidence rate,levels of postprandial blood glucose at 1 hour and 2 hour in groups of B,C,D,and E were significantly higher than those in group A (P ＜ 0.05).The levels of triglyceride,total cholesterol,and low density lipoprotein cholesterol were remarkably higher in groups of B,D,and E than those in group A (P ＜ 0.05).The bone mineral density was significantly lower in group A than that in groups of C,E,and F (P ＜ 0.05).Conclusion:The diet with normal calorie and normal protein is the scientific dietary structure.The pattern with high calorie and high protein intake is not recommended for pregnant women.

Objective:to investigate clinical significance of serum and urine NGAL (Neutrophil gelatinase-associated lipocalin) in the early kidney damage with primary hypertension.Methods:According to UAER ( urinary microalbumin excreting rate ) ,we divided 90 patients with primary hypertension into three groups (<30 mg/24 h,30-300 mg/24 h and >300 mg/24h),and selected 30 healthy people as the control group.Serum and urine NGAL and cystatin C ,serum creatinine,urea nitrogen,high sensitive C reactive protein , transferrin,and basis of blood pressure were detected and followed up one year.Results:Compared with healthy group ,GFR( glomerular filtration rate ) and serum NGAL were decreased significantly in medium and severe proteinuria groups , while urine NGAL was increased.Conclusion:Serum and urine NGAL have been a clear trend changes in kidney damage ,which could be used as a reliable indicator in monitoring renal function of patients with primary hypertension.

Objective To investigate the effect of different temperature moxibustion on serum IL-1β, IL-2 and TNF-αcontents in acute adjuvant arthritis rats and provide a basis for the mechanism of local anti-inflammatory and immune action of moxibustion. Methods A rat model of adjuvant arthritis (AA) was made by Freund’s complete adjuvant (FCA) modeling method. Of 32 SD rats, 8 were randomly selected as a normal group and the other 24 for model making. After successful model making, the rats were randomly allocated to model, treatment 1 and treatment 2 groups, 8 rats each. Treatment 1 and 2 groups received moxibustion. Local temperature at moxibustion point was controlled at (38±1)℃in treatment 1 group and at (45±1)℃in treatment 2 group. Rat serum IL-1β, IL-2 and TNF-αcontents were measured by enzyme-linked immunosorbent assay (ELISA). Results There were statistically significant differences in serum IL-1β, IL-2 and TNF-αcontents between the model, treatment 1 or treatment 2 group and the normal group (P<0.01). There was a statistically significant difference in serum IL-2 content between treatment 1 and the model groups (P<0.01). There were statistically significant differences in serum IL-1β, IL-2 and TNF-αcontents between treatment 2 group and the model or treatment 1 group (P<0.01). Conclusions Moxibustion has a reducing effect on serum IL-1βand TNF-αcontents and a raising effect on IL-2 content. 45℃moxibustion temperature can improve the effect of moxi bustion. The anti-inflammatory action of moxibustion may be through the mechanism of reducing serum IL-1βand TNF-αcontents and raising IL-2 content, which relieve body inflammatory reaction. The action of moxibustion needs proper moxibustion temperature.

Objective To analyze the therapeutic effect of qiweiqingyan aerosol combined with ribavirin in the treatment of herpetic angina of children hand-foot-mouth disease,and to compare the clinical effects with sim-ple use of ribavirin.Methods 160 children with hand foot and mouth disease were divided into two groups by random number table.They were the observation group (80 cases)and control group (80 cases),respectively.Two groups were both given ribavirin aerosol in the treatment,the observation group were added with qiweiqingyan aerosol agent to carry out treatment,then the clinical curative effects of the observation group and control group were copared.Results In the observation group,the total effective rate was 96.25%,and the total effective rate of the control group was 85.00%,the difference between the two groups had statistical significance (χ2 =5.959,P<0.05).Marked effective rate of the observation group was 86.25%.In the control group,the significant efficiency was 37.50%.The difference between the two groups had statistical significance (χ2 =40.300,P<0.05 ).Defervescence time and bleb disappear time were shorter in the observation group compared to the control group,the difference between the two groups was statistically significant (t=47.880,8.063,5.100,all P<0.05).The adverse reactions in the observation group were significantly lower than those in the control group (χ2 =9.608,P<0.05 ),after statistical analysis.Conclusion Using qiweiqingyan aerosol combined with ribavirin in the treatment of children hand foot and mouth herpangina,can significantly shorten the time of treatment,reduce adverse reactions and improve the cure rate.