Asphyxiation by an inhaled foreign body is a leading cause of accidental death among children younger than three years.The species of foreign body aspiration are many and varied.Immediately after inhalation the child starts to cough,wheeze,or have laboured breathing.The clinical manifestation will be different when foreign body stays in different part of bronchial tree.It's extremely easy to cause misdiagnosis.No matter whether aspiration or not,bronchoscopy should be taken.The bronchoscopy is not only the means of diagnosis,and removes the foreign body at the same time which helps to treat timely.

OBJECTIVE:To introduce water processing treatment technology and equipment for hospital manufacturing laboratory.METHODS:According to the relevant standards recorded in China Pharmacopoeia and electric conductivity,water quality of purified water manufactured by3kinds of techniques were evaluated.The advantages and disadvantages of these techniques were compared with regard to the utilization of source water,convenience of operation,environmental pollution,and so on.RESULTS:Purified water manufactured by these3kinds of techniques all met the standards recorded in China Phar?macopoeia,best quality was obtained by the technique of combining ion exchange with first order reverse osmosis,the next in order is obtained through the combination of second order reverse osmosis with electrode ionization(EDI).The purified water could be distilled to be water for injection which meets the standard in China Pharmacopoeia.CONCLUSION:Combination of second order reverse osmosis with EDI is the optimal water processing technique considering quality of purified water,utiliza?tion of source water,convenience of operation,environmental pollution and so on.Multiple distillation technology is the main artwork to prepare water for injection.

Objective To investigate the effects of different concentrations of ketamine on the differentiation of human T helper (Th) cells.Methods Twenty ASA Ⅰ patients (aged 20-60 years) undergoing elective operation under general anesthesia were enrolled in this study.Peripheral venous blood samples were taken before anesthesia.Peripheral blood mononuclear cells were isolated and divided randomly into three groups (n =20 each):being incubated in the presence of 0.9％ NaCl (group C),2.5 μg/ml ketamine (group K1) and 25.0 μg/ml ketamine (group K2),respectively,for 24 hours,and were then stimulated with phytohaemagglutinin for 48 hours,respectively.The percentages of Th1 and Th2 cells were detected by four-color fluorescence flow cytometry.The Th1/Th2 ratio was calculated.The levels of interleukin-2 (IL-2),IL-4,IL-6,IL-10,immunoreactive fibronectin-γ (IFN-γ) and tumor necrosis factor-alpha (TNF-α) in the supernatant were determined by cytometric bead array.Results There was no significant difference in the levels of IL-2,IL-4,IL-6,IL-10,IFN-γ and TNF-α in the supernatant,the percentages of Th1 and Th2 cells and the ratio of Th1/Th2 among groups C,K1 and K2(P＞ 0.05).Conclusion The sedative and anesthetic concentrations of ketamine exert no effect on the differentiation of human Th cells in vitro.

ObjectiveTo investigate the effects of different concentrations of ketamine on the differentiation of human T helper (Th) cells.MethodsTwenty patients ASA Ⅰ,20-60 years undergoing elective operation under general anesthesia were enrolled in this study.Peripheral venous blood samples were taken before anesthesia.Peripheral blood mononuclear cells were isolated and assigned to one of 3 groups ( n ＝ 20 each).Peripheral blood mononuclear cells were incubated in the presence of 0.9％ NaCl (group C),2 concentrations of ketamine (2.5,25.0 μg/ml) (groups K1,K2) for 24 h,and were then stimulated with phytohaemagglutinin for another 48 h.The perce.ntage of Thl and Th2 cells were detected by four-color flow cytometry.The Thl/Th2 ratio was calculated.The IL-2,IL-4,IL-6,IL-10,IFN-γ and TNF-α concentrations in the supernatant were determined by cytometric bead array.ResultsThere was no significant difference in the IL-2,IL-4,IL-6,IL-10,IFN-γ and TNF-α concentrations in the supernatant,the percentage of Thl and Th2 cells and Thl/Tb-2 ratio among groups C,K1and K2 ( P ＞ 0.05).ConclusionsThe sedative and anesthetic concentrations of ketamine exert no effect on the differentiation of human Th cells in vitro.

Objective:To analyze the clinical applicability of the sixth edition of nursing measures classification in children's general surgery, to provide a basis for standardizing clinical nursing terms and to promote the clinical use of standardized terminology of nursing measures.Methods:The research method of this study was mapping method. The electronic nursing records of the general surgery of Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine from October 1st to December 31st, 2018, including the records of care records for free entry and the records of nursing measures related to medical orders were selected. The degree of matching between electronic care records and classification of nursing measures (sixth edition of nursing measures classification) was compared with conceptual consistency. Difficulties and time-consuming analysis of the characteristics of the standardized care measures obtained by matching.Results:A total of 4 560 independent electronic care records mapped 86 treatments in seven areas. Among them, 98.84% (4 507/4 560) of the nursing records were completely matched with the nursing measures, 0.83% (38/4 560) of the nursing records were partially matched with the nursing measures, and 0.33% (15/4 560) of the nursing records did not match the nursing measures. Difficulty and time-consuming were expressed as standard deviation, which were 2.20±0.45 and 2.03±1.25 respectively.Conclusions:The classification of nursing measures can be used to describe the daily behavioral activities of the children's general surgery nurses, and can also solve the standardization problem of the nursing records in the presentation, and is suitable as a standardized nursing language for the nursing records of children's general surgery.

Objective To investigate the ultrasonic and pathological features of porcine striped muscle injury from thermal and chemical factors respectively, and to analyze the limitation of ultrasound diagnosis given by doctors with different skill levels. Methods An experimental study using fresh porcine striped muscle in vitro was designed, where the injury were caused by microwave ablation (2 450 MHz) and Anhydrous acetic acid (99.8%) injection separately. Blind to pathologic results, the two-dimensiona sonograms taken from each model were analyzed by sonographers with different skill levels independently. Finally, the diagnoses were evaluated and compared among them. Results Two-dimensional sonograms showed distinct changes of the textures in both injury models, which was characterized as the disappearance of regular tissue structure. However, the corresponding histopathology revealed obvious differences between the two interventions on ultrasonograms. There was no statistical difference between chief physician and attending doctor (both of them had over 5-year experiences on skeletal muscle ultrasound ) in identifying the ultrasonic features of boundary, shape and muscle texture (Kappa=0.933, 0.845, 0.789;Kappa=0.790, 0.935, 0.865, all P<0.05). Compared with residents′diagnosis, there were signiifcant differences in identifying the ultrasonic features of echo level and muscle texture in both injury models:Echo level in thermal injury group:chief physician vs residents, Kappa=0.323;attending doctor vs residents, Kappa=0.297. Texture feature in thermal injury group:chief physician vs residents, Kappa=0.259;attending doctor vs residents, Kappa=0.112. Texture feature in chemical injury group:chief physician vsresidents, Kappa=0.253;attending doctor vs residents, Kappa=0.070. Conclusions Microwave ablation and Anhydrous acetic acid can cause different histopathologic changes in correspondence with various features on two-dimensional sonograms. But ultrasonographers with different skill levels leads to signiifcant variations in identiifcation and qualitative diagnosis, which is impossible to be quantitatively analyzed. Chief physician and attending doctor can draw a consistent conclusion and demonstrate the ultrasounic characteristics in porcine striped muscle injury model from thermal or chemical factors.

Objective To explore the prognostic value of pre-chemotherapy serum cystatin C (Cys C) in patients with castration-resistant prostate cancer (CRPC).Methods The medical records of 48 patients with CRPC were reviewed.These patients were diagnosed and underwent docetaxel-based chemotherapy in Xinjiang Military Command General Hospital between January 2009 and January 2015.Statistical analysis was performed to identify the clinical and prognosis value of Cys C.Results Of 48 patients with CRPC,the expression of serum Cys C before chemotherapy was related with Gleason score (x2 =4.218,P =0.040) and distant metastasis(x2 =4.090,P =0.043).23 patients was in high group (Cys C ＞ 1.61 mg/L),25 in low (Cys C ≤ 1.61 mg/L).The median survival time of high group and low group were 15.6 and 25.3 months,respectively (x2 =13.876,P ＜ 0.001).Univariate analysis showed that TNM stage (x2 =6.934,P =0.018),Gleason score (x2 =7.933,P =0.005),baseline prostate specific antigen (PSA) (x2 =9.038,P =0.003),number of chemotherapy cycles (x2 =5.024,P =0.028),distant metastases (x2 =6.963,P =0.013) and serum Cys C before chemotherapy (x2 =6.976,P =0.012) were associated with overall survival of patients with CRPC.COX multivariate analysis showed that baseline PSA at diagnosis (x2 =4.257,P =0.039),number of chemotherapy cycles (x2 =6.245,P =0.017),distant metastases (x2 =5.122,P =0.028) and serum Cys C before chemotherapy (x2 =8.172,P =0.004) were independent risk factors of overall survival of patients with CRPC,especially serum Cys C before chemotherapy (HR =2.394).Conclusion The patients with high Cys C level have poor prognosis,and the pre-chemotherapy Cys C is an independent risk factor for prognosis of CRPC patients treated with docetaxel-based chemotherapy which can be used as an effective indicator to assess the prognosis of CRPC.

ABSTRACT:Objective To study the effect of curcumin on the learning and memory ability in a rat model of Alzheimer’s disease (AD).Methods AD rat model was prepared using intraventricular injection of Aβ1-42. Curcumin was acutely (single injection before the behavioral tests)or chronically (injected for 6 consecutive days) injected intraperitoneally at doses of 50,100 or 300 mg/kg.Brain-derived neurotrophic factor (BDNF)protein (1 μg/side)or BDNF shRNA (2×10 5 units/side)was infused into the hippocampus.The behavioral changes in Y-maze,open field test and Morris water maze and the expression of BDNF in the hippocampus were analyzed. Results Acute treatment with curcumin had no significant effects on the spontaneous alteration,locomotor activity or water maze latency of AD rats.AD rats treated chronically with curcumin (300 mg/kg ) showed significant elevation in the spontaneous alternation (P <0.000 1)in Y-maze and memory ability in the water maze test (P <0.05 )compared with those in the saline group.Chronic treatment with 100 and 300 mg/kg of curcumin induced an increased level of BDNF in the hippocampus as compared with the saline controls (P <0.05 and <0.000 1). Intrahippocampal injection of BDNF significantly decreased the escape latency of AD rats in the water maze (F 4,2 9 5=5.813,P <0.01 ).Rats chronically injected with curcumin combined with shBDNF showed no difference in the swimming time in Ⅱ quadrant as compared with saline controls (P =0.657).However,rats in 100 mg/kg curcumin group,BDNF group and sham group had significantly increased swimming time than the saline controls (P <0.05, P <0.05 and P <0.000 1,respectively).Conclusion Curcumin may activate the downstream signaling pathways by upregulating the expression of BDNF and ultimately contribute to the improvement of learning and memory in AD rats.

Objective To discuss the application effect of task-driven basic nursing probation based on the action research. Methods Using the frame of Lewin's action research, with random sampling, we selected a class for the study, for the first time in the traditional training model, and the second time in the task-driven model based on the action research. and information was collected according to the interviews and diary records, narrative description was used for records of the results. Results Action research promoted changes in basic nursing probation model, constructed knowledge, ability and improved various kinds of ability of nursing students. Conclusions The task-driven probation model improved the quality of clinic practice, which proved to be effective.

Objective To evaluate the ultrasonic feature and clinical significance of persistent left superior vena cava(PLSVC)in fetal life.Methods Fetal echocardiography was performed in 3368 fetuses.Thirty-one fetuses of PLSVC were confirmed.Results The dilated coronary sinus was observed in 30 of 31 fetuses.Congenital heart defects were presented in 14 of these cases,and extracardiac anomalies were presented in 6 fetuses.Both congenital heart defects and extracardiac anomalies were observed in 4 fetuses.Conclusions PLSVC is always associated with congenital heart defects.The prognosis Of affected fetuses largely depends on whether or not the PLSVC is associated with a congenital heart defect.Prenatal diagnosis of PLSVC can help US plan perinatal counseling and ameliorate the postnatal course.