Objective To improve the pipeline which is the second grade of oxygen pressure reducer in order to reduce the oxygen resistance. Methods This device accesses oxygen storage devices in the original pipeline which absorbs oxygen in the atmospheric with the second grade pressure reducer. Results Accessing oxygen storage devices almost can eliminate the additional resistance which is produced by the second pressure reducer. Conclusion The accessing device fully meets the demand of the people with weak breathing, who accesses oxygen for oxygen therapy via the second grade pressure reducer. Meantime, the device expands the scope of services and efficacy of the medical equipment.

Objective To study the correlation between apolipoprotein E (APOE) genetic polymorphisms and sepsis in Chinese children.Methods The inpatients suffered with sepsis were enrolled as septic group and the healthy children from child health division were enrolled as control group.The study of APOE genotypes were carried out by polymerase chain reactions followed a high-resolution melting curve analysis.SPSS 16.0 statistical software was used for data analysis.Mann-Whitney U test was used to compare the age between the groups.Hardy-Weinberg equilibrium was tested using the Pearson x2-test.The x2-test was used to compare gender and the genotype distribution between the groups.The odd ratio (OR) was calculated together with its 95％ confidence interval (CI).Potential confounding effects of variables were corrected using a multivariate unconditional logistic regression model.All statistical tests were two-sided and P ＜ 0.05 indicates statistically significance.Results Among a total of 285 children collected from March 2011 to June 2012,there were 88 patients with sepsis and 197 healthy children.In the septic group,15 septic patients were complicated with central nervous system infection.Four apolipoprotein E genotypes were identified to be ε3/ε3,ε2/ε3,ε3/ε4,and ε2/ε4.The percentage of each genotype found in patients of the septic group and the control group was 64.4％ vs.73.1％ (ε3/ε3);16.8％ vs.10.7％ (ε2/ε3);18.8％ vs.14.7％ (ε3/ε4);0％ vs.1.5％ (ε2/ε4),respectively.The number of patients with the genotype ε3/ε3 among septic patients was significantly lower than that among the control individuals (P =0.047,1-β =0.334,OR =0.585,adjusted OR =0.559).The number of patients with the genotype ε3/ε3 among the septic patients with central nervous system infection was 33.3％,which was also significantly lower than that among the septic patients without CNS infection (67.1％).(P =0.014,1-β5 =0.685,OR =0.245,adjusted OR =0.275).Conclusions Apolipoprotein E genetic polymorphisms were associated with the occurrence of sepsis and central nervous system complications in children.The susceptibility of children with genotype ε3/ε3 to sepsis and central nerve system infection complications is significantly lower than that of children with other genotypes.

A novel near-infrared (NIR) diffuse correlation spectroscopy (DCS) has recently been developed for noninvasive monitoring of tumor blood flow during photodynamic therapy (PDT).DCS offers several attractive new features for tumor blood flow measurement such as noninvasiveness,portability,low cost,high temporal resolution and relatively large penetration depth.DCS technology has been utilized for continuous measurement of tumor blood flow before,during and after PDT in both animals and humans.The ultimate goal is to predict treatment outcomes from the measured tumor hemodynamic responses to PDT.

Objective To compare 6 sub-function scale differences of frontal lobe function rating scale or a Frontal Assessment Battery(FAB)among patients with two subtypes of vascular cognitive impairment(VCI) to provide clues for the distinctive intervention and disease prevention and control of patients with two subtypes.Methods Totally 220 non-dementia vascular cognitive impairment (NDVCI)patients and 68 patients with vascular dementia(VaD)with final diagnosis were selected.The overall function and six sub-function scores were tested by FAB.Analyzing the score difference and probing a progress tendency from NDVCI to VaD were performed.Results The scores of frontal lobe function rating scale were higher in NDVCI(14.0 ± 2.8)than in VaD (9.5±2.0) patients with significant difference(t =29.92,P =0.00).The scales of frontal lobe function rating score of conceptualization ability (t =6.24,P =0.00),intelligence flexibility (t =7.00,P =0.00),antiinterference ability(t =7.21,P =0.00) and attention suppression(t =5.32,P =0.00) were lower in VaD group than in NDVCI group.The conceptualization weight capacity was significantly lower in VaD group than in NDVCI group(0.04 versus 0.32).Conclusions During a transitive process from NDVCI to VaD,it is important to focus on the mutation and deterioration of conceptualization capacity.

Objective:To evaluate the efficacy of Qingqi Huatan Decoction combined with conventional western medicine therapy in the treatment of severe pneumonia with phlegm-heat obstructing the lung syndrome.Methods:A total of 84 patients with severe pneumonia with phlegm-heat obstructing lung syndrome admitted to Zhangjiagang Hospital of Traditional Chinese Medicine from February 2018 to June 2020 were randomly divided into two groups, 42 in each group. The control group was treated with bronchoalveolar lavage (BAL) on the basis of routine treatment, and the combined group was treated with Qingqi Huatan Decoction on the basis of the control group. Both groups were treated for 7 days. The Clinical Pulmonary Infection Score (CPIS) was used to evaluate the degree of pulmonary infection, and the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) was used to evaluate the severity of the disease. The Serum CRP and IL-6 levels were detected by ELISA, and procalcitonin (PCT) levels were detected by electrochemiluminescence method to evaluate clinical efficacy.Results:The total effective rate was 88.1% (37/42) in the combined group and 69.0% (29/42) in the control group, with a statistically significant difference between the two groups ( χ2=4.53, P=0.033). After treatment, the CPIS (2.19±0.42 vs. 3.66±0.69, t=11.79) and APACHE Ⅱ (9.84±1.31 vs. 11.25±3.22, t=2.63) in the combination group were significantly lower than those in the control group. The serum CRP, PCT, and IL-6 levels in the combination group were significantly lower than those in the control group ( t=30.32, 8.59, 6.08, all Ps<0.001). During the treatment period, there was no obvious abnormality of liver and kidney function in both groups. Conclusion:Qingqi Huatan Decoction combined with conventional western medicine therapy can reduce the degree of pulmonary infection in patients with severe pneumonia with phlegm-heat obstructing the lung syndrome, reduce the level of inflammatory cytokines, and improve clinical efficacy.

Objective:To prospectively investigate the prevalence of heparin-induced thrombocytopenia (HIT) in critically ill children during extracorporeal membrane oxygenation(ECMO) and explore the clinical characteristics and prognosis of HIT during ECMO.Methods:A total of 22 critically ill children, who had received ECMO support for more than 96 hours in the Intensive Care Unit at the Children′s Hospital of Fudan University from March 2019 to December 2020, were enrolled.According to the 4T score and the heparin/platelet factor 4(PF4) antibody, children whose 4T scores were not less than 6 and heparin/ PF4 antibodies were positive, were classified into HIT group ( n=6), and non-HIT group ( n=16). The clinical outcomes and the incidence of thrombotic events were compared between two groups. Results:The incidence of HIT during ECMO in critically ill children was 27% in this study.The incidence of thrombosis in the ECMO circuit in the HIT group was higher (100% vs.63%, P=0.133), and the average time to the first thrombosis in ECMO circuit in the HIT group was shorter than that in the non-HIT group (3.70 d vs.5.44 d, P=0.06). During the first 14 days of ECMO, the proportion of children with thrombotic events no less than twice was higher in the HIT group (67% vs.19%, P=0.054). There was no significant difference regarding the survival rate at 28 days after ECMO withdrawal between two groups (33% vs.50%, P=0.664). Conclusion:The prevalence of HIT during ECMO in critically ill children is high.Thrombosis events tend to occur earlier and more extensively in children with HIT during ECMO.No significant effect of HIT on the survival rate of children during ECMO is found.Whether HIT has effect on the survival rate of children with ECMO requires a prospective and large clinical study.

Objective:To evaluate the clinical effect and safety of Qufeng-Zhike prescription in the adjuvant treatment of cough variant asthma (CVA) with severe wind and acute narrow airway syndrome. Methods:A total of 82 patients with CVA with severe Wind and acute narrow airway syndrome, meeting the inclusion criteria in the hospital, were divided into control group and observation group by random number table method between September 2018 and September 2020, with 41 in each group. The control group was treated with budesonide formoterol dry powder inhalation, while the observation group was treated Qufeng-Zhike prescription on basis of control group. Both were treated for 8 weeks. Before and after treatment, scores of TCM symptoms was recorded. The forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and peak expiratory flow (PEF) were detected by spirometer. The peripheral blood eosinophil (EOS) count was detected by full-automatic blood cell analyzer. The level of fractional exhaled nitric oxide (FeNO) was detected by expiration analyzer. The quality of life was evaluated by Leicester cough questionnaire (LCQ). The adverse events were recorded, and clinical curative effect was evaluated. Results:The differences in total response rate of TCM syndromes between observation group and control group was statistically significant [97.6% (40/41) vs. 82.9% (34/41); χ2=4.986, P=0.026]. At 1, 2 and 8 weeks after treatment, scores of TCM syndromes in observation group were significantly lower than those in the control group ( t=2.104, 5.329, 3.527, P<0.05 or P<0.01). After treatment, FEV1 (2.78 ± 0.41 L vs. 2.56 ± 0.37 L, t=2.551), FVC (3.55 ± 0.50 L vs. 3.24 ± 0.44 L, t=2.980) and PEF (357.58 ± 70.98 L/min vs. 316.30 ± 75.60 L/min, t=2.549) in observation group were significantly higher than those in the control group ( P<0.05), while peripheral blood EOS count [(0.26 ± 0.07)×10 9/L vs. (0.30 ± 0.09)×10 9/L, t=2.246], FeNO level (22.55 ± 7.83 μg/L vs. 28.87 ± 9.36 μg/L, t=3.316) and LCQ score (5.62 ± 1.71 vs. 7.04 ± 2.28, t=3.190) were significantly lower than those in the control group ( P<0.05). During treatment, there were no obvious adverse events (liver and kidney function damage) in either group. Conclusion:The adjuvant treatment with Qufeng-Zhike prescription can help to alleviate allergic reactions, improve clinical symptoms, lung function and quality of life in patients of CVA with severe wind and acute narrow airway syndrome.

Objective:To investigate the correlation and consistency between the parameters of the thromboelastography(TEG) and of routine coagulation tests and platelet count(PLT) in critically ill children in the pediatric intensive care unit.Methods:We conducted a retrospective analysis on the results of the simultaneous TEGs, coagulation tests and PLT of 231 children in pediatric intensive care unit at Children′s Hospital Affiliated to Fudan University from March 2019 to July 2019, including the correlation analysis, the chi-square test and Kappa consistency analysis.Results:The reaction time(R) was linearly dependent on activated partial thromboplastin time(APTT), prothrombin time(PT) and thrombin time(TT), respectively.The maximal amplitude(MA), clot time formation(K) and alpha-angle(α) were linearly dependent on fibrinogen.The MA, K and α were linearly dependent on PLT, too.And the correlation between MA and PLT was the best( R=0.656). There were significant differences( P<0.001) and poor consistency(Kappa value: 0.112, 0.047, 0.124) between R and APTT, PT, TT.There was no significant difference( P>0.05) and there was moderate consistency(Kappa value: 0528, 0.518, 0.408) between Ma, K, α and PLT.There were significant differences( P<0.001) and the consistency was poor or fair(Kappa value: 0.324, 0.188, 0.170) between Ma, K, α and fibrinogen. Conclusion:TEG is significantly correlated with PLT in evaluating platelet function and the consistency is good.The TEG parameters are linearly correlated with the relevant results of routine coagulation tests in evaluating the coagulation factor and fibrinogen function, but consistency is weak.Therefore, it is concluded that these two methods are irreplaceable.

Objective:To summarize the experience of the precise prevention and control strategy of novel coronavirus infection in the pediatric intensive care unit(PICU)during the epidemic of the Omicron variant.Methods:A retrospective analysis was performed on the strategies and management experience of precise prevention and control of novel coronavirus infection in PICU at Pediatric Hospital of Fudan University from March 1 to May 10, 2022.Results:According to the national and Shanghai novel coronavirus infection prevention and control standards, the PICU in our hospital, in accordance with the specialty characteristics of PICU, cooperated with the hospital′s department of infection and medical department to jointly construct a precise ward management strategy for the outbreak of the omicron mutants infection.Precise prevention and control management strategies were formulated from four aspects: the admission process of critically ill children, the division of PICU ward areas and nosocomial infection protection, the reception management system for children′s family members, and the " bubble management" system for PICU staff, and run them for 3 months.During the epidemic, there was no nosocomial infection of novel coronavirus infection in children or medical staff.During the period, a total of 140 critically ill children were admitted, including 87 cases transferred from the general ward in the hospital, 48 cases from the emergency department(non-febrile, 3 cases transferred by the transfer team), four cases from fever clinic, and one case from control ward.Four of the critically ill children had no emergency nucleic acid test report when they were admitted to the PICU.Among the 140 critically ill children, 54 patients received mechanical ventilation, 18 patients received blood purification, and two patients were monitored after liver transplantation.Seventy-eight (55.7%) children had underlying diseases.Conclusion:During the current round of novel coronavirus epidemic in Shanghai, PICU in our hospital formulated the admission and ward management procedures for critically ill children, which ensured the prevention and control of nosocomial infection of novel coronavirus, and at the same time ensured the treatment of critically ill children to the greatest extent.

Objective: To translate the English version of the Pressure Ulcer Risk Primary or Secondary Evaluation Tool (PURPOSE T) into Chinese and evaluate its reliability and validity. Methods: Firstly, PURPOSE T was translated and revised, cross-cultural debugging, and then 213 inpatients from Jiangsu University Affiliated Hospital from November 2017 to May 2018 were selected for investigation. Choosing the total item content validity index (S-CVI/Ave) and the content validity of the item level content validity index (I-CVI) to evaluate content validity, using the Chinese version of the Braden scale as the criterion to measure the validity-related validity of the Chinese version of PURPOSE T. The internal consistency reliability Cronbach α coefficient, the assessor reliability, and the test-retest reliability measure the reliability. Results: The Chinese version of PURPOSET S-CVI was 0.967; I-CVI was 0.6-1.0, The coefficients between PURPOSET and Braden scale in mobility, activity ability, perception status, nutritional status and humidity were 0.600, 0.661, 0.699, 0.519, and 0.783. The PURPOSET and Braden scales had a correlation coefficient of 0.407 in predicting the risk of pressure injury. The Cronbach α=0.859 of the evaluation tool, the assessor reliability were 0.87 and the correlation coefficient of the 2 measurements of the test-retest reliability were 0.91. Conclusions The Chinese version of PURPOSET has good reliability and validity and can be used as a risk assessment tool for pressure injury in hospitalized patients in China.