Objectives To investigate the clinical profile and prognosis of hemophagocytic syndrome (HPS). Methods A retrospective study was carried out to analyze the clinical features and laboratory findings in 28 children with HPS. Fisher's exact probability method and Logistic multivariate regression were used to explore the prognostic risk factors.. Results HPS was clinically characterized by prolonged fever (100%), hepatomegaly (64.29%),and other minor features including respiratory symptoms (53.57%), splenomegaly (50%), hydrops of multiple serous cavity (42.86%), lymphadenectasis (32.14%), jaundice (17.85%), skin rash (14.29%), central nervous system involvement (14.29%), and alimentary tract hemorrhage (10.71%). Labo-ratory data showed that 1iver dysfunction, pancytopenia, coagulation abnormalities, disseminated intravascular coagulation, hy-pertriglyceridemia, decreased number of natural killer cells and hyponatremia were prominent. The etiological analysis indicated that infection associated hemophagocytic syndrome was most common (60.71%), in which EB virus associated HPS was pre-dominant, accounting for 64.71%. Significant difference was observed in the difference of albumin,blood urea nitrogen and acti-vated partial thromboplastin time between death and survival cases (P<0.05). The Logistic regression multivariate analysis showed that hypoalbuminemia was an independent prognostic factor. Conclusions There are various underlying diseases and clinical manifestations for HPS. The lower level of serum albumin is an independent prognostic factor. A prompt diagnosis and treatment is very important for HPS prognosis due to the rapid progression and high mortality.

Objective: To explore the application value of pulmonary ultrasound for the treatment of severe acute respiratory distress syndrome in children with extracorporeal membrane oxygenation(ECMO). Methods: Seven children with severe acute respiratory distress syndrome (ARDS) who were treated with ECMO in the PICU ward of Hunan Children Hospital from August 2018 to March 2019 underwent pulmonary ultrasound before treated with ECMO, after each bronchoscopy and lavage, before ECMO withdrawal, and within 24 hours after ECMO withdrawal. Performance of pulmonary ultrasound and clinical data were retrospectively reviewed. Results: Seven patients treated with ECMO for 11.5(3-27)days, and 1 patient underwent ECMO transport. Six (86.7%) patients were successfully weaned from ECMO, and 1 (14.2%) patient failed to exit ECMO successfully. Four(57.1%) patients were discharged from hospital, and 3(42.8%) patients eventually died. In various diagnostic signs of pulmonary ultrasound were detected in 7 patients, including pulmonary edema (7 cases), lung consolidation (5 cases), followed by pleural effusion (4 cases), atelectasis (3 cases) and pneumothorax (3 cases). Pulmonary ultrasound showed that the lungs were re-expanded and suggested that the child could attempt to evacuate the ECMO. Conclusions Pulmonary ultrasound can comprehensively evaluate the various lung lesions in children with ECMO treatment, and can dynamically monitor the process of lung recruitment in real time, providing a reference for guiding the evacuation of ECMO.

We reported a case of preeclampsia complicated by acute stress cardiomyopathy following cesarean section at 37 weeks of gestation. The patient presented with chest tightness and suffocation two days after the operation and was considered as acute stress cardiomyopathy. The patient recovered and was discharged nine days after the surgery after a series of management, including non-invasive ventilation, vasodilation, lowing blood pressure, maintaining a negative fluid balance, anti-infection, and anticoagulation. Stress-induced cardiomyopathy during pregnancy and postpartum is rare, and cesarean section and preeclampsia may be the risk factors.

Objective To explore the application value of pulmonary ultrasound for the treatment of severe acute respiratory distress syndrome in children with extracorporeal membrane oxygenation( ECM O ) . Methods Seven children with severe acute respiratory distress syndrome ( ARDS ) w ho were treated with ECM O in the PICU ward of Hunan Children Hospital from August 2018 to M arch 2019 underwent pulmonary ultrasound before treated with ECM O , after each bronchoscopy and lavage , before ECM O withdrawal ,and within 24 hours after ECM O withdrawal . Performance of pulmonary ultrasound and clinical data were retrospectively reviewed . Results Seven patients treated with ECM O for 11 .5( 3－27) days ,and 1 patient underwent ECM O transport . Six ( 86 .7% ) patients were successfully weaned from ECM O ,and 1 ( 14 .2% ) patient failed to exit ECM O successfully . Four( 57 .1% ) patients were discharged from hospital , and 3( 42 .8% ) patients eventually died . In various diagnostic signs of pulmonary ultrasound were detected in 7 patients ,including pulmonary edema ( 7 cases ) ,lung consolidation ( 5 cases ) ,followed by pleural effusion ( 4 cases) ,atelectasis ( 3 cases) and pneumothorax ( 3 cases ) . Pulmonary ultrasound showed that the lungs were re‐expanded and suggested that the child could attempt to evacuate the ECM O . Conclusions Pulmonary ultrasound can comprehensively evaluate the various lung lesions in children with ECM O treatment ,and can dynamically monitor the process of lung recruitment in real time ,providing a reference for guiding the evacuation of ECM O .

Objective:To analyze the clinical features and ultrasonographic features of Williams syndrome(WS) in children, and to explore the diagnostic value of ultrasonography in this disease.Methods:A retrospective analysis was performed on 19 children with abnormal echocardiography at Hunan Children′s Hospital from January 2016 to December 2020, and the abnormal echocardiography was evaluated by WS phenotypic scoring method of American Academy of Pediatrics.Cardiological CT and genetic tests were performed, and the clinical data and ultrasound image characteristics were analyzed.Results:The WS score of 19 cases was more than six, which was highly suspicious clinically.In 19 cases, supra-aortic stenosis and pulmonary stenosis were the most common findings on echocardiography, accounting for 63.2%(12/19), among which three cases were complicated with aortic arch constriction and one case with mitral lobe deformity.There were 15.8%(3/19)children with supra-aortic stenosis associated with pulmonary artery velocity increase, and 10.5%(2/19)children with left and right pulmonary artery branch stenosis associated with aortic inner diameter narrowing.Other cardiac malformations were found in 42.1%(8/19) of the children.Chromosome 7 microdeletions accounted for 68.4%(13/19) in genetic examination, and no abnormalities were found in three cases(15.8%, 3/19). The genetic results of three cases were still under follow-up.Conclusion:Echocardiography can accurately and sensitively detect cardiac lesions in children with WS.Combined with WS score of American Academy of Pediatrics, the diagnosis rate of WS can be improved.

In recent years, the issue of conflicts of interest in the transformation of scientific and technological achievements in medical institutions in China has become prominent, mainly manifested as personal and institutional conflicts of interest, with the characteristics of complexity and sustainability. At present, there were some problems in the conflict management of scientific and technological achievements transformation of medical institutions, such as insufficient support of relevant laws, regulations and policies, insufficient supervision of medical institutions, and the lack of industry management atmosphere. The author suggestted that government departments should strengthen the formulation of relevant policies and regulations, medical institutions should establish an interest conflict management system and an independent management department, and industry associations should give full play to their role in assisting, so as to provide reference for promoting medical institutions to effectively manage interest conflicts in the transformation of scientific and technological achievements.

Objective To investigate the effect of the Shaofu zhuyu decoction on the changes of the body writhing behavior,inflammatory reaction and COX-2 expression of the rats with the primary dysmenorrhea. Methods Fifty SD female rats were randomly divided into blank control group,model control group,high,middle and low dose of Shaofu zhuyu decoction groups,10 in each group.Dysmenorrhea rat model was established by treating with estradiol benzoate and oxytocin.Effect of Shaofu zhuyu decoction of different doses on writhing behavior,changes of endometritis cells and COX-2 expression in uterine smooth muscle of dysmenorrhea rats were observed. Results In the model control group,latency of the body writhing behavior was shortened and the total score was high,many inflammatory cells (especially for neutrophils) infiltrated in endometrium and uterine smooth muscle,immunohistochemistry showed that brown granules were found in the cytoplasm of smooth muscle cells of uterus,and COX-2 expression was positive in uterine smooth muscle cells.As compared with the model control group,writhing latency increased,total score decreased in both the high and middle dose of Shaofu zhuyu decoction groups,and infiltration of a small number of inflammatory cells was seen in the endometrium and smooth muscle(P<0.01);COX-2 expression was decreased (P<0.01) especially for the high dose of Shaofu zhuyu decoction group.As compared with the model control group,the latency of the low dose of Shaofu zhuyu decoction group was significantly increased,and the total score was decreased(P<0.01),but there was no significant difference in inflammatory cell infiltration and COX-2 expression (P>0.05). Conclusion A potential mechanism by which Shaofu zhuyu decotion treats primary dysmenorrhea may be related with alleviating pain,inhibiting inflammatory responses,and down-regulating expression of COX-2.

Objective:To study the effects of recombinant human erythropoietin (rhEPO) on cerebral blood flow (CBF) in preterm infants using arterial spin labeling (ASL) magnetic resonance imaging (MRI).Methods:From September 2021 to June 2022, preterm infants (gestational age ≤32 weeks, birth weight ≤1 500 g) admitted to NICU of our hospital within 24 h after birth were randomly assigned into rhEPO group and control group for this prospective study. The rhEPO group was given rhEPO (500 IU/kg iv, once every other day for 2 weeks) within 72 h after birth plus symptomatic supportive treatment. The control group received same amount of normal saline injection. Both groups received brain MRI, diffusion-weighted imaging and ASL at adjusted gestational age of 35~37 weeks and CBF values of interested areas were measured.Results:A total of 85 infants were enrolled, including 40 in the rhEPO group and 45 in the control group. No significant differences existed in the incidences of periventricular-intraventricular hemorrhage, periventricular leukomalacia, focal white matter injury and extensive white matter injury between the two groups ( P>0.05). The CBF values [ml/(100 g·min)] of frontal cortex [left 15.1±3.9 vs. 17.9±3.1, right 15.9 (12.5, 17.8) vs. 18.1(16.1,20.2)], temporal cortex [left 15.8±4.3 vs. 18.6±3.8, right 16.3(13.2,19.4) vs. 18.1(15.7,19.7)], occipital cortex (left 15.8±6.1 vs. 18.8±3.3, right 16.8±5.5 vs. 19.3±4.8), basal ganglia (left 24.7±7.2 vs. 28.7±6.2, right 26.0±7.9 vs. 29.3±6.4) and thalamus (left 32.7±11.8 vs. 37.9±8.6, right 32.1±11.6 vs. 37.6±10.2) in the rhEPO group were significantly lower than the control group ( P<0.05). No significant differences existed of CBF value at the parietal cortex between the two groups ( P>0.05). Conclusions:Early application of rhEPO can reduce CBF in premature infants, which may be related to the neuro-protective effects of EPO.

Objective:To understand the characteristics of HIV-related risk behaviors and needs for prevention services among males who sell sex for money or anything of value (commonly known as money boys or MB), and to provide evidence for the development of targeted interventions.Methods:Using non-probability purposive sampling method and one-on-one interviews.Results:A total of 28 MBs were interviewed, with age range between 20 and 67, and education primarily at junior high school level. Among them 6 were married. Their household registration for residency cut across 15 provinces, and their sexual orientation is diverse. They migrate primarily among tier one cities and provincial capitals. Most enter the trade for economic reasons, relying on clubs and personal networks to find clients, and on word of mouth to obtain knowledge and skills. In addition to their primary clientele of the male homosexual community, 5 out of 28 serve male heterosexuals and 6 out of 28 also serve females. They have some awareness of self protection from diseases, primarily from word of mouth. Nevertheless, over half of them cannot maintain consistent condom use, and 12 out of 28 have a history of illegal drug use. Three of them reported being tested positive for HIV, and all continue to engage in sex work. They prefer their communication messages to be simple and straight-forward. Privacy comes first when they are accessing testing and treatment services.Conclusion:The bridge role of the MB community in transmitting HIV to the general population cannot be ignored, and interventions targeting the MB population need to be strengthened.

Objective:To summarize the experience of personalized treatment of pediatric prepuce trauma.Methods:The clinical data of children with prepuce trauma treated in the Department of Pediatric Surgery of the First Affiliated Hospital of Zhengzhou University from January 2019 to March 2021 were analyzed retrospectively. First, pediatric prepuce trauma was classified and graded before treatment, and then the treatment plans were developed with the informed consent of the children’s parents. Mild injuries were treated conservatively. In moderate injuries, in situ suture repair and frenuloplasty were performed. In severe injuries, modified circumcision and prepuce flap prepuceplasty were performed. In extremely severe injuries, composite flap (scrotal and mons pubis flap combined with prepuce flap) prepuceplasty was performed. The children were followed up for penile appearance and urinary and erectile function postoperatively.Results:A total of 36 male children, aged 6 months to 10 years, were enrolled in the study. Type of foreskin trauma: 7 cases of foreskin tie injury, 7 cases of inner plate injury, 12 cases of outer plate injury, and 10 cases of combined inner and outer plate injury; degree of foreskin trauma: 9 cases of mild injury, 6 cases of moderate injury, 19 cases of severe injury, and 2 cases of extremely severe injury. 9 of the 36 cases were treated conservatively; 4 cases were treated with in situ suture repair; 5 cases were treated with in situ suture repair + circumcision; 12 cases were treated with modified circumcision; 4 cases were treated with foreskin flap penile circumcision, and composite flaps (scrotal and mons pubis flaps as advancement flap + prepuce flap) were applied in 2 cases. All the children were followed up for 3~6 months. The appearance of the penis and scrotum was good, and the urination and erectile function were normal after treatment. The parents of the children were satisfied with the treatment results.Conclusions:For the treatment of pediatric prepuce trauma, it is necessary to comprehensively consider the location of the prepuce involved and the degree of prepuce injury and adopt an appropriate personalized treatment plan, which can achieve better results.