Objective To investigate the adrenal histopathology damage in critically ill non-survival children,and the incidence of adrenal damage,and to explore the risk factors for the adrenal hemorrhage and necrosis in critically ill children.Methods A total of 141 critically ill non-survival children was admitted in this study in Hunan Children's Hospital from January 1,2005 to December 30,2012.Clinical data in children were systematically collected,including age,sex,sodium,potassium,blood gas analysis,liver and kidney function,blood clotting function,etiology,treatment and pediatric clinical illness score (PCIS) or neonatal critical illness score (NCIS),and pathological data.All data were analyzed by SPSS 18.0.Results Logistic regression analysis showed the factors of adrenal hemorrhage and necrosis of critically ill non-survival children were sepsis,PCIS score ＜ 80 critically ill children are risk factors for adrenal hemorrhage necrosis (P ＜ 0.05),ORwas 3.659 (95％ CI:1.344-9.965),and 2.325 (95％ CI:1.028 -5.258).Intravenous corticosteroids were protective factors for critically ill non-survival children with adrenal hemorrhage necrosis (P ＜ 0.05),and ORwas 0.377 (95％ CI:0.163-0.875).Conclusions There were two significant risk factors of adrenal hemorrhage and necrosis:sepsis and critical illness score less than 80 points.Intravenous corticosteroid is a protective factor in critically ill children.

Objective To evaluate the value of plastic-embedded bone marrow (BM ) biopsy sections in diagnosing myelodysplas-tic syndrome(MDS) .Methods HGF and Gomori stained .Glycol methacrylate(GMA) embedded BM biopsy specimens were detec-ted from 125 MDS patients with 25 cases in good health as control .Dyshematopoiesis and abnormal stroma cell responses were se-lected as main observed projects .Results Bone marrow biopsy sections gave an exact assessment of cellularity ,19 cases (15 .2% ) showed a decrease of cellularity as hypocellular MDS .66 cases(52 .8% ) of these cases did show abnormal localization of erythro-blastic clusters ,biopsy of 64(62% ) of low risk group 103 cases did show abnormal localization of immature precursors such as blasts and promyelocytes(ALIP positive) .Numeration of megakaryocytes and mast cells within 1mm2 acre of BM tissue were all much in MDS group than in control group .Gomori′s stain revealed moderate increase in reticulin fibres in 65 cases ,10 cases(8 .0% ) showed degree of myelofibrosis were + + + as hyperfibrotic MDS .Among 125 cases ,33 cases(26 .4% ) of bone marrow biopsies showed different types of erythrocytic and granulocytic immature cells with unusual intrasinusoidal bone marrow infiltration .Con-clusion It is clear that GMA embedded BM biopsy section is helpful in making diagnosis of MDS ,and has important clinical appli-cation value .

Objective To analyze the clinical and pathologic features in patients with ldiopathic cytopenia of undetermined signif-icance (ICUS) ,and provide the diagnostic basis .Methods 10 ICUS patients who did not fulfil minimal diagnostic criteria for MDS but suffered from constant (>6 months) progressive cytopenia ,with no marked dysplasia (<10% in three-major cell lineages) and abnormal karyotype were reported .Results 2 of 10 patients transited to MDS ,bone marrow review showed that ≥2 cells appeared diagnostic pathology development .Karyotype analysis showed that 1 case was still normal ,1 case lost a normal chromosome 20 (20q-) ,the rest 8 cases had been efollowed up for 6 to 25 months and still maintain ICUS .Conclusion Patients with MDS who fail to meet the diagnostic criteria of ICUS ,must carry out regular follow-up .There are some patients can transition to public MDS after a certain incubation period ,in fact it is Pre-MDS or MDS-early before ,which shows that ICUS should cause clinical attention ,so that avoid missed diagnosis .

Objective To evaluate the mode of referral by response time for inter-hospital transfer of critically ill pediatric patients,and subsequently some measures taken for minimizing the response time in referral process.Methods A total of 9231 patients (≤14 years) transferred from primary hospital were included in a cross-section study.Information about age,sex,referral radius,the seasonal variation for inter-hospital transport of critically ill pediatric patients,time of referral telephone call and response time were collected.All computations were performed using the Statistic Package for Social Sciences for Windows version 18.0.Differences between groups were assessed by x2 tests or Wilcoxon test or Kruskal-Wallis for categorical data.Results Among all critically ill pediatric patients for the inter-hospital transfer,male to female ratio was 2.24:1,and the majority of patients were neonates and infants.Median retrieval mobilization time was 30 min (interquartile range,20-50 min).This study has demonstrated that referral time,age categories,referral radius,different years and seasons were associated with response time.Conclusions With the improvement of technologies and management mechanism,the response time was apparently minimized since the beginning of interhospital transportation.But there is still plenty of room for shortening rsponse time compared with advanced Westem countries.

Objective To summarize the clinical features and technical key points on brain death during decision-made process in children with suspected brain death.Methods Twenty-four coma children with Glasgow coma scale score 3 and no spontaneous respiration were collected from May 2015 to February 2017 in Beijing Children's Hospital,Capital Medical University to make the brain death determination.All children received at least one confirmatory test.According to the Chinese standards for determining brain death (pediatric),all patients were divided into brain death group and non-compliance group.The clinical features were analyzed.The sensitivity,specificity,false positive rate and false negative rate of electroencephalogram (EEG),short latency somatosensory evoked potential (SLSEP) and transcranial Doppler sonography (TCD) were calculated.Results Among these 24 cases,there were 16 males and 8 females,aged 5.6 (2.0,8.8) years old.Ten cases met the criteria of brain death.Twelve (50％,12/24 cases) cases received autonomic breathing test.A total of 25 tests were conducted,of which 21 were successful.The completion rates of EEG,TCD and SLSEP were 100.0％ (24/24 cases),83.3 ％ (20/24 cases) and 54.2％ (13/24 cases),respectively.EEG had the highest sensitivity (100％) and specificity (79％).SLSEP had good sensitivity (100％),but the specificity was only 40％.The combination of EEG with SLSEP had the highest specificity and sensitivity,both of which were 100％,and the false positive rate and false negative rate were 0.Conclusions The key to determine brain death successfully is to make adequate preparations,to receive formal training and to apply standard operation.In the determination of brain death in children,EEG has a good sensitivity and specificity in single confirmation test,which is the priority item.The combination of EEG with SLSEP is the most advantageous.

Child, Preschool ; Chromosomes, Human, Pair 22 ; Chromosomes, Human, Pair 8 ; Chromosomes, Human, Pair 9 ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; Translocation, Genetic

Objective To investigate the effect of the nursing care of critically ill patients in intensive care unit(ICU) with non-invasive ventilation assisted by sedation simultaneously. Methods During the intervention phase from June 2012 to June 2013 of 28 patients in ICU treated by non-invasive ventilation, sedatives were adjusted according to Ramsay Scale, and the parameters of the life signs (heart rate, blood pressure, oxygen saturation,etc) were measured by nurses. Results 89.3%(25/28) patients obtained the improvement of the disease despite of the complications such as over-sedation and instable hemodynamics. Conclusion The key points can increase tolerance of non-invasive ventilation and improve clinical outcomes, develop comprehensive nursing strategies on safety and effectiveness of sedation and non-invasive ventilation .

Objective To compare the curative effect of high ligation+exfoliation and subfascial endoscopic perforator surgery(SEPS)for superficial varicose veins in calf+invagination spot-striping surgery in great venous varicosity.Methods Study group(42 patients)accepted SEPS+invagination spot-striping surgery and control group (42 patients)accepted traditional surgeries.Operation duration,bleeding volume in operation,the time of beginning movement away from bed after operation,hospitalization duration,the degree of pain,the scar,the recrudescence af- ter operation and the instance of the ulcer heals of two groups were compared.Results Operation duration,bleeding volume in operation,the time of begin movement away from bed after operation and hospitalization durations of study group were significantly lower than those of control group(P0.05).All of the patients in study group recovered without severe syndromes such as venous thrombosis,skin necrosis,lower limb functional disorder etc.They had no recrudesce after 4～16 months and were satisfied with the curative effect.Con- elusions The clinical curative effect of SEPS+invagination spot-striping surgery in great venous varicosity is superi- or to that of traditional operation and it has the advantages such as minor wound,few scars,light pains,short hospi- talization duration,without recrudescence,the ulcer heals quickly and so on.

OBJECTIVETo investigate the time trends of cancer mortality among residents in Kaifeng county, Henan province.

METHODSData on cancer mortality from the vital registration system in Kaifeng county from 1988 to 2005 was analyzed. A total of 9543 death records (5974 males and 3567 females) due to malignant tumors were studied. A two-year-period age-specified standardized mortality rates were directly adjusted by the world standard population, and the annual percentage change (APC) of mortality were estimated by a linear logarithm regression.

RESULTSThe crude cancer death rate for male was 95.09/100,000 and its age-standardized death rate was 117.41/100,000. While, the crude cancer death rate for female was 59.13/100,000 and the age-standardized death rate was 57.15/100,000. There was a significant growth tread for lung cancer (APC: 6.54%), liver cancer (5.07%) in males and breast cancer (7.04%) in females in the groups aged over 18. On the contrary, the decreasing treads for esophageal cancer in both of sexes (-7.09%, -13.53%) were also observed in this study. Meanwhile, there was no other significant changes in the trend, either in the tumor sites or mortality, was observed.

CONCLUSIONIn the past two decades, there has been a significant increasing trend for cancer mortality in Kaifeng county, of Henan Province. Hence, it is necessary to enhance epidemiological survey to identify risk factors at the earlier stages.

China ; epidemiology ; Death Certificates ; Female ; Humans ; Male ; Mortality ; trends ; Neoplasms ; mortality ; Rural Population

Animals ; Antihypertensive Agents ; isolation & purification ; pharmacology ; Antioxidants ; isolation & purification ; pharmacology ; Antiviral Agents ; isolation & purification ; pharmacology ; Benzofurans ; chemistry ; isolation & purification ; pharmacology ; Chromones ; chemistry ; isolation & purification ; pharmacology ; Flavonoids ; chemistry ; isolation & purification ; pharmacology ; Magnetic Resonance Spectroscopy ; Mass Spectrometry ; Molecular Structure ; Morus ; chemistry ; Plants, Medicinal ; chemistry ; Resorcinols ; chemistry ; isolation & purification ; pharmacology ; Spectrum Analysis ; methods