Objective To conduct a bibliometric analysis of pediatric literature in recent 5 years in Pubmed database,and to explore the focus issues of pediatrics.Methods Bibliographies from research literature of pediatrics in PubMed database from 2012 through 2016 were retrieved.The publication years,journals,the prolific authors and frequency of Mesh major topics were counted.MeSH heading/subheading matrix were formed.SPSS 19.0 statistical software was applied for clustering analysis.Results A total of 9375 articles were included.There were 45 MeSH heading/subheadings,which were clustered into 4 categories.Conclusion The research focuses in pediatrics are as follows:the clinical competence training and education research;the related pediatric issues from the perspective of social medicine;medical error prevention and the related legislation;the situation of Chinese pediatricians and doctor-patient relationship.

The bladder meridian of foot-taiyang is considered as key of six meridians and the yang of the yang, which is the pivot of transportation for qi and blood in the meridians and zang-fu. The running route and treatment characteristic of bladder meridian is closely related with chronic fatigue syndrome (CFS). The bladder meridian belongs to brain and connects with governor vessel, which has a close relationship with zang-fu function, quality of sleep and fatigue. Besides, the running route of bladder meridian is highly consistent with the surface projections of important anatomical structures such as muscle, nerve and sympathetic trunk, etc. Therefore, regulating the meridian-qi of bladder meridian can harmonize five-zang and calm the mind, but also effectively relieve physical and mental fatigue in CFS.
Acupuncture Points ; Acupuncture Therapy ; Fatigue Syndrome, Chronic ; therapy ; Humans ; Meridians

Objective To explore the main anatomical factors for relapse in patients underwent radical mas-toidectomy and discuss the preventive measures .Methods A retrospective study was carried out 36 patients who had underwent radical mastoidectomy and 100 patients (100 ears) who had been cured underwent radical mastoidectomy during July 2011 toSeptember 2013 .The patients underwent axial and coronal temporal Computed Tomography (CT) .The incidence of low -lying middle cranial fossa ,high jugular bulb ,anterior locati(36 ears)on of sigmoid si-nus ,dehiscent tympani tegmen ,dehiscent of the facial nerve canal ,large sinus tympani ,low -lying horizontal facial nerve were recorded .Results The incidence of low -lying middle cranial fossa(36 .1% ) ,anterior location of sig-moid sinus(41 .7% ) ,dehiscent tegmen tympani (30 .6% ) ,dehiscent of the facial nerve canal (41 .7% ) ,large sinus tympani(25 .0% ) ,low -lying horizontal facial nerve(22 .2% ) were higher than those of in the normal group .There was no significant difference in high jugular bulb .Conclusion The main anatomical factors for relapse in patients un-derwent radical mastoidectomy were low -lying middle cranial fossa ,anterior location of sigmoid sinus ,dehiscent tegmen tympani ,dehiscent of the facial nerve canal ,large sinus tympani ,low -lying horizontal facial nerve .

Objective: To explore the clinical response on cardiac resynchronization therapy (CRT) in patients of chronic heart failure (CHF) with different QRS wave morphology. Methods: A total of 52 CHF patients received CRT in our hospital and the Seventh People's Hospital of Zhengzhou City from 2010-03 to 2013-07 were retrospectively studied. The patients were divided into 3 groups: True-complete left bundle branch block (t-CLBBB) group,n=20, Classic LBBB (CLBBB) group,n=15 and IVCD group,n=17. The general clinical condition, the indexes of echocardiography at 6 months of follow-up study including left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), NYHA classiifcation and 6-MWT were examined and compared among different groups. Results: In general clinical condition, the ratio of non-ischemic heart disease patients in t-CLBBB group was higher than those in CLBBB group and IVCD group, allP<0.05. By 6 months follow-up study, LVEDD in t-CLBBB group (62.6 ± 8.9) mm was lower than those in CLBBB group (70.0 ± 8.9) mm and IVCD group (72.8 ± 8.0) mm, LVEF was higher in t-CLBBB group (38.5 ± 6.2) % than those in CLBBB group (31.7 ± 6.7) % and IVCD group (30.1 ± 6.7) %. NYHA classiifcation in t-CLBBB group (2.00 ± 0.45) grade was lower than those in CLBBB group (2.73 ± 0.80) grade and IVCD group (3.12 ± 0.78) grade . 6-MWT in t-CLBBB group (302.0 ± 57.9) m was longer than those in CLBBB group (257.3 ± 59.0) m and IVCD group (220.2 ± 57.9) m, allP<0.05. Conclusion: CRT is an effective method for treating CHD patients, different QRS morphology may have different response, the patients with t-CLBBB would make better response.

Objective To evaluate the feasibility of applying spectral CT material suppressed iodine (MSI) imaging as virtual plain CT scan to replace traditional non-contrast (TNC) CT in head and neck neoplasms. Methods A total of 52 patients with initial diagnosis of head and neck neoplasms underwent TNC CT scanning and spectrum mode enhanced scanning in the head and neck with spectral CT. With GSI Volume Viewer software from GE AW4.6 workstation, the enhanced scanning data were processed and MSI images were acquired. The CT values of different tissues (fat, erector spinae, cervical vertebrae, thyroid, and brain parenchyma) and the enhancement rate in erector spinae, carotid sinus were compared between MSI and TNC images. Image quality was objectively evaluated in noise and SNR for MSI and TNC images, while the subjective evaluation included the visibility of lesions, subjective acceptance rate, diagnostic efficacy (with/without lesions or lesion calcification, necrosis). Radiation dose including volume CT dose index (CTDIvol) and effective dose (ED) was compared between MSI and TNC. Results (1) CT values of erector spinae on MSI and TNC imaging were(52 ± 6)and(52 ± 7)HU respectively, and the difference between the two image modes was not significant(t=0.39,P>0.05). CT values on MSI and TNC Imaging were[-74 (-86,-59)HU]and[-79(-73,-61)HU]for fat (Z=-2.71, P<0.05),[139(121,196)HU]and[282 (237,336) HU,Z=-5.46]for vertebrae (Z=-5.46, P<0.05),[57(48,61)HU]and[96(74,110) HU]for thyroid (Z=-4.85, P<0.05),[35(32,39)HU]and[35(32,39)HU]for brain parenchyma (Z=-4.74, P<0.05) respectively. (2) There was no significant difference in enhancement rate of erector spinae between MSI and TNC imaging 1.15(1.07,1.20) and 1.14(1.03,1.26) respectively, Z=-5.50, P>0.05). The difference of carotid sinus enhancement rate was significant 5.75(4.70,6.73) and 4.37(3.91,5.61) respectively, Z=-5.50, P<0.05). (3) The noise of MSI[10.61(8.34,13.57) HU)]was higher than that of TNC [9.32(7.40,11.42) HU](Z=-2.52,P<0.05), and the SNR of MSI [-6.59(-8.59—-4.25)] was lower than that of TNC[-7.94(-10.25,-5.51)] (Z=-2.73,P<0.05). (4) Median scores of subjective imaging quality evaluation were 4(3.00,4.75) and 4(3.00,4.00) in MSI and TNC images respectively, and the difference was not significant(Z=-0.45,P>0.05).Unacceptable and acceptable cases in imaging quality of MSI were 3 and 49 respectively, while those were 2 and 50 in TNC group. Subjective acceptance rate between MST and TNC images was not significantly different(?2=0.01,P>0.05). (5) Diagnostic performance evaluation showed that the consistency of two observers was good in detecting lesions, necrosis and calcification between MSI and TNC image, with K value 0.93, 0.83 and 0.90 respectively (P<0.05). (6) Radiation doses between pure energy spectrum enhanced mode and conventional pre plus post contrast enhanced mode were compared. And differences of CTDIvol[11.78(10.98,17.30) mGy]and[23.89 (22.42, 29.98) mGy] respectively],ED [1.89(1.63,2.29) mSv]and[3.77(3.21,4.16 ) mSv] respectively] were significant(Z=-6.28, P<0.05). Pure energy spectrum enhanced mode reduced 39.07% of CTDIvol and 45.75%of ED respectively. Conclusions MSI imaging can be a potential substitute for TNC imaging. And it has clinical values in the diagnosis of head and neck neoplasms.

Objective To study the expression of signal transducer and activator of transcription 3 (STAT3) and Suppressor of cytokine signaling 3(SOCS3) in the middle ear cholesteatoma epithelium ,and the possible roles of STAT3 and SOCS3 in middle ear cholesteatoma .Methods The immunohistochemical assay was used to detect ex-pression of STAT3 and SOCS3 protein in 30 cases of middle ear cholesteatoma epithelial tissue and 20 cases of nor-mal external auditory canal skin tissues as the control group .Results STAT3 immunoreactivity was detected in the nuclei and cytoplasm of epithelial cells .The expression rates of STAT3 in middle ear cholesteatoma epithelial tissue were 76 .7% and higher than in the normal epithelium (25 .0% ) .The differences between the two groups were sta-tistically significant (P<0 .05) .SOCS3 immunoreactivity was detected in the cytoplasm of epithelial cells .The ex-pression rates of SOCS3 in middle ear cholesteatoma epithelial tissue were 33 .3% and lower than in the normal epi-thelium (65 .0% ) .The differences were statistically significant (P<0 .05) .The expression of STAT3 and SOCS3 in the middle ear cholesteatoma had negative correlation (r= - 0 .476 ,P<0 .05) .Conclusion The abnormal ex-pression of STAT3 and SOCS3 in the middle ear cholesteatoma may be involved in hyper proliferation and anti -ap-optosis of cholesteatoma cell ,and play an important role in the formation and development of middle ear cholesteatoma .

Objective: To evaluate the short-term effect of thrombus aspiration catheters combining tiroifban medication for myocardial tissue reperfusion recovery in patients with acute ST-elevation myocardial infarction (STEMI).
Methods: A total of 105 STEMI patients with percutaneous coronary intervention (PCI) in our hospital from 2011-05 to 2013-05 were studied, there were 73 male and 32 female with the mean age of (58.39 ± 10.37) years. The patients were randomly divided into 2 groups, Group A, the patients received thrombus aspiration catheters with intravenous tiroifban, n=53 and Group B, the patients received tiroifban and PCI, n=52. The basic clinical features, myocardial tissue perfusion level, major adverse cardiovascular events (MACE) at post operative and in-hospital period were recorded, the cardiac function was examined by echocardiography at 6 months after PCI in both groups.
Results: The basic clinical features were similar between 2 groups. The thrombolysis in myocardial infarction trial (TIMI) 3 lfow rate was higher in Group A than that in Group B (92.45% vs 55.77%), P=0.000. TIMI 2 and TIMI 0~1 lfow rates were lower in Group A than that in Group B (7.55%vs 26.92%), P=0.008 and (0%vs 17.31%), P=0.002. The adjusted TIMI frame was lower in Group A (27.26±5.50) vs (38.98±5.42), P<0.001. The echocardiography at 6 months after PCI indicated that Group A had higher LVEF than that in Group B (0.55±0.06) vs (0.47±0.06), P<0.001;lower left ventricular end diastolic diameter (50.77±5.45) vs (54.76±5.34), P<0.001;less angina and target vessel revascularization (16.98%vs 40.38%), P=0.008 and (9.43%vs 17.31%), P=0.008. The incidence of MI, acute heart failure, cardiac death and non-target vessel revascularization were similar between 2 groups, P>0.05.
Conclusion:Thrombus aspiration catheters combining tiroifban medication may obviously improve the myocardial tissue reperfusion and the short-term cardiac function in STEMI patients after PCI, it could reduce the incidence of no-relfow without increasing MACE.

ObjectiveTo evaluate the efficacy and safety of spironolactone in treatment NYHA (New York Heart Association) class Ⅰ - Ⅱ heart failure patients. MethodsEighty eight patients with NYHA classⅠ- Ⅱheart failure were randomized to sprionolactone or placebo groups.Patients were assessed by echocardiography and 6-minute walking test (6MWT) ,plasma aldosterone and NT-proBNP were measured before and 6 months after treatment; serum potassium and creatinine were monitored through the study. ResultsThe E/A and E/E' in spironolactone group were significantly lower than those of control group (1.2±0.7 vs. 1.7±0.6, P=0.007;15.2±2.3vs. 17.7±3.0, P=0.000). No differences were observed in left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF)between two groups after treatment. Left ventricular mass index (LVMI) in spironolactone group decreased after theatment [(117 ±27) g/m2 vs.(112 ± 19) g/m2,P = 0.044]. Plasma aldosterone level in spironolactone group after treatment was significantly lower than that of control group [ ( 157 ± 16) ng/L vs.( 165 ± 16) ng/L, P =0. 021 ]. Although there were no differences in plasma NT-proBNP level between two groups after treatment, it decreased significantly comparing with that of before treatment ( P = 0. 000). No differences were observed in serum potassium and creatinine between two groups after treatment. However serum potassium and creatinine in spironolactone group increased significantly after treatment [ ( 83 ± 18 )pmol/Lvs. (87 ± 22) μmol/L, P =0.047; (4.4 ±0.4) mmoL/L vs. (4.5 ±0.6) mmol/L, P =0. 012]. ConclusionSpironolactone can alleviate cardiac remolding and diastolic function in NYHA classⅠ - Ⅱ heart failure patients.

Objective To understand the job satisfaction of health technicians at township health centers and explore the strategies of improvement.Methods Based on the theory of existence,relatedness and growth needs,both quantitative and qualitative methods were used in the study.The quantitative investigation was carried out with the multi-stage cluster sampling method.The questionnaire for township health center personnel was compiled by the research group as a measuring tool for a survey of 803 health technicians from 45 township health centers regarding their existence,relatedness and growth needs in terms of existence,relatedness and growth needs.The data acquired were subject to descriptive analysis and variance analysis.The qualitative investigation was made by means of convenient sampling in personal indepth interviews.The thematic framework method was used to analyze the contents of the interviews.Results The satisfaction of existence needs of health technicians at township health centers scored the lowest(2.59),followed by that of growth needs(2.91),and the highest scoring was relatedness needs(3.56).There exist significant differences in the scoring of existence,relatedness and growth needs,among different personnel category,gender,age,staffing quota,administrative posts,and academic titles.Conclusions The authorities should emphasize the existence,relatedness and growth needs of health technicians at township health centers,and improve their job satisfaction by perfecting the salary distribution system and perfecting the personnel training system.

Objective To explore the treatment experience of acute paraquat poisoning,thus to explore the prognostic factors and treatment measures.Methods The clinical data of 87 patients with paraquat poisoning who were treated with combined therapy in our hospital emergency department 2014-2015 were retrospectively analyzed.Results 49 cases survived and 38 cases were died in 87 paraquat poisoning patients,the survival rate was 56.32％.The average paraquat of the death group was 65.3mL,which was significantly higher than 41.2mL of the survival group(t =16.65,P ＜ 0.01).Conclusion Amount of poisoning is the key to the prognosis,white blood cells were significantly increased,early or large areas of lung disease is an important factor in poor prognosis;early gastric lavage,cathartic and timely blood purification,application of adrenal cortex hormones,antioxidant and other comprehensive treatment can reduce mortality.