Objective To elevate the achievement rate of kidney biopsy puncture through the analysis of puncture angle choice of ultrasound guided automatic kidney biopsy in 518 patients. Methods Under the guidance of color Doppler ultrasound,using the 3.5MHz probe with probe holder,we performed kidney biopsy in the degrees of 40°(group X),45°(group Y),60°(group Z) and 70°(group P) with the horizontal plane. Resnlts The total achievement ratio is 100 %. The one time success rate in group Y and group Z is 100 % (group Y, 164/164 ; group Z, 186/186) ;group X is 4.8% (22/46) ;group P is 84.4% (103/122).Conclusion The automatic kidney biopsy an- gle under the guidance of ultrasound should be between 45° and 60° with the horizontal plane which is safe and has higher achievement ratio. In the meantime, complications can be avoided.

Objective To study the effects of early application of integrated traditional Chinese medicine (TCM)and western medicine and massage on the incidence and severity of pneumonia and prognosis in the therapeutic course of infants with cytomegalovirus(CMV)infection infantile cholestatic hepatopathy(ICH)accompanied by gastric volvulus(GV). Methods A prospective randomized controlled trial was conducted. 120 infants 1-6 months old with CMV infection ICH and complicated with GV inpatients were divided into treatment group and control group (each,60 cases). The TCM Lidanheji(consisting of artemisiae capillaris 30 g,weeping forsythia 30 g,Chinese goldthread 5 g,prepared rhubarb 5 g,unpeeled root of herbaceous peony 30 g,cassia 5 g,fruit of citron or trifoliate orange 10 g,large-headed atractylodes 10 g,fruit of Chinese magnoliavine 10 g,pangolin scale 3 g and licorice root 5 g)for oral administration or enema and ganciclovir intravenous injection were given to both groups. In the control group,based on the above treatment,postural and diet therapy,prokinetics(domperidone)were given in cases with GV. The massage treatment was only applied for treatment of GV in treatment group. The pneumonia in both groups was treated in accord to the conventional diagnosis and treatment for infantile pneumonia,bronchiolitis,severe pneumonia and the guide and management of infantile community acquired pneumonia. The total number of cases with pneumonia and its severity occurring before and after treatment in the course of the disease,the clinical therapeutic effects of ICH, GV and infantile pneumonia,the clinical physical signs,biochemical indexes and the time of hospitalization were observed and compared between the two groups. Results Compared with control group,after treatment the curative rate and total effective rate of ICH,GV,infant pneumonia in treatment group were significantly higher〔the curative rate of ICH:83.05%(49/59)vs. 71.93%(41/57),total effective rate:96.61%(57/59)vs. 91.23%(52/57);the curative rate of GV:72.88%(43/59)vs. 51.79%(29/56),total effective rate:96.61%(57/59)vs. 78.57%(44/56);the curative rate of infant pneumonia:81.08%(30/37)vs. 67.44%(29/43),total effective rate:100%(37/37)vs. 100%(43/43),P<0.05 or P<0.01〕. In the treatment group,the total number of cases with pneumonia occurring in the therapeutic course and the incidence of severe pneumonia were significantly less than those in the control group〔the occurrence of pneumonia:12 cases vs. 21 cases,the incidence of severe pneumonia:16.67%(2/12) vs. 42.86%(9/21),P<0.05 or P<0.01〕. The enlargement of liver and spleen,the level of total bilirubin(TBil), direct bilirubin(DBil),total bile acids(TBA)and alanine aminotransferase(ALT)in two groups after treatment were significantly lower than those before treatment,the changes being more marked in treatment group(P<0.05 or P<0.01). The time of stay in hospital in treatment group was remarkably shortened(days:21.32±3.26 vs. 27.38±6.09, P<0.05). Conclusion Early interference with combined TCM and western medicine and massage for treatment of infants with CMV infection ICH accompanied by GV can significantly decrease the incidence of pneumonia and its severity occurring in the disease course,therefore this therapeutic method is beneficial to the treatment and prognosis of infants with CMV infection ICH.

Objective To systemically evaluate the clinical therapeutic effect and safety of traditional Chinese medicine on Kawasaki disease. Methods Through retrieval of the reports in PubMed, the Cochrane Library, China National Knowledge Internet (CNKI), VIP database, Wanfang database by computer, the correlative articles of clinically randomized controlled trials (RCTs) published in China during the period from 1990 to 2013 were collected, and their quality evaluation was made. All the articles were screened according to inclusion and exclusion criteria, in which interventions were traditional Chinese medicine therapy and conventional western treatment. The articles selected were assessed with the software of RevMan 5.2. Results There were 212 articles searched out, but only 13 articles, 656 children with Kawasaki disease were conformed to the inclusion criteria. The Meta analysis indicated that the total effective rate in the traditional Chinese medicine group was superior to the group treated with western medicine. The difference in the curative effects between the two groups had notable significance [odds ratio (OR) = 3.58, 95%confidence interval (95%CI) was 2.16-5.93, test for overall effect Z=4.94, P<0.000 01]. No difference was seen in the curative effect of improving coronary artery changes between the traditional Chinese medicine group and western medicine control group (OR=2.03, 95%CI was 0.74-5.62, test for overall effect Z=1.37, P=0.17). Conclusion The clinical therapeutic effect of traditional Chinese medicine on Kawasaki disease is superior to that treated by western medicine.

Water and salt requirements were studied in 17 and 18 healthy young men respectively. Each subject walked in a hot and humid environment (DB 28-34℃, RH 50-76%) at a speed of 5 km/hr with backpack loads of 15-25 kg for four hours. Dehydration would occur if no water or inadequate water was supplied and it would affect circulatory, sweating and thermore-gulatory function. It was suggested that MCHC= mightbeasensitive index to determine whether the body was dehydrated or not and to evaluate adequate amount of drinking water. The results showed that water loss should be replaced preferably by periodic intake of small amounts of water throughout the work period and the total amount required was about 80% of sweat loss. Thus, the rise of body temperature and heart rate was less than that of the subjects drinking 250 ml/hr of water or drinking voluntarily and there was little change in MCHC. The results also showed that the loss of salt by sweating was closely related to heat acclimatization. Therefore it is imporatnt to provide adequate salt to those unacclima-tized. Those taking 20 gm/day had a mild increase of rectal temperature and heart rate during work period and their urinary excretions of chloride were above 5 gm/day. According to the experiment, 20 gm/day of salt gave a satisfactory result.

Objective:To discuss the research progress in the field of coronavirus (CoVs) treatment based on the visualization analysis of knowledge graph.Methods:The related literatures in the field of CoVs treatment were retrieved from the establishment of Web of Science core collection database to February 15th, 2020, and the literature analysis tool of Web of Science database was used to count the annual trend of published literatures. The VOSviewer software was used to analyze the relationship among countries, institutions, authors, clustering and density of subject words. The HistCite software was used to screen important documents and to draw the evolution process of hot spots. The CiteSpace software was used to analyze the breakout points of subject words, so as to find the front and hot spots in this field.Results:A total of 1 747 data were retrieved, with the exception of 17 duplicate data, and 1 730 data were retained for visualization analysis. In terms of literature volume, the literatures on CoVs therapy rose after 2003 and 2012, and the number of published literatures had remained high since 2014. In terms of countries, the main countries that carried out the research on the treatment of CoVs were the United States ( n = 613), China ( n = 582), Germany ( n = 122), Canada ( n = 99), etc., and the cooperation among countries was close. In terms of institutions, the number of papers issued by Chinese Academy of Sciences in the field of CoVs treatment ranked first ( n = 82), followed by University of Hong Kong of China ( n = 74) and Chinese University of Hong Kong of China ( n = 58), followed by National Institute of Allergy and Infectious Diseases ( n = 37), and the cooperation among various institutions was close. In terms of literature authors, there were two high-yielding authors in the United States [Ralph S. Baric ( n = 21) and Kuochen Chou ( n = 17)], two Chinese authors [Yuen Kwok-yung ( n = 17) and Jiang Shibo ( n = 16)] and one Dutch author [Eric J. Snijder ( n = 17)]. In terms of the cluster analysis of authors, the authors were closely related in reverse genetics, respiratory infection, receptor binding domain, etc., and the 15 top-cited papers came mainly from China, the United States, Netherlands and other countries, and the literature content represented the frontiers and hot spots in different periods. The treatment hot spots focused on preventing virus adsorption, inhibiting the virus gene nucleic acid replication, transcription and translation. The main subject words were divided into three main categories, namely, CoVs epidemiology, basic research and drug development, in which basic research and drug development were strongly correlated. In the subject words breakthrough analysis, there were time-related breakthrough points in 1991, 1996 and 2002, and the "diagnosis" and "sequence" were continuous hot spots. Conclusions:Through the visualization analysis of knowledge graph, the development trend and hot spots of CoVs therapy research could be well observed. In this study, the degree of attention in the field of CoVs treatment showed periodic changes, related to the outbreak of new CoVs, and the country, institutions and the author were closely related. The treatment hot spots focused on preventing virus adsorption, inhibiting the virus gene nucleic acid replication, transcription and translation in order to develop new targets of drug.

Objective:To investigate the effects of metformin (MF) and vibration intervention on the improvement of bone mineral density (BMD) and glucose metabolism in diabetic rats with osteoporosis (DOP) .Methods:In this study, 125 rats were purchased, 100 rat models of diabetic osteoporosis were selected according to the random number table sampling method, and 100 rats were tested for modeling. According to the principle of random grouping, the rats successfully modeled were divided into model control groups (group MC) , metformin group (group MF) , vibration group (group V) , metformin + vibration group (group MV) . Normally fed 25 rats were blank control group (group C) . Rats in each group were treated for 20 weeks of intervention according to their own protocols. After the intervention, various samples were collected from rats in each group for BMD testing and HOME-IR testing.Results:Compared with the pre-measured BMD value of group C, the pre-measured BMD of group MC, group MF, group V and group MV were significantly reduced, respectively 0.21±0.03, 0.20±0.04, 0.20±0.03, 0.19±0.05 (g/cm 2) , P<0.05, indicating that the DOP model was successfully constructed. After 20 weeks of intervention, the BMD values of group MF, group V, and group MV were respectively 0.23±0.07, 0.24±0.05, 0.27±0.01 (g/cm 2) , significantly higher than the pre-measured value and the post-measured value of group MC, P<0.05. Comparing the changes in bone metabolism after the intervention of the patients, it was found that HOP of group MF, group V, and group MV after the intervention were 17.07±2.33, 16.95±4.22, and 15.43±3.75 (mg/g) respectively; DPD of group MF, group V and group MV were 3.26±0.09, 3.13±0.10, 2.95±0.10 (mmol/L) , respectively; The TRACP of the MF group, the V group and the MV group were 152.51±10.89, 149.67±11.05, and 143.90±10.67 (μg/L) respectively; The bone metabolism indexes of the patients were significantly lower than the pre-measured values and the post-measured values of the MC group, P<0.05. Comparing the glucose metabolism and insulin sensitivity of the patients after the intervention, it was found that FPG of group MF, group V, and group MV after the intervention were 15.32±4.98, 16.34±5.76, 19.76±5.71 (mmol/L) respectively. The FINS of group MF, group V and group MV were 25.46±6.21, 27.92±5.33, 29.85±7.22 (mmol/L) respectively. The HOME-IR of group MF, group V, and group MV were 17.39±1.37, 20.27±1.36, 26.81±1.83 (mmol/L) respectively, and all the indexes were significantly lower than those of group MC, P<0.05. Conclusion:This study believes that metformin and vibration intervention can significantly reduce blood glucose and relieve symptoms in diabetic rats with osteoporosis Insulin sensitivity, reduce bone loss, increase bone density.

Objective To observe the clinical characteristics of infants with pertussis syndrome and the influence of gastroesophageal reflux (GER) on pertussis syndrome in small infants, and provide experience for improving curative effect. Methods ① The clinical data of 807 infants with pertussis syndrome treated at Wuhan Children's Hospital from January 2015 to June 2017 were retrospectively analyzed, in which their clinical characteristics including symptoms, signs and related physical and chemical examinations were summarized. ② Prospective randomized controlled trials were performed at the Children's Hospital of Wuhan from June 2017 to June 2018, there were 120 infants with ages < 6 months diagnosed as pertussis syndrome and simultaneously accompanied by gastric volvulus (GV) and GER, and they were randomly divided into a study group and a control group according to the date sequence of definite diagnosis, 60 cases in each group. The control group was given conventional medical treatment, while in the study group, additionally the infants received massage to restore gastric proper position and anti-reflux therapy. The clinical efficacies of two groups were observed. Results ① Retrospective analysis showed that clinically, pertussis syndrome commonly occurred in infants of ages < 6 months, accounting for 88.30% (713 cases); all cases had spastic cough, and 60.00% (484 cases) infants' coughing was severer at night. In laboratory examinations, 83.27% (672 cases) of the infants had elevated platelets (PLT), 25.03% (202 cases) had abnormal myocardial zymograms, and 70.38% (568 cases) had elevated white blood cells (WBC). In the pathogen examination, only were pathogens found in 34.8% infants, mainly single pathogen infection, accounting for 86.12%. Chest radiographs suggested 71.50% of infants with pneumonia, and 73.00% of infants with GER, among which 77.92% of infants were accompanied by GV. ② The prospective study showed that in the treatment of infants with pertussis syndrome accompanied by GV and GER, manual massage should be used timely to correct GV and simultaneously anti-reflux therapy should be given, in the aspects of time required to improve cough symptoms (days: 5.36±1.40 vs. 6.59±1.56, P < 0.01) and shortening of the hospital stay (days: 6.50±1.41 vs. 8.09±1.63, P < 0.01) in the study group were superior to those in the control group; the case of respiratory failure in the study group was lower than that in the control group [2 cases vs. 8 cases, P < 0.05]. Conclusions In pertussis syndrome, lymphocytes occupy the main proportion of WBC elevation that is an important differential criterion between pertussis syndrome and infantile pneumonia with gastric volvulus and gastroesophageal reflux. PLT elevation in pertussis syndrome suggests that attention should be paid to the elevation as that might be related to the disease prognosis. It is necessary to further investigate whether the positive pathogen discovered in the course of pertussis syndrome is a pathogenic one, and attention should also be paid to the medical examination of GV and GER in the small infants with pertussis syndrome, since early proper intervention to correct GV and GER can significantly improve their clinical efficacies.

Objective To investigate and analyze the cognition , attitude to disease in outpatient with atrial fibrillation ( AF) to provide the basis for clinical nursing .Methods One hundred and sixty outpatient with AF from March 2013 to April 2013 were chosen and were surveyed by the self-made questionnaire about the cognition, attitude to disease in AF patients .The related factors which can affect the cognition , attitude to disease in AF patients including age , gender , occupation , education , economic income monthly , payment of medical expenses , type of AF were analyzed .Results The score of the cognition in AF patients was (14.91 ± 4.92), and was in a bad level .The score of the attitude to disease was (18.59 ±4.16), and was in a good level.The differences were found in the cognition in AF patiens with different age , occupation, education, the type of AF (F=1.00, 2.61, 2.20, 4.21, respectively;P<0.05).The differences were found in the attitude to disease in AF patients with different occupation , education, payment of medical expenses (F=0.28, 0.95, 0.92, respectively;P<0.05).Conclusions The nurses should carry out health education according to the different clinical characteristics in AF patients , and improve the patient compliance , and actively cooperate with medical treatment .