Sepsis is a major cause of mortality among children and newborns.The largest part of the global pediatric sepsis burden occurs in middle-and low-income countries,where the mortality of sepsis reaches 24％-50％.It is necessary to provide clinicians with a framework to improve the management of pediatric septic patients.The key of treatment is to ensure adequate tissue perfusion,to maintain cardiovascular and hemodynamic stability,the administration of adequate antibiotics,the proper use of glucocorticoid,and so on.

Objective:To investigate the effect of IRH on pulmonary fibrosis and its intervention mechanism.Methods:45 sprague-dawley rats were randomly divided into three groups.The model group and the intervention group were received endotracheal injection of bleomycln to induce pulmonary fibrosis,while the control group were received endotracheal injection of saline.From the second day the intervention group IRH were injected to the stomach,while the other two groups were injected saline instead.On the 7th day,14th day and 28th day the lungs were isolated.The expression of MMP-2 and TIMP-1 was detected by immunohistochemical method respectively.Results:There was only a very weak expression of MMP-2 and TIMP-1 in the control group,there was significantly higher level in model group compared with control group on the 7th day,14th day and 28th day.The IRH group was significantly lower than the model group with the same time points,though it was also obviously higher than the control group all over the period(P

Objective To observe the curative effect of acupuncture point bloodletting,flash tank combined with ultrashort wave auxiliary in the treatment of infantile cough.Methods 102 children with cough were selected and randomly divided into control group (50 cases)and observation group (52 cases).The control group adopted general anti -infection,reduce phlegm,the method of atomizing inhalation.The observation group received control method based on the acupuncture point thorn bloodletting,cans,combined with ultrashort wave.The clinical curative effect was compared in the two groups.Results In the treatment group,34 cases got cure,improvement in 17 cases, 1 case had no effect,the cure rate was 65.3%,total effective rate was 98.0%,without efficiency 1.9%.In the control group,18 cases got cure,improvement in 23 cases,9 cases of invalid,and the cure rate was 36.0%,the total effective rate was 82.0%,without efficiency was 18.0%.The total effective rate between the two groups had statistically significant difference (χ2 =4.105,P <0.05).Conclusion Acupuncture point bloodletting,flash tank combined with ultrashort wave auxiliary in the treatment of infantile cough can obviously improve the clinical effect.

Fractal is a new conception.In this paper some knowledge of fractal is first described.Our research work of fractal application in Doppler ultrasound technique is reported.

Objective To study the method based on gradient vector flow (GVF) and particle swarm optimization (PSO) for realizing multimodal medical image registration and improving its accuracy. Methods In view of three major components of image registration, i.e. the feature space, the similarity metric and the search strategy, a novel method was proposed with three improvements. Firstly, the GVF field was employed as the feature space. Then three similarity metrics were proposed based on GVF field. Finally, an improved PSO combined with crossover mechanism of genetic algorithm was utilized to search for the optimal transformation of two images. Results With 54 times of experiments on both simulated and real medical images, it was demonstrated that this method accurately registered the multimodal medical images to be superior to the method based on PSO of pixels, and the Walsh transform method. Conclusion The method based on GVF and PSO is effective for multimodal medical image registration.

Objective: To explore the clinical effect of modified preflush on the treatment of CRRT without heparin in patients received dialysis with complication of cerebral hemorrhage. Methods: 44 patients received dialysis with complication of cerebral hemorrhage were divided into control group (28 cases) and observation group (16 cases) according to the implemented time of modified preflush. A retrospective analysis was adopted to compare the effect of filter in blood coagulation grade and service life between conventional preflush (control group)and modified preflush (observation group). Results: The differences of I, II, III grade of blood coagulation between the two methods were significant (x2=12.020, P<0.05), and the differences of average service time of filter, transmembrane pressure(TMP), pressure of filter and value of pressure drawdown (ΔP) between the two methods also were significant (t=3.535, t=4.024, t=6.071, t=3.524, P<0.01). Besides, the difference of venous pressure (PV) between them was significant (t=2.166, P<0.05), while the differences of BFR, UFR and Pa between the two methods were not significant (t=0.263, t=1.162, t=0.258, P>0.05). Conclusion: Modified preflush method can make the fiber of filter to obtain more full stretch and soak, and it also can prolong the service of time, and decrease incidence of blood coagulation, and ensure curative effect and smooth process.

Objective To explore the efficacy of oppression hemostsis time on hemorrhage and patient comfort after carotid endarterectomy. Methods Patients with carotid artery stenosis from January 2014 to September 2015 were enrolled.The patients were divided into three groups according to oppression hemostasis time:control group for 24 hours,experimental group one for 12 hours,experimental group two for 6 hours.The outcomes were the incidence of hematoma,errhvsis,anxiety,and neck pain. Results No significant differences were observed in hematoma and errhysis among these three groups.The total scores of anxiety and neck pain of experimental group two were (51.43±8.18) points,(1.28±1.06) points,obviously surpassed the comparison group (56.64 ± 7.08) points,(2.31 ± 1.17) points,showed a significant decrease in two groups (t=2.96, 4.03, P<0.05). The total scores of anxiety and neck pain of experimental group one were (54.14±8.99) points,(1.97±0.97)points,showed no significant in compared with comparison groups(t=1.31, 1.32, P>0.05). Conclusions The preferred option for oppression hemostasis time is 6 hours that has an effective hemostasis with a favorable patient comfort.

Objective:To explore the effects of formative assessment using sitcom play in obstetrics and gyne-cology nursing teaching.Methods:Totally 214 undergraduate of grade 2011 nursing students were recruited in the present study.Using envelope method,2 classes were randomly selected as the control group and 2 as the experi-mental group.Students in the control group (n--107) were assessed with traditional assessment method,while those in the experimental group (n =107) were taught using situational drama performance and assessed with form-ative assessment method throughout the process.Students' test scores of obstetrics and gynecology nursing in these two groups were compared,and the opinions on the formative assessment method using sitcom play were investiga-ted among students in the experimental group.Results:Students in the experimental groupscored significantly high-er than those of the control group(78.43 ± 5.21 vs.76.67 ± 6.40,t =2.20,P ＜ 0.05).About 98.31％ of the students approved the formative assessment mode.They reported that this approach was helpful to improve the abili-ty to combine theory and practice andto communicate with others,to cultivate students' creative thinking,and to stimulate their learning interest and learning initiative.Conclusion:The application of formative assessment mode using sitcom play in obstetrics and gynecology nursing teaching is beneficial to enhance teaching effect and improve the ability of nursing students,which is worth popularizing.

Objective: To investigate the effect of different analgesia methods on blood coagulation in patients who underwent esophageal carcinoma surgery through thrombelastography (TEG). Methods:A total of 60 patients who underwent radical esophagecto-my were randomly divided into the patient-controlled epidural analgesia (PCEA) group and patient-controlled intravenous analgesia (PCIA) group with 30 cases each. The visual analogue scale (VAS) and patient-controlled analgesia (PCA) bottom pressing times were recorded at 6, 12, 24, and 48 h after surgery. The TEG parameters were measured at the time before anesthesia (T0), the end of surgery (T1), first day after operation (T2), second day after operation (T3), and third day after operation (T4). Results:(1) Compared with the PCIA group, the VAS scores and PCA bottom pressing times were significantly lower (P<0.05). (2) The R and K values of the PCEA group had no significant difference compared with T0 (P>0.05), and were significantly prolonged than those in the PCIA group at T2, T3, and T4 (P<0.05). (3) The platelet amount of the two groups decreased at T2 and T3 compared with that at T0 (P<0.05). Conclu-sion:The analgesic effect of PCEA was better than that of PCIA in patients who underwent esophageal carcinoma surgery, and may im-prove their hypercoagulability.

Objective To evaluate the value of Binax NOW pneumococcal antigen test for rapid diagnosis in patients with purulent meningitis.Methods Cerebrospinal fluid (CSF) were collected prospectively from 86 children who were diagnosed with purulent meningitis in the Department of Infectious Diseases at Beijing Children′s Hospital from March 2013 to March 2014 and were tested by Binax NOW method.CSF culture was considered as golden standard to evaluate the sensitivity and specificity of the Binax NOW method.Continuous variables were compared with t test, categorical variables were compared with χ2 test.Results Among 86 cases of purulent meningitis, 34 (39.5%) had positive culture and 21 (24.4%) were Streptococcus pneumonia, while 31 (36.0%) were positive by Binax NOW test.Using CSF culture as golden standard, the sensitivity and specificity of Binax NOW for diagnosis of pneumococcal meningitis were 90.5% (19/21) and 81.5% (53/65), respectively.Conclusion Binax NOW pneumoniae antigen test in CSF yields high sensitivity and specificity, which is useful in clinical application and enables prompt and adequate treatment.