Many PICU and NICU have been gradually established from 80's in China,and the rescueing success rate of critically ill pediatrics is increasing fast.However,to assess the severity of disease and to determine the ICU admission standards is a quite complex job.Using scoring systems to predict hospital mortality in critically ill patients can be more objectively,scientifically and effectively.There are some scoring systems widely used in the world.Hospitals in china use PCIS more and these in foreign prone to PRISM score highly in pediattic field.PCIS was made in china and it achieves great success on the side of risk adjustment and mortality prediction.But pediatrics are special,sometimes the severity of disease is not completely consistent with the prognosis and the differences among individuals cannot be ignored yet,so PCIS have unavoidable limitations.The scoring systems and clinical symptoms and signs and therapeutic effect should be combined to assess the severity of disease more accurately.Acute physiology and chronic health evaluation(APACHE),and sequential organ failure estimation score(SOFA) are rarely used in the field of pediatric applications,but both are useful tools for clinical research,if it can be introduced into the pediatric field,there may be a new breakthrough.Besides,Pediatric Risk of Mortality Score and Pediatric Risk of Mortality are not widely used in our country.

Objective: To evaluate the reliability and validity of the inventory of experience of close relationship-revised version (ECR-R).Methods:286 college students were collected for testing the internal consistency and structure validity of the inventory. Test-retest reliability was founded in 31 students. Criteria validity was also studied in 32 cases with anxiety neurosis. Results: The Cronbach ? of the ECR-R and its two subscales (anxiety and avoidance) were 0.87, 0.86 and 0.81 respectively. The test-retest reliabilities of them were 0.75, 0.82 and 0.61 respectively. The two subscales had good discriminating ability and were confirmed by factor analysis, anxiety and avoidance could explain 21.28 and 11.20 of the total variance. Conclusion: The ECR-R is psychometrically acceptable and may be applied to study attachment of Chinese adolescents.

Objective To investigate the effect of several scoring systems including of acute physiol-ogy and chronic health evaluation Ⅱ (APACHE Ⅱ)score,sequential organ failure assessment (SOFA) score,pediatric risk of mortality score(PRISM),pediatric critical illness score(PCIS)and paediatric index of mortality(PIM)in estimating the prognosis of illness in pediatric severe cases.To select a more appropriate scoring system for PICU.Methods From January 2013 to December 2014,486 cases admissed in PICU of Shengjing Hospital of China Medical University were enrolled in the study,including 42 hospital death cases (dead group)and 444 survived or cured cases(survival group).We estimated each patient with APACHEⅡ,SOFA,PCIS,PRISM and PIM on admission and compared the scores between dead group and survival group.Results The results of APACHE Ⅱ,SOFA,PCIS,PRISM,PIM showed significant defferences be-tween dead group and survival group(13.43 ±8.70 vs.3.48 ±3.94;78.38 ±9.33 vs.88.24 ±6.84;0.142 0 ±0.214 7 vs.0.015 3 ±0.030 7;5.48 ±3.42 vs.1.73 ±1.94;22.02 ±8.48 vs.12.68 ±4.88,P <0.001 ). Areas under the receiver operating characteristic curves of APACHE Ⅱ,SOFA,PRISM,PCIS and PIM (95%CI)were 0.854 (0.798,0.910 ),0.838 (0.778,0.898 ),0.881 (0.828,0.934 ),0.808 (0.748, 0.869),0.936(0.913,0.960).Areas under the receiver operating characteristic curves of PIM was the lar-gest.Conclusion All the 5 kinds of severe scoring systems are effective and have a good ability to asses the prognosis and severity of diseases.It seems that PIM is the most effective.

Objective: To understand the effect of dobutamine on the integrated backscatter of myocardium. Methods: Nineteen open-chest dogs were detected by HP Sonos 5500 with S8 transducer, and the WT, AIBS and CVIB were measured before and after the dobutamine stress. Results: During the dobutamine stress, following the increase of WT, the transmural, subepicardial and subendocardial CVIB all increased. And the increase of subepicardial CVIB was greater than that of subendocardial CVIB, leading to the decrease of TGI. But the AIBS didn't change significantly in the whole process. Conclusion: Dobutamine can enhance myocardium CVIB but has no obvious infleunce on AIBS.

Objective To review the clinical characteristics of paraganglioma of the urinary bladder with 5 cases reprt.Methods The clinical data of 5 patients (2 males and 3 females,age 23-68 years)with paraganglioma of the urinary bladder were reported.Two cases were diagnosed by ultrasonography during health examination,1 case was found by hematuria,1 had difficulty of voiding,and 1 presented with palpitation,chest discomfort while urination.Two cases were clinical diagnosed as bladder paraganglioma,1case urachal carcinoma,and 2 cases bladder tumor.Cystoscopy showed a protruding tumor within the bladder or bladder had compressed changes.One case of tumor located in the triangle,1 in the posterior wall,1in the top,2 in the anterior wall.Three cases of biopsy were negative.Three cases of preoperative endocrine examinations showed norepinephrine significantly higher.Results Laparoscopic partial cystectomy was performed in 3 cases,open partial cystectomy in 1 case,and transurethral resection of bladder tumor (TURBT) in 1 case.One case had the complication of stress cardiomyopathy during TURBT,3 cases found intraoperative hypertensive crisis.The bleeding volume was 20-800 ml (average 126 ml),and I case received blood transfusion.During the follow-up period for 3-48 months,the blood pressure was normal,and no recurrence was found.Conclusions Bladder paraganglioma is uncommon and easily misdiagnosed.For the patients with bladder tumor,accompanied by changes in blood pressure,palpitations during urination should be highly suspicious of bladder paraganglioma.Partial cystectomy is the main treatment method.

[Objective]To investigate the value of degree centrality(DC),a novel resting-state fMRI parameter,in voxel-wise whole-brain functional networks analysis in primary insomnia(PI)after acupuncture therapy.[Methods]The resting state fMRI were performed in 29 PI patients and 22 age,education,and sex-matched normal healthy subjects. Analysis of DC map changes between the two patient groups and the control group were performed by two sample t test.(threshold at P<0.05).[Results]Compared with the control group,patients with PI showed significantly reduced DC value in middle temporal gyrus(MTG. R);hippocampus(HIP. B);parahippocampal gyrus(PHG. R);putamen(PUT. R);cuneus(CUN. L).[Conclusions]Changes of DC value occurred in some region of brain in the PI patient groups when compared with the control group. It was indicated that DC ,as a novel resting-state fMRI parameter in the voxel-wise whole-brain functional networks ,might be an appealing alternative approach for further study on pathologic and neuropsychological states of PI.

Objective: To understand the effect of dobutamine on the integrated backscatter of myocardium. Methods: Nineteen open chest dogs were detected by HP Sonos 5500 with S8 transducer, and the WT, AIBS and CVIB were measured before and after the dobutamine stress. Results: During the dobutamine stress, following the increase of WT, the transmural, subepicardial and subendocardial CVIB all increased. And the increase of subepicardial CVIB was greater than that of subendocardial CVIB, leading to the decrease of TGI. But the AIBS didn't change significantly in the whole process. Conclusion: Dobutamine can enhance myocardium CVIB but has no obvious infleunce on AIBS. [

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Objective To investigate the feasibility and clinical effect of immediate ureterovesical reimplantation after ureteral rupture during laparoscopic hysterectomy. Methods From August 2010 to December 2015, 5 cases of ureteral rupture during the operation of laparoscopic hysterectomy were treated with immediate ureterovesical reimplantation under laparoscopy. Results All operations were successfully performed without transversion to open surgery. No patients with urinary leakage occurred. The mean follow-up were 21 months (range 3-60 months) . No cases with ureteral stricture were observed. Slight urine reflux was found in two patients, of whom obvious hydronephrosis and renal damage were not found. Conclusion Immediate ureterovesical reimplantation under laparoscopy is a feasible, safe and minimal invasive method for treatment of ureteral ruputure during laparoscopic hysterectomy.

Objective:To evaluate the effect of antiviral therapy on HBV reactivation and liver function after liver resection in patients with hepatocellular carcinoma (HCC). Methods:A total of 174 HBV-DNA(?) HCC patients were recruited into two groups:antiviral ther-apy group (66 cases) and control group (108 cases). In the antiviral group, patients were given entecavir dispersible tablet, whereas no antiviral therapies were given in the control group. The HBV reactivation and liver function index rates were statistically analyzed. Re-sults:Rates of HBV reactivation after hepatectomy were 3.0%and 27.8%in the antiviral therapy group and control group, respectively. Multivariate analysis revealed that minor hepatectomy (HR, 4.695;95%CI, 1.257-17.537, P=0.021) and no antiviral therapy (HR, 8.164;95%CI, 1.831-36.397, P=0.006) were independent risk factors for HBV reactivation. The levels of ALT, TBil, ALB, and PT within 7 days af-ter liver resection were similar between the antiviral therapy group and the control group and between the reactivation group and no-reactivation group. However, the ALT and ALB levels were significantly better in the antiviral group compared with that in the control group after 30 days. Conclusion:HBV reactivation can occur after liver resection for HBV-DNA(?) HCC patients. Preoperative antiviral therapy can reduce the risk of HBV reactivation, thus protecting liver function in patients undergoing liver resection.