Objective To evaluate the accuracy of ultrasonographic measurement of the transverse diameter of the cricoid cartilage in selecting the cuffed endotracheal tube (ETT) size for pediatric patients.Methods A total of 120 pediatric patients of both sexes,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 1 month-6 yr,with body mass index of 10.9-31.2 kg/m2,undergoing endotracheal intubation and general anesthesia,were divided into group A and group B,with 60 pediatric patients in each group.The pediatric patients were intubated with a cuffed ETT in two groups.The ETT size was selected based on the transverse diameter of the cricoid cartilage measured by ultrasonography in group A.The ETT size was selected according to the age-based formula in group B.A tracheal leak was detected after intubation to determine whether or not the ETT size selected was appropriate.ETTs were replaced when the actually selected ones were not appropriate,and the number of replacement was recorded.The development of intubation-related complications was also recorded.Results The accurate rate of cuffed ETT size selected at the first time was 95％ in group A,and it was significantly higher than that in group B (60％) (P＜ 0.05).There was no significant difference in the incidence of intubation-related complications between the two groups (P＞0.05).Conclusion Uhrasonographic measurement of the transverse diameter of the cricoid cartilage produces higher accuracy in selecting the cuffed ETT size for pediatric patients and is worthy of clinical application.

Objective:To analyze the characteristics of vocabulary and phrase acquisition in Mandarin-exposed children with autism spectrum disorder (ASD), intellectual developmental disability (IDD) or general developmental delay (GDD) in rehabilitation training institutions, and to provide a basis for selecting training vocabulary for ASD children.Methods:A cross-sectional study was carried out on 75 cases of 1-6-year-old children with neurodevelopmental disorders of ASD (the ASD group), IDD and GDD [the developmental disability(DD) group] by using a self-designed questionnaire containing nouns, verbs, adverbs, adjectives and pronouns, 464 words in total.The participants were recruited from Department of Rehabilitation Medicine, Beijing Shouer Liqiao Children′s Hospital and Beijing Shunyi District Shouer Yazhi Children′s Rehabilitation Center from March 2019 to February 2020.Effective co-mmunication vocabulary was obtained." Children Neuropsychological and Behavioral Scale, Revision 2016" was used for developmental evaluation.At the same time, 37 children with normal development and equivalent intellectual age [the typical development(TD) group] were recruited from the outpatient department of children′s Health Department of Children′s Hospital, Capital Institute of Pediatrics as a control group.The rank sum test or chi- square test was used for data analysis. Results:There were 31 children in the ASD group, with a median chronological age of 36.0 (27.0-59.0) months and median mental age of 20.6 (12.0-35.0) months.There were 44 children in the DD group, with a median chronological age of 37.0 (12.0-77.0) months and median mental age of 24.3 (6.0-56.0) months.There were 37 children in the TD group, with a median chronological age of 20.0 (10.0-61.0) months and median mental age of 21.9 (12.0-55.0) months.No significant difference was found in the mental age among the 3 groups ( χ2=0.718, P=0.698). The total development quotients of the ASD group and the DD group were 56 (36-83) and 68 (17-92), respectively, which were significantly lower than that of the TD group [99 (79-128)] ( χ2=45.234, 48.583; all P<0.001). Developmental assessment subscales: the developmental quotients of gross motor, fine motor, adaptive ability, language and social behavior as well as communication warning behavior indices in the ASD group were 77, 52, 60, 39, 52 and 40, respectively; the above scores in the DD group were 75, 64, 73, 60, 60 and 8, respectively.The developmental levels of the ASD group in all the above 6 aspects, except for the gross motor, were significantly lower than those of the DD group ( χ2=5.763, 5.172, 11.174, 6.108, 41.917; all P<0.05). The effective communication vocabulary was 10 in the ASD group, 174 in the DD group and 146 in the TD group, and the difference was significant ( χ2=12.785, P=0.002). The ratio of children that could speak phrases was 9.7%in the ASD group, 29.5%in the DD group, and 51.4% in the TD group.The difference was significant ( χ2=13.733, P=0.001). Based on the analysis of the effective communication vocabulary, the number of effective communication words was none in the ASD group, only 1 in the DD group and 49 in the TD group if taking that more than 75% of the children could speak the word as the statistical cut-off point.If taking that 50%-<75% of the children could speak the word as the cut-off point, the number of effective communication words was only 6 (Mama, Baibai, Baba, Baobao, Men, and Bu successively) in the ASD group, 187 in the DD group, and 71 in the TD group.If taking that 25%-<50% of the children could speak the word as the cut-off point, the number of effective communication words was 112, 183 and 103 in ASD, DD and TD groups, respectively.There was a statistically significant difference in the number of effective communication words among the three groups ( χ2=456.694, P<0.001). Matching the effective communication vocabulary that more than 25% of the children in the ASD group could speak with that that more than 50% of the children in the TD group could speak, there were 93 overlapping words, accounting for 78.8%(93/118) of the ASD group and 77.5%(93/120) of the TD group.In the overlapping words, nouns accounted for 67.7%(63/93) and verbs accounted for 26.9%(25/93). Conclusions:The vocabulary acquired by children with ASD and DD is similar to that by TD children of the same mental age.However, ASD children have extremely low vocabulary expression and comprehension ability.The effective communication words of ASD and TD children overlap at different percentages.These overlapping words provide a basis for optimizing the selection of training vocabulary.Training vocabulary dominated by nouns and verbs may help to improve the effect of intervention training in ASD children.

Objective To construct a diagnostic model based on the information of the TCM four diagnoses in hyperactive liver yang syndrome in patients with essential hypertension.Methods Syndromic investigation was carried out in patients with essential hypertension in some hospitals in Fujian and Beijing,and diagnostic information such as age,gender,symptoms,tongue and pulse were collected.On the basis of statistical analysis,this study adopted C5.0,CRT,CHAID and QUEST decision tree models respectively.After evaluating the stability and performance consistency of the models,the accuracy of the models was measured by diagnostic rate,and the optimal model of hyperactivity of liver yang in essential hypertension was selected.Results Totally 533 patients with essential hypertension were included,including 198 patients with hyperactive liver yang syndrome and 335 patients without hyperactive liver yang syndrome.The diagnostic rates of the four models were 75.2%,66.2%,67.7%and 65.0%,respectively.The diagnostic efficiency of C5.0 was better than that of CRT,CHAID and QUEST models."Aggravation after emotional excitement,poor complexion,string-like pulse,irritability,head swelling pain,bitter mouth,heavy pulse,fatigue,dark tongue,irritability,dizziness,thin pulse,yellow fur"could be regarded as the specific items of the syndrome model of hyperactive liver yang in essential hypertension.Conclusion The C5.0 decision tree model can clearly and intuitively identify the hyperactive liver yang syndrome in essential hypertension patients based on clinical TCM four diagnostic information data,and summarize diagnostic rules.

TCM dispensing is the most basic clinical pharmaceutical work of TCM.In recent years,based on the 9 key technologies of TCM dispensing,the TCM dispensing industry has ushered in great development,and innovative TCM dispensing information system and intelligent dispensing equipment have appeared.This article sorted out the current situation of TCM dispensing industry and looked forward to its future development route.The results showed that the introduction of new technology and new equipment in the key technical links of procurement acceptance,dispensing review,TCM decocting,medication guidance and so on have improved the quality of dispensing service and ensured the quality and safety of medication.In the development of modern TCM dispensing industry,it is necessary to improve the quality control standard system,service standard system and core equipment standard system in the standardization of dispensing technology;in terms of talent cultivation in the field of dispensing,it is necessary to focus on restructuring and building new educational models to cultivate new medical talents that intersect medical and engineering fields;in terms of informatization and intelligence,it is necessary to develop intelligent equipment that is more in line with the characteristics of TCM,and further promote and improve the"shared TCM pharmacy"model.Through improving the content of TCM clinical pharmaceutical care,developing new technology and equipment of TCM dispensing,and improving the level of dispensing service and education,it is expected to gradually realize the standardization,informatization and intelligent development of modern TCM dispensing industry.

This study delves into the pivotal factors influencing the consensus process within traditional Chinese medicine guideline development, with the objective of augmenting the quality of this process through methodological recommendations aimed at elevating standardization.