Objective To evaluate the influence of laboratory critical value reporting on the efficacy of pediatric critical care.Methods A comparative analysis was conducted to evaluate the changes after the establishment of laboratory critical value reporting system.The parameters chosen for assessment included laboratory test turnaround time,medical intervention start time,survival rate,etc.Results Before the establishment of laboratory critical value reporting system,laboratory test turnaround time was (44.5±14.6)min,medical intervention start time was (40.7±5.3)min,and the success rate of the emergency treatment in ICU was (80.36±6.32)%[the rate in normal ward was(82.64±9.21)%].But after the establishment of laboratory critical value reporting system,laboratory test turnaround time,medical intervention start time,the success rate of the emergency treatment in ICU (normal ward) were (18.7±8.8)min,(23.9±6.7)min and (89.49±4.58)% [(90.04±6.45)%].Laboratory critical value reporting system shortened laboratory test turnaround time and medical intervention start time (P<0.05),and the successful rate of the emergency treatment improved evidently.Conclusion Laboratory critical value reporting system can improve successful rate of the emergency treatment significantly.

Cytokeratin 1 4 (CK1 4)has a different degree of expression in NSCLC,breast cancer,cer-vical cancer,esophageal cancer and other tumors,except in the normal basal cells.CK1 4 is mainly expressed in the peripheral part of the tumor,which is rarely expressed in the non-aggressive part.Usually the higher malignant of the tumor has the more expression of CK1 4.Given all that,CK1 4 gene plays an important role in the tumor progression and metastasis in a variety of tumors,which can be considered as an biomarker being used in the diagnosis,treatment and prognosis evaluation.

Objective: To investigate the efficacy of acupuncture and point injection in cooperation with Tuina and reposition for treating lumbar intervertebral disc protrusion.Methods: Treatment was given by first acupuncture, then point injection and last Tuina and reposition. It was administered once daily, 6 times as a course and compared with simple Tuina and reposition. Results: Both the effective rate in the clinical treatment and the cure rate in the same period were significantly higher in the treatment group than in the control group. Conclusion: A composite treatment by acupuncture and point injection in cooperation with Tuina and reposition is better in curative effect and shorter in the course of treatment than simple Tuina and reposition.

Objective To investigate the expression and correlation of P73 and PS3 proteins in esophagus squamous cell carcinoma. Methods The immunohistochemistry staining assay was conducted to detect the expression of PS3 and P73 proteins in 46 cases with squamous cell carcinoma of esophagus and 30 normal mucosa cases. The protein expressions and clinic pathological observation and the correlation between two proteins were statistically analyzed. Results The expression of P53 and P73 proteins showed differences between esophageal cancer tiksue and normal mucosa ( P = 0.007,0.008) . The expression of P53 appeared to be correlated with lymph node metastasis(P = 0.047) and gender(P =0.028),but not correlated with age, the depth of invasion , differentiation of cancer tissue, gross observation and position of the tumor( P > 0.05 ). The expression of P73 appeared to be correlated with differentiation of cancer tissue and lymph node metastasis ( P = 0. 023, 0.035), but not correlated with age, gender, the depth of invasion,gross observation and position of the tumor (P >0.05). P73 expression was positively corelated with P53 expression in squamous cell carcinoma of the esophagus ( r = 0.359 ,P = 0.014 ). Conclusion Both P73 and P53 proteins are associated with the occurrence of squamous cell carcinoma of the esophagus and participate in the development of esophagus squamous cell carcinoma.

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OBJECTIVE To investigate the causes and preventive measures of postoperative pneumonia due to cervical part and upper thoracic part esophageal carcinoma surgery. METHODS Fifty seven cases with cervical part or upper thoracic part esophageal carcinoma from 2001 to 2005 were studied restropectively. RESULTS One patient died of aspiration pneumonia,one died of anastomotic leakage,and three died of adult respiratory distress syndrome(ARDS).The tracheotomy and mechanical ventilation were applied.Pneumonia was confirmed among sixteen patients at different degree. CONCLUSIONS Many causes contribute to postoperative pneumonia on patients with cervical part or thoracic part esophageal carcinoma,and the lesion of recurrent nerve is an important reason.Protection of recurrent nerve may decrease postoperative pneumonia.

The theory of static and dynamic combination coincides with the effect of osteoblast stress, although there are few articles on molecular biology about the theory in recent years. The treatment of static and dynamic combination theory for fractures and other orthopedic disorders is to use the localized stress fracture, and the stress controls bone formation results through afffecting proliferation of osteoblast differentiation, which has proved by relevant experimental evidence. This article discussed the molecular biology basis about the correlation between theory of static and dynamic combination and osteoblast proliferation and differentiation by stress stimulation.

Objective To investigate the optimal timing of surgical treatment for multi-drug resistance patients,discuss the clinical effect of surgery with chemotherapy treatment for muhi-drug resistant tuberculosis,and obtain more evidence for further optimizing surgical treatment strategy for such patients.Methods 100 cases who were multi-drug resistant and who received treatment in our hospital from July 2003 to June 2010 were included in this retrospective study.Among them,50 (observation group) received pulmonary lobectomy followed by anti-tuberculosis chemotherapy for 12 to 24 months,and the others (control group) only received anti-tuberculosis regimens although they had indications for pulmonary lobectomy.All patients in both groups were followed up for 12 to 24 months.Therapeutic effects and post-operational events were compared statistically in the observation group patients according to their duration of disease.Results Results At the end of follow-up,the cure rate,illness exacerbation rate and mortality were 36.0％ (18/50),16.0％ (8/50) and 26.0％ (13/50) respectively in the control group,whereas those in the observation group were 80.0％ (40/50),2.0％ (1/50) and 4.0％ (2/50) respectively.Resistanee to new anti-tuberculosis drugs appeared in 3 cases (6％) in the control group,while there was no new resistance in the observation group.The cure rate and complication rate were 96.30％ and 3.70％ respectively for patients whose duration of illness was less than 2 years,whereas those were 47.8％ and 43.5％ respectively for cases whose duration of illness was more than 2 years.Bronchopleural fistula,hemorrhage,pyothorax and pulmonary atelectasis were main postoperative complications,from which 11 cases recovered and 2 died,the death caused by choking of big haemoptysisand and multiple organs failure.Conclusion The therapeutic effects of surgical treatment plus anti-tuberculosis chemotherapy were better than chemotherapy alone.Pulmonary lobectomy could result in better response if done at the earlier stages of illness.Complications of operations were acceptable.

Objective To observe the effect and mechanism of nasal continuous positive airway pressure(nCPAP)in the treatment of obstructive sleep apnea/hypopnea syndrome(OSAHS)with coronary heart disease.Methods 126 OSAHS patients with coronary heart disease were randomly divided into two groups.The treatment group was treated by nCPAP on the basis of former medicine but the control group was treated by former methods.Three months later,polysomnography(PSG)and the holter ECG examination were conducted.Results After three months,the nocturnal myocardial ischemia episodes decreased significantly in both groups(55.6%and 6.35%,P＜0.01).Conclusion nCPAP may abolish sleep apnea and hypopnea,correct hypoxemia,reduce the nocturnal mean heart rate and systolic blood pressure,and improve myocardial ischemia episodes,so to reduce the incidence of cardiac end-point events.

Objective To retrospectively demonstrate risk factors for mortality in multiple trauma patients with acute respiratory distress syndrome(ARDS).Method This wes a retrospective cohort stuay regarding multi-ple trauma as a single cause for intensive care unit admission.Patients identified multiple trauma with ARDS en-rolled in prospectively maintained database between May 2003 and April 2008 were observed,and 23 items of po-tential risk factors of impacting mortality were calculated by univariate and multivariate logistic analyses in order to find distinctive items in these multiple trauma patients.Information on patients demographics characteristics,treat-ment procedures and injury severity were collected at the time of EICU admission.The criteria used for ARDS met definition of the guideline(2006)of Chinese medical association.The commonly accepted definition of multiple injuries was consistent with both several injury sites(generated from two or more than two anatomic sites)and in-jury in one anatomic site at least threatening life.Severity of injury was quantified by injury severity seore and the simplified acute physiology score and chronic health evaluation score (APACHE Ⅱ)in EICU admission.We in-cluded adult patients(age≥18 years),those with an EICU length of stay longer than 48 hours,and those accept-ing mechanical ventilation more than 24 hours.Patients who were readmitted to EICU by virtue of non-traffic injury or transferred to EICU from other hospitals after long-term treatment were excluded.Mortality was assessed at the 28th clay after trauma.Results There were 269 multiple trauma patients with posttranmatic ARDS admitted to ICU during the study period,the unadjusted odds ratio(OR)and 95% confidence intervals(CI)of mortality were associated with six risk factors(APACHE Ⅱ score,duration of tratuna factor,pulmonary contusion,aspiration of gastric contents,sepsis and duration of mechanical ventilation)out of 23 items.The adjusted Odds Ratios(ORs) with 95% CI were denoted with respect to surviving beyond 96 hours ICU admission(APACHE Ⅱ score,duration of trauma factor,aspiration of gastric contents),APACHE Ⅱ score beyond 20 ICU admission(duration of trauma factor,scpsis,duration of mechanical ventilation)and mechanical ventilation beyond 7 days ICU admission(dura-tion of trauma factor and sepsis).Conclusions Impact of pulmonary contusion and APACHE Ⅱ score contribut-ing to prediction of mortality may exist in prophase after multiple trauma.Sepsis is still a vital risk factor referring to systemic inflammatory response syndrome,infection,and secondary multiple organs dysthnetion.Aspiration of gastric contents could lead to incremental mortality due to scvere ventilation associated pneumonia.Duration of trauma factor determined degree of injury and outcomes,longer duration generally manifested higher mortality.Long-standing mechanical ventilation should be constrained on account of occurring severe refractory complications.