Objective To investigate the relationship among serum levels of suppressors of cytokine signaling-3(SOCS-3),insulin-like growth factor binding protein-1(IGFBP-1) and hyperglycemia in critically ill children. Methods The 64 critically ill children who suffered from sepsis,after surgical repair of congenital heart dis-ease by extracorporeal circulation, and after surgery of severe traumatic from January 2009 to January 2012 in Depart-ment of Pediatric Intensive Care Unit( PICU) of Guangzhou Women and Children′s Medical Center were selected as the research object. According to the blood glucose levels on admission, the 64 children were divided into the normal glu-cose group and the hyperglycemia group. The 15 cases of healthy children in the same period in Guangzhou Women and Children′s Medical Center were selected as the healthy control group. The levels of blood glucose,insulin,SOCS-3,IG-FBP-1 and insulin resistance index( HOMA-IR) were measured and compared among groups when they were on ad-mission. Results (1) The blood glucose of the hyperglycemia group was significantly higher than those in the normal glucose group and the healthy control group[(9. 83±2. 48) mmol/L vs (4. 82±0. 76) mmol/L,(4. 49±0. 81) mmol/L] (P<0. 05). (2) Both of the insulin and HOMA-IR in critically ill children with hyperglycemia were significantly higher than those in the other 2 groups[9. 68(5. 85,17. 35) mU/L vs 4. 08(2. 00,7. 41) mU/L,2. 83(2. 00,10. 10) mU/L;4. 30(2. 70,7. 66) vs 0. 87(0. 39,1. 94),0. 52(0. 38,2. 56)](P<0. 05). (3) The serum SOCS-3,IGFBP-1 levels among the hyperglycemia group,the normal glucose group and the healthy control group were not of significant difference (P>0. 05). (4) The blood glucose was positively correlated with the insulin and HOMA-IR(r=0. 455,0. 773,P<0. 05),but there was no significant correlation among the blood glucose,insulin,HOMA-IR,SOCS-3 and IGFBP-1(P>0. 05). Con-clusions In the critically ill children,hyperglycemia was related to the insulin resistance which can not be evaluated through changes in serum levels of SOCS-3 and IGFBP-1. In addition,it cannot be excluded that the critically ill chil-dren may have insulin resistance and pancreaticβ-cell dysfunction simultaneously.

BACKGROUND:Location relationship between maxilary incisor labial inclination and the thickness of anterior alveolar bone displays ethnic and regional differences. OBJECTIVE:To study the correlation of alveolar bone structure and incisor labial inclinationin adolescents with skeletal class II malocclusion in Uygur and Han populations of Xinjiang, China. METHODS:Sixty Uygur and 60 Han patients at 11-16 years of age (average 13.8 years old), 32 males and 28 females, with skeletal class II malocclusion wereincluded. The thickness of anterior alveolar bone and incisor labial inclination were measuredon lateralcephalometric films, and the results were analyzed using SPSS 17.0 statistical software. RESULTS AND CONCLUSION:In Han and Uygur populations, palatalalveolar bone thicknessin maxilary incisor regionwas significantly negatively correlated with the inclination of maxilary incisor (r=-0.715 for Han,r=-0.651 for Uygur,P< 0.05), while labial alveolar bone thicknessin mandibular incisor regionwas significantly positively correlated with the lower incisor inclination (r=0.902 for Han,r=0.745 for Uygur,P< 0.05). These results indicate thatthepalatal alveolar bone thicknessin maxilary incisor region decreases with the increase of the inclinationof maxilary incisor; however,thelabial alveolar bone thicknessin mandibular incisor regionincreases with the increase of the lower incisor inclination.

Objective: To investigate the detection ability of two reagents by automated coagulation analyzer ACL-TOP using immune turbidimetric method, and to determine the merits and demerits of them. Methods:Two reagents were compared in the study. We selected 532 cases of hospitalized patients in Anzhen Hospital, 388 cases of which were unstable angina, 60 cases were pulmonary thromboembolism, 70 cases were coronary atherosclerosis, 14 cases were abdominal aneurysm, and the rest were the patients with high blood pressure and coronary heart disease. The plasmas of all the patients were extracted, and D-dimer was detected on ACL-TOP by D-Dimer (referred to as reagent A) and D-DHS (referred to as reagent B). Results:The results of D-dimer increased in different degrees, and there are 88 cases of false positive cases. The case whose FDP and individual D-dimer of D-dimer simultaneous detection was elevating and clinical symptoms were disappeared was detected by the VIDAS instrument platform verification. There were significant differences between A and B. The detection result of reagent A was [1594.15±2286.18], and reagent B was [912.97±1814.06]. There were significant differences between them (t=3.654, P<0.05). In addition, the consistency of the two reagents was poor (r=0.419, P<0.05). Conclusion:Comparing two reagents to detect D-dimer quantitatively by automated coagulation analyzer ACL-TOP, D-DHS owns greater ability to exclude false-positive results, so does the ability of anti-interference with jaundice, hemolysis and chylemia.

Sepis s is the leading cause of death in critically ill children,but it lack biomarkers with a higher sesn itivity and specificity for sepsis diagnosis,severity assessment,and prognostication.Soluble uroki-nase plasminogen activator receptor( suPAR) ,as a nvo el receptor ts imual ted by inflammation,is involved in the plasminogen activating pathways,inflammation and migration,adhesino ,chemotaxis,signal transduction of v ra ious immuen cell.suPAR serum levels have been shown to significantly incer ase in various infectious dis-easse .This revei w provided a ed scriptive overview of the role of suPARd etection in sepsis judgmne t and prognostication,hoping to find a perfetc biomarker for timely evaluait ng of chidlr en with spe sis and screening for childrena dmitted to the intensive care uin t in order to improve outcome and reduce mortality.

OBJECTIVETo explore a safe and effective scheme of analgesic for labor.

METHODSEighty-four primiparas without contraindication of vaginal delivery were divided into an observation group and a control group, 42 cases in each one. In the observation group, the acupoint injection was given at Zusanli (ST 36) combined with electroacupuncture (EA) at Hegu (LI 4) and Sanyinjiao (SP 6) till the cervical opening at the end of first stage labor. In the control group, the routine respiratory instruction was applied. In 5 min, 10 min and 60 min of acupuncture (the same time points in the control group) as well as at the end of the first and second stage labor, the analgesic effect was assessed for the primiparas of the two groups. The labor stages, adverse reactions, postpartum hemorrhage, postpartum urine retention, newborn asphyxia rate and usage rate of oxytocin were compared between the two groups.

RESULTSIn the observation group, in 5 min, 10 min and 60 min of acupuncture as well as at the end of the first and second stages, the visual analogue scale (VAS) was lower apparently as compared with the control group at the corresponding time points (all P < 0.05). The differences in the time limit in the active period, the second and third stages were not significant between the two groups (all P > 0.05). The incidence of adverse reactions and the usage rate of oxytocin were lower than those in the control group [2.4% (1/42) vs 31.0% (13/42); 2.4% (1/42) vs 23.8% (10/42), both P < 0.05]. The differences in postpartum hemorrhage, postpartum urine retention and newborn asphyxia rate were not significant between the two groups (all P > 0.05).

CONCLUSIONThe combination of acupoint injection and EA is the effective analgesic scheme for labor. This scheme effectively alleviates labor pain and has no maternal and child complications.

Acupuncture Analgesia ; Acupuncture Points ; Adult ; Analgesics ; administration & dosage ; Combined Modality Therapy ; Electroacupuncture ; Female ; Humans ; Labor Pain ; drug therapy ; therapy ; Labor, Obstetric ; Pregnancy ; Young Adult

Objective To investigate the effect of clinical nursing pathway on patients with cerebral infarction. Methods Two hundred patients with cerebral infarction were randomized by random digit table into the clinical pathway group and the conventional nursing group.The former was managed with the clinical nursing pathway and the latter received conventional nursing. The neurologic impairment and the activities of daily life were assessed respectively by national institute of health stroke scale(NIHSS) and Barthel index(BI).The two groups were compared in terms of hospital stay,medical expense,patient’s satisfaction and curative effect. Results Compared to the conventional nursing group,the clinical pathway group was shorter at hospital stay,lower at lower hospitalization cost,higher at patient’s satisfaction and higher in the score by Barthel index,compared to the conventional nursing group(all P<0.05). Conclusion The application of clinical nursing pathway in patients with cerebral infarction can improve the activities of daily living and the quality of care,shorten length of stay,reduce medical cost and increase patients’satisfaction drgree.

To investigate causes and clinical picture of fever of unknown origin (FUO), and to sum up the experiences in diagnosis of FUO, the medical records of 107 patients with FUO were reviewed retrospectively. Specific causes were identified in 99. 1% of these patients, including infections in 50 patients(46. 7%) , rheumatic problems in 22(20. 6%) and malignancies in 17(15. 9%). The main pathogens responsible for the infections were pyogenic bacteria(72. 0% , 36/50) and M tuberculosis (18. 0% , 9/50), mostly extrapulmonary. Lymphatic and he-mopoietic tissue neoplasms were the main forms of malignancy (88. 2%, 15/17), including histiocytosis, malignant lymphoma and leukemia. Drug fever was another common cause of FUO, accounting for 8. 4% in our series.

SUMMARY Hyperparathyroidism is the clinical syndrome that results from elevated circulating parathyroid hormones,leading to multiple systems manifestations,and is divided into three kinds: primary, secondary and ternary.This patient’s main chief complaint was intermittent melena for 3 days,with the diagnosis of upper gastrointestinal hemorrhage according to endoscopy. Hypercalcemia, hypophosphatemia and high level of circulating parathyroid hormone and chronic renal failure were also found during hospitalization. Furthermore, MIBI showed a parathyroid adenoma located near the isthmus in the lower part of the left lobe. The patient had undergone nephrectomy because of kidney carcinoma 2 years ago. Primary hyperparathyroidism usually has the common gastrointestinal syndrome , but upper gastrointestinal hemorrhage reported as the chief complaint is rare and we had never seen similar reports before.

Objective To explore the application effect of paclitaxel combined with carboplatin neoadjuvant chemotherapy in patients with advanced cervical carcinoma.Methods Forty patients with stage Ⅱa and above cervical cancer who were treated between August 2015 and August 2016 were selected as the research objectives and all patients were diagnosed by pathological examination.They were divided randomly into experimental group(n=20)and control group(n=20).Patients in the experimental group were treated with intravenous chemotherapy before operation.This scheme included paclitaxel and carboplatin.It included 2 cycles,and the interval between the 2 cycles was 3 weeks.Extensive hysterectomy and pelvic lymphadenectomy were made in 14 days after chemotherapy.The patients in the control group were treated only with extensive hysterectomy and pelvic lymphadenectomy.The efficacy of neoadjuvant chemotherapy was evaluated according to WHO criteria,and observed the operation condition.Adverse drug reactions were evaluated according to WHO anti-cancer drug adverse reaction grade.The quality of life of the two groups was evaluated by the mos item short from health survey(SF-36).Results 20 patients completed chemotherapy,CR5 cases,PR11 cases,SD3 cases,PD1 cases,and the total effective rate(CR+PR)was 80％.At the same time,The paracervical tissue becomed soft in varying degrees,the gap widened,the invasive lesions were controlled in different degrees.Adverse reactions were mild and relieved without special treatment.There was no kidney and heart function damage.All cases were operated successfully after chemotherapy.There were no significant difference in operation time and blood loss between the two groups.The rate of lymph node metastasis,the infiltration rate of uterine tissue and the residual rate of tumor tissue in the vaginal margin were lower than those in the control group(P<0.01).The SF-36 scores of the two groups were higher than those before treatment,but the score of the experimental group was higher significantly than that of the control group,and the difference was statistically significant(P<0.01).Conclusion Paclitaxel combined with carboplatin in neoadjuvant chemotherapy of cervical cancer can reduce the tumor volume,increase the chance of surgery,has less toxic side effects,lower metastatic rate and improve the quality of life of patients.It is worthy of further clinical research and recommendation.