Through analyzing the children's pre-hospital transport,emergency medicine,intensive care medicine,nursing,professional training and research,we reviewed the current status of construction and issues of pediatric emergency and critical care system,then put forward recommendations of its development.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Female ; Humans ; Lower Extremity ; physiopathology ; Male ; Middle Aged ; Muscle Spasticity ; etiology ; therapy ; Paralysis ; etiology ; therapy ; Stroke ; complications

Objective To discuss the clinical application of simplified neonatal critical illness score (sNCTS)in comparison with original neonatal critical illness score(oNCIS)published in 2001.Method A total of 705 neonates referred to neonate ICU(NICU)from 1 st January 2007 to 31th December 2009 were prospectively studied with control.The patients were scored by oNCIS on admission day,3rd,7th days after admission and on the day of discharge or dead.At the first scoring on admission,2 items of the PaO2 and pH were excluded from oNCIS's 10 items,and the remaining 8 items were used.Three items of plasma sodium,potassium and creatinine or BUN were scored out from 8 items and the still remained 5 items were used for the subsequent 3 scorings.The remaining 8 and 5 items were used as a simplified neonatal critical illness score.The simplified NCIS was evaluated by comparing the patients'condition that was assessed by the originat NCIS.The consistency rate between oNCIS and sNCIS should be over 80%.Results There were 8 items were used to evaluate the severity of disease on admission, and the consistence rate was 86.7%with the original NCIS.The 5 items selected from the original NCIS were used on the 3rd,the 7th days and the day of discharge or death.the consistence rate with original NCIS were 86.6%to 95.7%.A close correlation existed between the original NCIS and simplified NCIS(P<0.01).There were significant differences in mortality rates of the non-serious,serious and extremely serious groups between original NCIS and simplifled NCIS used for the first and the last seorings(P<0.01).Within a cohort of neonates with the same general condition,the assessments of mortality rates were not significantly different between these two methods (P>0.05).Conclusions Compared with the original NCIS.the simplified NCIS is consistent to a large extent in disease assessment,which is a concise way to evaluate the critical ill neonates objectively and can be easily applied to clinical practice.

The Pharmacopoeia of the People’s Republic of China 2025 edition is to be issued in March 2025. Chinese Pharmacopoeia is the basic requirements on the drug manufacture, drug testing, drug use and drug administration. The new edition Chinese Pharmacopoeia will be dramatically improved on the pharmacopoeia monographs included, establishing the standards system, standards conversion and application of drug quality control for the new technology, new method & new tool, drug control on the safety and effectiveness as well as the drug standard international harmonization. It will take important role on improving the drug quality, ensuring the safety of drugs for public use, strengthen technical support for drug administration, promoting the high-quality development of China’s medical and pharmaceutical industry. This paper introduces the development and revision of the Chinese Pharmacopoeia 2025 Edition,aim at helping the industries well understanding and implantation the new edition Chinese Pharmacopoeia.

Objective To discuss the value of high-resolution magnetic resonance imaging (HR-MRI) in the etiological diagnosis of patients with head and neck artery occlusion.Methods From December 2015 to February 2017,25 consecutive patients with acute head and neck artery occlusion in Xuanwu Hospital,Capital Medical University were enrolled prospectively.The 32-channel head-neck combined coils were used to conduct head-neck integrated HR-MRI.The characteristics of proximal vascular wall of the occluded vascular segments and the signal features of thrombi in the middle and distal segments of occlusion were analyzed.The evaluation of the occlusive etiology was performed by two neurologists according to the clinical history,laboratory examinations,and imaging examinations of the patients,and the accuracy of conventional lumen imaging and conventional lumen imaging combined with HR-MRI in etiological classification were compared.Results Twenty-five patients with acute head and neck artery occlusion completed HR-MRI examinations.A total of 31 segments of the occluded vessels were diagnosed,and 21 of these were diagnosed with the conventional luminal imaging,30 were diagnosed with the conventional luminal imaging+HR-MRI,including 24 segments of atherosclerotic occlusion (n=19),4 segments of arterial dissecting occlusion (n=4),and 3 segments of arteritis occlusion (n=2).(2) In patients with atherosclerotic occlusion,the eccentric thickening was observed in the proximal wall of occlusive segment;the typical double-lumen or crescent-shaped hyperintense hematoma were observed in occlusive arterial dissection;long-segment annular thickening and enhancement were observed in the segment of arteritis occlusion.(3) The accuracy of the cause classification diagnosis of conventional luminal imaging and conventional luminal imaging+HR-MRI were 67.7% (21/31) and 96.8% (30/31) respectively (P<0.01).Conclusions Compared with the luminal imaging,the head and neck combined HR-MRI can reveal the arterial wall characteristics of the initial segment of occlusion.It has certain advantages in the interpretation of the causes,such as atherosclerosis,arterial dissection and arteritis.

Objective The study aimed to explore the relationship between AIF related pathway and the inju-ring of cultured SGNs (spiral ganglion neurons)by glutamate toxicity,and to find AIF expression and distribution changes in SGNs.Methods SGNs of 40 newborn rats within 3 day were obtained and cultured in vitro.Cultured cells were divided into four groups:the normal control group,10 mM,20 mM and 40 mM glutamate injured group, separately.After 48 h hours culturing,optical microscopy,immune fluorescence staining and real-time fluores-cence quantitative PCR were used to observe the morphology,AIF distribution,and AIF,calpain,Caspase3 expres-sion changes in SGNs in vitro.TUNEL was used to verify the cell apoptosis.ResuIts Noticeable morphological chan-ges and cell apoptosis were occurred in 20 mM glutamate group,with AIF nuclear translocation.AIF gene expression was significantly higher than normal after glutamate administration (P<0.05);moreover,calpain gene expression increased(P<0.05);but caspase3 expression was not statistically significantly increased in all glutamate treated groups (P>0.05). ConcIusion In the process of cultured SGNs injured by glutamate,AIF participated in the cell apoptosis.Noticeable cell apoptosis were occurred in 20 mM glutamate group with AIF nuclear translocation.Calpain up-expression also contributed to excitatory neurotransmitter injury on SGNs,but Caspase 3 had no obvious effects.

Objective To study the effects of chronic manganism on hearing and cochlear cells in rats by using animal model of chronic manganism .Methods Sixty adult SD rats were randomly divided into Mn - exposed and controlgroups.RatsweretreatedwithMnCl24H2O(100mg·kg -1·d-1)ordeionizedwaterbygastricperfusion, lasted for 12 weeks .The Mn concentration in peripheral blood was measured respectively at 4 weeks ,8 weeks and 12 weeks after treatment .At 12 weeks after treatment ,the auditory brainstem response was recorded ,the hair cells morphology and counting were examined by stretched preparation of basilar membrane stained with FITC -phalloi-din ,and the spiral ganglion cells morphology and counting were studied by HE staining ,the ultrastructure changes of hair cells and spiral ganglion cells were detected by transmission electron microscopy .Results The blood Mn concentration increased gradually with time after treatment .ABR thresholds at 4 ,8 ,16 ,24 and 32 kHz were sig-nificantly increased at 12 weeks after treatment ,especially in the high-frequency range .Morphological study at 12 weeks after treatment showed loss of outer hair cells ,mainly in the basal turn of the cochlea ,and decreased number of spiral ganglion cells .The ultrastructure changes of outer hair cells and spiral ganglion cells included the break -ups ,disappearance or vacuolar change of mitochondria cristas .Conclusion Our data demonstrate that chronic man-ganism can cause loss of outer hair cells and spiral ganglion cells in cochlear in rats ,leading to hearing loss .

The Chinese Pharmacopoeia 2020 edition was reviewed and approved by the National Medical Products Administration and the National Health Commission of the People's Republic of China in July 2020.The current edition was officially implemented on December 30,2020.The general chapters of the Chinese Pharmacopoeia discuss the general testing methods and guidelines,which are the common re-quirements and basis for the implementation of drug standards in the Chinese Pharmacopoeia.Owing to adherence to the principles of scientificity,versatility,operability,and sustainable development,there is an improvement in the general chapters of the 2020 edition over those of the previous editions.Further,the application of advanced and mature analytical techniques has expanded,the development of testing methods for exogenous pollutants in traditional Chinese medicines has been strengthened,and technical requirements are now better harmonized with international standards.The updated edition provides technical and methodological support to ensure safety,effectiveness,and control of pharmaceuticals in China and will play an important and active role in encouraging the application of advanced technolo-gies,improving the quality control of medicines,and strengthening the means of drug regulation in China.This review provides a comprehensive introduction of the main features of and changes to the general chapters in the Chinese Pharmacopoeia 2020 edition and aims to provide reference for its correct understanding and accurate implementation.

Objective: To investigate the clinical effect of posterior unilateral short segment screw fixation and bone graft fusion in the treatment of special upper cervical spine injuries. Methods: A retrospective case series study was conducted to analyze the clinical data of 15 patients with upper cervical spine injury admitted to Shanxi Bethune Hospital from July 2012 to May 2017. There were nine males and six females, aged 10-69 years [(41.9±20.9)years]. There were eight patients with traumatic atlantoaxial dislocation, one with congenital atlantoaxial dislocation, two with atlantoaxial dislocation with nonunion of odontoid process, three with Anderson type II odontoid process fracture, and one with old odontoid process fracture. All patients had cervico-occipital pain to different degrees, slender unilateral pedicle and distinct stenosis of vertebral artery. All patients were treated with posterior unilateral screw fixation and bone graft fusion. The injury of spinal cord and vertebral artery, operation time and intraoperative blood loss were recorded. Visual analogue scale (VAS) was used to evaluate pain before and after operation, and Japanese Orthopaedic Association (JOA) score was used to evaluate spinal cord function and postoperative improvement rate before and at the last follow-up. The position of internal fixation and fusion of bone graft were observed by X-ray after operation. Results: All 15 patients were followed up for 6-36 months [(20.4±8.6)months]. All the screws were implanted successfully at the first time, without spinal cord or vertebral artery injury. The operation time was 100-210 minutes [(131.3±32.0)minutes], and the intraoperative blood loss was 100-450 ml [(203.1±104.0)ml]. Preoperative VAS score was (7.9±0.9)points, and postoperative VAS score was (3.7±0.8)points (P<0.01). Preoperative JOA score was (12.1±4.4)points, and the JOA score at postoperative follow-up was (16.1±1.4)points, with the improvement rate of 68%. Postoperative X-ray showed good recovery of cervical spine sequence. One patient developed loosened internal fixation after the neck brace protection was removed one month after surgery, and the patient recovered after timely second surgical fixation and fusion. The remaining 14 patients did not have loosened internal fixation, fracture or loss of reduction, with bone fusion 6-12 months after surgery. Conclusion Posterior cervical unilateral short-segment screw fixation and bone graft fusion can restore cervical stability, relieve pain, and improve function recovery, which can be used as a complementary procedure to treat upper cervical spine injury with anatomic structure variation.

Objective:To investigate the differences between the expression levels of ribosomal protein L32 (RPL32) in human breast cancer tissue and normal breast tissue and the effects on the proliferation of breast cancer cells.Methods:Paraffin samples of breast cancer tissues and adjacent tissues (more than 3 cm from the tumor margin) were collected from 56 breast cancer patients in the Department of Thyroid and Breast Surgery of the First People's Hospital of Shangqiu City from July 2020 to May 2022. The expression of RPL32 in 56 breast cancer patients and their corresponding paracancer tissues was detected by immunohistochemistry. MCF7 cells were divided into experimental group (ribosomal protein L32, RPL32) and control group (negative control, NC). MCF7 cells in experimental group were transfected with RPL32-siRNA vector, while MCF7 cells in control group were transfected with scramble siRNA vector. RPL32 mRNA content in each group was detected by RT-PCR. The expressions of RPL32 and P53 in the experimental group and control group were detected by western blot. The proliferative ability of cells in each group was detected by CCK8 assay. The clonogenesis ability of each group of cells was detected by clone formation experiment.Results:The positive rate of RPL32 in breast cancer patients was 8.93% (5/56), and the expression rate of RPL32 in paracancer tissues was 78.57% (44/56). The expression rate of RPL32 in breast cancer patients was significantly higher than that in paracancer tissues, with statistical significance ( P=0.007). After transfection with siRNA vector, the mRNA content of RPL32 in MCF7 cells of experimental group and control group decreased, and the protein expression level of RPL32 was 1.09±0.21 and 0.40±0.11, respectively. The expression levels of P53 protein were 1.24±0.32 and 0.37±0.09, respectively. The absorbance of CCK8 at 120 h was 1.11±0.24 and 2.19±0.28, respectively, and the proliferation ability of MCF7 cells in the experimental group was significantly decreased ( P=0.043). The results of clone formation experiment showed that the cell clone formation rate of the experimental group and the control group was (21.11±3.46) % and (58.75±4.29) %, respectively, and the cell clone formation of the experimental group was decreased ( P=0.026) . Conclusions:The expression of RPL32 is significantly increased in breast cancer, which may be related to the malignant degree of breast cancer. Inhibition of RPL32 expression in breast cancer cells affects its proliferation ability.