Objective To evaluate the efficacy of routine extraluminal use of an Arndt endobronchial blocker (AEB) for one-lung ventilation (OLV) in infants.Methods Thirty American Society of Anesthesiologists physical status Ⅰ or Ⅱ infants,aged 6-36 months,weighing 5-18 kg,undergoing elective thoracoscopic surgery,were enrolled in the study.The loop of AEB was fastened to the front of the endotracheal tube (ETT),and the blocker was placed externally to the ETT.After induction of general anesthesia,the AEB's placement was facilitated through the use of a fibreoptic bronchoscope.Mean arterial pressure,heart rate,end-tidal pressure of carbon dioxide,oxygen saturation and airway pressure were recorded before AEB placement (T1),during AEB placement (T2),at the beginning of OLV (T3),at the beginning of two lung ventilation (T4) and at extubation (T5).The AEB placement time and successful placement and lung collapse time were recorded.The satisfaction with lung collapse,AEB shifting,hoarseness and development of intraoperative adverse cardiovascular events and hypoxemia and hypoventilation during OLV were recorded.Results Compared with the baseline at T1,no significant change was found in heart rate or mean arterial pressure at the other time points (P＞ 0.05),airway pressure was significantly increased at T2,3,and end-tidal pressure of carbon dioxide was increased at T4 (P＜0.05).The AEB placement time was (5.6± 1.2) min,the success rate of AEB placement 93％,the rate of satisfaction with lung collapse 83％,and the incidence of AEB shifting (only found in the pediatric patients in whom AEBs were placed on the right side) 13％.No intraoperative adverse cardiovascular events,hypoxemia or hypoventilation was observed in the pediatric patients in whom AEBs were successfully placed.Conclusion Routine extraluminal use of an AEB can provide a fast,safe and effective method for OLV in infants.

Objective To investigate the effective connectivity of limbic circuit in patients with major depressive disorder when they recognized dynamic positive face expressions,aiming to discuss the possible mechanism of emotion processing in depressed patients.Methods Eighteen depressive patients and eighteen well-matched healthy control volunteers participated in the experiment.All subjects were asked to recognize the emotion face during the magnetoencephalograph (MEG) scanning.The regions of interested (ROI) brain areas included the orbital frontal cortex (OFC),the anterior cingulated cortex (ACC),the amygdala (AMYG),the hippocampus and the insula.The MEG data were preprocessed by the SPM8 software and further analyzed by the Granger casual model (GCM).The non-parameter permutation was used to compare the value of effective connectivity between the healthy controls and the depressed patients.Results Compared with healthy controls,the effective connectivity from the ACC to the AMYG (P=0.0052),from the OFC to the AMYG(P=0.0046),from the Hippocampus to the ACC (P=0.0016),and from the ACC to the Hippocampus (P=0.0042)was significantly reduced in depressed patients.Conclusion The depressed patients display decreased interaction of the limbic circuit during the happy facial emotion processing,indicating that the depressed patients are unable to deal with the positive stimuli,and to certain extent,explaining the abnormal neuropathophysiological mechanism of positive stimuli in MDD.

Objective To explore the influencing factors of compression fatigue time and the correlation between fatigue and the quality indexes of chest compression. Methods A convenience sample of 120 medical staff members in Emergency Department of PUMCH were selected and implement single hand chest compression 2 minutes according to the quality requirements of the AHA 2010 guidelines, and the computer automatically recorded the pressing quality data, including pressing frequency, pressing depth, chest wall recoil, and recording the operator fatigue time. Results The rescuer fatigue is associated with gender, body mass index and pressposture(r= -0.233,0.232,0.400;P<0.05); fatiguetimeofthemalewas(110.5±18.2)swhile the female was (81. 9 ± 20. 8)s (P<0. 05);low body mass index pressers as well as overweight tended to feel fatigue earlier than pressers with normal one. Fatigue time of kneeling posture pressing was longer than the standing posture; fatigue time was negatively associated with depressing frequency, and positive with the pressing depth. Conclusions In order to delay the compression fatigue in the chest compression process, the male and kneeling posture should be chosen with the control of pressing frequency;the female and underweight pressers should be early replaced to guarantee the pressing quality.

Objective To summarize the nursing experience of the first case of recurrent cervical cancer patient treated by after-loading therapy with interstitial brachytherapy assisted by 3D printing device in China.Methods For a patient with recurrent cervical cancer after radiotherapy,preoperative CT scan was carried out,preoperative plan was designed,3D printing template was designed,and brachytherapy was carried out according to the guidance of 3D printing source device and CT image verification. The treatment dose(D90) was four Gy/fraction,two fractions per week and five fractions in all. The patient was given psychological and medical nursing. Key points of nursing were summarized and role of nursing was evaluated.Results Nursing work was involved in the entire process of treatment,including psychological nursing,diet guidance,instruments preparation,patient assessment and preparation,nursing during brachytherapy,nursing during and after radiotherapy,and nursing for complications,etc. Operation risks and radiation complications could be effectively reduced by comprehensive nursing,together with more reasonable and accurate distribution of implant needles guided by 3D printing source device.Conclusions The advantages of interstitial brachytherapy assisted by 3D printing source device include individuality,accuracy,and good repeatability. A serious and comprehensive nursing work before,during and after the treatment plays an essential role in improving therapeutic effect, reducing patients′ risk of injury and improving operational efficiency.

Objective To filter the traditional Chinese medicine with strong antibacterial activity and effects of reversing drug resistance of bacteria for providing new ideas for the treatment of multi-drug resistant bacteria infection.Methods Six kinds of antibacterial Chinese traditional medicines commonly used in clinic treatment as Radix Paeoniae Rubra,Indigo Naturalis,Galla Chinensis,Flos Chrysanthemi Indici,Herba Hout-tuyniae,and Berberine were used in this study.After preparation of the extract using decocting method,bacte-riostatic effects of these six kinds of Chinese medicine on multiple resistant bacteria were detected by double dilution method.To evaluate the effects of Chinese medicines on reversing drug resistance of multi-drug resist-ant bacteria,minimum inhibitory concentrations for multi-drug resistant bacteria and the original strain were detected by K-B method and calculated the difference of the bacterial inhibition rings.Results T he six kinds of traditional Chinese medicines had different degrees of inhibitory effects on MDR-AB and MDR-PA,and the bacteriostatic effect sequence were Galla Chinensis,Herba Houttuyniae,Flos Chrysanthemi Indici,Radix Pae-oniae Rubra,Indigo Naturalis,and Berberine.The bacteriostatic titer of Galla Chinensis on MDR-AB and MDR-PA was 512-1 024,whose antibacterial activity was the strongest in the six antibacterial Chinese tradi-tional medicines.Galla chinensis and Berberine had significant effects on reversing drug resistance of MDR-AB MDR-PA(P<0.05),but the difference value of inhibition zone diameters before and after reversing were less than 3 mm.Conclusion Radix Paeoniae Rubra,Indigo Naturalis,Galla Chinensis,Flos Chrysanthemi Indici, Herba Houttuyniae,and Berberine could inhibit MDR-AB and MDR-PA in different degrees,in which Galla Chinensis was the most effective antibacterial Chinese Medicine.Ggalla chinensis and Berberine could reverse drug resistance of MDR-AB and MDR-PA to some extent.

Objective? To explore the effects of systematic desensitization therapy on training for newly admitted emergency nurses. Methods? Totally 60 newly admitted nurses working in the Emergency Department, Peking Union Medical College Hospital between July 2014 and July 2017 were selected using convenient sampling and divided into the observation group (n=30) and the control group (n=30) according to the random number table. Patients in the control group received conventional training for newly admitted nurses, while patients in the observation group received systematic desensitization therapy. Self-Anxiety Scale (SAS), New Emergency Nurse Core Competency Questionnaire (NENCCQ) and New Emergency Nurse Teaching Satisfaction Questionnaire (NENTSQ) were used to evaluate the effects of intervention. Results? The SAS scores of the observation group were lower than those of the control group (P＜ 0.05); the total score and scores of various dimensions of NENCCQ of the observation group were higher than those of the control group (P＜ 0.05); and the satisfaction of the observation group was higher than that of the control group (P＜0.05). Conclusions? Systematic desensitization therapy in the training for newly admitted emergency nurses can effectively mitigate the anxiety in newly admitted emergency nurses and improve their core competency and satisfaction.

Objective To investigate the diagnostic value and clinical significance of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) in children with bronchial asthma.Methods A total of 182cases newly diagnosed with asthma were divided into mild persistent group (68cases), moderate persistent group (63cases) and of severe persistent group (51cases), and 100ageand sex-matched pediatric healthy children at the same period were chosen as healthy control group.WBC, NEU, LYM, MON, EOS, PLT, IgE, NLR, PLR and LMR of all subjects enrolled in this research were retrospectively reviewed.Results There was no significant difference in age and sexuality between children with asthma and control group (P＞0.05), but WBC, EOS, NEU, MON, PLT and IgE were all significantly up-regulated, and LYM was down.NLR and PLR were significantly up-regulated in children with asthma, while LMR decreased significantly.The area under the curve (AUC) of ROC curve was 0.88and the cutoff value were 2.619for NLR in diagnosing asthmatic children.The diagnostic value of PLR was similar to that of NLR, the AUC of ROC value was 0.87, and the cutoff value was 111.1.The diagnostic value of LMR was only0.79, and the cutoff value was 5.093.In addition, there was a significant correlation between NLR and IgE or lung function indexes.PLR was also correlated with IgE, but only negatively correlated with lung function indexes such as FVC, FEV1and FEV1/FVC％.There was no significant correlation between LMR and all indexes.NLR and PLR were significantly decreased in children with severe asthma after treatment with budesonide, while LMR was significantly up-regulated.Conclusion There are abnormal changes in NLR, PLR and LMR in children with bronchial asthma, which can be used as an index for auxiliary diagnosis, disease assessment and therapeutic effect monitoring in children with bronchial asthma.

Objective To compare the effect of ultrasound measurements of the distance from skin to vocal folds (DSV), neck diameter (d) and the ratio among the two measurements (R) used to predict difficult laryngoscopy. Methods Seventy-two toddelers scheduled to undergo general anesthesia, aged ≤ 3 years, falling into ASA physical status Ⅰ or Ⅱ, were included and categorized as having easy (n = 48, grades Ⅰ and Ⅱ) or difficult (n = 24, grades Ⅲ and Ⅳ) laryngoscopy based on the criteria of Cormack and Lehane. When children were ventilated by mask, we measured DSV by ultrasound; obtained d and R. Receiver operating characteristic (ROC) curve analysis was used to determine the DSV, d and R in predicting difficult laryngoscopy. The value of cutoff was obtained by maximizing the Youden's index. Results DSV was significantly shorter in difficult laryngoscopy group (P ＜ 0.05). The areas under the ROC curve of R was 0.807, and the cutoff value was 0.090. the sensitivity was 70.83％, the specificity was 83.33％ Conclusion The ratio of distance from skin to vocal folds to neck diameter is a good predictor of difficult laryngoscopy in children under 3 years old.

Objective:To explore the latent classes of parental feeding behaviors in preschool children, and to examine the relationship between potential types of parental feeding behaviors and parental depression status.Methods:From May to July 2021, parents of preschoolers from eight kindergartens in Shanghai were recruited and investigated.A paper-based questionnaire consisting of the Chinese preschooler’s caregivers’ feeding behavior scale (CPCFBS) and the center for epidemiological studies depression scale (CESD-10) was employed.Finally, a total of 1 006 valid questionnaires were retrieved.Mplus 8.0 and SPSS 26.0 were used for statistical analysis.The latent class analysis was used to identify subgroups of parents based on their feeding practices.Multinomial Logistic regression was used to examine the relevant influencing factors.Results:The feeding behaviors of parental of preschool children could be divided into four potential categories: " high responsiveness and high non-responsiveness type" (24.55%), " low responsiveness and high non-responsiveness type" (27.44%), " high responsiveness and low non-responsiveness type" (28.33%) and " low responsiveness and low non-responsiveness type" (19.68%). The parents with depression status were less likely to be categorized as " high responsiveness and low non-responsiveness type" ( OR=0.386, 95% CI: 0.218-0.684). The parents with older children were more likely to be categorized as " low responsiveness and low non-responsiveness type" ( OR=1.318, 95% CI: 1.039-1.672). Conclusion:The feeding practices of parents of preschool children can be categorized into four latent classes.The parents with depression status are more likely to adopt non-responsive feeding practice than responsive feeding practice.Actively paying attention to and improving the depression status of parents may help the feeder to adopt scientific feeding behavior.

Objective To investigate the quality of emergency medical staffs to understand single hand cardiac compression, and analyze factors influenced the quality of cardiac compression. Methods A convenience sample of 120 medical staffs in the Emergency Department of PUMCH had been selected according to the compression′s quality requirement of AHA 2010 guidelines, that compressed heart 2 min by single hand and the computer would recorded the data automatically including pressing rate, pressing depth, chest wall recoil, etc. Results A total of 120 doctors and nurses accuracy rate of chest compression positioning was 75. 8% (91/120);the accuracy rate of pressing depth was 66. 7%;the average compression rate was (131. 1 ± 14. 3) beats/min;press depth was (5. 4 ± 0. 5) cm in 0-30 s, press depth (5. 2 ± 0. 5) cm in 31-60 s, press depth (4. 9 ± 0. 4cm), pressing depth (4. 7 ± 0. 5) cm cm in 61-90s and 91-120s ; rebound rate of chest wall was (66. 9 ± 29. 2)%. Chest compression quality indexes impacted by different gender, of which the male did better than the women in press frequency control, and they had statistical significant (P<0. 05) and the pressing depth in the press time, but rebound of chest wall had no statistical difference (P>0. 05). There were significant differences for working years and professional title in the third and fourth stage of pressing time, that medical staffs with intermediate title or above press more deep than the primary title, staffs with long working experiences press deeper. No statistically significant difference had been found in other quality index such as different ages, working years, and professional title. Conclusions The chest compressions quality of emergency medical staffs still can not meet the requirement of 2010 new guidelines, so we should focus on training on the press frequency controlling, to guarantee the pressing depth and chest wall resilience sufficient rate, keep the press position accurately, especially for women, and we can reduce the continue compression time to guarantee the pressing quality.