Holter monitoring remains an useful diagnostic tool in the evaluation of syncope in children if synco-pe remains unexplained after the initial examination.But it should not be used as a screening tool.Holter monitoring is recommended in children who were suspected as cardiac syncope or who had an abnormal electrocardiogram.For chil-dren with frequent syncope,Holter monitoring is highly recommended.More information can be provided with extended Holter monitoring to 48 hours if possible.Heart rate variability is probably useful in predicting head -up tilt test diagno-sis of neurally mediated syncope.

The 53rd ASH meeting was held in San Diego in December 2011. The meeting has received many advanced reports on the diagnosis and treatment of multiple myeloma (MM).On therapy,with the application of thalidomide, lenalidomide and bortezomib as inductive treatments, the clinical outcomeshave been improved greatly in MM patients.Pomalidomide,a new immunomodulator,can be hopefully used as a frontline medicine for MM because of its high response. Bendamustine combination with other treatments induced efficient response and good response rates in MM patients with renal insufficiency or relapsed/refactory disease. Currently autologous stem cell transplantation is still the standard care for newly diagnosed young MM patients.At this time other kinds of novel agents have entered into clinical trials and have shown a bright future of application.

Objective: To study the entry points of pharmaceutical care performed by clinical pharmacists for patients in ICU.Methods: Clinical pharmacists participated in the medication treatment process of one case of patient with torsade de pointes by providing individualized pharmaceutical service, including antiarrhythmic drug selection, anti-infection therapy adjustment and electrolyte disorder rectification.Results: The therapeutic effect and medication safety of the patient were both improved by giving clinical pharmaceutical care.The vital signs of the patient were stable, and then the patient transferred from ICU and continued to be treated with rehabilitation therapy.Conclusion: Clinical pharmacists can play an active role in the rescue of ICU patients by the pharmaceutical thinking and provide efficient pharmaceutical care with high quality.

Objective: To explore the working methods of clinical pharmacists for improving the rationality of drug use through participating in individualized treatment practice for the patients with tumor.Methods: Clinical pharmacists participated in the individualized treatment of the patients with tumor, found out adverse drug interactions, adjusted dosage for the renal insufficiency patients, treated infection or pain and corrected inappropriate drug combination, etc.Results: Clinical pharmacists provided integrated pharmaceutical care and offered medical advice in accordance with the individualized information of patients, which improved the treatment effect and avoided potential adverse drug reactions or adverse events.Conclusion: Clinical pharmacists provide pharmaceutical care and participate in the performance of individualized treatment for cancer patients, which can effectively improve the level of drug treatment.

Objective To investigate the level of anxiety and emotional intelligence in general nurses of community health service centers in Shenzhen city, and provide theoretical basis for the intervention of anxiety in general nurses by analyzing the relationship between anxiety and emotional intelligence . Methods The self-rating anxiety scale ( SAS ) and emotions intelligence scale ( EIS ) were employed for the survey among 92 general nurses from 20 community health service centers in Shenzhen city . Results The SAS scores was 40.18 ± 7.26, significantly higher than the national norm. The rate of anxiety was 54.35%. Thirty-nine contracted anxiety at a low level, accounting for 42.39%, 10 did at a moderate level, accounting for 10.87%, and 1 did at a higher level, accounting for 1.09%. The EIS score was 3.49 ± 0.47. The highest dimension score was management of emotions for others and the lowest score was emotional perception. The dimension of management of emotions for others was positively related to social anxiety (P<0.05), and the dimension of use of emotions negatively related to social anxiety (P<0.05). Conclusions General nurses of community health service centers in Shenzhen suffer from anxiety at a high level and their emotional intelligence is at a medium level. Both factors predict the level of social anxiety in general nurses of community health service centers . Improving the emotional intelligence can be an approach to reduce the level of anxiety.

ObjectiveThe aim of this study is to investigate whether oral administration of collagen Ⅱ peptide (250-270)[C Ⅱ (250-270)]-cholera toxin B subunit (CTB)complex could effectively set up oral immune tolerance to collagen-induced arthritis (CIA) in mice. MethodsDBA/1 mice were divided into Ⅰ, Ⅱ, Ⅲ and Ⅳgroups. Group Ⅰ was normal control group. Collagen type Ⅱ emulsified in Freund's complete adjuvant were injected to mice of groups Ⅱ , Ⅲ and Ⅳ twice from the base of the tail. Mice of group Ⅲ were fed with C Ⅱ (250-270)-CTB covalent complex twice after the arthritis was developed. Mice of group Ⅳ were fed with C Ⅱ(250-270) and CTB mix at the 14th day after primary immunization. Visual scores and histopathologic scores of arthritis were recorded. The frequencies of arthritis between the groups were compared usingFisher's exact test. The clinical and histological severity of arthritis were analyzed by ANOVA.Results The frequencies of arthritis in groups Ⅰ , Ⅱ , Ⅲ and Ⅳ were 0, 100％, 100％ and 25％ respectively. Average accumulative scores of arthritis were 0, 5.0±1.7, 10.8±2.8 and 1.0±2.0 respectively. Average accum-ulative histopathological scores of arthritis were 0, 16±8, 32±13 and 7±6 respectively. Conclusion Oral administration of C Ⅱ (250-270) and CTB mix in arthritis mice after C Ⅱ immunization can suppress the onset and severity of arthritis. Oral administration of C Ⅱ (250-270)-CTB covalent complex in the acute stage of arthritis can accelerate arthritis.

Objective To explore the relationship between the classification and imageology,the dynamic changes of bronchoscopy and CT features of endobronchial tuberculosis(EBTB).Methods CT findings and bronchoscopic findings in 48 cases with EBTB proved by sputum culture , bronchoscopic biopsy and surgical pathology were analyzed.The classification,dynamic changes and CT characteristics were also evaluated.Results Bronchoscopic results showed 13 of edematous-hyperemic type, 8 of caseous nocrosis type, 5 of fibrostenotic type, 2 of tumorous type, 6 of granular type, 7 of ulcerative type and 7 of mixed type. CT manifestations in different types were intersected,including thickened bronchial wall (64.6%) , bronchial stenosis (41.7%) , aerated bronchus sign ( 37.5% ) ,intra-luminal nodules ( 25% ), bronchial structure with obstructive atelectasis ( 37.5% ) and pneumonia (25% ) .The corresponding rate between bronchoscopy and CT was 83.3% in detecting diseases.19 cases were followed-up by bronchoscopy during the initial 1~5 months of treatment,and 12 cases (3 edematous-hyperemic,4 caseation,3 ulcerative,2 mixed type) were resolved or healed without sequelae,6 cases changed into the other type,4 cases changed into the fibrostenotic type, 2 cases remained in a fibrostenotic state in spite of drug therapy.28 cases were followed-up by CT during the initial 1~5 months of treatment, and 20 cases (6 edematous-hyperemic,4 caseation,3 ulcerative, 1 granular,2 fibrostegnotic 1 tumorous,3 mixed type) were improved,6 cases changed into the other type,2 cases turned into the fibrostenotic type, 2 cases did not improve despite antituberculosis chemotherapy.CT correlated well with fibrobronchoscope(88.5%) in predicting the therapeutic outcome of EBTB.Conclusion CT as a non-invasive method has high clinical value in observing the evolution , predicting the complications and evaluating the therapeutic effect of EBTB.

Transition metal oxide ZnO nanoparticles as inorganic matrix was adopted in the matrix assisted laser desorption ionization time-of-flight mass spectrometry ( MALDI-TOF-MS ) analysis of small molecule compounds including sugars and stearic acid and its performances were investigated. In addition, the feasibility of metal ion selective ionization of L-arginine by using NiO and CuO nanoparticles as matrix directly was explored initially. In the experiment, the analyte and nanoparticle suspension were mixed on the sample plate. The crystal of analyte and matrix was excited by 337 nm laser after the solvent was evaporated, and then detected under reflection mode of TOF-MS. The results indicated that ZnO nanoparticles with high UV absorption could eliminate the interference of conventional matrix, simplify the mass spectra, and enhance the peak intensity of stearic acid under negative mode. Moreover, Cu+ ion selective ionization of L-arginine was achieved in comparison of CuO and NiO as matrix for MALDI-TOF-MS analysis of L-arginine.