Objective:To investigate the methods of the anesthetization of the foreign body extraction in respiratory tract of infants.Methods:This clinical study compared two anesthetic methods in foreign body extraction of respiratory tract of infants:Ketamine+Sodium r-hydroxybutyrate intravenous (group A) and Ketamine+propofol intravenous (group B) and analyzed the advantages and disadvantages of both methods.Results:Compared with group B,the extent of the changes of heart rate and blood oxygen saturation in patients of group A is littler,and the incidence rate of breath holding and asphyxiation is littler too.Conclusions:The anesthetic effect of Ketamine+Sodium r-hydroxybutyrate intravenous in better than that of Ketmaine+propcfol intravenous.

Objective To identify the features of 1H-magnetic resonance spectroscopy(1H-MRS) in patients with chronic obstructive pulmonary disease(COPD) of the hippocampus.Methods 32 patients with COPD randomly selected and 30 normal controls were selected.1H-MRS of the hippocampus was performed given to on all the subjects on hippocampus.The ratios of NAA/Cr and Cho/Cr were determined.Results In the bilateral hippocampus, the NAA/Cr ratio in patients with COPD demonstrated lower than that in normal controls(t=4.963,P=0.007 and t=4.856,P=0.023).The Cho/Cr ratio in patients with COPD showed higher than that in normal controls, the differences was were statistically significant(t=3.469,P=0.013 and t=3.019,P=0.047) Conclusion Abnormal metabolism of neurons on the hippocampus in patients with COPD is showed.

Objective To detect the lymphocyte subpopulations in patients with early syphilis ,so as to know their immunity con‐dition and guide clinical treatment .Methods Flow cytometry was used to detect CD3+ ,CD4+ and CD8+ lymphocyte subpopula‐tions in peripheral blood from 59 volunteers ,including 20 normal individuals (Cont group) ,10 patients with primary syphilis (PS group) ,15 patients with secondary syphilis (SS group) and 14 patients with early latent syphilis (ELS group) .Results CD3+ , CD4+ and CD8+ lymphocyte subpopulations in each syphilis groups were higher than Cont group .SS group had the highest CD3+level ,second was PS group ,and third was ELS group .There was significant difference among three groups (P<0 .05) .The CD3+level of SS group was significantly higher than that of Cont group (P<0 .05) .ELS group had the highest CD4+ level ,second was SS group ,third was PS group .The difference of CD4+ level was significant among three groups (P<0 .05) .PS group had the high‐est CD8+ level ,second was SS group ,third was ELS group .However ,the difference of CD8+ level among three groups was not sig‐nificant (P>0 .05) .There was no significant difference of CD4+ /CD8+ among three groups(P>0 .05) .Conclusion Cytoimmunity in early syphilis enhances ,which could be benefit to eliminate Treponema Pallidum .

Objective To understand the interaction between surfactant proteins and pneumocystis carinii pneumonia (PCP),and the impact of corticosteriods on surfactant proteins.Methods We established rat models of PCP and bacterial pneumonia induced by subcutaneous injection of 25mg cortisone acetate.At 8- 12 wk,the bronchoalveolar lavage fluid(BALF)of rats was collected.Total nucleated cells of BALF were counted and differentiated,and the concentrations of surfactant protein A(SP-A)and surfactant protein D(SP-D)were measured by immunoblotting assay.The rats were divided into three immunosuppressive groups and a normal control group.Group I,normal control(n = 6),consisted of healthy SD rats;group Ⅱ,negative control(n = 6),consisted of rats with cortisone acetate injection for over 8 wk without lung infection;group Ⅲ,bacterial pneumonia(n = 11),rats were injected with cortisone acetate over 8 wk that resulted in bacterial pneumonia without other pathogens isolated;and group Ⅳ,PCP(n = 14),rats with injected cortisone acetate for 8 - 12 wk and developed PCP without other pathogens isolated.Results Our results indicated that the total cell count in BALF in the negative control group was lower than that in the normal control group(P ＜ 0.001).During PCP infection,the total cell count and the percentage of polymorphonuclearcytes(PMNs)in BALF were significantly increased(P ＜ 0.01),but were lower than those in the bacterial pneumonia group.The concentration of SP-A of BALF in PCP(45.1 ± 22.1 μg/ml)was significantly increased in comparison with that in the negative control(16.2 ± 9.9 μg/ml,P ＜ 0.05)and bacterial pneumonia groups(6.2 ± 5.6 μg/ml,P ＜ 0.001).We also found that the relative content of SP-D was significantly higher in PCP(24249 ±4780 grey values)than that in the negative control (13 384 ± 2887 grey values,P ＜ 0.001)and that in bacterial pneumonia(11 989 ± 2750 grey values,P＜0.001).SP-A and SP-D were also higher in the moderate to heavy group of PCP than those seen in the mild group(P ＜ 0.01,P ＜ 0.001).SP-A and SP-D were higher in the negative control group than those in the normal control group,but there was no significant difference between the 2 groups.Conclusion These results suggest that the concentrations of SP-A and SP-D in BALF are increased by pneumocystis carinii specific stimulation,but the alteration is not related to the corticosteriod usage.

Objective To explore the plasma-activated medium(PAM)produced by low temperature plasma(LTP)on the proliferation and angiogenesis of human umbilical vein endothelial cells(HUVECs)so as to provide theoretical basis for the future use of PAM to promote wound healing and inhibit tumor angiogenesis.Methods HUVECs were selected as the in vitro research model.The PAM-containing medium after LTP treatment for different time points(0 s,15 s,30 s,45 s,60 s,and 75 s)was used for intervention.The influence of PAM on HUVECs viability was assessed using the MTT assay and cell cycle analysis.The effects of PAM on angiogenesis were examined through angiogenesis experiments.Intracellular levels of reactive oxygen species(ROS)were measured using fluorescence probes.A melanoma mouse model was established,and CD31 expression was detected by immunohistochemistry.Results As the treatment time increased,the intracellular levels of ROS also elevated.PAM derived from LTP exhibited a bidirectional effect on angiogenesis in HUVECs.Compared to the control group(0 s),low-dose treatments(15 s and 30 s)enhanced HUVECs viability,while high-dose treatments(45 s,60 s,and 75 s)significantly decreased cell viability(P＜0.05).The proportion of HUVECs in the S phase was significantly increased in the PAM-15 s and PAM-30 s groups,but markedly decreased in the PAM-45 s,PAM-60 s,and PAM-75 s groups,with statistically significant differences(P＜0.05).The HUVECs tube formation ability was enhanced in the 15 s and 30 s PAM groups,but diminished in the PAM-45 s,PAM-60 s,and PAM-75 s groups,characterized by the decreased numbers of vascular nodes,intersections,meshes,and branching points(P＜0.05).After PAM treatment in the melanoma mouse model,the control group exhibited widespread distribution of CD31 in tumor tissue,while the PAM-5 min and PAM-10 min groups displayed reduced distribution of CD31.Conclusion Short-term exposure to PAM enhances HUVECs proliferation and angiogenesis,whereas prolonged exposure suppresses cell viability and inhibits angiogenesis.

Post-intensive care syndrome (PICS) is the most common complication in patients discharged from intensive care unit (ICU), which seriously affects the life quality of the patients. At present, there is still lack of standardevaluation methods for PICS. Continuous and dynamic assessment can earlyidentify PICS, moreover, early identification and intervention of PICS can improve the life quality of patients those patients, which is critical to improve the long-term outcome of the patients. In this paper, we reviewed the current research states of evaluation timing, contents, tools and modalities of PICS domestic and abroad, analyzed the problems and prospects of the existing evaluation methods, aiming to provide a reference for clinical staff to effectively and comprehensively evaluate PICS.

Since the global COVID-19 pandemic, SARS-CoV-2 infection, which causes COVID-19, has been associated with a range of diseases whose atypical manifestations have been increasingly reported. The mild encephalitis or encephalopathy associated with reversible corpus callosum lesions or mild encephalitis/encephalopathy with reversible splenial lesion (MERS) is a rare clinical and radiographic syndrome. At present, the pathogenesis of MERS caused by COVID-19 is still unclear, and its pathogenesis may include hypoxic damage, inflammatory response, immune disorders, changes in osmotic pressure, excitatory amino acid toxicity, oxidative stress and functional abnormalities of renin-angiotensin system. This paper reports a case of severe COVID-19 complicated with MERS, and discusses the pathogenesis from a pathophysiological point of view.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.