Objective:　To explore the therapeutic effect and safety of thrombolysis and pure anticoagulation therapy in patients with acute submassive pulmonary embolism. Methods: A total of 63 patients with acute submassive pulmonary embolism were randomly divided into thrombolysis group (n=32) and pure anticoagulation group (n=31). Arterial blood gas index and right heart functional index changes of two groups were observed before treatment and after two-week treatment, and their therapeutic effects were compared and analyzed. Incidence of bleeding and thrombocytopenia were counted in two groups. Results: Compared with before treatment, there were significant improvements in arterial blood gas and right heart functional indexes after treatment in two groups, P<0.05 or <0.01; compared with pure anticoagulation group, there were significant rise in partial pressure of oxygen in artery [PaO2,（77.8±7.3）mmHg vs. (83.4±8.7) mmHg], right ventricular anterior wall motion [RVAWM, (4.9±1.7) mm vs. (5.8±2.2) mm]; and significant descent in alveolar-arterial oxygen difference [P (A-a)O2, (23.1±2.8) mmHg vs. (16.5±2.4) mmHg mmHg], pulmonary artery systolic pressure [PASP, (54.6±7.9) mmHg vs. (34.2±7.5) mmHg] in thrombolysis group, P<0.05 or <0.01. Total effective rate of thrombolysis group (100%) was significantly higher than that of pure anticoagulation group (80.6%), P=0.002. There were no significant difference in incidence rates of bleeding and thrombocytopenia between two groups, P>0.05. Conclusion:　Thrombolysis therapy can significantly lower pulmonary artery pressure and improve oxygenation and right ventricular function indexes in patients with acute submassive pulmonary embolism. It may be a preferred recommendation for patients without contraindications.

Objective To probe a simple, safe, and minimally invnsive method to treat ectopic pregnancy with preservation of the organs. Methods Superselective catheterization of uterine artery through cannulation of right femoral artery was achieved in 56 patients with ectopic pregnancy. Location of the lesions involved, feeding arteries, and active bleeding were observed on angiography. 150 mg of methylamine neopterin diluted in 100 ml of saline water was infused slowly into the target artery. Small gelatin spongy particles with size of 0.5 mm in diameter were used to embelize the uterine artery until its branches were totally obliterated. Follow-up was undertaken to observe the results of the treatment. Results Suporselective uterine arterial infusion and embolization were successfully performed in all 56 patients without any related complications. Active bleeding in the peritoneum in 33 cases ceased soon after embolization. The embryos in 13 patients were confirmed to have died by ultrasound two days after the procedure. Beta-HCG value dropped to below 5 U/L within two to twelve days. Hemorrhage in the peritoneum dissolved after seven days in all cases. Mixed mass disappeared after one month. Histerosalpingography was performed three months after the procedure in 19 patients and patent fallopians were demonstrated in 11 patients. Conclusions Superselective uterine arterial infusion and embolization is a minimally invasive procedure, which can be used to effectively treat ectopic pregnancy by disabling the ectopic embryo and embelizing leaking arteries with the advantages of preserving the fallopian tubes.

Objective To compare two different dumping cooking methods (boiling vs.frying) in their effect on postprandial glucose level in diabetic patients using continuous glucose monitoring (CGM).Methods 10 type 2 diabetes mellitus (T2DM) in-patients in the Department of Endocrinology of Peking Union Medical College Hospital between February and May 2011 were enrolled,whose fasting and preprandial glucose levels were controlled with a insulin pump.On day 2 and day 4 in the study period,the patients were given fried dumplings and boiled dumplings for lunch respectively,with the same nutrient contents.The starch digestibility of these two kinds of dumplings were compared using in vitro resistant starch digestion,measuring the concentrations of rapidly digestible starch,slowly digestible starch,and resistant starch.CGM was used to record blood glucose changes,in order to evaluate glycemic effect of these two dumpling cooking methods on postprandial glucose levels at 9 time points (0,15,30,60,90,120,150,180,and 240 minutes),peak blood glucose,and area under the curve (AUC) in 4 time periods (0-60,63-120,123-180,and 183-240 minutes).Results The percentage of rapidly digestible starch was remarkably lower in fried dumplings than in boiled dumplings (30.8％ vs.77.0％),but the content of slowly digestible starch in fried dumplings was higher than that in boiled ones (63.7％ vs.20.7％),and the content of resistant starch in both dumplings were similarly low (1.9％ and 2.3％).The average time to the peak glucose value was shorter in fried dumplings compared with boiled dumplings [(93 ± 53) minutes vs.(156 ± 61) minutes,P =0.02],but the average glucose levels at all the 9 time points and the AUC in all the 4 time periods were not significantly different (all P ＞ 0.05).Conclusions Compared with fried dumplings,boiled dumplings show faster starch digestion,but long time to the peak postprandial glucose level.Fried dumplings may raise the glucose level faster than boiled dumplings do in T2DM patients.

Objective:To establish the prediction model of the ultimate risk of mechanical ventilation for patients undergoing nasal high-flow oxygen therapy in the intensive care unit (ICU), provide clinicians with a convenient and effective prediction method and accurate treatment timing, and improve the prognosis of ICU patients.Methods:Patients admitted to the ICU of our hospital from January 2019 to December 2021 were retrospectively enrolled. General clinical data of the patients were collected, including vital signs, biochemical indices of blood gas, inflammatory indices, acute comorbidities, APACHE Ⅱ score, length of stay in ICU and total length of stay, within 24 h after admission. Statistical analysis was performed on the above indicators and a chart was constructed.Results:Finally, 362 patients were enrolled in this study, and were divided into the transnasal high flow oxygen therapy group (HFNC group) and noninvasive positive pressure ventilation group (NIPPV group) according to whether mechanical ventilation was finally performed. The univariate and binary Logistic multivariate regression analysis showed that APACHE Ⅱ score ( OR=1.323, 95% CI: 1.818-1.483), ROX index ( OR=0.371, 95% CI: 0.226-0.609), total length of stay ( OR=1.097, 95% CI: 1.003-1.200) and complicating acute respiratory failure ( OR=2.456, 95% CI: 1.368-4.506) were independent influencing factors for determining whether patients underwent mechanical ventilation. Based on the above independent influencing factors, the lipopograms were constructed. The goodness of fit R2 and C-index of the model were 0.892 and 0.985, respectively through evaluation and verification model. The calibration curve of the model fitted well with the ideal curve, and the areas under the ROC curve of the rosettes and independent factors were 0.985, 0.959, 0.899, 0.656 and 0.576, respectively, indicating that the model was more effective than the independent index in predicting risk. Decision curve analysis also showed that the rosette had high clinical benefit. Conclusions:There are many related factors affecting whether patients undergo mechanical ventilation after nasal high-flow oxygen therapy. In this paper, after univariate and multivariate analysis, the most valuable indicators are combined to establish a line chart with better predictive performance to assess patients' risk, which can further provide clinicians with simple and effective prediction methods and improve the prognosis of patients.

Under the leadership and high-level promotion of the central and local governments, the construction of national regional medical centers(NRMCs) in China has achieved initial results, and has received recognition and high attention from all sectors of society. The current focus of NRMCs construction has progressed from the project selection to the evaluation of construction effectiveness and the establishment of corresponding operating mechanisms. On the basis of analyzing the characteristics of NRMCs construction and reviewing the evaluation of NRMCs construction at the national level, this paper systematically introduced the monitoring index system and its application of NRMCs construction in Beijing Children′s Hospital, and put forward corresponding policy suggestions. The monitoring of the construction indexes of NRMCs could provide a basis and support for hospitals to identify problems in time, seek government support, and carry out target management, and has reference for promoting the effective construction of NRMCs.

Objective: To investigate the trueness and precision of routine clinical biochemistry tests in the third-grade class-A hospitals of Chongqing city. Methods: The fresh frozen serum samples were assigned the target values with reference methods, and then allocated to the clinical laboratories of the third-grade class-A hospitals in Chongqing city for testing. The trueness and precision were analyzed and evaluated. Results: The pass rates of trueness of creatinine (Cr), total protein (TP), total bilirubin (T-Bil), uric acid (UA) and glucose (Glu) in 33 clinical laboratories were below 50%. The pass rate of trueness of UA (33%) in the closed detection system was lower than that in the opening detection system (79%, P=0.033). In the opening detection system, the pass rate of trueness of Cr in the mode with the same brand of reagents and calibration materials was higher than that with different brands (P=0.014). The precisions of level 1 of T-Bil and Urea in the closed detection system were better than that in the opening detection system (P=0.043 for T-Bil; P=0.031 for Urea). Conclusion The trueness of clinical biochemistry tests in the third-grade class-A hospitals of Chongqing city needs to be further improved. There is no significant difference in trueness and precision between the opening detection system and the closed detection system, even the performance of some tests in the opening detection system is better than that in the closed detection system.