Objective To evaluate the effect of transcutaneous electrical acupoint stimulation(TEAS)on emergence agitation in children under?went general anesthesia with sevoflurane. Methods Sixty children aged 3?6 years underwent adenoidectomy and tonsillectomy were selected and randomly divided into two groups:TEAS(group T,n=30)and control(group C,n=30). After venous induction,the general anesthesia was main?tained with sevoflurane. Group T received continuous TEAS at point hegu and neiguan after anesthesia induction till the end of operation. Control group were not given TEAS. The change of the blood flow dynamics in the process of anesthesia,the time of extubation,awaking time and the time in PACU were recorded. The emergence agitation,postoperative nausea and vomitting and respiratory depression were observed. Results There were no significant differences in gender,age,weight,anesthesia time,and operative time between the two groups (P>0.05 ). There was no significant difference in extubation time,awaking time and time in PACU between the two groups(P>0.05). The mean arterial pressure and heart rate in group T were lower than those in group C at the time of extubation and in PACU(P<0.05). The emergence agitation scale in group T was lower than in group C(P<0.01). There was no significant difference in incidence rate of PONV and respiratory depression between two groups. Conclusion TEAS can reduce emergence agitation in children with sevoflurane?induced general anesthesia,but not prolong extubation time,awaking time and time in PACU. In addition,it does not increase the incidence of respiratory depression.

Parenting competence is a new index to evaluate the parents′ ability to take care of their children and it gradually becomes a new research focus in the field of nursing. It not only meets the demand for child care, but also significantly reduces the occurrence of various medical problems during perinatal period by improving parents′parenting competence so as to enhance the level of maternal and child health care. So this paper aims to state the factors of sense of competence and provide a reference for clinical nursing staff.

Objective:This paper is to propose a calibration model based on sine function which enables more choices to determine the functional relationship between the absorbance and the concentration of the tested substance.Methods:This paper uses Taylor series expansion and Levenberg-Marquardt to obtain the optimal parameters for the Sine model and then summarizes the characters of the Sine model. On the basis of these characters, this paper compares and evaluates the experimental data processed by the Sine model from four aspects: correctness, precision, linearity and correlation.Results:The generated sine function calibration model achieved deviations within ±3% of the national standard substance, precision ( CV%) less than 2%, and a linear correlation coefficient greater than 0.990 within the measurement range of 32-710 mg/L. The correlation coefficients between the sine model and other well-performing linear calibration models for 104 clinical samples were all greater than 0.990. Conclusions:The performance evaluation of the prealbumin assay kit using the sine function calibration model meets industry standards and shows good correlation with the results of clinical sample measurements. This indicates that the sine function calibration model can serve as a new calibration model for in vitro diagnostic research and clinical applications.

Objective To establish a quantitative assay of serum Golgi protein 73 ( GP73) using xMAP technology and evaluate its performance. Methods Monoclonal antibodies against GP73 were prepared and purified, and antibody pair screening was performed by double?antibody sandwich enzyme?linked immunosorbent assay. The screened antibodies were used to construct a Luminex liquid chip detection system, and the analysis performance of the detection system was evaluated. The serum levels of GP73 were detected in 90 clinical samples from healthy controls and patients with chronic hepatitis B infection ( CHB) and hepatocellular carcinoma ( HCC). Results Five anti?GP73 monoclonal antibodies were prepared and purified, and 5 antibody pairs were successfully screened.The Luminex liquid chip detection system of GP73 was successfully constructed using 8F10D1 and 10B9F11 antibody pairs. The analytical performance evaluation showed that the sensitivity of this system was 0.25 ng／ml and the dynamic range was 0.25?100 ng／ml. No cross reactivity was observed. The intra? and inter?assay variation for GP73 was ＜8% and ＜11%, respectively. The recovery was 83%?92%. The linear regression equation was y＝1.141x+6.436 ( r2 ＝0.998 4, P＜0.001). The GP73 concentrations in the serum samples of healthy control, CHB group, and HCC group were 42.8 (38.68, 55.90) ng／ml, 61.49 (43.59, 81) ng／ml, and 122.78 (49.36 liter, 264.55) ng／ml, respectively.The levels of GP73 in HCC group were significantly higher than those in CHB group and healthy controls (P＜0.05). Moreover, the levels of GP73 in CHB group were significantly higher than those in healthy controls ( P＜0.05). Conclusions A liquid chip detection system of GP73 was successfully constructed. It provides a powerful tool for the clinical application of GP73 in the future.

Objective To establish a quantitative assay of serum Golgi protein 73 ( GP73) using xMAP technology and evaluate its performance. Methods Monoclonal antibodies against GP73 were prepared and purified, and antibody pair screening was performed by double?antibody sandwich enzyme?linked immunosorbent assay. The screened antibodies were used to construct a Luminex liquid chip detection system, and the analysis performance of the detection system was evaluated. The serum levels of GP73 were detected in 90 clinical samples from healthy controls and patients with chronic hepatitis B infection ( CHB) and hepatocellular carcinoma ( HCC). Results Five anti?GP73 monoclonal antibodies were prepared and purified, and 5 antibody pairs were successfully screened.The Luminex liquid chip detection system of GP73 was successfully constructed using 8F10D1 and 10B9F11 antibody pairs. The analytical performance evaluation showed that the sensitivity of this system was 0.25 ng／ml and the dynamic range was 0.25?100 ng／ml. No cross reactivity was observed. The intra? and inter?assay variation for GP73 was ＜8% and ＜11%, respectively. The recovery was 83%?92%. The linear regression equation was y＝1.141x+6.436 ( r2 ＝0.998 4, P＜0.001). The GP73 concentrations in the serum samples of healthy control, CHB group, and HCC group were 42.8 (38.68, 55.90) ng／ml, 61.49 (43.59, 81) ng／ml, and 122.78 (49.36 liter, 264.55) ng／ml, respectively.The levels of GP73 in HCC group were significantly higher than those in CHB group and healthy controls (P＜0.05). Moreover, the levels of GP73 in CHB group were significantly higher than those in healthy controls ( P＜0.05). Conclusions A liquid chip detection system of GP73 was successfully constructed. It provides a powerful tool for the clinical application of GP73 in the future.

BACKGROUNDThe treatment of the patient with pelvic fracture urethral disruption defects (PFUDD) remains controversial especially in pediatric urology. Debate continues in regarding the advisability of immediate repair versus delayed repair. The aim of this study was to analyze our experience in the outcomes of immediate and delayed repair of pelvic fracture urethral distraction defects in young boys.

METHODSWe retrospectively reviewed the records of 210 boys with posterior urethral disruption after pelvic injury between 1992 and 2012. Exclude partial urethral injury, a total of 177 cases acquired follow-up. All patients were evaluated by plain radiography, ultrasonography, or a computed tomography scan to assess the conditions of the upper urinary tract and to exclude other severe injuries. Data on 35 patients who underwent immediate repair were compared to those on 142 treated with delayed urethroplasty. After the diagnosis of a complete urethral injury, the immediate repair group underwent urethroplasty via the perineal approach if the patient's condition was stable, and serious complications were treated. The delayed repair group patients with the delayed urethroplasty average 6 months after injury. All patients were evaluated postoperatively for urethral strictures, incontinence and impotence. The patients were assessed by uroflowmetry and renal ultrasonography with evaluation of the postmictional residue every 3 months during the first year of follow-up. We assessed incontinence and erectile function by questioning the parents or the children themselves. Statistical analysis with the chi-square test was performed using SPSS software.

RESULTSOne hundred and seventy-seven patients were followed up with an average 58 months (range 6 to 192 months). Strictures developed in 3 (9%) patients in immediate repair group; two required direct visual internal urethrotomy (DVIU), the other patient required dilatation. Strictures developed in 11.9% of the delayed repair group, 17 patients need visual internal urethrotomy or urethroplasty. Incontinence (11.4%) and impotence (8.6%) seem less frequent in the immediate repair group than in the delayed reconstruction group (17.7% and 21.8%, respectively). However, the results showed that there was no statistical difference between the two groups in strictures after first surgery, incontinence and impotence. Patients with delayed reconstruction underwent an average of 2.6 procedures compared with an average of 1.1 in the immediate repair group.

CONCLUSIONSImmediate repair of urethral disruption is possible when the patient's condition was stable. It may decrease the requirement for subsequent urethral surgeries. Immediate repair does not appear to increase the rate of impotence or incontinence. The strictures after immediate repair also may be easier to treat. Although immediate repair could be inconvenient in the massively injured patient, it is still a worthwhile maneuver in dealing with PFUDD.

Adolescent ; Anastomosis, Surgical ; methods ; Child ; Child, Preschool ; Fractures, Bone ; surgery ; Humans ; Male ; Pelvic Bones ; injuries ; surgery ; Retrospective Studies ; Urologic Surgical Procedures ; methods

Objective: To establish a quantitative assay of serum Golgi protein 73 (GP73) using xMAP technology and evaluate its performance. Methods: Monoclonal antibodies against GP73 were prepared and purified, and antibody pair screening was performed by double-antibody sandwich enzyme-linked immunosorbent assay. The screened antibodies were used to construct a Luminex liquid chip detection system, and the analysis performance of the detection system was evaluated. The serum levels of GP73 were detected in 90 clinical samples from healthy controls and patients with chronic hepatitis B infection (CHB) and hepatocellular carcinoma (HCC). Results: Five anti-GP73 monoclonal antibodies were prepared and purified, and 5 antibody pairs were successfully screened. The Luminex liquid chip detection system of GP73 was successfully constructed using 8F10D1 and 10B9F11 antibody pairs. The analytical performance evaluation showed that the sensitivity of this system was 0.25 ng/ml and the dynamic range was 0.25-100 ng/ml. No cross reactivity was observed. The intra- and inter-assay variation for GP73 was <8% and <11%, respectively. The recovery was 83%-92%. The linear regression equation was y=1.141x+ 6.436 (r²=0.998 4, P<0.001). The GP73 concentrations in the serum samples of healthy control, CHB group, and HCC group were 42.8 (38.68, 55.90) ng/ml, 61.49 (43.59, 81) ng/ml, and 122.78 (49.36 liter, 264.55) ng/ml, respectively. The levels of GP73 in HCC group were significantly higher than those in CHB group and healthy controls (P<0.05). Moreover, the levels of GP73 in CHB group were significantly higher than those in healthy controls (P<0.05). Conclusions A liquid chip detection system of GP73 was successfully constructed. It provides a powerful tool for the clinical application of GP73 in the future.

【Objective】 To explore the safety of RhD-positive red blood cells (RBCs) immunization schedules in RhD-negative volunteers, so as to facilitate the development of domestic anti-D immunoglobulin. 【Methods】 From January 2018 to April 2020, 23 RhD negative volunteers with informed consent were enrolled and divided into initial immunization group and booster immunization group. The initial immunization included first immunization, second immunization and third immunization. Four groups, i. e. 3 cases of 20 mL, 8 of 30 mL, 6 of 40 mL, and 6 of 50 mL, were involved in initial immunization. After the initial immunization response, booster immunizations were performed every 3 months. According to the anti-D titer before each immunization, the booster immunization doses were set to 0.5, 1 and 2 mL. Whole blood samples of 5mL/ person (time) were collected 24 h and 1 week after each infusion, and the blood routine, liver, kidney and blood coagulation function and anti-D titer were detected. The differences of detection (index) values at 24 h and 1 week after the first immunization and booster immunization in each (dose) group were compared. 【Results】 No statistically significant differences were observed in hemolysis index values (all within the range of medical reference values) 24 h or 1 week after initial immunization among RhD positive RBCs of 20, 30, 40 and 50mL(P>0.05). The differences between the hemolysis index values and the basic values before the immune response (all within the range of medical reference values) after 0.5 or 1 mL booster immunizations were also not statistically different (P>0.05). However, the differences (μmol/L)between total bilirubin levels and the basic values before the immune response (1.55±1.87, 6.29±2.66) were significantly different after 2 mL booster immunization (P<0.05). 【Conclusion】 No risks affecting the safety of RhD negative volunteers was found in the immunization schedule proposed in this study.

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.