In recent years,the incidence and mortality rate of pediatric respiratory infection have been increasing globally,with rhinovirus being of particular correlation to pediatric respiratory infection.In addition to upper respiratory tract infection,rhinovirus RNA is also found in the lower respiratory tract during the infection period.The epithelial cells of the upper respiratory tract are the target cells of rhinovirus.In recent years,studies done on the relationship between rhinovirus infection and upper respiratory tract infection have provided evidence for clinical treatment.Further investigation is needed on the pathological mechanisms of rhinovirus-induced respiratory infections.

Objective To investigate the clinical efficacy and safety of transurthral electrovaporization of the prostate(TUVP) for benign prostatic hyperplasia( BPH) at high risk.Methods Forty-eight patients with BPH at high risk were treated with transurthral electrovaporization of the prostate(TUVP).The clinical data and therapeutic results were measured.Results All patients went through the perioperiative period safely and had been followed up for 3 to 14 months.Postvoid residual ( PVR) , the International Prostate Symptom Score (IPSS) and quality of life (QOL) before operations were (97.5 ± 16.9) ml, ( 28.4 ± 2.3 ) score and (5.5 ±0.6) score respectively.Three months after operation ,PVR ,IPSS and QOL were( 30.2 ± 12.3 ) ml, (8.2 ± 1.3 ) score and( 1.9 ±0.5) score respectively,there was significant difference between them(t =22.31,53.16,31.94,all P<0.05).Conclusion TUVP is an effective and safe method in treating BPH patients at high risk.

Objective To evaluate the significance of fiberoptic bronchoscopic brush cytology in the diagnosis and histological classification of lung carcinoma.Methods Data of 309 patients with lung carcinoma were retrospectively analyzed.Both bronchoscopic cytology and histology diagnosis were available.The positive rate of bronchoscopic cytology and tissue biopsy were calculated respectively.The classification accuracy of cytological diagnosis for lung carcinoma was evaluated.In tissue biopsy standard,evaluated the significance of bronchoscopic cytology in diagnosis and histological diagnosis.Results The positive rate of bronchoscopic cytology and tissue biopsy were 86.1％ (266/309) and 83.8％ (259/309),respectively.Bronchoscopic cytology combined with bronchial biopsy could obviously improve the positive rate to 94.2％ (291/309) in lung carcinoma diagnosis.Taking the tissue biopsy histological type as a standard,the cytotyping accuracy for brush method was 85.1％(74/87) in squamous carcinoma,82.4％(108/131) in adenocarcinoma and 100％(11/11) in small cell carcinoma for higher.However,the accuracy in diagnosing poorly differentiated carcinomas was only 12.2％ (5/ 41).Conclusion Fiberoptic bronchoscopic brush cytology plays an stable and important role in diagnosing lung carcinomas and histological type determination.However,it has limited use in diagnosing poorly differentiated carcinomas.

BACKGROUND: Peri-intraventricular hemorrhage (PIVH) in preterm infants is one of the most important reasons for mortality and disability. Moreover, investigative exponents may bring supported data for incidence rate of PIVH and high-risk factors of preterm infants with PIVH.OBJECTIVE: To explore the incidence rate and analyze the high-risk factors of PIVH in preterm infants.DESIGN: Survey and analysis.SETTING: Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology; Beijing Obstetrics & Gynecology Hospital, Capital Medical Universit; Qinhuangdao Maternity and Infants' Hospital of Hebei Province.PARTICIPANTS: A total of 1 122 preterm infants of 26.3-36.8 gestational age were selected from Beijing Obstetrics & Gynecology Hospital, Qinhuangdao Maternity and Infants' Hospital from January 2002 to August 2005. All infants received ultrasonic examination on skull within 1 week. There were 594 boys and 528 girls, and the birth weight was 850-4 500 g.METHODS: All infants received ultrasonic examination on skull within 1 week. New Philips 5500 and GE Healthcare Logiq 400 ultrasonic diagnosis devices were provided by Philip Company, Dutch and GE Company, respectively.MAIN OUTCOME MEASURES: The incidence rate and related high-risk factors of PIVH.RESULTS: All 1 122 preterm infants were involved in the final analysis. Among 1 122 preterm infants, 619 cases (55.2%) had PIVH; especially, 110 had severe PIVH with the degree more than Ⅲ, which was accounted for 17.8%.High-risk factors were mainly low gestational age, low birth weight, mechanical ventilation, hypoglycemia, hypercapnia,hyperlactic acidemia, acidosis, hypoxia, abnormal blood coagulation, and so on. Antenatal corticosteroid could reduce the incidence rate of PIVH. However, there was no obvious effect on preterm infants of old gestational age.CONCLUSION: Routine intracranial ultrasonic examination is useful for the diagnosis of PIVH in preterm infants.

Objective To evaluate the accuracy and reliability of Diana automated blood grouping analyzer in blood grouping and cross matching.Methods 2 300 patients′ABO and RhD blood groups were examined by conventional tube test and the fully auto-mated blood grouping analyzer and 900 patients′samples were tested using Diana automated blood grouping for blood cross matc-hing,and it was compared with polymatching method.Results The analyzer′s accuracy rate of blood grouping by two methods were 99.87% and 100.00%.The incompatibility occurred in 30 specimens in automatic blood type instrument,in 3 specimens in manual polymatching method.Conclusion The results of Diana automated blood grouping analyzer used for blood grouping and cross matc-hing blood testing are reliable.Its experimental operation is normalized and standardized with an advantage of low incidence of human er-ror.Moreover,the experimental results can be permanently preserved,which provides a convenience to search for medical proof.

T lymphocyte subpopulation and level of soluble interleuckin 2 receptor in peripheral bloodand serum of primary hepatocellular carcinoma and donor were tested.The results show that de-crease of T lymphocyte subpopulations is related with increase of level of soluble interleuckin2 re-ceptor in patients with primary hepatocellular carcinoma.

Objective:To discuss the clinical efficacy of minimally invasive pulmonary surfactant (PS) therapy technology (MIST) in the treatment of neonatal respiratory distress syndrome (NRDS) and analyze the high-risk factors for failure.Methods:A total of 91 NRDS infants treated in the Affiliated Hospital of Jining Medical College from July 2017 to July 2019 were selected as the research objects, and 46 cases were performed minimally MIST (MIST group), 45 cases performed intubate-surfactant-extubate to continuous positive airway pressure (INSURE group), the infants were given 70-100 mg/kg porcine pulmonary phospholipid injection through vascular catheter or endotracheal intubation, respectively. The clinical efficacy of the two groups was compared and the risk factors for failure in the treatment of NRDS by PS were analyzed.Results:The total operating time in the MIST group was longer than that in the INSURE group: (90.06 ± 14.38) min vs. (62.57 ± 11.44) min, there was statistical difference ( P<0.05). The duration of non-invasive auxiliary ventilation, total oxygen uptake time and length of hospitalization time in two groups had no significant differences ( P>0.05). The incidence of bronchopulmonary dysplasia in the MIST group was lower than that in the INSURE group :10.87%(5/46) vs. 31.11%(14/45), there was statistical difference ( χ2 = 5.64, P<0.05). Univariate analysis showed that the male, cesarean section, birth weight <1 500 g, maternal gestational diabetes, arterial partial blood oxygen pressure (PaO 2) <59 mmHg (1 mmHg = 0.133 kPa) before the application of PS, and PaO 2/inhaled oxygen concentration (FiO 2) <185 mmHg and arterial partial pressure of carbon dioxide>55 mmHg were high risk factors for failure ( P<0.05). Conclusions:Although the operation of MIST is difficult, it is safe and feasible. In clinical work, various risk factors should be comprehensively analyzed to select an appropriate early respiratory support model for NRDS children.

OBJECTIVETo explore the epidemiological characteristics of inhalation injury and to summarize the clinical application experience of diagnostic standard of burn of larynx.

METHODSMedical records of 443 patients with inhalation injury admitted to our burn unit from January 1999 to June 2013 were analyzed, including gender, age, severity of inhalation injury, complications and diseases before injury; total area and that of full-thickness burn injury, admission time after burn, and burn condition of larynx of patients with different degrees of inhalation injury; treatment and outcome including rate, time, and complication of tracheotomy, mortality, and cause of death. Data were processed with nonparametric Kruskal-Wallis test and chi-square test. The relationship between severity of inhalation injury and total burn area, degree of burn of larynx, tracheotomy rate, and mortality was assessed by Spearman correlation analysis.

RESULTS(1) Among the patients, there were 353 (79.7% ) male and 90 (20.3% ) female, with the ratio of male to female 4:1. There were 64 (14.4%) patients younger than or equal to 20 years, 203 (45.8%) patients older than 20 years and younger than or equal to 40 years, 144 (32.5%) patients older than 40 years and younger than or equal to 60 years, and 32 (7.2%) patients older than 60 years. The numbers of patients with mild, moderate, and severe inhalation injury were respectively 297, 108, and 38. Seven patients suffered from complications, and 21 patients had diseases before injury. There were statistically significant differences among the patients with different degree of inhalation injury in regard to total burn area and full-thickness burn area (with H values respectively 73.752 and 142.830, P values below 0.01), while no statistically significant difference was observed in admission time after burn ( H = 1.528, P > 0.05). Correlation analysis showed that severity of inhalation injury was positively correlated with total burn area (r = 0.399, P < 0.001). Among the patients with mild inhalation injury, incidences of patients with mild, moderate, and severe burn of larynx were respectively 68.0% (202/297), 32.0% (95/297), and 0, and those among the patients with moderate inhalation injury were respectively 0,53.7% (58/108), and 46.3% (50/108). There were statistically significant differences in degree of burn of larynx of patients with different degree of inhalation injury (χ2 = 336.703, P < 0.001). Correlation analysis showed that severity of burn of larynx was positively correlated with severity of inhalation injury (r = 0.700, P < 0.001). (2) The rate of tracheotomy was 37.02% (164/443). The rates of tracheotomy in patients with mild, moderate, and severe inhalation injury were respectively 10.44% (31/297), 87.96% (95/108), and 100.00% (38/38), χ2 = 271.654, P < 0.001. Correlation analysis showed that the rate of tracheotomy was positively correlated with severity of inhalation injury (r = 0.784, P < 0.001). Tracheotomy was done mainly within 6 h post burn (63.4%, 104/164). The incidence rate of complication of tracheotomy was 5.5% (9/164). (3) Thirty-one patients died, with a mortality rate of 7.00%. The mortality rates of patients with mild, moderate, and severe inhalation injury were respectively 1.01% (3/297), 12.96% (14/108), and 36.84% (14/38), H = 74.273, P < 0.001. It was found that the mortality was positively correlated with severity of inhalation injury (r = 0.371, P < 0.001). The causes of death of the patients were respectively sepsis (14, 45.2%), respiratory failure (7, 22.6%), airway obstruction (2, 6.5%), airway hemorrhage (2, 6.5%), cerebral hemorrhage (2, 6.5%), cardiac accident (2, 6.5%), and diabetes insipidus (1, 3.2%), and 1 (3.2%) patient quit treatment and discharged from hospital for economic reason.

CONCLUSIONSAmong the patients with inhalation injury, male is dominated in number, and the young adults formed the highest constituent ratio. The severity of inhalation injury was correlated with total burn area, severity of burn of larynx, tracheotomy rate, and mortality. With the guidance of diagnostic criteria of burn of larynx and indication of tracheotomy, the risk of laryngeal obstruction can be eliminated. The early preventive tracheotomy can decrease the difficulty and risk of the operation.

Adolescent ; Adult ; Age Distribution ; Aged ; Airway Obstruction ; etiology ; surgery ; Burn Units ; Burns ; Burns, Inhalation ; complications ; mortality ; surgery ; China ; epidemiology ; Female ; Humans ; Incidence ; Injury Severity Score ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Sepsis ; epidemiology ; Severity of Illness Index ; Sex Distribution ; Tracheotomy ; methods ; Young Adult

Objective:To explore the value of 70 keV virtual monoenergetic images(VMI) on dual-layer spectral detector CT in improving abdominal arterial phase images quality.Methods:The arterial phase images of patients who underwent abdominal enhanced scan on the Philips IQon dual-layer spectral detector CT in Shengjing Hospital of China Medical University from January to May 2019 were retrospectively analyzed. Fifty patients (12 males, 38 females) were included with age of 26-74 （53±12） years. Objective and subjective evaluation was performed in 120 kVp polychromatic conventional images (group CI) which derived from iterative reconstruction algorithm and group 70 keV VMI which derived from spectral reconstruction algorithm. The attenuation, noise, signal to noise ratio and contrast to noise ratio of abdominal aorta, celiac trunk, superior mesenteric artery, left kidney artery, right kidney artery, liver, spleen, pancreas, left and right kidney were compared between group 70 keV VMI and CI by using paired t test. Image quality of group 70 keV VMI and CI was evaluated by two radiologists independently with a 5-point scale and compared by Wilcoxon rank test. The inter-agreement of subjective scoring between the two radiologists was evaluated by Kappa test. Results:Except for pancreas, the attenuation of abdominal arteries and solid organs in group 70 keV VMI were higher than that of group CI and the difference was statistically significant ( Pall<0.05). The attenuation of pancreas was lower than that of group CI ( t=-3.097， P=0.003). The noise of abdominal arteries and solid organs in group 70 keV VMI showed lower values compared to group CI and the difference was statistically significant ( Pall<0.001). The signal to noise ratio as well as contrast to noise ratio of abdominal arteries and solid organs in group 70 keV VMI was higher than that of group CI and the difference was statistically significant ( Pall<0.001). Subjective image quality scores in group 70 keV VMI were higher than that of group CI and scores of group 70 keV VMI and CI were 5 (4,5) and 4 (4,5), respectively. The difference was statistically significant ( Z=-4.131, P<0.001). There was a good consistency of subjective image quality scores between two radiologists, which Kappa values of group 70 keV VMI and CI were 0.79 and 0.69, respectively. Conclusions:Compared to CI, 70 keV VMI derived from dual-layer spectral detector CT can optimize abdominal arterial phase image quality by decreasing the noise, improving the signal to noise ratio and contrast to noise ratio.

Objective:To explore the effect of mini-clinical evaluation exercise (Mini-CEX) combined with simulation teaching + case-based learning (CBL) in pediatric clinical teaching.Methods:A total of 60 medical students who practiced in Department of Pediatrics, Affiliated Hospital of Jining Medical College from August 2019 to August 2020 were selected as the research objects. According to different teaching methods, they were divided into control group ( n=30) and observation group ( n=30). The control group received traditional teaching, and the observation group received Mini-CEX combined with simulated teaching + CBL. The assessment results, comprehensive ability of medical interview, critical thinking ability and teaching satisfaction of the two groups were compared. SPSS 20.0 was performed for t-test and Chi-square test. Results:The test scores and total scores of the observation group were significantly higher than those of the control group ( P<0.05). After teaching, the Mini-CEX scores, the CTDI-CV (critical thinking disposition inventory Chinese version) scores and the total scores of the two groups increased significantly, and the above scores were significantly higher in the observation group than the control group ( P<0.05). The scores of the teaching program satisfaction questionnaire in the observation group were significantly higher than those in the control group ( P<0.05). Conclusion:The application of Mini-CEX combined with simulation teaching + CBL in pediatric clinical teaching can help to cultivate the medical interview ability, clinical practice ability and critical thinking ability of interns, improve the examination results, and improve the teaching satisfaction.