Objective To investigate the influence factors of central venous catheter related infections (CVC-RI) in postoperative patients with gastric carcinoma treated with parenteral nutrition,in order to provide scientific basis for prevention and treatment.Methods Using the retrospective study method,150 patients who treated with parenteral nutrition after operation of gastric carcinoma from December 2013 to March 2014 were selected.Information including age,sex,anamnesis,catheter indwelling time,infusion rate of nutrient solution,and so on were collected.Patients with central venous catheter related infections were set as infection group,patients without infection as the control group,and the group logistic regression analysis was used to analyze the collected data.Results 21 patients in infection group had CVC-RI,and the incidence was 14.00％ (21/150),while 129 patients in control group had CVC-RI.Univariate analysis showed there was significant difference between infection group and control group in age,anamnesis,catheter indwelling time and infusion rate of nutrient solution (x2=17.126,5.447,12.795,7.973,P＜0.05),however there was no significant difference in sex,health insurance,the success rate of catheterization and whether glutamine was in nutrient solution (P＞0.05);the group logistic regression analysis showed that age (OR=15.927,95％CI 3.305-76.756,P＜0.05)and catheter indwelling time (OR=3.511,95％CI 1.028-11.992,P＜0.05) were independent risk factors for CVC-RI,however infusion rate of nutrient solution (OR=0.140,95％CI 0.033-0.597,P＜0.05) was a protective factor.Conclusions For the postoperative patients with gastric carcinoma treated with parenteral nutrition,CVC-RI is closely related to age,catheter indwelling time and infusion rate of nutrient solution.So reducing catheter indwelling time,restoring the enteral nutrition under condition permission as so on as possible can reduce infection of elderly patients.

OBJECTIVETo analyze the clinical characteristics of negative pressure pulmonary edema (NPPE).

METHODA retrospective investigation of the clinical manifestation, imageology, clinical course and outcome of 4 children with NPPE seen between June 2012 and July 2013 in a children's hospital. The causation of the airway obstruction was also explored.

RESULTAll the 4 cases were boys, the range of age was 40 days to 9 years. They had no history of respiratory and circulatory system disease. In 3 cases the disease had a sudden onset after the obstruction of airway, and in one the onset occurred 1.5 hours after removing the airway foreign body. All these cases presented with tachypnea, dyspnea, and cyanosis, none had fever. Three cases had coarse rales. Chest radiography was performed in 3 cases and CT scan was performed in 1 case, in all of them both lungs displayed diffuse ground-glass-like change and patchy consolidative infiltrates. Three cases were admitted to the ICU, duration of mechanical ventilation was less than 24 hours in 2 cases and 39 hours in one. Oxygen was given by mask to the remaining one in emergency department, whose symptoms were obviously improved in 10 hours. None was treated with diuretics, glucocorticoids or inotropic agents. Chest radiographs were taken within 24 hours of treatment in 2 cases and 24-48 hours in the other 2; almost all the pulmonary infiltrates were resolved. All the 4 cases were cured. The causes of airway obstruction were airway foreign bodies in two cases, laryngospasm in one and laryngomalacia in the other.

CONCLUSIONNPPE is a life-threatening emergency, which is manifested by rapid onset of respiratory distress rapidly (usually in several minutes, but might be hours later) after relief of the airway obstruction, with findings of pulmonary edema in chest radiograph. The symptoms resolve rapidly by oxygen therapy timely with or without mechanical ventilation. In children with airway obstruction, NPPE should be considered.

Acute Disease ; Airway Obstruction ; complications ; Child ; Child, Preschool ; Foreign Bodies ; complications ; Humans ; Infant ; Intensive Care Units ; Intubation, Intratracheal ; methods ; Laryngismus ; complications ; Larynx ; Lung ; diagnostic imaging ; pathology ; Male ; Oxygen Inhalation Therapy ; Positive-Pressure Respiration ; methods ; Pulmonary Edema ; diagnosis ; etiology ; therapy ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed

ObjectiveTo explore the potential suitable distribution area and spatial production area of high-quality medicinal materials of Miao medicine Laportea bulbifera. MethodBased on 200 distribution spots of L. bulbifera and 120 ecological factors, the maximum entropy model（MaxEnt） and ArcGIS software were applied to predict the potential suitable areas. The content of rutin, kaempferol-3-O-rutinoside, and quercitrin from 33 batches of L. bulbifera in Guizhou province was determined by high-performance liquid chromatography (HPLC). Combined with the previous content data of total polysaccharides and total flavonoids, the correlation between the main pharmacodynamic components of L. bulbifera and ecological factors was analyzed. Eventually, the quality regionalization of L. bulbifera was exhibited by the collocated Cokriging in ArcGIS. ResultThe optimum distribution areas of L. bulbifera were Yunnan, Guizhou, Sichuan, Hunan, and Hubei provinces in China, and the high and medium suitable areas accounted for 59.48% of the total distribution areas. October precipitation, slope, min temperature of the coldest month, altitude, solar radiation intensity in June, and April precipitation were the main ecological factors affecting the growth and distribution of L. bulbifera. Temperature, radiation intensity, precipitation, and soil composition and properties had great effects on the accumulation of secondary metabolites in L. bulbifera. The results showed that the high-quality areas of L. bulbifera mainly included Leishan county, Kaili city, Qingzhen city, Pingba district, Huishui county, Longli county, Kaiyang county, and Jiangkou county in Guizhou province. ConclusionL. bulbifera is widely distributed in China， but the suitable distribution areas are mainly concentrated in southwest China and part of central China. The planting bases of L. bulbifera can be selected in parts of cities and counties in southeast and central Guizhou province. In this study， the potential suitable growing areas and the optimum planting areas of L. bulbifera in Guizhou were predicted， which could provide scientific references for the cultivation and the site selection of large-scale planting for L. bulbifera.

China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.