Objective:To summarize and analyze the clinical characteristics of different treatment in children with esophageal foreign bodies.Methods:This study collected 246 children with esophageal foreign bodies in our hospital from January 2016 to January 2020, which was divided into endoscopic group and operative group.The general and clinical data of children treated with different treatment were collected and statistical analyzed.Results:There were 222 children in endoscopic group and 24 children in operative group, respectively.The rate of surgery was 9.75%.There were no significant differences in gender and location of esophageal foreign bodies.However, the average age of operative group was(2.92±2.67) years, which significantly younger than that in endoscopic group(4.12±3.37)years( P=0.049). The residence time in operative group(median 29.10 h)was remarkable longer than that in operative group(median 11.80 h)( P<0.001). The proportion of sharpness(50.00%) and corrosive(45.83%) foreign bodies in operative group were more than those in endoscopic group[16.22% and 8.11%( P<0.001)]. Moreover, the occurrence rate of major complication in operative group was 83.33%, which was dramatically higher than that in endoscopic group(0.90%)( P<0.001). Conclusion:The younger and longer residence time of esophageal foreign bodies in children contribute to the rate of operative treatment.Additionally, the sharpness and corrosive foreign bodies increase the risk of surgery and serious complications.

Objective:To explore early predictive factors for outcomes of congenital hypothyroidism (CH) in neonates.Methods:A total of 242 neonates diagnosed as CH in Shanxi Provincial Newborn Disease Screening Center from October 2009 to October 2014 were enrolled in the study. All CH children were treated with levothyroxine sodium (L-T 4) for 2-3 years and continued to follow up for more than 1 year after drug withdrawal. Seventy two cases dropped out during the follow-up; among 170 patients entering the final analysis, there were 61 cases of permanent congenital hypothyroidism (PCH group) and 109 cases of transient congenital hypothyroidism (TCH group). The clinical data and the L-T 4 dose during follow-up period were compared between two groups; and the predicting factors of clinical outcomes were analyzed. Results:There were significant differences in baseline thyroid stimulating hormone(TSH)level [127.0 (83.7,175.4) μIU/ml vs. 55.8(22.1,102.5)μIU/ml], initial treatment timing [26.0(20.5,34.5)d vs. 31.0(24.0,37.5)d], time required for TSH to return to normal [52.0(33.0,71.5)d vs.36.0(32.0,41.5)d], and thyroid ultrasound results [18.3%(11/60) vs. 94.0%(78/83)] between PCH group and TCH group. The initial screening TSH levels in children (optimal cut-off: 71.29 μIU/ml) and L-T 4 dose at 7 months after diagnosis (optimal cut-off: 24.4 μg/d) can be used for early differentiation between children with PCH and TCH. Conclusion:The initial TSH screening levels and the dose of L-T 4 during the follow-up period have predictive value for early differentiation of PCH and TCH in children.

Objective To investigate the influencing factors of nosocomial pneumonia in elderly pa-tients with CHD and HF.Methods A total of 196 elderly CHD patients with HF diagnosed and treated in our department from March 2021 to August 2023 were enrolled,and divided into infec-ted group(n=52)and non-infected group(n=144)based on whether pulmonary infection oc-curred during hospitalization.Logistic regression analysis was used to identify the risk factors af-fecting secondary nosocomial pulmonary infection.Based on these risk factors,a comprehensive in-dex was built.ROC curve was drawn to analyze the diagnostic value of the index for secondary nosocomial pulmonary infection.Results The infected group had significantly advanced age,lar-ger proportions of NYHA grade Ⅲ to Ⅳ,smoking history,diabetes history,mechanical ventila-tion time＞48 h,length of hospital stay＞14 d,and albumin at admission＜30 g/L,and higher RDW at admission when compared with the non-infected group(P＜0.05,P＜0.01).Logistic regression analysis showed that NYHA grade Ⅲ to Ⅳ,diabetes history,mechanical ventilation time＞48 h,length of hospitalization＞14 d,albumin＜30 g/L at admission and RDW at admis-sion were risk factors for secondary nosocomial pulmonary infection in elderly CHD patients with HF(OR=2.398,95％CI:1.157-4.969;OR=2.732,95％CI:1.278-5.839;OR=2.607,95％CI:1.138-5.973;OR=3.368,95％CI:1.567-7.242;OR=2.677,95％CI:1.218-5.886;OR=1.762,95％CI:1.488-61.222).ROC curve analysis indicated that the AUC value of NYHA grade Ⅲ to Ⅳ,diabetes history,mechanical ventilation time＞48 h,length of hospitalization＞14 d,albumin＜30 g/L at admission and RDW at admission in predicting secondary nosocomial pulmonary infec-tion in elderly CHD patients with HF was 0.598,0.620,0.586,0.595,0.615 and 0.850,respectively,and the value of the comprehensive index was 0.743,which is superior to that of above single indi-cator(P＜0.05).Conclusion Age,NYHA grade,smoking history,diabetes history,mechanical ventilation time,hospital stay and albumin and RDW levels at admission have adverse effects on secondary nosocomial pulmonary infection in elderly CHD patients with HF.Our built compre-hensive index based on these risk factors has high efficacy in predicting nosocomial pulmonary in-fection.

Objective:To investigate the effectiveness and safety of nasojejunal tube placement in children by gastroscopic drafting method.Methods:We retrospectively analyzed the clinical data of children with nasojejunal tube placement from January 2016 to December 2021 in our hospital, and compared the operation time, successful rate and complications of nasojejunal tube placement in the gastroscopic wire drawing method retraction group(observation group)and the gastroscopic foreign body clamp placement method placement group(control group).Results:All of the 167 cases, 65 cases were in observation group and 102 cases in control group.There were no significant differences in sex and age between two groups( P>0.05). The operation time was(6.7±0.8)min in observation group and(8.2±1.3)min in control group, and the difference was statistically significant( t=8.312, P<0.001). The successful rate was 100% in observation group and 96% in control group.One child in control group complicated with the mucosal erosion and bleeding in the duodenal bulb, while the observation group with no erosion, bleeding, perforation, and other complications. Conclusion:The gastroscopic wire drawing method of nasojejunal tube placement has a shorter operation time, higher successful rates, and lower complication rates, which is significantly superior to the gastroscopic foreign body clamp placement method.

Objective To evaluate effect of antithrombotic pressure pump on the intracranial pressure (ICP) of the severe traumatic brain injury(STBI) patients who were performed the surgery.Methods A total of 120 consecutive STBI patients after the surgery , who were admitted at Neurological Intensive Care Units (NICU) from April 2013 to September 2014, were randomly divided into (research group and control group ). Each group had 60 patients .In the 6 days observation , research group received the treatment of antithrombotic pressure pump among the first 3 days after the surgery , and the treatment was stopped among the last 3 days. Control group received the opposite treatment .ICP was continuously monitored and all the data ( mean ICP, times of ICP ≥20 mmHg, the highest ICP per day ) were performed statistical analysis .Results Mean ICP,times of ICP≥20 mmHg and the highest ICP per day in two groups decreased significantly after the surgery ( P<0.05).The difference of Mean ICP, times of ICP ≥20 mmHg and the highest ICP per day between the two groups were not significant .No patient got the deep vein thrombosis ( DVT ) .Conclusions Antithrombotic pressure pump could efficiently prevent deep vein thrombosis , which is a safe treatment for STBI patients and has no influence on the ICP .

Objective: To develop and evaluate a beads-based light-initiated chemiluminescent assay (LICA) for quantitation of cow milk component (Bos d 5) specific IgG 4 antibody in human serum. Methods: The sIgG 4 -LICA was performed by incubated serum samples with biotinylated allergens, emission beads coated with mouse anti-human IgG 4 antibody and streptavidin-coated sensitizer beads. The reaction conditions of sIgG 4 -LICA were optimized and the analytical performance was evaluated. Results: The precision of intra-assay, within-day and inter-assay (coefficient of variation) were 1.78% to 3.13%, 6.65% to 8.41% and 7.94% to 12.30%, respectively. The functional sensitivity of this assay was 4.71 ng/mL. For the linear range, the sIgG 4 -LICA had a good linear relationship within the range between 28.13 and 1 800 ng/mL, and the linear regression equation was Y=0.98X-1.31(r 2 =0.997). Maximum dilution limit was 1∶64. The disturbing rates measured by adding hemoglobin, triacylglycerol, total bilirubin, acid resistance and biotin to human sera with different concentrations of Bos d 5 sIgG 4 were from -6.38% to 8.60%. Conclusions The sIgG 4 -LICA introduced in this study was demonstrated to have effective performance for quantitation of allergen-specific IgG 4 and can meet the need of clinical requirement.