Objective To formulate a five-level pediatric emergency triage standard and evaluate the efficacy and reliability of it in determining severity of emergency pediatric patients.Methods According to the assessment methods in Pediatric Advanced Life Support recommended by American Heart Association and American Academy of Pediatrics,we formulated a five-level pediatric emergency triage standard based on the situation of our hospital and analyzed the data one year before and after the application of it.Results Before and after the application of the triage standard,the average satisfaction rate of emergency patients were (81.28 ± 3.97) ％ and (94.13 ± 4.62) ％,and there was significant difference (P ＜ 0.01) ; the proportion of whom became worse during waiting time were 1.83％ (628/34275) and 0.04％ (16/36 187),and there was significant difference (P ＜0.01) ;the average waiting time of emergency admission patients were (12.71 ± 2.32) min and (3.34 ± 1.95) min,and there was significant difference (P ＜0.01) ;the misjudgment rate of severity were 3.78％ (1 296/34 275) and 0.57％ (205/36 187),and there was significant difference (P ＜ 0.05).Conclusion The five-level triage standard is objective,easy to master,and suitable for pediatric triage.It can quickly sort out critical cases from emergency pediatric patients,which can improve the effectiveness of emergency service,make use of medical resources rationally and somewhat solve the problem of overcrowding.

Objective To understand the status of knowledge,attitude,and practice of schistosomiasis prevention and con-trol and infection status in Armed Police Forces stationed along the Yangtze River,so as to provide the reference for formulating the schistosomiasis prevention and control measures in Armed Police Forces. Methods A questionnaire survey was conducted in the Armed Police Forces along the Yangtze River in Jiangsu Province,and the investigation content included social demo-graphic data,schistosomiasis prevention knowledge,attitude and behavior. All the subjects were examined for Schistosoma ja-ponicum infection. Results Totally 376 soldiers were investigated in 2 sites. The total passing rate of schistosomiasis knowl-edge was 72.87%. The passing rate among different age groups had no significant difference( χ2 =0.26,P > 0.05). The passing rate of soldiers from endemic areas was significantly higher than that of the soldiers from non-endemic areas( χ2 =4.71,P <0.05). The passing rate of officers was significantly higher than that of the soldiers(χ2 = 4.21,P <0.05). The passing rate of sol-diers with the education levels of junior school,high school,college,undergraduate and above increased gradually,with a sig-nificant difference( χ2 =8.16,P < 0.05). The soldiers with positive attitude accounted for 93.88%. Among the water contact be-haviors,training accounted for 17.55% and participating in the task(such as flood fighting and water work)accounted for 86.44%. When launching,the rate of taking protective measures was 52.93%. The rate of taking protective measures in the knowledge passing group was much higher than that in the knowledge failed group( χ2 =10.55,P < 0.05). The stool was harm-lessly treated in the two camps. Among 376 soldiers,the positive rate of blood examinations was 0.53%,but the stool examina-tions were all negative. Conclusions The overall level of knowledge and correct behavior of schistosomiasis prevention in the Armed Police Forces along the Yangtze River still should be improved. The better health education and behavior intervention are crucial to schistosomiasis prevention in the army.

Objective To explore virtual three-dimensional (3D)model for intravascular interventional devices,the method of preoperative simulation and its value in clinical work.MethodsThe virtual models including catheter,guide wire,stent and coil were established by using the 3D moulding software of 3D Studio MAX R3. The interventional preoperative simulation was performed on personal computer including 21 patients of cerebral aneurysm embolization ( anterior communicating artery 5,posterior communicating artery 10,middle cerebral artery 3,internal carotid artery 2,and vertebral artery 1 ),during interventional procedures,the surgeon relied on the simulation results for plastic micro-guide wire,catheter and the release of micro-coils and stents.Results( 1 ) All the virtual instruments and real instruments had similar shape,the overall tine for constructing virtual model was about 20 hours.The preoperative simulation took 50 to 80 minutes. (2) The simulation result of catheter insertion in the 18 cases had relevant value to guide micro-catheter,molding micro-guide wire tip,and shortened the operating time.For embolization,the simulation results of filling coil and releasing stent were similar to surgical results in 76％ of the patients (16/21).(3)For teaching and training,93％ (38/41) of doctors in training believed that preoperative simulation facilitated the understanding of surgery. ConclusionsThe method of virtual model of intravascular interventional devices was reliable.The preoperative simulation results could be used to guide practical clinical operation with relatively high degree of similarity,and could play a role in promoting researches on interventional virtual operations.

Objective: To explore the clinical characteristics, therapeutic methods and effects of blood blister-like aneurysms (BBA) of the supraclinoid segment of the internal carotid artery (ICA). Methods: A total of 40 patients with BBAs of the ICA treated at Department of Neurosurgery of West China Hospital between January 2010 and January 2016 were retrospectively reviewed. There were 14 males and 26 females with the mean age of 44.7 years (ranging from 25 to 64 years). There were 38 patients presented with subarachnoid hemorrhage (SAH), and 2 patients were found incidentally with unruptured aneurysms in regular examination. Surgical treatment was performed in 22 patients, including direct clipping, clipping over wrapping and trapping. Endovascular treatment with single or multiple stents and coiling was performed in 18 patients. Clinical outcomes were assessed with modified Rankin Scale. The patients were followed up with CT angiography. Results: Direct clipping of BBA was performed in 18 patients, clipping over wrapping in 3 patients and trapping of ICA in 1 patient. Intraoperative rupture occurred in 5 patients. Postoperative cerebral infarction developed in 6 cases, 4 patients died. Single stent-assisted coiling was performed in 8 cases, and multiple stents with coiling in 10 patients. Procedure-related hemorrhage occurred in 2 patients, postoperative massive cerebral infarction developed in 1 patient with stent-assisted coiling. The follow-up time was 26.8 months (ranging from 6 to 72 months), among the patients with surgery, good results (modified Rankin Scale 0-2) were achieved in 16 patients; one patient was score 3, and the other was 4. In endovascular group, 15 patients had good results and one with mRS 4. Follow-up angiography revealed recurrence of BBA in 2 patients treated with stent and coiling, which was retreated with coiling. No recurrence was found in surgical group. Conclusions BBA of the supraclinoid ICA is a specific and complicated intracranial aneurysm with high risk and complications no matter the treatment is surgical or endovascular, take proper operation methods could achieve satisfactory results.

One year survey on the concentrations and monthly or seasonal variations of airborne microbe in Guangzhou city were analysed and studied with JWL-IIB airborne microbial sampler. The results showed that the yearly average airborne microbe content of outdoor was 2, 298 cfu/m3, and that of indoor was 1,792 cfu/m3 in Guangzhou city. The monthly variation range of outdoor airborne microbe was from 1,073 to 4,096 cfu/m3, the highest content was 4,096 cfu/m3 in March, and the lowest content was 1,073 cfu/m3 in October. The outdoor airborne bacteria and fungi counts were the highest in spring, next in summer, lower in winter and the lowest in autumn in the four seasons . The yearly average concentrations of outdoor airborne microbe at the Garbage compression station, the business walk street, the key traffic route, the residential area, the industrial district and the garden were 4, 573, 3, 835, 1, 580, 1,413, 1, 197 and 1, 187 cfu/m3respectively; and Ones of indoor at the key traffic route, the tourist three star-route hotel and the subway station were 2,511, 1,699and 1,167 cfu/m3 respectively . The study on airborne microbe can be used for the research of health prevention and environment control measures in Guangzhou .

OBJECTIVETo observe the effects of qi-supplementing dominated Chinese materia medica (QSDCMM) combined with rehabilitation training on the quality of life (QOL) of ischemic post-stroke fatigue (PSF) patients of qi deficiency syndrome.

METHODSNinety ischemic stroke patients of qi deficiency were randomly assigned to 3 groups, 30 in each. Patients in the Chinese medicine treatment group were treated with oral administration of QSDCMM decoction and rehabilitation. Those in the Western medicine treatment group were treated with Chinese medicine placebo, Western medicine, and rehabilitation. Those in the control group were treated with Chinese medicine placebo and rehabilitation. The therapeutic course for all was 4 weeks. All patients were assessed using Stroke Specific Quality of Life Scale (SS-QOL) and Fatigue Severity Scale (FSS) before treatment and 4 weeks after treatment.

RESULTSAfter treatment the scores of SS-QOL and FSS increased in the 3 groups, especially in the CM treatment group, showing significant difference (P < 0.05). After treatment significant difference existed between the CM treatment group and the Western medicine treatment group, between the CM treatment group and the control group, showing significant difference (P < 0.05). There was no statistical difference between the Western medicine treatment group and the control group (P > 0.05).

CONCLUSIONQSDCMM combined with rehabilitation training could improve the QOL of ischemic PSF patients of qi deficiency syndrome.

Aged ; Brain Ischemia ; rehabilitation ; Drugs, Chinese Herbal ; therapeutic use ; Fatigue ; etiology ; rehabilitation ; therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Qi ; Quality of Life ; Rehabilitation ; Stroke ; complications ; Stroke Rehabilitation

OBJECTIVETo design and synthesize ribozymes targeting 138 and 218 sites of the mRNA nucleotide of mouse caspase-12, a key intermedium of ER stress mediated apoptosis, and to identify their activities through in vitro transcription and cleavage.

METHODSThe mouse caspase-12 gene fragment was obtained by RT-PCR and cloned into the PGEM-T vector under the control of T7 RNA polymerase promoter. The transcription product of the target was labeled with a-32P UTP, while ribozymes were not labeled. Ribozyme and target RNA were incubated for 90 min at 37 degree C in a reaction buffer to perform the cleavage reaction.

RESULTSIt was found that under a condition of 37 degree C, pH 7.5 and with Mg2+ in a concentration of 10 mmol/L, Rz138 and Rz218 both cleaved targets at predicted sites, and the cleavage efficiency of Rz138 was 100%.

CONCLUSIONRz138 and Rz218 prepared in vitro possess the perfect specific catalytic cleavage activity. Rz138 has excellent cleavage efficiency. It may be a promising tool to prevent ER stress induced apoptosis through catalytic cleavage of caspase-12 mRNA in vivo. It also can be used to verify whether caspase-12 is necessary in ER stress induced apoptosis.

Animals ; Base Sequence ; Caspase 12 ; genetics ; Endoplasmic Reticulum ; metabolism ; Mice ; Mice, Inbred BALB C ; Molecular Sequence Data ; Oxidative Stress ; genetics ; RNA, Catalytic ; chemistry ; genetics ; RNA, Messenger ; genetics

Objective:To analyze the imaging features of magnetic susceptibility-weighted imaging (SWI) in the patients with cerebral amyloid angiopathy-related hemorrhage (CAAH),and to clarify the diagnostic value of SWI for CAAH.Methods:A total of 68 patients presumptively diagnosed as CAAH were collected,and their imaging data of routine MRI and SWI were collected and analyzed.The detection rates of hemorrhage focus of the CAAH patients were compared between two kinds of imaging examination.The consistency of detection of CAAH by routine MRI and SWI was analyzed.The imaging features of SWI and the risk of focus hemorrhage in the patients with CAAH were analyzed by multivariate Logistic regression analysis.Results:Sixty-one patients were confirmed as CAAH by pathologic diagnosis,and 53 patients were confirmed as CAAH by routine MRI;the detection rate was 86.89％;59 cases of hemorrhage focus were confirmed by SWI and the detection rate was 96.72％.The number of lesions detected by SWI was more than that of routine MRI (P＜0.05).The consistency of detection of CAAH by routine MRI and SWI was poor,and the value of Kappa was 0.3666.The patchy high signal and multiple clear edge low signal area were the relative imaging features of CAAH with SWI in the patients with CAAH analyzed by multivariate Logistic regression analysis (OR=3.895,P=0.025;OR=3.124,P=0.029).Conclusion:SWI can efficiently detect the hemorrhage focus in the patients with CAAH and the diagnostic value is better than routine MRI.

Objective To observe the influence of long-term treatment with inhaled corticosteroid on biochemical bone indexes and bone mineral density (BMD) in children with asthma. Methods The design was a randomized, paralleled group study with 3 low dose regiments of 100, 200,300 micrograms of budesonide per day in 45 children with asthma aged 5-8 years old for 12 months. Before inhaled corticosteroid therapy and 6th,12th month,clinical effects were observed and lung function(FEV1) was measured; concentration of serum osteocalcin(OST),insulin-like growth factor-1(IGF-1),bony alkaline phosphatase (BALP) and urinary deoxypyridinolin: creatinine (DPD/Cr) were measured; BMD was examined by dual energy X-ray absorptiometry. Results Clinical evaluation was improved and there was significant increase in FEV1 of asthmatic children. The amount of serum OST was slightly higher,yet no significant compared with that of normal control group. There was significant increase of serum BALP in asthmatic children after treatment; there was significant increase in serum IGF-1 of patients group after treatment compared with in normal children at the same age group; there was significant decrease in urinary DPD/Cr after treatment.There was no significant decrease in BMD before and after treatment at the hip (neck of femur , trochanter of femur ,Ward′s triangle),the lumber area of the spine (L2-4) and forearm (ultradis, distal). Conclusion Long-term treatment with low does corticosteroid dose not restrictedly affect bone metabolism and BMD in children with asthma.

OBJECTIVETo investigate the correlation between vascular remodeling index (RI) and serum adiponectin, plasma monocyte chemoattractant protein-1 (MCP-1), endothelial function and evaluate the mechanism of coronary in-stent restenosis.

METHODSRI 6 months after percutaneous coronary intervention (PCI), serum adiponectin, plasma MCP-1 and flow-mediated dilation (FMD) before and 3 days,6 months after PCI were measured in 30 patients with and 30 without coronary in-stent restenosis.

RESULTSCompared with patients without restenosis and those with restenosis before PCI, the patients with coronary in-stent restenosis showed significantly increased plasma MCP-1 3 days and 6 months after PCI (P<0.05) and reduced RI 6 months after PCI, serum adiponectin and FMD 3 days and 6 months after PCI (P<0.05). RI was positively correlated to serum adiponectin and FMD and inversely to MCP-1.

CONCLUSIONThe occurrence of coronary in-stent restenosis is the result of the interrelations between multiple factors.

Adiponectin ; blood ; Adult ; Aged ; Angioplasty, Balloon, Coronary ; Chemokine CCL2 ; blood ; Coronary Disease ; blood ; physiopathology ; therapy ; Coronary Restenosis ; blood ; etiology ; Endothelium, Vascular ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Stents ; adverse effects