Objective To investigate the serum levels of certain vitamins and trace elements in infant and children with pneumonia.Methods Totally 120 pediatric patients with pneumonia who were treated in our hospital were enrolled in the study.Meanwhile,60 age-matched healthy children were randomly selected as the control group.The serum vitamin A level was analyzed using high-performance liquid chromatography.The serum 25-hydroxy vitamin D level was analyzed using enzyme linked immunosorbent assay.The serum zinc,calcium,magnesium,and iron contents were detected using atomic absorption spectrometry.The differences of serum levels of vitamins and trace elements as well as the ratios of vitamins and trace elements deficiency were compared between these two groups.Results The rates of iron,zinc,and vitamin A deficiencies were 35.36％,37.09％,and 46.59％,respectively,in pediatric patients with pneumonia,which were significantly higher than those in the control group ( 18.76％,x2 =4.32; 20.08％,x2 =4.15 ; 25.08％,x2 =5.81 ; all P ＜0.05).There were no significant differences in the rates of calcium,magnesium,and vitamin D deficiencies between these two groups ( all P ＞ 0.05 ).The serum zinc [ ( 16.07 ± 3.56) vs.(23.24 ± 4.05) μmol/L,t =15.82,P ＜ 0.05 ],iron [ ( 19.89 ± 4.79) vs.(25.13 ± 5.07 ) μmol/L,t =6.65,P ＜ 0.05 ],and vitamin A levels [ ( 365.76 ±35.37 ) vs.(451.09 ± 32.16) μg/L,t =2.14,P ＜ 0.05 ] in the pneumonia group were significantly lower than those in the control group.The serum levels of calcium,magnesium,and 25-hydroxy vitamin D showed no significant difference between these two groups ( all P ＞ 0.05 ).Conclusion Zinc,iron,and/or vitamin A deficiencies are common among infant and children with pneumonia.

In recent years , with the development of error theory and the requirements of the international accreditation bodies , the quality indicators ( QIs) have become one of the important tools in the laboratory quality management .To explore the evolution and origin of QIs , the status and the future of QIs will be helpful for us to understand and to use the QIs .

Objective Through statistical analysis of specimen rejection reasons, aimed at finding the ways to reduce the failed specimen, making sure of continuous improvements in laboratory quality. Methods Department of Laboratory, Beijing ChaoYang Hospital, Capital Medical University had analyzed rejections specimen from October 2013 to September 2014 in CAP Q-TRACKS QT3 ( QT3: Laboratory Specimen Acceptability ) , and compared the laboratory rejection reasons with all laboratories of CAP. Results From October 2013 to September 2014, the total number of rejection specimen number was 2 367, in which 225 were incomplete labeled specimen/inadequate filled-out form, accounting for 9.5%.898 samples were rejected because of specimen clotted, accounting for 37.9%.The samples could not meet the requirement of specimen quantity of 254, accounting for 10.7%.Other reasons accounting for above 1%included wrong collection container, specimen hemolysis, lipemia or icteric specimen.After comparing the first five rejection reasons, Department of Laboratory, Beijing ChaoYang Hospital was found to be different with others laboratories of CAP.Conclusion The quality of the specimen is very important for the accuracy and reliability of the test results, and doing some positive statistical analysis and taking corrective measures can effectively reduce the unqualified specimen of the proportion.

0.05),but the t1/2 was longer and the AUC and the Cmax were lower in group B than in other groups(P

Objective To investigate the implementation of the surgical safety checklist in the hospital.Methods The investigation covered the participants of 560 surgical operations of a tertiary hospital,including the surgeons,surgical assistants,scrub nurses and anesthetists,to learn their compliance and awareness of the content of the surgical safety checklist.Results Poor compliance and unawareness of some items of surgical safety checklist in surgical team members were found,plus insufficient understanding of some the items on the checklist.This checklist can improve the quality and safety awareness of the team.Conclusion The implementation of the surgical safety checklist is feasible and effective for avoidance of risks in selective operations,and conducive to promoting communication among the surgical team and preventing surgical errors.

The effects of Sonic hedgehog (Shh) signaling pathway activation on S-type neuroblastoma (NB) cell lines and its role in NB tumorigenesis were investigated. Immunohistochemistry was used to detect the expression of Shh pathway components-Patched1 (PTCH1) and Gli1 in 40 human primary NB samples. Western blotting and RT-PCR were used to examine the protein expression and mRNA levels of PTCH1 and Gli1 in three kinds of S-type NB cell lines (SK-N-AS, SK-N-SH and SHEP1), respectively. Exogenous Shh was administrated to activate Shh signaling pathway while cyclopamine was used as a selective antagonist of Shh pathway. S-type NB cell lines were treated with different concentrations of Shh or/and cyclopamine for different durations. Cell viability was measured by using MTT method. Apoptosis rate and cell cycle were assayed by flow cytometry. The xenograft experiments were used to evaluate the role of Shh pathway in tumor growth in immunodeficient mice. High-level expression of PTCH1 and Gli1 was detected in both NB samples and S-type NB cell lines. Cyclopamine decreased the survival rate of the three cell lines while Shh increased it, and the inhibition effects of cyclopamine could be partially reversed by shh pre-treatment. Cyclopamine induced the cell apoptosis and the cell cycle arrest in G(0)/G(1) phase, while Shh induced the reverse effects and could partially prevent effects of cyclopamine. Cyclopamine could also inhibit the growth of NB in vivo. Our studies revealed that activation of the Shh pathway is important for survival and proliferation of S-type NB cells in vivo and in vitro through affecting cell apoptosis and cell cycle, suggesting a new therapeutic approach to NB.

Objective To improve hand hygiene compliance among health care workers(HCWs)through continu-ous quality improvement,and effectively reduce the incidence of healthcare-associated infection(HAI).Methods Continuous quality improvement was performed by adopting plan-do-check-action(PDCA)cycle,all HCWs were trained,hand hygiene was stressed,periodical and random checking was conducted.Results After the implementa-tion of PDCA cycle,the acknowledge rate of hand hygiene enhanced from 48.00% to 63.99%;hand hygiene com-pliance rate enhanced from 65.11% to 82.40%,the difference were both significant(χ2=12.75,259.65,respective-ly,both P<0.05).The daily consumption of instant hand antiseptic per 1 000 bed day increased obviously,which was 2.95-fold of pre-implementation.Conclusion Continuous quality improvement through PDCA cycle can effec-tively improve hand hygiene compliance rate of HCWs.

Objective To investigate the effects of anxiety and anti - anxiety therapy on vascular endothelium function and platelet activation in patients with acute coronary syndrome (ACS).Methods One hundred and thirty -nine ACS patients were enrolled in this prospective and controlled clinical study from January 2009 through December 2010.Patients with severe heart failure,liver and renal dysfunction,infection,allergy to benzodiazepines and taking antipsychotic drugs in recent 2 weeks as well as patients unable to complete the questionnaire were excluded.All these patients were divided into the anxiety group ( n =68 ) and the non - anxiety group ( n =71 ) according to Hamilton Anxiety Scale (HAMA).The plasma levels of NO,ET,CD62p,CD63 and flow- mediated diastolic functions (FMD) of humeral arteries were measured.The patients in anxiety group were randomly assigned to group A ( n =34 ) and group B ( n =34).Lorazepam in a dose of 0.5 mg twice a day and Vitamin B6 in dose of 10 mg twice a day as placebo were prescribed for patients of Group A and B respectively.After 2 weeks,all above variables of group A and group B were measured once again as well as the score of Hamilton Anxiety Scale.The chi - square test was used for constituent ratios,while t - test was applied to analysis of differences in above variables between two groups.Results The plasma level of NO and FMD of humeral artery in the anxiety group were significantly lower than those in the non -anxiety group (t =2.090 and 2.558,P =0.038 and 0.012,respectively),and the plasma levels of ET,CD62p and CD63 in the anxiety group were significantly higher than those in the non - anxiety group ( t =2.082,2.042 and 2.145,P =0.039,0.043 and 0.034,respectively).There were no statistical differences in all above variables as well as HAMA score between group A and group B before anti - anxiety treatment.Two weeks after treatment,the level of NO and FMD of humeral artery in group A were significantly higher than those in group B ( t =2.821 and 2.246,P =0,006 and 0.028,respectively) and the levels of ET,CD62p,CD63 and HAMA score in group A were significantly lower than those in group B ( t =2.107,3.242,2.079 and 7.779,P =0.039,0.002,0.041 and ＜0.01,respectively).Conclusions Anxiety mood markedly aggravates the disorder of vascular endothelial function and platelet activation,and both of them can be improved by anti - anxiety therapy.Consequently,the intervention in anxiety mood may improve the outcomes of ACS patients.

Objective To investigate the effects of remifentanil in painless bronchoscopic examination of elderly panents.Methods One hundred and twenty elderly patients undergoing painless bronchoscopic examination were randomly divided into 4 groups (n=30),the group A was administered with propofol and the groups B,C and D were administered with propofol and remifentanil(remifentanil dose:0.05 μg · kg-1 · min-1 in the group B,0.10μg · kg-1 · min-1 in the group C and 0.15 μg · kg-1 · min-1 in the group D).The body moving response,hemodynamic changes,propofol dose,examination time,wake-up time,departure time and adverse reactions in each group were observed during the examination process.Results During the examination process,the body moving response and bucking of the group A were significantly higher than those of the other three groups(P＜0.05);in hemodynamics,the group A fluctuated greatly,while the group B,C and D were relatively stable,but the incidence rate of hypotension,bradycardia and transient respiratory depressionof the group D were higher than those of the other three groups(P＜0.05);propofol dose of the group A was significantly higher than that of the other three groups (P＜0.05)and the group B was higher than the group C and D(P＜0.05).In wake-up time and departure time,the groups B,C,D were significantly better than the group A(P＜0.05),while the group C and D were better than the group B(P＜0.05).Conclusion Remifentanil can be used in painless bronchoscopic examination for elderly patients,and the effect is better by using propofol combined with remifentanil at a dose of 0.1 μg · kg-1 · min-1.

Objective To investigate the distribution of critical values of adults in Beijing, to provide the evidence for the formulation of the Standardized Management Guideline in Critical Values, in order to promote the accurate management of critical values.Methods A total of 110 398 data of critical values from the tertiary and above medical institutions during January 1 to May 31 in 2015 in Beijing were collected by the way of on-site inspection, covering the disciplines of hematology, clinical chemistry, coagulation and blood gas analysis.Fristly, the selected critical values were classified by the factor of admission departments and disease types,then were analyzed by using Kruskal-Wallis test, to compare the differences in each group.Secondly,the combined groups were classified by the factor of gender then were analyzed by using Mann-Whithey U test, to compare the differences in each group.Finally, the stratification thresholds of critical values were established.Results Except for the upper limits of Ca, pH, pCO2, Hb and the lower limits of Glu, pH, the rest of thresholds of critical values had significant differences due to different admission departments and disease types and/or gender.Conclusion Depending on the different admission departmentsces disease types and/or gender, hierarchical limit values on each critical value were formulated.