Objective:To study the experience of frontline medical workers in COVID-19 quarantine points.Methods:Purposive sampling method was employed and 12 frontline medical workers in COVID-19 points of Zhaoyuan City were selected for semi-structured and in-depth interview. Colaizzi′s seven-step analysis method was adopted to analyze and categorize the data.Results:The real experience of frontline medical workers in quarantine points were classified into five themes: professional mission and pride, inadequate initial response in dealing with public health emergencies (shortage of personal protective equipment,inadequate preparation of medical workers and imperfect settings of quarantine points), having some negative emotions (worrying about being infected and feeling fearful for family members), facing complex and diverse working difficulties (repugnance and diversified demands of people quarantined, heavy workload, discomfort from personal protective equipment and occupational exposure), and gaining support and appreciation (getting support from epidemic control and prevention departments as well as medical systems and winning appreciation from people quarantined).Conclusions:The frontline medical workers are lack of experience in dealing with public health emergencies and have some psychological and working pressure. Administrative department should further complete the emergency plan of centralized isolation medical observation, strengthen the contingency management of public health emergencies, attach importance to the mental health of medical workers, optimize management methods and establish flexible work schedules.

Objective To explore the relationship between severity of symptom and immune function in left-to-right shunt congenital heart disease (CHD) infants combined with pneumonia. Methods The clinical data of 45 left-to-right shunt CHD combined with pneumonia infants were retrospectively analyzed. The infants were divided into 2 groups according to the modified Ross score:mild group (0-6 scores, 28 cases) and severe group (7-12 scores, 17 cases);then, the infants were divided into 2 groups according to deformities:single deformity group (the infants had a kind of deformity such as ventricular septal defect, atrial septal defect and patent ductus arteriosus, 21 cases) and composite/complex deformity group (the infants combined 2 or more deformities or other malformations, 24 cases). Twelve cases of healthy check-up infants were selected as control group. The levels of lymphocyte subsets (including CD3+, CD4+, CD8+, CD4+/CD8+, NK cell and B lymphocyte) and IgG, IgA, IgM were detected in every group. Results There were no statistical differences in IgG, IgA, IgM, CD8 +, CD4 +/CD8 +, NK cell and B lymphocyte among mild group, severe group and control group or single deformity group, composite/ complex deformity group and control groups (P>0.05). The CD3+ in severe group was significantly lower than that in mild group and control group (0.59 ± 0.10 vs. 0.69 ± 0.13 and 0.69 ± 0.12), the CD4+was significantly lower than that in control group (0.34 ± 0.07 vs. 0.45 ± 0.09), and there were statistical differences (P<0.05). For CD4+, though there was statistically difference among single deformity group, composite/complex deformity group and control groups (P<0.05), no statistically significant difference was in multiple comparison among the 3 groups (P>0.05). The CD4 + in the composite/ complex deformity group was significantly lower than that in the single deformity group and the control group (0.34 ± 0.07 vs. 0.45 ± 0.15 and 0.45 ± 0.09), and there was statistical difference (P<0.05). Conclusions In left-to-right shunt CHD infants combined with pneumonia, the reduction of CD3+and CD4+may be one of the causes of serious illness.

Objective To study the disease pathogenesis of systemic lupus erythematosus patients with thrombocytopenia ,and discuss reticulated platelets (RP) in SLE merger thrombocytopenia disease of diagnosis and treatment in the clinical application val-ue .Methods 55 patients diagnosed with SLE patients and 50 cases of healthy check-up ,low platelet count patients of SLE patients treated before and after the inspection by Sysmex XE-5000 automatic blood cell analyzer immature platelet fraction (IPF) and other peripheral blood cell parameters .Results Group of patients with SLE and normal controls of IPF test results respectively was (5 .30 ± 3 .75)% ,(2 .74 ± 1 .05)% ,both comparative difference was statistically significant (P<0 .05);SLE associated with throm-bocytopeniagroupofIPF[(10.14±3.66)% ],platelets(PLT)[(67.2±13.5)×109/L],meanplateletvolume(MPV)[(12.64± 0 .92)fL] ,platelet distribution width(PDW)[(18 .24 ± 1 .70)fL] compared with normal control group and SLE did not reduce plate-let group ,differences had statistical significance(P<0 .05);SLE associated with thrombocytopenia in patients with IPF respectively before and after treatment was (9 .76 ± 1 .82)% and (5 .86 ± 0 .96)% ,both comparative difference was statistically significant (P<0 . 05) .Conclusion The main cause of SLE patients with thrombocytopenia may be associated with peripheral blood platelet destruc-tion ,IPF′s result can reflect the bone marrow platelet production ,Help in the auxiliary diagnosis of disease and prognosis judg-ment .

Objective To explore the clinical and imaging features of reversible posterior leukoencephalopathy syndrome(RPLES).Methods The data of clinic five cases with RPLES were analyzed retrospectively.Results The primary diseases in this group were hypertension for one case,uraemia for three cases and lupus nephropathy for another.Clinical features of five patients include acute onset of hypertension,headache with vomiting.Neurological symptoms were conscious disturbance,seizures(in 5 cases)and visual disorder(in 3 cases).The movement of limbs were normal.The abnormal laboratery data was renal inadequacy in 5 cases.The findings of imaging of all cases included bilateral white matter of parietal and occipital lobe abnormalities,which appeared as large areas of low density on CT scan,hypo-intense in T1 and hyper-intense in T2 on MRI scan.Four cases presented clinical symptoms improvement in a short time and radiological recovery obviously after anti-hypertensive and anhydration therapy.One patient died caused on brain herniation.Conclusions Clinical features of RPLES is brain damage associated with malignant hypertension or the use of immunosuppressive agents.The most important pathogenesis is considered to be failure of the self regulation of cerebral vascular circulation.The imaging findings are bilateral symmetry cortical and subcortical edema in the posterior areas of the brain.Most patients can be recovery by timely therapy,otherwise the irreversible neuronal injury even death can be also found in very few serious cases.

Facing the new problems under the background of new era,with the establishment of the market economy of our country and the improvment of the medical health system,how to solve medical health problems,how to strengthen the modernization management of state-owned hospital,and how to improve their comprehensive strength become the focus of the health research.With the internal and external environment analysis and the strategic management theory,this paper puts forward the development strategy and the support system of the children's hospital of Chongqing Medical University.

Malnutrition in patients with acute stroke is quite common. It is an independent risk factor affecting stroke prognosis. Early enteral nutrition can improve the nutritional status of the stroke patients, lower infection rate and mortality, promote recovery of neurological function, and improve the quality of life. Therefore, under the premise of the gastrointestinal tolerance, the patients with severe stroke should select early enteral nutrition as early as possible.

Objective To find a indicator in urine to assist diagnosis of cerebral infarction,we investigated the changes of urine ferritin in patients with cerebral infarction.Methods Collected serum from 30 healthy volunteers and 53 patients with cerebral infarction(CI),with ratio of males to females 19∶11 vs.30∶ 23,and average age was (56 ± 11) vs.(63 ± 11) respectively.Collected urine from 39 heathy volunteers and 33 patients with CI,with ratio of males to females 25∶14 vs.20∶ 13,and average age was (57 ± 10) vs.(64 ± 11) respectively.Ferritin concentration in all samples was detected with the chemical luminescence method,and the urine ferritin/urine cretinin (uFer/uCr) ratio was calculated.Differences of serum ferritin and uFer/uCr between healthy volunteers and CI patients were analyzed with the statistical software under Wilcoxon test.Urinary proteins were extracted with absolute ethanol.The extracted ferritin was displayed with Western blot for light chains and heavy chains to investigate the difference between healthy volunteers and CI patients.Results uFer/uCr was higher than that from healthy volunteers (U =292.00,P ＜0.05),and the median was (14.86 vs.6.22) μg/g.Moreover,after extraction of urinary proteins with alcohol,both light chains and heavy chains of ferritin in urine from CI patients were much more obvious than that from healthy volunteers.Conclusion The uFer/uCr ratio could provide a new proof to assist the diagnosis of cerebral infarction.

Objective To discuss the expression and significance of platelet ultrastructure and platelet acti-vating factor(PAF)relationship in patients with acute cerebral infarction.Methods 40 patients with cerebral infarc-tion were chosen onset in 6-24 hours as the observation group,while at the same time 20 cases of healthy adults were selected as the control group.The observation group was given 1-7d of aspirin enteric-coated metformin hydrochloride 300mg,qd,and 8-14d had worship of aspirin enteric-coated metformin hydrochloride 100mg,qd.And before and 1,7, 14 days after treatment,control group and observation group respectively preclude the use of transmission electron microscopy ultrastructure of platelets,before and 1,14 days after treatment automatic blood cell analyzer test was used to analyze the average platelet volume (MPV),platelet count (PLT),platelet volume distribution width (PDW)of the two groups.And 1,2,3,7,14 days after treatment,enzyme-linked immunosorbent determination of double clamp method was used to test the concentration of PAF.Results Before treatment,MPV,PDW and PAF in peripheral blood of the observation group were (9.22 ±1.30)fL,(17.89 ±1.23)%,(211.31 ±11.22)pg/mL,which were sig-nificantly higher than those of the control group (8.68 ±1.03)fL,(16.06 ±1.03)%,(155.49 ±8.70)pg/mL(t =2.082,2.563,14.401,all P <0.05),while PLT was (173.22 ±63.40)×109 /L,which was significantly lower than that in the control group (231.22 ±56.76)×109 /L(t =3.048,P <0.05).After treatment in patients with acute cer-ebral infarction,the MPV,PDW of peripheral blood were (8.43 ±1.28)fL,(16.66 ±1.11)%,which were signifi-cantly lower than before treatment (9.22 ±1.30)fL,(17.89 ±1.23)% (t =1.937,3.320,all P <0.05),while PLT (195.33 ±61.45)×109 /L was significantly higher than before treatment (173.22 ±63.40)×109 /L(t =1.915, P <0.05).PAF peaked in the treatment of 3 days,which was (240.12 ±13.78)pg/mL,and gradually declined after 7 days,which was (215.33 ±16.43)pg/mL,and that after 14 days was(170.27 ±11.40)pg/mL,compared with before treatment (211.31 ±11.22)pg/mL,the difference was statistically significant (t =16.24,P <0.05).Before treatment,platelet shape had irregular,increased pseudopodia,several visible platelet aggregation,and was blend together.And after 14 days treatment in the observation group,platelet ultrastructure greatly recovered.Conclusion Monitoring of MPV,PDW,PAF and PLT in peripheral blood of patients with acute cerebral infarction before and after treatment has important clinical value for disease diagnosis and treatment.

Objective To research the electrocardiogram (ECG) manifestations of common electrolyte disturbance and to discuss the accuracy of ECG diagnosis. Methods One hundred and sixty-nine hospitalized patients with hyperkalemia and 170 patients with hypokalemia were selected and the results of ECG were analyzed. Results In mild hyperkalemia patients (serum potassium concentration 5.5- 6.5 mmol/L), the ECG abnormal rate was 91.4% (64/70). In mild hypokalemia patients (serum potassium concentration 3.0-3.5 mmol/L), the ECG abnormal rate was 56.9% (41/72). There was significant difference (P < 0.05). The greater the deviation of serum potassium concentration, the more obvious the characteristic changes of ECG. Conclusions In addition to the blood biochemical test, ECG is also a kind of check tool that can help to diagnose abnormal blood potassium.