OBJECTIVE:To evaluate the efficacy and safety of Xuebijing injection in the adjuvant treatment of children with perforated appendicitis. METHODS:72 children with perforated appendicitis in the Dept. of Pediatric General Surgery of our hospi-tal were enrolled into a prospective clinical trial,and randomly divided into experimental group (n=36) and control group (n=36). Both groups received the emergency surgery and anti-infective treatment;experimental group had additionally given Xuebijing injection. The white blood cell count (WBC),C-creation protein (CRP) and procalcitonin (PCT),liver and kidney function and hospitalization time before and after treatment were collected and adverse reaction. RESULTS:The WBC in experimental group af-ter 3 and 6 d of treatment was respectively(13.6±3.4)×109 L-1 and(9.1±4.2)×109 L-1,CRP was respectively(52.7±13.6)mg/L and(8.5±3.3)mg/L,the PCT(0.3±0.2)ng/ml,and the hospitalization time after 3 d were lower than control group,with signifi-cant difference(P<0.05). There were no significant difference in the liver and kidney function(P>0.05). There was 1 case with itch of skin but with no severe ADR. CONCLUSIONS:Xuebijing injection in the adjuvant treatment of children with perforated ap-pendicitis is safe and effective.

OBJECTIVE:To systematically review the efficacy and safety of Kanglaite injection combined with radiothreapy in the treatment of the non-small cell lung cancer (NSCLC),and provide evidence-based reference for clinical treatment. METH-ODS:Retrieved from PubMed,Cochrane Library,EMBase,VIP,CJFD,Wanfang database and CBM,randomized controlled tri-als(RCT)about the efficacy and safety of Kanglaite injection combined with radiothreapy in the treatment of NSCLC were collect-ed. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation with modified Jadad scale. RESULTS:Totally 9 RCTs were included,involving 561 patients. Results of Meta-analysis showed,Kanglaite injection com-bined with radiothreapy can significantly improve the effective rate [OR=2.99,95%CI(2.07,4.31),P<0.001] and improvement rate of life quality [OR=3.74,95%CI(2.36,5.92),P<0.001],and reduce the incidence of radiation pneumonitis [OR=0.23,95%CI (0.12,0.47),P<0.001] and radiation esophagitis [OR=0.10,95%CI(0.05,0.21),P<0.001] of NSCLC patients,the differences were statistically significant. CONCLUSIONS:Both the efficacy and safety of Kanglaite injection combined with radiothreapy in the treatment of NSCLC are superior to radiothreapy alone.

Objective To study the relationship among hepatitis B viral genome (HBV‐DNA) ,hepatitis Be antigen(HBeAg) and liver function in chronic hepatitis B patients ,and to provide the reference for clinical treatment .Methods The quantitative levels of HBV‐DNA ,HBeAg ,alanine aminotransferase (ALT) and aspartate aminotransferase(AST) in 401 patients were analyzed and the correlation analysis between HBV‐DNA and HBeAg was performed .The grouping was performed according to the HBV‐DNA and HBeAg quantitative levels and the differences of ALT and AST levels were compared among the groups .Results (1) The correla‐tion existed between HBV‐DNA and HBeAg positive rate ,r=0 .671(P<0 .01);(2)when HBV‐DNA load reaching 105 copies/mL , serum ALT and AST levels showed significantly increased compared with the HBV‐DNA negative group and low load group ,the difference was statistically significant (P<0 .05);(3)when HBV‐DNA load was equivalent ,the difference of ALT and AST activity had no statistically significant difference between the HBeAg‐positive and HBeAg‐negative groups .Conclusion (1)HBeAg has a correlation with HBV‐DNA ;(2)the patients with higher HBV‐DNA load are easy to develop the liver function abnormality ;(3)the HbeAg existence situation has no obvious relation with the liver function .

Objective To investigate the distribution characteristics of serum hepatitis B virus (HBV) markers of population in hospital and to provide the basis for prevention and control of virus B hepatitis .Methods 11 210 people in hospital who had accepted HBV serological testing were enrolled ,and were divided into >0 -25-year old group(n=3 553) and >25 -50-year old group(n=7 651) according to their ages .Enzyme-linked Immunosorbent Assay(ELISA) and Roche Cobas E601 Automatic Electro-chemiluminescence immunoassay analyzer were employed to detect serum HBV surface antigen (HBsAg ) ,anti-HBV surface anti-body(HBsAb) ,HBV e antigen(HBeAg) ,anti-HBV e antibody(HBeAb) and anti-HBV core antibody(HBcAb) .Results HBsAg positive rates of subjects in > 0 -25-year old group and > 25 -50-year old group were 16 .16% and 21 .19% ,respectively .The overall positive rates of HBsAg and HBsAb and full-negative rate were 19 .59% (2 195/11 204) ,37 .02% (4 148/11 204) and 11 .84% (1 327/11 204) ,respectively .Conclusion Distribution characteristics of HBV markers of population in hospital may pro-vide a reliable basis for taking effective protective and control measures against virus B hepatitis .

Objective To investigate the integrated perinatal management and prognosis of prenatally diagnosed congenital diaphragmatic hernia (CDH).Methods Clinical data of 32 cases of neonatal CDH that were diagnosed and treated in the Third Affiliated Hospital of Zhengzhou University from June 2015 to June 2017 were collected and retrospectively analyzed.All cases were classified into mild,moderate and severe groups based on prenatal lung-to-head ratio (LHR),observed to expected LHR and observed to expected total fetal lung volume.The integrated perinatal management included prenatal management (prenatal diagnosis and consultation),intrapartum management (delivery) and postnatal management (postnatal diagnosis,neonatal treatment and surgical treatment).Neonatal outcomes were analyzed.Statistical analysis was performed using Chi-square test and t-test.Results All of the 32 cases were diagnosed by prenatal ultrasonography and assessed by MRI.There were 18 mild,nine moderate and five severe CDH cases,respectively.Left-sided and right-sided CDH were respectively found in 27 and five cases.Thirty neonates underwent surgery when the diagnosis had been confirmed after birth and the conditions were stable after comprehensive treatment.The total survival rate was 81％ (26/32).The neonatal survival rates of severe and mild groups were 1/5 and 18/18,respectively.The more severe the CDH,the lower the survival rate (x2=16.538,P＜0.001).Among the 18 neonates with mild CDH,five neonates underwent minimally invasive laparoscopic surgery had shorter fasting time,duration of postoperative antibiotic administration and hospital stay than those received open surgery (n=13)[(2.4±0.5) vs (4.6±1.2) d,t=-3.939;(7.6±1.2) vs (9.8±1.4) d,t=-3.144;(14.4±1.1) vs (19.7±2.8) d,t=-4.064;all P＜0.01].Neonates who were discharged alive received a three months to two years postoperative treatment and follow-up and one received a second operation due to recurrence and all recovered.Conclusions Prognosis of neonatal CDH are closely related to prenatal conditions.Integrated management is of great significance in CDH.

Objective:As the amount of scientific reagents/consumables procurement in tertiary medical institutions increases year by year, it is necessary to seek for a more optimized operation mode for the current management needs to improve the procurement service and management of scientific reagents/consumables.Methods:Focused on the bottleneck problem of scientific research reagents/consumables procurement management, combined with the investigation of management mode in the same field and the review of relevant literature, a scientific research reagents/consumables procurement platform suitable for hospital was established, which was operated in the whole hospital for 2 years and continuingly improved.Results:The application of the scientific reagents/consumables procurement platform is expected to save 7%~8% of the scientific reagents/consumables related expenditure, which can make the scientific research procurement work standardized and simple, the procurement management precise and fast, and also provide favorable support for the prevention and control of epidemic diseases in hospitals.Conclusions:This platform is conducive to improving the service and management level of scientific reagents/consumables procurement in our hospital, and has conditions to expand the scope and increase the depth of management and service.

Objective:To investigate the different outcomes of two types of acute kidney injury (AKI) according to standard of Kidney Disease: Improving Global Outcomes-AKI (KDIGO-AKI), and to analyze the risk factors that affect the prognosis of intensive care unit (ICU) patients in China.Methods:A secondary analysis was performed on the database of a previous study conducted by China Critical Care Clinical Trial Group (CCCCTG), which was a multicenter prospective study involving 3 063 patients in 22 tertiary ICUs in 19 provinces and autonomous regions of China. The demographic data, scores reflecting severity of illness, laboratory findings, intervention during ICU stay were extracted. All patients were divided into pure AKI (PAKI) and acute on chronic kidney disease (AoCKD). PAKI was defined as meeting the serum creatinine (SCr) standard of KDIGO-AKI (KDIGO-AKI SCr) and the estimated glomerular filtration rate (eGFR) at baseline was ≥ 60 mL·min -1·1.73 m -2, and AoCKD was defined as meeting the KDIGO-AKI SCr standard and baseline eGFR was 15-59 mL·min -1·1.73 m -2. All-cause mortality in ICU within 28 days was the primary outcome, while the length of ICU stay and renal replacement therapy (RRT) were the secondary outcome. The differences in baseline data and outcomes between the two groups were compared. The cumulative survival rate of ICU within 28 days was analyzed by Kaplan-Meier survival curve, and the risk factors of ICU death within 28 days were screened by Cox multivariate analysis. Results:Of the 3 063 patients, 1 042 were enrolled, 345 with AKI, 697 without AKI. The AKI incidence was 33.11%, while ICU mortality within 28 days of AKI patients was 13.91% (48/345). Compared with PAKI patients ( n = 322), AoCKD patients ( n = 23) were older [years old: 74 (59, 77) vs. 58 (41, 72)] and more critical when entering ICU [acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score: 23 (19, 27) vs. 15 (11, 22)], had worse basic renal function [eGFR (mL·min -1·1.73 m -2): 49 (38, 54) vs. 115 (94, 136)], more basic complications [Charlson comorbidity index (CCI): 3 (2, 4) vs. 0 (0, 1)] and higher SCr during ICU stay [peak SCr for diagnosis of AKI (μmol/L): 412 (280, 515) vs. 176 (124, 340), all P < 0.01]. The mortality and RRT incidence within 28 days in ICU of AoCKD patients were significantly higher than those of PAKI patients [39.13% (9/23) vs. 12.11% (39/322), 26.09% (6/23) vs. 4.04% (13/322), both P < 0.01], while no significant difference was found in the length of ICU stay. Kaplan-Meier survival curve analysis showed that the 28-day cumulative survival rate in ICU in AoCKD patients was significantly lower than PAKI patients (Log-Rank: χ2 = 5.939, P = 0.015). Multivariate Cox regression analysis showed that admission to ICU due to respiratory failure [hazard ratio ( HR) = 4.458, 95% confidence interval (95% CI) was 1.141-17.413, P = 0.032], vasoactive agents treatment in ICU ( HR = 5.181, 95% CI was 2.033-13.199, P = 0.001), and AoCKD ( HR = 5.377, 95% CI was 1.303-22.186, P = 0.020) were independent risk factors for ICU death within 28 days. Conclusion:Further detailed classification (PAKI, AoCKD) based on KDIGO-AKI SCr standard combined with eGFR is related to ICU mortality in critical patients within 28 days.