The COVID-19 epidemic has spread to the whole world for three years and has had a serious impact on human life, health and economic activities. China's epidemic prevention and control has gone through the following stages: emergency unconventional stage, emergency normalization stage, and the transitional stage from the emergency normalization to the "Category B infectious disease treated as Category B" normalization, and achieved a major and decisive victory. The designated hospitals for prevention and control of COVID-19 epidemic in Tianjin has successfully completed its tasks in all stages of epidemic prevention and control, and has accumulated valuable experience. This article summarizes the experience of constructing a hospital infection prevention and control system during the "Category B infectious disease treated as Category A" period in designated hospital. The experience is summarized as the "Cluster" hospital infection prevention and control system, namely "three rings" outside, middle and inside, "three districts" of green, orange and red, "three things" before, during and after the event, "two-day pre-purification" and "two-director system", and "one zone" management. In emergency situations, we adopt a simplified version of the cluster hospital infection prevention and control system. In emergency situations, a simplified version of the "Cluster" hospital infection prevention and control system can be adopted. This system has the following characteristics: firstly, the system emphasizes the characteristics of "cluster" and the overall management of key measures to avoid any shortcomings. The second, it emphasizes the transformation of infection control concepts to maximize the safety of medical services through infection control. The third, it emphasizes the optimization of the process. The prevention and control measures should be comprehensive and focused, while also preventing excessive use. The measures emphasize the use of the least resources to achieve the best infection control effect. The fourth, it emphasizes the quality control work of infection control, pays attention to the importance of the process, and advocates the concept of "system slimming, process fattening". Fifthly, it emphasizes that the future development depends on artificial intelligence, in order to improve the quality and efficiency of prevention and control to the greatest extent. Sixth, hospitals need to strengthen continuous training and retraining. We utilize diverse training methods, including artificial intelligence, to ensure that infection control policies and procedures are simple. We have established an evaluation and feedback mechanism to ensure that medical personnel are in an emergency state at all times.

Objective To analyze and assess the postoperative motor function in children with spastic cerebral palsy (SCP) by surface electromyography (sEMG) and joint angle. Methods Sixteen children with SCP were involved in this study. The sEMG of rectus femoris, biceps femoris, semitendinosus, tibialis anterior, lateral gastrocnemius and medial gastrocnemius muscles and joint angles of the hip, knee and ankle during straight walking were collected preoperatively and postoperatively. In every gait phase, the mean values of joint angles, root mean square and integrated electromyography of sEMG were calculated, to evaluate muscle strength and muscular tension quantitatively. Results The muscle tension of lower limbs was significantly decreased (P<0.05). The muscle strength of rectus femoris and biceps femoris was decreased in the swing phase. At the midswing and terminal swing phase, the strength of tibialis anterior increased significantly (P<0.05). The flexion angle of hip and knee decreased significantly (P<0.05). The dorsiflexion angle of ankle increased significantly (P<0.05), and the varus angle decreased significantly (P<0.05). Conclusions After operation, the crouching gait and clubfoot were improved positively. Therefore, the motor function of children was improved. Combining sEMG and joint angle can evaluate the muscle function of patients quantitatively, and it also can provide references for clinical diagnosis.

The negative effects of low temperature can readily induce a variety of diseases. We sought to understand the reasons why cold stress induces disease by studying the mechanisms of fine-tuning in macrophages following cold exposure. We found that cold stress triggers increased macrophage activation accompanied by metabolic reprogramming of aerobic glycolysis. The discovery, by genome-wide RNA sequencing, of defective mitochondria in mice macrophages following cold exposure indicated that mitochondrial defects may contribute to this process. In addition, changes in metabolism drive the differentiation of macrophages by affecting histone modifications. Finally, we showed that histone acetylation and lactylation are modulators of macrophage differentiation following cold exposure. Collectively, metabolism-related epigenetic modifications are essential for the differentiation of macrophages in cold-stressed mice, and the regulation of metabolism may be crucial for alleviating the harm induced by cold stress.
Acetylation ; Animals ; Cold-Shock Response ; Epigenesis, Genetic ; Macrophages/metabolism* ; Mice ; Mitochondria/metabolism*

Three cases of renal pelvic neoplasm associated with staghorn calculi were enrolled to the study from March 2015 to June 2019. All patients underwent minimally invasive procedures previously including extracorporeal shock wave lithotripsy (ESWL), flexible ureteroscopic lithotripsy(FURL), or percutaneous nephrolithotripsy (PCNL). 3 patients of renal pelvic neoplasm with giant staghorn calculus were diagnosed by resection biopsy during laparoscopic pyelolithotomy intraoperatively and then treated by laparoscopic radical nephroureterectomy (LRNU). Case 1 was identified retroperitoneal lymph node metastasis 16 months after operation. Case 2 and 3 remained disease free. The timely diagnosis of renal pelvic neoplasm associated with staghorn calculi is always difficult, nevertheless, the laparoscopic pyelolithotomy with resection biopsy intraoperatively can be more effective in selected cases compared with routine endoscopic biopsy.

Objective:To investigate the pathology characteristics, so as to provide treatment experience of primary cardiac tumors for pediatric patients.Methods:A retrospective study was conducted for 135 patients with primary cardiac tumor between January 2004 and December 2017 in Shanghai Children′s Medical Center.The median age was 0.54 years (range, 0-14.36 years). Single tumor was discovered in 61 cases and multiple rumors were found in 74 cases.Forty-five patients presented obvious clinical symptoms, 4 patients with mild symptoms and 86 patients without symptoms.Forty-one patients underwent surgical treatment, including complete resection of the tumor in 24 cases, partial resection in 16 cases and heart transplantation in 1 case.Concomitant valvuloplasty was required in 13 patients.Ninety-four patients did not receive surgical treatment.Results:A total of 40 patients underwent surgical treatment in Shanghai Children′s Medical Center.Three patients died of low cardiac output (in-hospital mortality: 7.5%), and 2 patients recovered from postoperative low cardiac output.The hemodynamic status was stable in the remaining 35 cases.One patient who received heart transplantation in another hospital survived and had good cardiac function during 24 months follow-ups.There were no significant differences in the survival rate between partial resection and complete resection of benign tumors.One late death was observed in patients with malignant tumors for 2 years after operation.Surveillance was kept in 94 non-surgical patients, among whom 1 case died for the abandon of surgery and 1 case died when waiting for heart transplantation.Other 2 patients were waiting for heart transplantation and other 90 patients had no hemodynamic disorder.Conclusion:Most of primary cardiac tumors are benign and long time follow-up should be able to get on for pediatric patients.When patients develop hemodynamical obstruction, arrhythmia or malignant tumor, surgical treatment is necessary.The principle of surgical therapy in these patients is to restore normal hemodynamic status, instead of completely removing tumor.Heart transplantation is potentially the only way for patients whose tumor cannot be resected.

Objective To investigate the effect of allergen-specific immunotherapy on FEV1 and airway responsiveness in patients with idiopathic asthma.Methods 90 patients with idiopathic asthma from January 2013 to August 2015 in Deqing City People's Hospital were selected and randomly divided into control group and study group with 45 cases in each group.Control group were treated with anti-infection, relieving cough and eliminating phlegm, relieving spasm and relieving asthma, the study group was treated with allergen specific immunotherapy based on the control group, and a total of 3 months for a course of treatment.Blood samples were used to measure inflammatory mediators , airway sensitivity index, pulmonary function and airway responsiveness, at the same time, the clinical efficacy and complications were compared.Results Compared with before treatment, the levels of FVC, PEF, FEV1 and FEV1/FVC in the two groups increased, levels of AI, AO, T and WA decreased, levels of serum IL-4 decreased, levels of IL-10, IFN-γincreased, levels of serum IgE, SIgE, TIgE and EOS decreased, the difference was statistically significant (P<0.05), compared with the control group, the levels of FVC, PEF, FEV1 and FEV1/FVC in the study group were higher, the levels of AI, AO, T and WA were lower, serum IL-4 levels were lower after treatment, levesls of IL-10, IFN-γwere higher, levels of serum IgE, SIgE, TIgE and EOS were lower, the difference was statistically significant (P<0.05), and the effective rate in the control group (71.11%) was lower than the study group (88.89%), the difference was statistically significant(P <0.05).Conclusion Allergen-specific immunotherapy was effective for cough variant asthma, it can improve pulmonary function, inflammation and airway sensitivity.

Objective To investigate the feasibility of inserting and detaining nasointestinal feeding tube in small bowl guided by bedside ultrasound(US)in critically ill elderly patients.Methods This was a retrospective study.Sixty four aged patients(≥ 60 years)in general ICU,the Second Affiliated Hospital of Jiaxing College,received the US-guided nasointestinal feeding tubes inserting and detaining.Feeding tubes passed through nasal and went into the stomach by manual blind method.Under US-guiding condition,the tube passed through the pyloric sphincter and further into the duodenum or jejunum.Finally the correct position of the tube head was assessed by bedside X-ray examination.Results The US-guided nasointestinal feeding tube-detaining technique was successfully operated in 57 patients(89.1％).The feeding tube heads were in the duodenum in thirty four cases(53.1 ％),and in proximal jejunum in twenty-three cases(35.9％).The untoward reaction included the bleeding of nasal cavity in 1 case,and hypotension in another case.Conclusions Bedside US-guided nasointestinal feeding tube placement is safe and feasible in aged critical patients.

OBJECTIVE:To study the influence of oscillator on the cleanliness of class 100 clean bench in PIVAS. METH-ODS:Using sedimentated bacteria and the number of dust particle as index,in common drug configuration room,antibiotics con-figuration room and risk drugs configuration room including biological safety cabinet and horizontal laminar flow,the cleanliness of class 100 clean bench were monitored when oscillator was set at clean bench and different positions in work and non-working state. RESULTS & CONCLUSIONS:In working and non-working state of oscillator,there was no difference in sedimentated bacteria and the number of dust particle which was in line with the requirements of 2010 edition of GMP,i.e. the application and location of oscillator didn't influence the cleanliness of class 100 clean bench. From a view of safety,it is suggested to place the oscillator in the left(or right)posterior wall of clean table when biological safety cabinets is used to dispense antibiotic and risk drugs.

The author carried on bibliometrics statistical analysis of published papers during 2003-2012 by Disease control agencies of Chongqing and put forward some suggestions based on the results of the analysis.The results showed that in 10 years,the number of published papers for a total of 1154 with an average annual growth rate of 10.41％,of which 467 core journals,journal article 687.the difference between the municipal,district and county larger.The quantity and quality of published papers showed an upward trend,but there is still development space and the quality of the paper should be improved.

OBJECTIVETo study the role of endoplasmic reticulum stress (ERS) in acute liver failure (ALF) using a mouse model of D-Galactosamine/lipopolysaccharide (D-GalN/LPS)-induced ALF.

METHODSThe ALF model was established by administering intraperitoneal (i.p.) injections of D-Ga1N (700 mg/kg) and LPS (10 mug/kg) to six C57BL/6 mice. Three of the modeled mice were also administered 4-phenylbutyrate (4-PBA; 100 mg/kg i.p.) at 6 hours before the onset of ALF and served as the intervention group. Non-modeled mice served as controls. All mice were analyzed by western blotting and qRT-PCR to determine the expression levels of ERS-related proteins in liver tissue. Liver function was assessed by measuring levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum. Extent of injury to the liver tissue was assessed by hematoxylin-eosin staining and histological analysis. qRT-PCR was also used to detect differences in expression of inflammation-related genes, and western blotting was also used to detect differences in expression of the apoptosis related protein Caspase-3.The extent of apoptosis in liver tissue was assessed by TUNEL assay.

RESULTSThe ERS markers GRP78 and GRP94 showed increased expression at both the gene and protein levels which followed progression of ALF. The ERS effector proteins XBP-1, ATF-6 and IRE 1 a involved in the unfolded protein response were activated in the early stages of ALF, and the ERS-induced apoptosis regulators Caspase-12 and CHOP were activated in the late stage of ALF. Inhibition of ERS by 4-PBA intervention protected against injury to liver tissue and function, as evidenced by significantly lower levels of serum ALT and AST and a remarkably decreased extent of histological alterations. Furthermore, the inhibition of ERS suppressed expression of the proinflammatory cytokines TNFa, IL-6 and IL-1 β, and reduced the extent of hepatocyte apoptosis.

CONCLUSIONERS is activated in the mouse model of D-GalN/LPS-induced ALF. Inhibition of ERS may be protective against liver injury and the mechanism of action may involve reductions in inflammatory and apoptotic factors and/or signaling. Therefore, inhibiting ERS may represent a novel therapeutic approach for treating ALF.

Animals ; Apoptosis ; Disease Models, Animal ; Endoplasmic Reticulum Stress ; Galactosamine ; adverse effects ; Lipopolysaccharides ; adverse effects ; Liver Failure, Acute ; chemically induced ; metabolism ; pathology ; Male ; Mice ; Mice, Inbred C57BL