Objective:Discipline construction is the key and effective method for the high-quality development of hospitals. This study summarized the practical and valuable experience of discipline construction with the support of the ″Sanming Project of Medicine″ in Shenzhen, to provide a worthy reference for similar projects and hospital specialty development.Methods:Taking the introduction of the hematology-oncology team of the Canadian Children′s Hospital as an example, we analyzed the background, the process, and the effectiveness of discipline construction of hematology and oncology of Shenzhen Children′s Hospital under the support of the ″Sanming Project of Medicine″, and explored the common rules for rapid specialty development.Results:Through the implementation of two levels supporting policies from cities and hospitals and quantifiable and verifiable annual progressive program, the adoption of the international advanced medical management mode and concepts, and the transformation and application of cutting-edge clinical technologies, we successfully built the largest pediatric hematologic oncology diagnosis and treatment center in South China and the largest pediatric hematopoietic stem cell transplant center in China. By executing a multi-level talent developing program, the number of specialists with MD and PhD degrees increased by 6.5 times, and 23 doctors and nurses were trained abroad, leading to the development of provincial key clinical specialties and municipal key scientific research platforms.Conclusions:This project concluded the beneficial experience of introducing high-level overseas medical teams to boost discipline construction, including internationally advanced medical concepts and management modes, tiered talent cultivation schemes, the construction of clinical and basic research platforms, etc., providing references for the rapid improvement of discipline construction in terms of health care for other hospitals in Shenzhen and similar cities.

Objective:To explore the safety and efficacy of radiofrequency in the treatment of overactive bladder(OAB).Methods:A prospective, multicenter, non-randomized controlled trial was conducted. Eligible patients were divided into test group and control group in Zhejiang Provincial People’Hospital, The First Affiliated Hospital of Wenzhou Medical University, and Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine from March 2019 to June 2020. Inclusion criteria: patients diagnosed with OAB, and bladder capacity>100ml. Exclusion criteria: pregnant and lactating women; patients with secondary OAB symptoms such as urinary tract obstruction; patients with uncontrolled urinary tract infection within 1 week; patients in stable stage by using other treatment methods; patients implanted with any nerve stimulator, cardiac pacemaker or implantable defibrillator; patients with malignant tumors, serious cardiovascular, cerebrovascular diseases, renal insufficiency or received BTX treatment in recent 12 months. The patients were allocated to test group and the control group in a ratio of 2∶1 according to the time sequence of the visit. The patients in the test group were treated with radiofrequency treatment. After entering the group, they were treated for 4 times at the 1st, 2nd, 7th and 8th week respectively. In the control group, the energy was turned off during the radiofrequency treatment. The patients were followed-up every week until the end of the 12th week. The treatment success rate [the average frequency of urination in 24 h was reduced more than 50% from the baseline or returned to the normal (≤8 times/day) or the average frequency of urgent urination in 24 h was reduced more than 50% from the baseline], the frequency of urination, urgent urination and nocturnal urination before and after treatment, the residual urine volume of the bladder, the quality of life (QOL) score and the occurrence of catheter related adverse events in two groups were compared.Results:114 patients were enrolled in the study, including 76 patients in the test group and 38 patients in the control group. There were no significant differences in the age [(44.2±12.8) vs. (41.7 ± 12.1) years old], male female ratio (13/63 vs. 4/34), average course of disease [2.0(1.2, 5.0) vs. 2.0 (1.0, 4.0) years], the frequency of urination[12.8 (10.6, 16.8) vs. 12.8 (10.3, 17.0) times], urgency urination [11.8(9.3, 15.8) vs. 11.8 (9.0, 17.0) times], nocturia [2.7 (1.3, 3.7) vs. 2.3(0.7, 3.3) times], residual urine volume of bladder [12.0 (3.0, 28.0) vs. 14.0 (3.7, 20.0) ml ] and the QOL score [5.0(4.0, 5.0) vs. 4.0(4.0, 5.0)]before the treatment between the two groups ( P>0.05). The treatment success rate in the test group was 76.3% (58/76), while 26.3% (10/38) in the control group, with a statistically significant difference ( P<0.01). There were significant differences between the test group and control group in the frequency of urination [9.7 (7.7, 12.0) vs. 12.9 (9.6, 15.7) times], urgent urination [7.3 (5.0, 10.0) vs. 11.7 (7.3, 15.3) times], nocturia [1.3 (0.7, 2.0) vs. 1.7 (1.0, 3.0) times] and the QOL score of the patients[3.0(1.0, 3.0) vs. 4.0(3.0, 4.5)]after the treatment(all P<0.05). The frequency of urination, urgency urination, nocturia, the residual urine volume and the QOL score in the test group were significantly improved ( P<0.05) after the treatment.The frequency of urination, nocturia, residual urine volume and the QOL score in the control group were improved ( P<0.05) after the treatment. 13 (11.4%) patients had catheter related adverse events. In the test group and the control group, there were 7 cases of macroscopic hemorrhage caused by the placement of instruments (5/76 vs. 2/38), 5 cases of acute urinary tract infection within 3 days (3/76 vs. 2/38), and 1 case of instrument breakage (catheter breakage) (0/76 vs. 1/38). There were no significant differences in the adverse events between the two groups ( P> 0.05). Conclusions:Radiofrequency treatment of OAB can effectively improve the symptoms of patients, improve the QOL of patients, and has low incidence of adverse events, with good efficacy and safety.

Objective:To analyze the clinical characteristics of Group A Streptococcal(GAS) toxic shock syndrome (STSS) in children. Methods:The clinical data of 10 STSS children hospitalized in Shenzhen Children′s Hospital from January 2015 to March 2022 were downloaded from the electronic medical record system.The clinical manifestations were analyzed and treatment experience was summarized respectively.Results:There were 5 males and 5 females, with an average age of (5.29±2.87) years.All the patients were healthy in the past.The diagnoses were confirmed by blood culture in 2 cases, pus culture in 5 cases, and blood metagenomics next generation sequencing in 3 cases.The rapid detection of GAS antigen was positive in 7 cases.All cases had fever, and 9 cases of them developed fever after viral infection, including pneumonia in 7 cases, skin and soft tissue infections in 6 cases, necrotizing fasciitis in 3 cases, and purulent meningitis in 1 case.All cases also presented with shock.Six cases had liver function injury, and 4 cases suffered from acute kindey injury.Four cases had infection-related encephalopathy, and 7 cases were afflicted with disseminated intravascular coagulation.Two cases had respiratory failure, and 2 cases had rhabdomyolysis.There were 3 cases with a decreased white blood cell (WBC) count and 7 cases with an increased WBC count on admission.Seven cases were found to have thrombocytopenia, but their platelet levels were all elevated after recovery.C-reactive protein and procalcitonin and the proportion of neutrophils were markedly increased in all cases.All cases suffered from hypoalbuminemia, hyponatremia and hypocalcemia.All the 10 positive strains were sensitive to Penicillin, Ceftriaxone/Cefotaxime and Vancomycin.Eight cases were treated with combined antibiotics after admission.Eight patients received intravenous immunoglobulin.All cases were cured and discharged.Conclusions:The STSS progresses rapidly in children, so pediatricians should pay great attention to the disease.Early identification, diagnosis of infection sources, infusion of antibiotics and surgical treatment are the keys to disease management.

Objective:To study the clinical characteristics, diagnosis, complications and prognosis of neonatal varicella.Methods:From September 2008 to December 2019, the clinical data of hospitalized neonates with varicella in our hospital were retrospectively analyzed.Results:A total of 33 cases of neonatal varicella were reviewed, including 18 males and 15 females, 32 full-term infants and 1 premature infant. The gestational age (GA) was (38.8±1.2)w and birth weight (BW) was (3 670±247)g. The onset of the disease occurred at 14.0 (8.0,19.0)d and was diagnosed at 18.0 (11.5,23.0)d. The hospital stay duration was (8.1±3.7)(2~20)d. All mothers denied varicella history or varicella vaccination. Among the 33 infants, 29 had a history of varicella/zoster exposure. All 33 infants had typical rash and 25 had fever, body temperature (38.3±0.6) ℃ and duration (2.4±1.4) d. 13 cases were congenital varicella, 20 cases were acquired varicella. 24 cases abnormality of cardiac enzymes, 11 cases skin infection, 8 cases liver damage, 4 cases pneumonia, 6 cases granulocytopenia/agranulocytosis, 9 cases anemia, 4 cases sepsis and 1 case viral encephalitis were diagnosed. 20 infants received intravenous antiviral therapy (acyclovir), 17 were treated with antibiotics, 15 were given intravenous immunoglobulin (IVIG), 8 received both antiviral therapy and IVIG and 6 were treated with recombinant human granulocyte stimulating factor. 31 infants were cured and discharged. 2 infants were discharged after improvement of rashes. All infants reported complete recovery on telephone follow-up.Conclusions:Most neonatal varicella cases have a definite exposure history. Besides rashes, complications including pneumonia, liver damage, myocardial injury, granulocytopenia/agranulocytosis, viral encephalitis are common. Intravenous antiviral therapy with acyclovir and combined treatment of IVIG and symptomatic support can often achieve a good prognosis.

Objective:To explore the current situation of college students′ risk behavior and its relationship with alexithymia.Methods:A total of 992 college students from two colleges in Jiangxi Province were investigated with evaluation scale for risk behaviors of teenagers and Toronto alexithymia scale. SPSS 17.0 software was used for descriptive statistics, correlation analysis and regression analysis.Results:Evaluation scale for risk behaviors showed that 15.2% of college students had at least one risk behavior factor scored more than 3, and 1.0% had at least one factor scored more than 4. The scores of bad habits and extroversion behavior question of boys((1.72±0.50), (1.61±0.56)) were significantly higher than those of girls ((1.66±0.38), (1.45±0.40), t=2.205, P=0.028, t=5.020, P<0.01), and the scores of introversion behavior question and academic maladjustment of girls ((2.13±0.56), (2.51±0.53)) were significantly higher than those of boys ((1.97±0.62), (2.39±0.63), t=-4.157, P<0.01, t=-3.282, P=0.001). The four factors of risk behaviors were positively correlated with each other (0.497-0.673), and the risk behaviors of college students were clustered. There were significant differences in the total score of risk behaviors ((2.28±0.43), (1.99±0.37), (1.71±0.36)), introversion behavior question ((2.60±0.54), (2.17±0.49), (1.80±0.50)), bad habits ((1.95±0.49), (1.73±0.38), (1.54±0.36)), academic maladjustment ((2.82±0.52), (2.57±0.50), (2.25±0.54)) and extroversion behavior question ((1.72±0.56), (1.57±0.46), (1.37±0.38)) in alexithymia group, possible alexithymia group and non alexithymia group( F=157.252, 172.027, 75.654, 85.424, 45.604, all P<0.01). Multiple stepwise regression analysis showed that alexithymia could predict college students′ risk behaviors. Conclusion:Taking effective measures to reduce the level of alexithymia can reduce the occurrence of risk behaviors of college students.

This article introduces the components of surgical smog and the harmfulness to human health. In order to reduce the hazards of surgical smog, some protective measures are suggested, such as improving the protection consciousness of medical staff, reducing the occurrence of surgical smog, strengthening the discharge of surgical smog and preventing the smog inhalation.

Objective To study the level and clinical value of differential display code 3 (DD3) in peripheral blood of patients with prostate cancer.Methods 27 patients with prostate cancer from April 2014 to April 2015 in Affiliated Hospital of Hangzhou Normal University were researched.26 patients with non prostate diseases were selected as control group.DD3 mRNA levels were detected in peripheral blood of all patients.DD3 absorbance value of three groups of patients,the relationship between the relative content of DD3 mRNA and the clinical characteristics of prostate cancer,DD3 mRNA in urine and peripheral blood of patients with prostate cancer and benign prostatic hyperplasia were observed.Results In the patients with benign hyperplasia of prostate and non prostate diseases,a total of 4 patients did not appear to be DD3 specific bands.In prostate cancer patients,all patients were found to have DD3 specific bands.The relative content of patients with non prostate diseases was (0.18 ± 0.05) copies/mL.The relative content of benign prostatic hyperplasia patients was (0.30 ± 0.09) copies/mL.The relative content of prostate cancer patients was (0.78 ± 0.23) copies/mL.The positive expression rates of DD3 mRNA in peripheral blood and urine of patients with prostate cancer were 85.18％ (23/27),51.85％ (14/27),respectively,which were significantly higher than those in patients with benign prostatic hyperplasia[21.42％ (6/28),7.14％ (2/27)] (x2 =22.416,13.319,all P ＜ 0.05).Conclusion The specific expression of DD3 mRNA in peripheral blood of patients with prostate cancer can be used as an effective basis for judging the patients' condition,and it has certain value for the treatment and prognosis of patients with prostate cancer.

Objective To investigate the changes of microRNA-223 (miR-223) in patients with complication of sepsis after mini-invasive surgery of upper urinary tract stones, and to approach the value of miR-223 in the early diagnosis of sepsis. Methods Patients with upper urinary tract stones underwent micro-invasive treatment in the Department of Urology Surgery of the Affiliated Hospital of Hangzhou Normal University from January 2014 to January 2017 were enrolled. There were 60 patients with sepsis within 24 hours after surgery were assigned in the sepsis group, and 60 patients without sepsis were included in the non-sepsis group. The clinical data of miR-223, CD4+CD25+regulatory T cells (CD4+CD25+ Treg), procalcitonin (PCT) interleukin-10 (IL-10), tumor necrosis factor-α(TNF-α), C-reactive protein (CRP) in the blood, etc were collected within 24 hours after surgery. The differences in above indexes were compared between the two groups. The receiver operating characteristic curve (ROC curve) was drawn to evaluate the diagnostic values of blood mir-223, PCT and CRP in the patients, predicting whether septic complication after urinary calculi surgery would occur. Correlation analyses were used to analyze the correlations between mir-223 and CD4+CD25+ Treg, IL-10 and TNF-α. Results The miR-223 expression level and the contents of CD4+CD25+ Treg, IL-10, TNF-α, PCT and CRP in sepsis group were obviously higher than those in non-sepsis group [2ΔΔCt (×10-4):2.81±1.04 vs. 2.13±0.91, CD4+CD25+ Treg(×10-2): 17.61±4.48 vs. 8.37±2.71, IL-10 (ng/L): 58.42±16.38 vs. 34.68±12.45, TNF-α (pg/L): 249.41±30.69 vs. 167.54±25.98, PCT (ng/L): 4.45±1.89 vs. 0.31±0.08, CRP (μg/L):10.29±3.63 vs. 4.13±1.57, all P < 0.05); in sepsis group, the miR-223 expression and the level of CD4+CD25+ Treg (r = 0.367, P = 0.004) and IL-10 (r = 0.516, P = 0.006) were also significantly positively correlated, but miR-223 and TNF-α were not markedly correlated (r = 0.237, P > 0.05). The area under ROC curve (AUC), sensitivity, specificity and 95% confidence interval (95%CI) of miR-223 predicting sepsis occurrence after urinary operation were higher than those of CRP, PCT (AUC: 0.923 vs. 0.547, 0.769, the sensitivity: 81.73% vs. 71.23%, 66.59%, specificity: 86.00%vs. 42.00%, 83.00%, 95%CI: 0.862-0.979 vs. 0.351-0.679, 0.682-0.927). Conclusions The expression levels of plasma miR-223 in patients with sepsis after mini-invasive treatment for upper urinary tract lithotrity can reflect their immune reaction status, and can be one of the early diagnostic markers of whether the sepsis complication may occur after the surgery.

Objective To analyze the clinical characteristics of Kawasaki disease shock syndrome ( KDSS) and to improve the diagnosis,treatment and prognosis of patients. Methods A total of 924 cases of Kawasaki disease ( KD) hospitalized from January 2013 to April 2017 in our hospital were retrospectively an-alyzed,including 16 children with KDSS. And 30 patients with KD were randomly selected as the control group. The clinical characteristics,laboratory examination and treatment of the two groups were compared and analyzed. Results There were 9 males and 7 females in KDSS group,and average age was (3. 95 ± 2. 56) years. The average time to happen shock was (4. 31 ± 0. 79) days. There were no significant differences in gender,age and duration of fever between KDSS group and KD group respectively ( P >0. 05 ) . KDSS patients were more likely to develop abdominal pain, hepatic injury ( including elevated transaminase and jaundice),proteinuria,peritoneal effusion,pneumonia,coronary aneurysm,IVIG resistance and longer hospi-talization (P<0. 05). WBC[(28. 42 ± 10. 46) × 109/L vs. (20. 34 ± 7. 57) × 109/L],the neutrophils [(89.86 ± 7.00)％ vs. (73.14 ± 13.91)％],hsCRP (mg/L) [181.95(141.58,218.00) vs.94.65 (55. 33,109. 50)],PCT(ng/ml)[9. 68 (4. 85,12. 07) vs. 0. 09 (0. 04,0. 37)] and serum ferritin (ng/ml) [(388. 12 ± 241. 75) vs. (169. 86 ± 95. 14)] in the KDSS group was significantly higher than those in KD group (P<0. 05). There were no differences in ESR(mm/h) [(75. 71 ± 25. 25) vs. (79. 87 ± 22. 76)], fibrinogen (g/L) [(6. 17 ± 1. 45) vs. (6. 03 ± 1. 47)] between two groups (P>0. 05). The levels of plate-let count[ (655. 50 ± 226. 98) × 109/L vs. (549. 93 ± 119. 15) × 109/L],the albumin (g/L) [(22. 54 ±5.13)vs.(33.32±3.18)],serumsodium(mmol/L)[(130.47±2.79)vs.(134.77±2.81)]andserumpotassi-um (mmol/L) [(4. 59 ± 0. 74) vs. (4. 04 ± 0. 43)] and ejection fraction [(60. 16 ± 6. 18)％ vs. (64. 81 ± 3. 71)％] in KDSS group were lower than those in KD group (P<0. 05). During the course of treatment,14 patients were accepted fluid resuscitation and the average volume of fluid was (27. 19 ± 19. 58) ml/kg. Ten patients used vasoactive drugs. Six patients were treated with hormone ( methylprednisolone ) . All patients were discharged from hospital. Conclusion KDSS is a serious form of KD,the indicators of inflammatory response increased more obviously. Organ damage occurs more frequently,and often accompanies abdominal pain. Anti-shock treatment often requires fluid resuscitation and use of vasoactive drugs.

Objective To discuss the expression level of serum procalcitonin( PCT) and clinical val-ue in acute viral diarrhea patients. Methods A total of 186 patients with acute viral diarrhea treated in our hospital from September 2013 to September 2015 were retrospectively reviewed. One hundred and seven were male and 79 were female,of which 171 cases were infected by rotavirus and 15 cases infected by norovirus. The average age was ( 1. 29 ± 0. 89 ) years old. All patients′ blood and stool cultures were negative. The patients were divided into three groups according to the degree of dehydration and whether complicated with multiple organ dysfunction or not:severe group( complicated with severe dehydration,shock or multiple organ dysfunction,n=33),mild-moderate dehydration group(n=68) and no dehydration group(n=85). Thirty-five healthy children with the same age were enrolled as the control group. Serum PCT levels,high sensitivity CRP(hs CRP) and blood routine were detected. Results The serum PCT levels increased in 73 patients with acute viral diarrhea,8 cases>100 ng/ml,21 cases 5 to 100 ng/ml and 44 cases 0. 5 to 5. 0 ng/ml. PCT( ng/ml)[0. 36(0. 14,1. 67),hsCRP(mg/L)[3. 50(0. 70,14. 83)] and WBC( × 109/L)[9. 06(6. 79,12. 50)] levels increased in the diarrhea patients compared with those in the healthy group[0. 09(0. 05,0. 13);1. 00 (0.40,2.50);6.90(5.90,8.20)](all P < 0.05). The level of PCT in patients with dehydration [0.54 (0. 19,7. 83)]was higher than that without dehydration[ 0. 26(0. 11,0. 55)](P<0. 05) and increased in severe group[13. 69(3. 41,60. 30)] compared with in those the mild-moderate group[0. 33(0. 13,0. 89)] and no dehydration group[0. 26(0. 11,0. 55)](all P<0. 017),but there was no difference among groups in hsCRP and WBC levels ( P>0. 05 ) . Conclusion PCT can increase in pediatric patients with acute viral diarrhea,especially in those with severe dehydration,shock and organ dysfunction. Continued high levels of PCT indicates critical condition and has poor prognosis. PCT can be used as a good indicator to evaluate the severity of disease and the prognosis.