Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

To observe the efficacy and safety of apatinib in the treatment of advanced bone and soft tissue sarcoma, and to analyze the possible related factors affecting the progression-free survival (PFS) of patients. Methods: Twenty-one patients with ad-vanced bone and soft tissue sarcoma admitted to the Department of Orthopaedics, Yunnan Cancer Hospital from June 2017 to Sep-tember 2018, were treated with apatinib tablets. The main efficacy index was progression free survival (PFS), and the secondary effica-cy index was overall survival (OS). Clinical efficacy was evaluated according to response evaluation criteria in solid tumors (RECIST) 1.1, and overall response rate (ORR), disease control rate (DCR), and safety were olserved according to the National Cancer Institute (NCI) 4.0 standard. Results: All of the 21 patients were followed up. At the last follow-up time point, March 31st, 2019, there were no CR, 2 patients (9.5%) with PR, 7 patients with SD (33.3%), and 12 patients with PD (57.1%). The ORR was 9.5%, the DCR was 42.8%, the medi-an PFS was 8 months, and the median OS was 14 months. The patient's gender, age, ECOG score, tissue source, surgery, or chemother-apy had no statistically significant effect on PFS (P>0.05). Only the history of radiotherapy before taking apatinib was a factor for pa-tients with PFS. The effect was statistically significant (P<0.05), and patients with a history of radiotherapy had a lower PFS than pa-tients without a history of radiotherapy. The adverse reactions of gradeⅢand above had hand-foot syndrome (14.3%), pneumotho-rax (14.3%) and anemia (4.8%). Conclusions: Apatinib has a certain effect for advanced bone and soft tissue sarcoma. The adverse re-actions are generally predictable, controllable and reversible. Apatinib can be a choice for patients with advanced bone and soft tissue sarcoma with good treatment adherence and no other treatment options.

Objective To detect the effect of low-dose heparin on endothelial function by detecting the change of yon Willebrand factor (vWF) in blood plasma of patients with sepsis shock after treatment with low-dose heparin in order to observe organ function and prognosis of patients.Methods A total of 118 patients with sepsis shock were randomized into low-dose heparin group and control group.In addition to the routine treatment,the patients in low-dose heparin group were given low-dose heparin,while those in control group were not.The levels of APTT,PT,platelet (PLT) count,hepatic function and renal function were determined before and after treatment in two groups,and hemorrhagic events or other complications were recorded.The lengths of stay in ICU and in hospital,the days of mechanical ventilation and the rates of acute respiratory distress syndrome (ARDS),disseminated intravascular coagulation (DIC) and multiple organ dysfunction syndrome (MODS) and 28-day survival rate in the two groups were documented.The levels of vWF in patients of two groups were determined by using immunoturbidimetry before and after treatment.Results The rates of DIC and MODS in low-dose heparin group decreased significantly after therapy (rate of DIC,10.6％ vs.26.7％,P ＜ 0.05;rate of MODS,19.3％ vs.32.0％,P ＜ 0.05).Hepatic function and renal function in low-dose heparin group were significantly improved than that in the control group (P ＜ 0.05),28-day survival rate in the low-dose heparin group was higher than that in the control group (78.3％ vs.69.1％,P ＜0.05),the differences between low-dose heparin group and control group were not statistically significant in the lengths of stay in ICU and hospital,the days of mechanical ventilation and the rate of ARDS (P ＞ 0.05).The differences in APTT,PT and PLT were not significant from pre-treatment to after treatment and between the two groups (P ＞ 0.05).The levels of vWF in low-dose heparin group decreased significantly after therapy rather than those in control group (P ＜ 0.05).Conclusions The endothelial function is improved in patients with sepsis shock after employment of lowdose heparin.Low-dose heparin alleviates the interaction between coagulation and inflammation,improves hepatic,renal and other important organs function,decreases the rate of MODS and increases 28-day survival rate patients with sepsis.The low-dose heparin therapy is a safe and promising treatment in sepsis patients without severe side effects.

BACKGROUND: There are many methods for investigating the physical development and the somatotype of child. Among them, Heath-Carter so matotype method is a comprehensive evaluation method on somatotype. In this method, 10 items of anthropometric indicators are selected from several dozens of items as assessment indicators for development and somatotype.OBJECTIVE: To analyze the rules and characteristics of soma totype development of Hah children in rural area of Huludao city, so as to supplement the essential data for physical anthropology.DESIGN: Normal children were chosen as the subjects, and cross-sectional investigation was carried out.SETTING: Department of Anatomy, Jinzhou Medical College. PARTICIPANTS: With cluster sampling, the Han children between 7 to 10 years old were selected from central primary school of Mingshuixiang Village of Suizhong County of Huludao city from July 2001 to September 2003. All the selected children should be verified healthy by physical examination at school. The children were divided into two groups according to gender, and each group was divided into 4 subgroups according to age,with 46 to 63 members in each group. There were 8 groups altogether.Complete data of 408 children were collected (male 213, female 195).METHODS: Each indicator was measured twice with Heath-Carter soma to type method and selected the average value. Specialists were responsible for the 10 indicators, and a database was established in computer according to age and gender. Calculated the following indicators in turn: endomorphic factor, mesomorphic factor and ectomorphic factor, coordinate values of X and Y on somatotype chart, Height/Weight1/3, mean of dimensional distances from the average somatotype to all somatotypes in the sample,difference between the two somatotypes in three-dimensional space, percentage of body fat and frequency distribution of each somatotype.MAIN OUTCOME MEASURES: Height, body mass, upper arm circum ference, calf circumference, intracondylar diameters of humerus and femur,skinfold of brachial triceps, subscapular skinfold, skinfold of anterosuperior iliac spine, skinfold of gastrocnemius muscle.RESULTS: All the 408 children entered results analysis. ①Height and body mass of 7 to 10 year old children increased as age went up, indicators of Height/Weight1/3 of 7,8,10 year old girls were higher than boys, that of 9 years old boys was higber than girls, which were related to that the growth of height of 8 & 9 year old boys (5.61 cm) was more than girls (3.88 cm).The content of body fat of girls was more than boys. The 3 somatotype values were 3.2-3.9, 2.3-2.6 and 3.0-3.4 in boys and 3.5-4.6, 1.9-2.6 and 3.3-3.5 in girls, so endomorphic factor and ectomorphic factor were the main factors both in girls and boys, and endomorphic gene in girls was higher than boys, which indicated that the content of body fat of rural children in Hulutao city was relatively high, their bodies were finely high and thin, their skeletal muscle was not so muscular and the hypodermic fat in girls was more abundant. Seen from the comparison of somatotype between boys and girls in each age group, the differences between two somatotypes in the three dimensional space of 7-, 8-, 9-, 10-11 year old groups were 0.46, 0.68, 1.03 and 0.61 respectively, except 7-year old group, there were significant differences in somatotype of boys and girls between each age groups (P ＜ 0.01). ②The average value of somatotype of Han boys in rural area was 3.4-2.5-3.2, which belonged to medial type; that of girls was 4.0-2.3-3.4, which beglonged to ectomorphic endomorphic type. Endomorphic factor and ectomorphic factor were the dominant factors both in boys and girls, whereas mesomorphic factor was relatively low; the frequency of somatotype kept changing as the increase of age. ③Compared with the data at home and abroad, the endomorphic factor of the Han children in rural area in Huludao City was relatively high, while the mesomorphic factor was relatively low, and the ectomorphic factor was almost the same.CONCLUSION: The somatotype of Han children in rural area in Huludao City develops better. Their heights are tall, whereas their skeletal muscles are not so muscular. Somatotype development of children is diversified with age.