Objective:To summarize the experience of the precise prevention and control strategy of novel coronavirus infection in the pediatric intensive care unit(PICU)during the epidemic of the Omicron variant.Methods:A retrospective analysis was performed on the strategies and management experience of precise prevention and control of novel coronavirus infection in PICU at Pediatric Hospital of Fudan University from March 1 to May 10, 2022.Results:According to the national and Shanghai novel coronavirus infection prevention and control standards, the PICU in our hospital, in accordance with the specialty characteristics of PICU, cooperated with the hospital′s department of infection and medical department to jointly construct a precise ward management strategy for the outbreak of the omicron mutants infection.Precise prevention and control management strategies were formulated from four aspects: the admission process of critically ill children, the division of PICU ward areas and nosocomial infection protection, the reception management system for children′s family members, and the " bubble management" system for PICU staff, and run them for 3 months.During the epidemic, there was no nosocomial infection of novel coronavirus infection in children or medical staff.During the period, a total of 140 critically ill children were admitted, including 87 cases transferred from the general ward in the hospital, 48 cases from the emergency department(non-febrile, 3 cases transferred by the transfer team), four cases from fever clinic, and one case from control ward.Four of the critically ill children had no emergency nucleic acid test report when they were admitted to the PICU.Among the 140 critically ill children, 54 patients received mechanical ventilation, 18 patients received blood purification, and two patients were monitored after liver transplantation.Seventy-eight (55.7%) children had underlying diseases.Conclusion:During the current round of novel coronavirus epidemic in Shanghai, PICU in our hospital formulated the admission and ward management procedures for critically ill children, which ensured the prevention and control of nosocomial infection of novel coronavirus, and at the same time ensured the treatment of critically ill children to the greatest extent.

Shear wave elastography (SWE) is used to quantitatively analyze the hardness of the tissue by Young's modulus.The hardness of the tissue is visualized in the form of color coding to distinguish the benign and malignant tissue detected.SWE has higher sensitivity,accuracy and specificity compared with traditional color doppler,which is more objective than elastography,safer,cheaper and simpler than MRI.SWE has a good application prospect in the diagnosis,clinical staging and curative effect monitoring of cervical cancer.

Objective To investigate the effect of early intervention with mirror therapy on hemiparetie survivors of ischemic stroke.Methods Thirty-six hemiplegic patients within one month after a stroke were randomly divided into a mirror therapy group (MT group,n=18) and a routine rehabilitation control group (RRC group,n=18).The participants in the MT group received MT for 45 min/d,5 d/wk for 3 weeks in addition to conventional stroke rehabilitation.Those in the RRC group received exercise therapy at the same frequency without the mirror protocol.The Fugl-Meyer assessment (FMA),Wolf motor function test (WMFT),functional ambulation category scale (FAC),Brunnstrom stages of motor recovery,and the modified Ashworth scale (MAS) were used to assess changes in the upper limb,gross hand dexterity and lower limb recovery before and right after the interventions,as well as one and two months after the treatment.Results Significant improvement was observed in the limb function of both groups after the treatment.Compared with the RRC group,there was significantly greater improvement observed in the MT group.This was true of the FMA ratings at all time points,the average WMFT scores one and two months after the intervention,the FAC ratings two months after the intervention,and the Brunnstrom stages at both one and two months after the intervention.However,no significant difference between the two groups in terms of the average MAS scores was observed at any time point.Conclusion Early intervention with MT can significantly accelerate the recovery of a paretic upper limb aud improve walking ability after stroke.Such intervention is worthy of promotion and application in clinical practice.

Objective To evaluate systematically the efficacy of mirror therapy for improving the upper limb function, daily life and pain of stroke survivors. Methods The PubMed, EBSCO, Web of Science, Ovid, Co-chrane Library, Open Gray, China Biological Medicine, China National Knowledge Infrastructure, GoogleScholar, VIP and Wan Fang Data databases were searched for reports of randomized and controlled trials ( RCTs) of mirror therapy for improving the upper limb function of stroke survivors. Only papers published before December 2015 were surveyed. The relevant references of the primary studies were also searched. The literature screening, data extraction and assessments were conducted by two reviewers independently. The meta-analysis was performed using version 5.2 of the RevMan software. Results A total of 22 RCTs involving 823 patients were discovered, some not dealing with mirror therapy. Comparing the studies with and without visual feedback, there were significant differences in upper limb motor function as measured by the Fugl-Meyer, ARAT and Brunnstrom instruments. The average Barthel indexes and visual analogue scale were also significantly different. Conclusion Mirror therapy can improve upper limb function and ability in the activities of daily living, and also relieve pain among stroke survivors to some degree, though its long-term efficacy is still unclear. Large-sample, multi-center, high-quality RCTs are required to verify these conclusions.

Objective To explore the relationship between the levels of plasma coagulation factors (F) and acute myocardial infarction (AMI) in low age period (<60 years old) and their diagnostic value in diagnosing AMI in low age period.Methods One hundred and sixty inpatients with low age AMI in the cardiology department of the Heze Municipal Hospital were selected as the case group,and contemporaneous 160 cases of low age non-AMI served as the control group.F Ⅱ,FⅦ,FⅧ,fibrinogen (Fg) and von willebrand (vWF) were measured with enzyme-linked immunoabsorbent anti-sandwich assay.The relationship between coagulation factors and low age AMI was analyzed with univariate and multivariate analysis,and their value for diagnosing low age AMI was evaluated with diagnostic test and receiver operating characteristics (ROC) curve.Results The univariate analysis showed that FⅡ,FⅦ,FⅧ and Fg levels had significantly statistical difference between the case group and control group(P<0.05),and the vWF level had no statistically difference(P>0.05).The multivariate analysis indicated that the FⅡ level≥ 14.27 μg/L and FⅦ level ≥22.99 μg/L were the independent risk factors for low age AMI.The value of FⅡ for diagnosing low age AMI was lower,and the optimal cut off value of Fg for diagnosing low age AMI was 22.99 μg/L,its area under ROC curve was 0.709 with a moderate diagnostic value,and the sensitivity (91.88%) and negative predictive value (86.02%) were higher,the false negative rate (13.98%) was lower,and the accuracy (70.94%) was moderate.Conclusion The FⅡ level ≥14.27 μg/L and Fg level ≥22.99 μg/L are the independent risk factors for low age AMI,and detecting the Fg level could have hint significance in diagnosing low age AMI.

Objective To study the significance of S100A12 in patients with acute pancreatitis (AP).Methods 139 patients with AP were divided into the severe acute pancreatitis (SAP) and moderate acute pancreatitis (MAP) groups.61 patients in the SAP group were further subdivided into the infection group (n =32) and the non-infection group (n =29) based on the presence/absence of secondary infection.Serum samples of these patients were collected on the 3rd,7th and 14th day after treatment.ELISA was used to determinate the S100A12,IL-1 β and IL-6 levels in serum.The area under ROC was used to evaluate the predictive role of S100A12,IL-1β,IL-6 and CRP for infection in patients with SAP.Results The S100A12,IL-1β and IL-6 levels in SAP patients were markedly higher than those in MAP patients and normal controls on the 3rd,7th and 14th day after treatment.These levels decreased toward normal range in MAP patients.They were persistently high in SAP patients after treatment for 7 days,but decreased significantly after 14 days.The serum levels of S100A12,IL-1β,IL-6 and CRP were significantly higher in the infection subgroup(647.5 ± 300.1,155.9 ±48.5,95.7 ±25.5,166.8 ±53.0) than the non-infection subgroup(249.0 ± 176.3,108.0 ± 46.1,64.0 ±38.5,117.9 ±34.9) (P ＜0.05).The sensitivity and specificity of serum S100A12 in diagnosing secondary infection in SAP were 96.8％ and 83.3％,which were higher than those of serum IL-1β,IL-6 or CRP.Conclusion The level of S100A12 was associated with systemic inflammatory response syndrome (SIRS) in AP,and it may serve as a new marker in early diagnosis of SAP and in secondary infection in SAP.

Objective To explore the effect of SFI in radiation-induced mice brain injury after 20 Gy cranial radiation.Methods The mice were divided into three groups:(1) control group,(2) RT-only group:the whole brain was irradiated with a dose of 20 Gy,(3) RT and SFI group:SFI at 20 ml/kg/d from 4 weeks after 20 Gy cranial radiation theraty(CRT).Results Morris water maze test showed that the latency of the irradiated group was longer than control group and SFI improved the cognitive function of mice (t =6.34,6.70,P ＜0.05).The expression of TNF-α reached to the highest level at 3 h after irradiation,and then it decreased but got the second higher level again at 4 weeks after irradiation.The expression of IL-1 β reached to the highest level at 72 h after irradiation and decreased until 4 weeks after irradiation.SFI decreased both expressions of TNF-α (t =11.34,9.70,6.07,P ＜ 0.05) and IL-1 β (t =12.27,5.70,7.52,P ＜ 0.05).Immune florescence staining showed that SFI reduced the number of activated microglia (t =12.35,8.64,7.82,P ＜ 0.05)and inhibited the translocation of p65 of microglia after irradiation.Conclusions Findings suggest that SFI may decrease microglial activation and suppress the expression of TNF-α and IL-1β by inhibiting the translocation of NF-κB p65 and then attenuate irradiation-induced brain injury.

PurposeTo evaluate multislice spiral CT (MSCT) in diagnosing abdominal anaphylactoid purpura (AAP), and to explore its role in treatment follow-up.Materials and Methods Clinical and MSCT data of 13 patients with confirmed AAP were retrospectively analyzed. All patients underwent abdominal CT scan and thin layer reconstruction. Upper endoscopy was performed in 8 patients prior to treatment. MSCT was performed in 10 patients and endoscopy in 4 patients posttreatment, then clinical and CT features were compared to pretreatment findings.Results In pretreatment CT scan, single segment bowel involvement was found in 2 cases, multisegmental bowel involvement in 10 cases, and no positive finding in 1 patient. The duodenum and jejunum were involved in 8 patients and stomach in 5 patients. The diseased bowel wall showed swelling and thickening with decreased attenuation and homogeneous luminal narrowing with equivocal lining and double loop sign. Infiltration was found in 10 patients, small ascites in 3 patients. Patients were misdiagnosed as acute pancreatitis in 2 cases, acute cholecystitis, small bowel obstruction and peritonitis in 1 case respectively. Of 13 patients, five patients were cured, and the other 8 patients were improved. The clinical symptoms including rash, abdominal pain, occult blood, leukocytosis, vomiting, melena, urine occult blood were improved (χ2=5.59-18.33,P<0.05 orP<0.01). Post treatment CT showed significant improvement of bowel edema and infiltration (P<0.01). There was no statistically significant difference in change of ascites (P>0.05).Conclusion MSCT findings of AAP are nonspecific. CT diagnosis is difficult before skin rash. Combining CT characteristics of multisegmental bowel edema and clinical manifestations is helpful. CT examination can effectively follow up treatment response.

Objective To explore the diagnostic value of 64 layers spiral CT for gastric carcinoma .Methods The 87 patients (primarily diagnosed gastric carcinoma )were studied and scanned under 64 layers spiral CT including plain scans and enhanced scans respectively .The source images were reconstructed using the technique of multilane volume reconstruction (MPVR) and CT virtual endoscopy (CTVE) and conducting TNM stage ,then compared to histopathology results after surgery .Results 85 out of 87 patients with gastric carcinoma were diagnosed by CT .Detection rate of multi-detector CT(MDCT) for gastric cancer was 97 .7% , while the early stage and advanced stage gastric carcinoma were 66 .7% and 100% respectively .The accuracies of 64 layers spiral CT for the T stage ,the N stage and the M stage of the gastric carcinoma were 83 .9% ,72 .4% and 92 .0% respectively .Conclusion 64 layers spiral CT could be helpful for the diagnosis of gastric carcinoma and TNM stage .It might play great roles for the diag-nosis and treatment of gastric carcinoma .

Objective To establish a model of malignant transformation of human cells in vitro to study the lung cancer induced by radon and cigarette smoke. Methods The immortalized human bronchial epithelial cells BEAS-2B were divided into control group( C ), radon group ( Rn), cigarette smoke group (Sm) and combined group (Rn-Sm). Cells were planted onto transwell membrane one day before exposure and were directly exposed to radon and cigarette smoke pumped in a gas inhalation box. After the exposure cells were trypsinized into dishes for further growth and malignancy transformation phenotype was detected in order to compare the effects due to radon and cigarette smoke exposure. Results BEAS-2B cells showed malignantly transformed phenotype by exposure to radon and cigarette smoke. A series of sequential steps emerged among transformed cells, including altered growth kinetics, resistance to serum has changed from 0. 31 ± 0. 18 to 1.92 ± 0. 27,2. 03 ± 0. 14,2.95 ± 0. 60, and anchorage-independence growth increased from (0.01 ±0.02)% to (4.89 ±0.30)%,(8.36 ±0.50)%,(11.74 ±0.69)%.After being subculture for 20 generations, cell apoptosis of the fifth generation cells exposed to radon,cigarette smoke and both was significant decreased from ( 11.76 ± 0. 17 ) % to (4. 62 ± 0. 42 ) %、 ( 8.63 ±0. 15 )%、 (3.68 ± 0. 33 )%. Conclusions BEAS-2B cells could be malignancy transformed by radon and cigarette smokein vitro, which could be used as a cell model in lung bronchial carcinogenesis.